Anwar Ali Shah

Fluorides, orthodontics and demineralization: a systematic review

Objectives To evaluate the effectiveness of fluoride in preventing white spot lesion (WSL) demineralization during orthodontic treatment and compare all modes of fluoride delivery. Data sources The search strategy for the review was carried out according to the standard Cochrane systematic review methodology. The following databases were searched for RCTs or CCTs: Cochrane Clinical Trials Register, Cochrane Oral Health Group Specialized Trials Register, MEDLINE and EMBASE. Inclusion and exclusion criteria were applied when considering studies to be included. Authors of trials were contacted for further data. Data selection The primary outcome of the review was the presence or absence of WSL by patient at the end of treatment. Secondary outcomes included any quantitative assessment of enamel mineral loss or lesion depth. Data extraction Six reviewers independently, in duplicate, extracted data, including an assessment of the methodological quality of each trial. Data synthesis Fifteen trials provided data for this review, although none fulfilled all the methodological quality assessment criteria. One study found that a daily NaF mouthrinse reduced the severity of demineralization surrounding an orthodontic appliance (lesion depth difference −70.0 μm; 95% CI −118.2 to −21.8 μm). One study found that use of a glass ionomer cement (GIC) for bracket bonding reduced the prevalence of WSL (Peto OR 0.35; 95% CI 0.15–0.84) compared with a composite resin. None of the studies fulfilled all of the methodological quality assessment criteria. Conclusions There is some evidence that the use of a daily NaF mouthrinse or a GIC for bonding brackets might reduce the occurrence and severity of WSL during orthodontic treatment. More high quality, clinical research is required into the different modes of delivering fluoride to the orthodontic patient.

Postretention changes in mandibular crowding: A review of the literature

Posttreatment stability is one of the challenges facing orthodontists today. Relapse of the mandibular anterior segment during the postretention period is perhaps the most predictable and frustrating of all orthodontic relapses. This type of relapse is sometimes erroneously construed as a sign of inappropriate treatment or evidence of misdiagnosis or incorrect mechanics. This article reviews mandibular incisor postretention stability outcomes in the setting of different treatment techniques and different ages of beginning orthodontic treatment. Mandibular incisor relapse is almost inevitable, regardless of orthodontic techniques and timing of orthodontic treatment. However, mandibular incisor relapse might be reduced when palatal expansion is combined with prolonged retention.

Incisor crown shape and crowding

The aim of this study was to investigate correlations between the shape of mandibular incisor crowns and crowding. Study models of 50 untreated white subjects (25 men and 25 women) with varying degrees of crowding were studied. The lower incisors were sectioned and imaged at the contact point and midpoint levels, and the mesiodistal width was measured. Crowding was quantified by using both Littles irregularity index and anterior tooth size-arch length discrepancy. The ratio of the 2 mesiodistal widths was correlated with Littles irregularity index and anterior tooth size-arch length discrepancy. In the women, the ratio showed correlations of 0.52 (P =.008) and 0.55 (P =.005) for central and lateral incisors, respectively, with anterior tooth size-arch length discrepancy. No predictors of lower incisor crowding could be established from mandibular incisor crown shape in this study.

How to ... place a lower bonded retainer.

Post-orthodontic relapse of lower incisors is a common phenomenon. Sometimes a bonded retainer is fitted to prevent this relapse. In this article, we suggest a handy clinical technique of fitting a lower bonded retainer, which is convenient and easy to carry out.

How to … take a wax bite for a Twin Block appliance

The Twin Block appliance is the most commonly used functional appliance in the UK. It is very important to take a satisfactory wax bite, as it not only helps the technician to make an accurate appliance but it is essential for the successful use of this appliance. In this article, we suggest the appropriate clinical technique for taking an effective wax bite for the Twin Block appliance.

Postgraduate training in orthodontics in the UK

This article briefly describes the postgraduate pathways in orthodontics in the United Kingdom. It is hoped that this will assist potential trainees who want to pursue postgraduate training to understand the different career pathways available to them. It may also add to the knowledge of some senior colleagues who can explain these career opportunities to their students, as not all potential trainees will have the opportunity to read this article. In the following pages we will discuss the different pathways leading to specialist qualification in orthodontics, in the United Kingdom.