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Biomedical subjects

S J Littlewood

Publications and source records attributed to S J Littlewood.

10 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 Authors of randomised controlled trials (RCTs) were identified and contacted to identify unpublished trials.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↗
PubMed2006

Twin-block re-activation.

This paper briefly reviews reasons for re-activating Twin-blocks, discussing different approaches and describing a new, simple, cost effective approach, which can be undertaken at the chairside.

Acrylic Resins↗
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↗
PubMed2001

The role of removable appliances in contemporary orthodontics.

The contemporary uses of removable appliances are considerably more limited than in the past. This article discusses possible reasons for their declining use, including recognition of their limitations. It is possible to achieve adequate occlusal improvement with these appliances providing that suitable cases are chosen. Specific indications for their appropriate use on their own in the mixed dentition are presented. Removables can also be used as an adjunct to more complex treatments, to enhance the effect of fixed appliances, headgear or in preparation for functional appliances. Further research is required to confirm whether their use in conjunction with more complex treatments enhances the quality and efficiency of treatment or not.

Contraindications↗
PubMed2001

A randomized controlled trial to investigate brackets bonded with a hydrophilic primer.

OBJECTIVE: To compare the clinical failure rates of brackets bonded using a prototype hydrophilic primer, designed to be insensitive to moisture, with brackets bonded with a conventional primer. DESIGN: Single centre randomised controlled clinical study. Thirty-three patients were bonded using a split mouth technique: randomly allocating the hydrophilic primer to one side of the mouth and a conventional primer to the other. SETTING: Hospital orthodontic department, Bradford, UK. SUBJECTS: Orthodontic patients requiring fixed appliances. MAIN OUTCOME MEASURES: The site and time to bond failure was recorded for each bracket that failed over 6 months. RESULTS: Using survival analysis, there was an increased risk of bracket failure when bonded with the hydrophilic primer compared with the conventional primer (hazard ratio = 2.2, 95% confidence interval: 1.1 to 4.5, P = 0.01). CONCLUSIONS: This hydrophilic primer cannot be recommended for routine clinical use.

Adolescent↗
PubMed2000

Investigation of a hydrophilic primer for orthodontic bonding: an in vitro study.

A common reason for bond failure is moisture contamination. This study investigates the in vitro bond strength of brackets bonded using a new hydrophilic primer, designed to be insensitive to moisture, and compares it with a conventional primer. Using a standardized technique, the in vitro bond strength of brackets bonded with the hydrophilic primer was compared to identical brackets bonded with a conventional primer. Although designed to be moisture insensitive, the directions for use stipulate drying the teeth before bonding. Therefore, for the purposes of comparison with a conventional primer the experiment was conducted under dry conditions. The results were analysed using the Weibull distribution modelling. The median bond strength with the hydrophilic primer (6.43 MPa, 95 per cent C.I. 7.69-9.50) was significantly lower (P = 0.0001) than the conventional primer (8.71 MPa, 95 per cent C.I. 5.89-7.59). The Weibull distribution modelling showed that brackets bonded with the hydrophilic primer were 3.96 times more at risk of failure (95 per cent C.I.: 2.39-6.56; P <0.0001). The bond strength at which 5 per cent of the brackets failed was also lower for the hydrophilic primer. The bond strengths obtained with the hydrophilic primer were significantly lower than with the conventional primer. Although the median bond strength values were promising, the laboratory results for this particular hydrophilic primer were disappointing when using the Weibull analysis, where the whole distribution of bond strength is taken into account.

Adolescent↗
PubMed1998

A videofluoroscopic comparison of straw and cup drinking: the potential influence on dental erosion.

OBJECTIVE: Videofluoroscopy was used to compare drinking from a cup with drinking through straws of two varying bore diameters in different positions in the mouth. DESIGN: Clinical study at a single centre. SETTING: UK dental school. SUBJECTS AND METHODS: Twenty patients showing clinical signs of erosion which had necessitated advice and/or treatment. INTERVENTIONS: Subjects drank from a cup and through a narrow straw, which was then repositioned more posteriorly. A wide bore straw was used in two equivalent positions. Swallowing was viewed laterally and anteroposteriorly to assess involvement of incisors and molars respectively. MAIN OUTCOME MEASURES: Video recordings examined for presence or absence of fluid contact with teeth following each swallow. If contact occurred, the time was measured. RESULTS: Fourteen patients avoided fluid contact with both incisors and molars when using a straw. Compared with the cup, significant differences were found with the narrow straw (P = 0.03, 95% confidence interval of 22.6% to 31.6%), the narrow straw repositioned (P = 0.008, 95% confidence interval of 12.3% to 47.1%) and the wide straw repositioned (P = 0.03, 95% confidence interval of 3.1% to 37.5%). Contact time of fluid with anterior teeth was also significantly reduced. CONCLUSIONS: Drinking through a straw positioned toward the back of the mouth may reduce the erosive potential of soft drinks.

Adolescent↗
PubMed1998

The dental problems and management of a patient suffering from congenital insensitivity to pain.

Congenital insensitivity to pain is a rare condition usually manifested in childhood by a history of unrecognized trauma, indifference to painful stimuli or self-mutilation. This paper describes the management of a 13-month-old male who had severely lacerated his tongue by habitually chewing it, using soft polyvinyl mouthguards retained with a minimal amount of denture fixative.

Dental Care for Children↗
PubMedDate not supplied

Use of jigs to standardise orthodontic bond testing.

OBJECTIVES: The aim of this study was to test whether the use of jigs for in vitro orthodontic bond strength testing helped to standardise the technique. METHODS: Two jigs were developed, one for mounting teeth with bonded brackets all in the same plane, and the second for debonding the brackets at 90 degrees to this plane. These jigs ensured the debonding force was applied in a controlled direction. Teeth mounted and debonded in this manner were compared with teeth tested with an existing protocol where the direction of the debonding force is not standardised. RESULTS: Although the same material was tested in both groups the use of jigs produced much higher mean bond strengths, and a reduced spread in the distribution of the results. CONCLUSIONS: To allow more legitimate comparisons between products and approaches, orthodontic bond strength testing must be universally standardised. The use of jigs to accurately direct the plane of the debonding force reduces the wide variations in results often seen in laboratory bond testing, improving standardisation.

Acrylic Resins↗