In the United Kingdom (UK) over the last 10 years, there has been a significant increase in the use of vacuum-formed retainers (VFRs) rather than conventional Hawley retainers. There are currently no data to compare the cost-effectiveness of this change in practice. The two aims of this study were to compare (1) the cost-effectiveness of VFRs and Hawley retainers over 6 months, from the perspective of the National Health Service, orthodontic practice, and the patient and (2) patient satisfaction in the two retainer groups. A randomized controlled trial (RCT) was carried out in a specialist orthodontic practice. Three hundred and ninety-seven eligible patients were randomized to one of two retainer groups, and followed up for 6 months. All subjects were invited to complete patient satisfaction questionnaires. Additional data were collected for the cost analysis from the patient records and national databases. Descriptive and bivariate analyses were used to compare patient satisfaction between retainer groups. In all, 196 subjects were randomized to the Hawley group (mean age 14 years 8 months, 63 per cent female, 37 per cent male) and 201 to the VFR group (mean age 15 years, 59 per cent female, 41 per cent male). VFRs were more cost-effective than Hawley retainers from all perspectives. The majority of subjects showed a preference for VFRs compared with Hawley retainers. There were also fewer breakages than in the Hawley group.
This review examines specific aspects of orthodontic treatment and periodontal health, namely the effects of orthodontic banded attachments on periodontal disease and more specifically the microflora found around the gingival margins. This review highlights critical developments in orthodontic techniques and microbiological advances which have helped clarify the interrelationships between orthodontic appliances and periodontal disease. Suggestions as to how these may be modified are made, as well as targeting specific areas for research.
This study examined features of dental occlusion in patients born with a unilateral cleft lip and palate (UCLP). The intention was to develop a 'Goslon type' index for 5 year old children. The Goslon ranking system was used on longitudinal study models taken at 5 and 10 years of age of the same patients. All patients had UCLP and this had been repaired using a Millard type lip repair and a Veau Wardill or Von Langenbeck palatal closure. There was good intra-examiner agreement for ascribing 5 and 10 year old models to one of five categories (excellent-very poor). Inter-examiner agreement on both sets of models was at worst moderate. Two of the examiners identified up to 93 per cent of 5 year old models which either remained in the same category or deteriorated by 10 years of age. At worse the results demonstrated 70 per cent of cases of 5 years of age remained in the same category or deteriorated by 10 years of age. Consensus agreement has produced five categories of outcome for these 5 year old models. This new index is to be subjected to further validation. This study has therefore provided, for the first time, a mechanism for assessing the results of CLP surgery earlier than indices already available.
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