Kathryn Derringer

A Cephalometric Study to Compare the Effects of Cervical Traction and Andresen Therapy in the Treatment of Class II Division 1 Malocclusion: Part 1—Skeletal Changes

Lateral cephalometric radiographs at the beginning of treatment, end of active treatment, and post-treatment of 30 Andresen and 40 cervical traction patients were analysed, and compared with those of a control group of 22 untreated cases. The cervical traction group was divided into a non-extraction group and an extraction of maxillary second molars group. A clinically significant reduction of ANB was achieved, mainly by mandibular changes in the Andresen group and by maxillary changes in the cervical traction groups. Cervical traction was associated with a small distal positioning and anterior downward tipping of the maxilla during treatment. A more favourable sagittal position of the mandible was achieved in the Andresen group compared to the cervical traction groups, particularly the non-extraction group, where a greater transient backward rotation of the mandible occurred during treatment. A significant, but clinically small increase in mandibular body length occurred in Andresen patients compared to the control. However, in both treatment groups this was due to an increase in growth of the vertical ramus. The lower face heights, both anterior and posterior, increased in all groups, with the anterior upper face height also increasing in the cervical traction group.

A cephalometric study to compare the effects of cervical traction and Andresen therapy in the treatment of class II division 1 malocclusion. Part 2--Dentoalveolar changes.

Absolute distal movement of upper first molars together with distal tipping, but no significant extrusion, occurred with cervical traction. Distal movement of the maxillary first molars was more stable in the group where maxillary 2nd molars had been extracted. With Andresen treatment a restraining effect took place on the upper molars, while mesial movement of the lower first molars contributed to correction of the molar relationship.

Angiogenic growth factors released in human dental pulp following orthodontic force

OBJECTIVE The aim of this study was to investigate if a combination of five diffusible angiogenic growth factors were released in human dental pulp during orthodontic force application, by using growth factor neutralising antibodies (NAs) to block their effects. MATERIALS AND METHODS Dental pulps from 18 premolar teeth treated with orthodontic fixed appliances for 2 weeks were divided vertically, and each half pulp further sectioned and co-cultured with a section of rat aorta in collagen surrounded by growth media. NAs (anti-h VEGF, anti-h FGF2, anti-h PDGF, anti-TGFbeta and anti-h EGF) were added to the media of the co-cultures from one half of each pulp from 10 teeth. The co-cultures from the remaining eight teeth acted as controls. Sections of rat aorta alone were also cultured with and without NAs. Cultures were examined daily by light microscopy for growth and number of microvessels. RESULTS NAs significantly reduced microvessel numbers in the co-cultures, but not in the rat aorta alone cultures. CONCLUSIONS The results show that a combination of these angiogenic growth factors are released in the pulp following orthodontic force.

Orthodontic referrals: why do GDPs get it wrong?

Aim &objectives A clinical audit was carried out to assess suitability of orthodontic referrals at Kings College Hospital Orthodontic Department with the objective to investigate the reasons and seek solutions to inappropriate orthodontic referrals.Design and setting Prospective audits of consecutive new patient referrals to the Kings College Hospital Orthodontic department diagnostic teaching clinics.Methodology Two hundred and twenty-eight patients referred to the orthodontic diagnostic teaching clinics over a 5-month period were assessed. Data were collected using a questionnaire, completed by the undergraduate dental student and checked by the supervising clinical teacher. A second audit cycle was carried using the same methods after implementation of an action plan devised for referral guidelines and pathway to be sent back to the referring practitioner.Results At the initial audit cycle, 37.2% of patients met the standards, dropping to 33.3% at second audit cycle demonstrating high levels of inappropriate referrals. Our results showed: poor use of IOTN, patients presenting with IOTN scores too low for treatment, poor oral hygiene and caries; patients presenting too early for treatment, adult patients; and incorrect referral pathway implementation. Targeted education of referring practitioners via referral guidelines were found ineffective. We suggest that other methods to improve the quality of referrals are required, such as proformas and improving education among the profession.