The bonded lingual retainer (BLR) is considered a favorable choice for retaining lower incisors’ alignment post-orthodontic treatment; however, it may cause some unwanted effects such as inadvertent tooth movement and torque changes. These often result in gingival recession (Miller class III-type) with exposure of the root surface, which compromises the esthetics and hinders the comfort of the patient. Fifteen post-orthodontic patients presenting Miller class III-type recessions with BLR were examined. Two protocols were used: the first included the removal of the BLR prior to surgery and the second included only a surgical approach. All patients underwent the same surgery of a modified tunnel double papilla procedure for root coverage. The gingival recession was measured using a dental probe before, and three to six months post-surgery. The average improvement in recession depth was significantly greater (p = 0.008) for the protocol that included removal of the BLR (4.0 ± 0.83 mm) with an improvement of 87.2% as compared to the second protocol that showed an improvement of 43.8% (1.88 ± 1.29 mm). Removing the BLR prior to surgery is beneficial for predictable root coverage in post-orthodontic Miller class III recessions.
Introduction Early diagnosis and referral is essential in order to provide the best orthodontic care. Paediatric specialists (PSs) and general dental practitioners (GDPs) are usually the first dental professionals to diagnose a malocclusion. Aim To evaluate the knowledge and approach of PSs and GDPs in the management of children in reference to the timing of referral and early orthodontic intervention. Methods A survey assessed referral patterns and the respondents’ orthodontic knowledge regarding treatment timing and indications for early treatment in the early and late mixed dentition. Results One hundred and seventeen dentists participated in the study, of whom 79 were GDPs and 38 were PSs. The average total accuracy score in a 27-knowledge questionnaire was 68.6%, resulting in a statistically significant difference between the PSs and the GDPs. This difference arose from confusion regarding the prevention of maxillary permanent canine impaction and the need for a leeway space maintainer. Conclusions The GDPs and the PSs had a sound knowledge of orthodontics and a reasonable referral pattern, although the knowledge of PSs was significantly higher than that of the GDPs. There is a need for further education regarding orthodontic treatment needs and timing both in undergraduate/postgraduate training as well as in professional continuing education programs.
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