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Biomedical subjects

D R Bearn

Publications and source records attributed to D R Bearn.

11 recordsLinked to original sources
PubMed2006

Retention procedures for stabilising tooth position after treatment with orthodontic braces.

BACKGROUND: Retention is the phase of orthodontic treatment that attempts to keep teeth in the corrected positions after treatment with orthodontic (dental) braces. Without a phase of retention there is a tendency for the teeth to return to their initial position (relapse). To prevent relapse almost every patient who has orthodontic treatment will require some type of retention. OBJECTIVES: To evaluate the effectiveness of different retention strategies used to stabilise tooth position after orthodontic braces. SEARCH STRATEGY: The Cochrane Oral Health Group's (OHG) Trials Register, CENTRAL, MEDLINE and EMBASE were searched. Handsearching of orthodontic journals was undertaken in keeping with the Cochrane OHG search programme. No language restrictions were applied. Authors of randomised controlled trials (RCTs) were identified and contacted to identify unpublished trials. Most recent search: May 2005. SELECTION CRITERIA: RCTs on children and adults, who have had retainers fitted or adjunctive procedures undertaken, following orthodontic treatment with braces to prevent relapse. The outcomes were: how well the teeth were stabilised, survival of retainers, adverse effects on oral health and quality of life. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two review authors. As no two studies compared the same retention strategies (interventions) it was not possible to combine the results of any studies. MAIN RESULTS: Five trials satisfied the inclusion criteria. These trials all compared different interventions: circumferential supracrestal fiberotomy (CSF) combined with full-time removable retainer versus a full-time removable retainer alone; CSF combined with a nights-only removable retainer versus a nights-only removable retainer alone; removable Hawley retainer versus a clear overlay retainer; multistrand wire retainer versus a ribbon-reinforced resin bonded retainer; and three types of fixed retainers versus a removable retainer. There was weak unreliable evidence, based on data from one trial, that there was a statistically significant increase in stability in both the mandibular (lower) (P < 0.001) and maxillary (upper) anterior segments (P < 0.001) when the CSF was used, compared with when it was not used. There was also weak, unreliable evidence that teeth settle quicker with a Hawley retainer than with a clear overlay retainer after 3 months. The quality of the trial reports was generally poor. AUTHORS' CONCLUSIONS: There are insufficient research data on which to base our clinical practice on retention at present. There is an urgent need for high quality randomised controlled trials in this crucial area of orthodontic practice.

Humans↗
PubMed2005

The effectiveness of undergraduate teaching of the identification of radiographic film faults.

OBJECTIVES: To see if there were any differences in the ability of final year dental students at two UK dental schools, who were within 4 months of graduation, to identify radiographic film faults. METHODS: The two groups of undergraduates were shown 11 dental radiographs using a slide format. The 11 radiographs included 8 films with film faults, 2 films without technical or processing errors and a film with minimal faults. Each student was asked to assess each film for the presence/absence of film fault(s), to detail how to correct the fault (if appropriate) and to give a subjective quality rating of each film. RESULTS: The range of marks obtained by both groups of students was low. All students found the identification of panoramic film faults more challenging than faults associated with intraoral films. 15% of students from University B scored more than half the possible marks compared with 2% from University A. CONCLUSIONS: Both groups of students had the necessary knowledge of how to correct faults once identified. However, the marked difference in competency in identifying faults between the two groups of students has implications for the future teaching and development of the radiology curriculum.

Chi-Square Distribution↗
PubMed2004

Retention procedures for stabilising tooth position after treatment with orthodontic braces.

BACKGROUND: Retention is the phase of orthodontic treatment that attempts to keep teeth in the corrected positions after orthodontic (dental) braces. Without a phase of retention there is a tendency for the teeth to return to their initial position (relapse). To prevent relapse almost every patient who has orthodontic treatment will require some type of retention. OBJECTIVES: To evaluate the effectiveness of different retention strategies used to stabilise tooth position after orthodontic braces. SEARCH STRATEGY: The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched. Several journals were handsearched. No language restrictions were applied. Authors of randomised controlled trials (RCTs) were identified and contacted to identify unpublished trials. Most recent search: December 2002. SELECTION CRITERIA: RCTs on children and adults, who have had retainers fitted or adjunctive procedures undertaken, following orthodontic treatment with braces to prevent relapse. The outcomes are: how well the teeth are stabilised, survival of retainers, adverse effects on oral health and quality of life. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two reviewers. As no two studies compared the same retention strategies (interventions) it was not possible to combine the results of any studies. MAIN RESULTS: Four trials satisfied the inclusion criteria. These trials all compared different interventions: circumferential supracrestal fiberotomy (CSF) combined with full-time removable retainer versus a full-time removable retainer alone; circumferential supracrestal fiberotomy (CSF) combined with a nights-only removable retainer versus a nights-only removable retainer alone; removable Hawley retainer versus a clear overlay retainer; and three types of fixed retainers versus a removable retainer. There was weak unreliable evidence, based on data from one trial, that there was a statistically significant increase in stability in both the mandibular (p < 0.001) and maxillary anterior segments (p < 0.001) when the CSF was used, compared with when it was not used. There was also weak, unreliable evidence that teeth settle quicker with a Hawley retainer than with a clear overlay retainer after 3 months. The quality of the trial reports was generally poor. REVIEWER'S CONCLUSIONS: There are insufficient research data on which to base our clinical practice on retention at present. There is an urgent need for high quality randomised controlled trials in this crucial area of orthodontic practice.

Humans↗
PubMed2002

Teaching and learning: an update for the orthodontist.

Developments in teaching and learning have implications for every orthodontist. This paper describes some of the theories of teaching and learning that have led to a quiet revolution in higher education. Developments have included the incorporation of self-directed and problem-based learning concepts, together with a more active and interactive role for the learner. The importance of these changes for orthodontic education is discussed.

Feedback↗
PubMed2001

Functional regulator treatment of Class II division 1 malocclusions.

This controlled retrospective study aimed to identify the contribution of skeletal and dental changes in the correction of Class II division 1 malocclusions using Fränkel's functional regulator II (FRII), with reference to a concurrently recruited control group. One hundred and thirty-eight patients with Class II division 1 malocclusions were identified, those accepting treatment forming the study group and those declining treatment the control group. The study group (n = 70) were treated with a Fränkel appliance. Pre- and post-treatment observation cephalometric radiographs were analysed and compared. Mean values for both skeletal and dental variables in the control group were remarkably consistent throughout the study period; however, this masked individual variations in this group. The skeletal variables in the study group that showed statistically significant differences from the control group were SNB, ANB, BaNA and ANS-Me, but none of these was sufficiently large to be regarded as clinically significant. Dental variables showed clinically and statistically significant differences, including a 10 degree reduction in UI-Max and 3.1 degree increase in LI-Mand. The Fränkel appliance was thus found to be effective in producing desirable occlusal and dental changes in the majority of patients treated.

Adolescent↗
PubMed2001

Computer-aided Learning (CAL): an effective way to teach the Index of Orthodontic Treatment Need (IOTN)?

OBJECTIVE: To identify if a lecture or access to a computer aided learning (CAL) programme is more effective in teaching undergraduate dental students IOTN. DESIGN: Prospective controlled trial. SETTING: University Dental Hospital of Manchester, 1999 SUBJECTS: Eighty-five 3rd year undergraduate dental students allocated by pseudo-randomisation to two groups. The first group received a lecture and seminar on IOTN, and the second group were given a seminar and access to a purpose written CAL programme. MAIN OUTCOME MEASURE: A standard test was given to the two groups in the form of ten sets of patient records that they had to score with IOTN Dental Health Component (DHC) and Aesthetic Component (AC). RESULTS: There was no difference in mean score for the two groups with AC score (5.02 and 5.03). The CAL group of students performed best for DHC grade (mean score 5.41 compared with 4.24 for lecture group) and this was statistically significant (p < 0.01). CONCLUSION: Undergraduate dental students can learn to use IOTN as well or better when using a CAL programme compared with a lecture.

Computer-Assisted Instruction↗
PubMed1997

Bonded orthodontic retainers: the wire-composite interface.

The bonded orthodontic retainer constructed from multistrand wire and composite is an efficient esthetic retainer, which can be maintained long-term. Clinical failures of bonded orthodontic retainers, most commonly at the wire/composite interface, have been reported. This in vitro investigation aimed to evaluate selected multistrand wires and composite materials that are available for use in the construction of bonded fixed retainers. An in vitro model was developed to simulate the forces encountered at the wire/composite interface. No significant difference was detected between different multistrand wire types and diameters with regard to retention in composite. Wires were placed in one of three groups according to surface characteristics identified with scanning electron microscopy. Increasing the thickness of composite overlying the wire increased the force required to detach the wire from the composite. Thickness of composite greater than 1.0 mm overlying the wire may give little clinical advantage. Greater force was required to detach the wire from Concise Orthodontic (3M Unitek) than any other composite tested. In vitro abrasion resistance testing found Heliosit Orthodontic (Vivadent) and Right On (TP Orthodontics, Inc.) to have poor abrasion resistance, whereas Concise Orthodontic and Transbond (3M Unitek) had abrasion resistance comparable with restorative composites. Clinical recommendations are made based on these findings.

Adhesiveness↗
PubMed1996

Index of Oral Cleanliness (I.O.C.). A new oral hygiene index for use in clinical audit.

Although plaque control influences orthodontic treatment planning, treatment progress and outcome, current national orthodontic clinical audit software does not include an assessment of oral hygiene. This paper presents the development of the Index of Oral Cleanliness, a new simple rapid measure of oral hygiene, and describes its validation and reliability by comparison with the Silness and Loe plaque index in an unselected group of adolescents. It is concluded that the Index of Oral Cleanliness provides a valid quantitative method of scoring oral hygiene, with advantages for use in routine clinical practice.

Adolescent↗
PubMed1995

Bonded orthodontic retainers: a review.

Recent reports have suggested that long-term retention may be required to prevent posttreatment changes. The bonded orthodontic retainer constructed from composite and multistrand orthodontic wire provides an esthetic and efficient system for maintained retention. The development, indications for use, and clinical techniques are described. The range of materials reported for clinical use in construction of bonded orthodontic retainers are reviewed. Recommmendations based on the literature are made. This review implicates placement of insufficient resin or use of a resin with inadequate abrasion resistance in the failure of bonded fixed retainers.

Bisphenol A-Glycidyl Methacrylate↗
PubMed1995

Ex vivo bond strength of adhesive precoated metallic and ceramic brackets.

Compared with conventional adhesive systems, adhesive precoated (APC) are reported to have advantages in clinical use. The ex vivo bond strength to human premolar teeth of metallic and ceramic APC brackets was compared with that of identical brackets bonded with Transbond (3M Unitek) light cured orthodontic adhesive, and patterns of failure were examined. There was no significant difference (P > 0.05) in mean bond strength between metallic brackets bonded with the two systems. Ceramic brackets bonded with Transbond had significantly higher (P < 0.05) mean bond strength and failure more normally occurred at the composite/enamel interface when compared with APC ceramic brackets and metallic brackets. Following debonding no enamel damage was observed with either APC or conventionally bonded ceramic brackets.

Analysis of Variance↗