bluuebunny/crossref_metadata_2025 huggingface dataset:
A guide to deep neck space fascial infections for the dental team
Authors: Main Barry , Collin John , Coyle Margaret , Hughes Ceri , Thomas Steven
Published: August 2017

The majority of serious dental infections can be prevented by early treatment of the local pathology. Patients with potentially life-threatening neck space infections arising from the oral cavity may, however, still present in dental practice. This paper outlines the pertinent surgical anatomy and pathophysiology, signs and symptoms, and key early-stage management of these severe infections.

CPD/Clinical Relevance: The dental team should be able to assess patients presenting with potential neck space involvement from a dental or oral infection. They should be able to instigate appropriate early treatment, and identify those requiring prompt referral for assessment and management.
Natural rubber latex allergies from dental local anaesthetic: a review and guidance for the dental practitioner
Authors: Thomas Joel , Bell Christopher
Published: August 2017

Natural rubber latex (NRL) is present within many dental products including local anaesthetic (LA) cartridges. Patients with NRL sensitivity are at risk of developing type I and type IV allergic reactions from exposure to these products. Evidence from current literature is inconclusive yet highly suggestive that NRL contamination may occur in medicines stored within vials containing natural rubber components. It would therefore be prudent to avoid using such products in patients with a known NRL allergy. For dental practitioners this applies to LA cartridges and is easily achievable, as manufacturers now produce products not made with NRL. This article aims to provide guidance for dental health professionals regarding the use of LA in patients with a known NRL hypersensitivity.

CPD/Clinical Relevance: NRL allergies are a rising concern amongst medical professions and these reactions should be avoided wherever possible.
The importance of prompt referral when tooth roots are displaced into the maxillary antrum
Authors: Beech Andrea N , Farrier Jeremy N
Published: August 2017

When an upper tooth is extracted a possible complication is the creation of an oro-antral communication with the added risk of displacement of tooth roots into the antrum. We present a case of a displaced palatal root of an upper first molar tooth which was found in a superior position in the maxillary antrum having been left in situ for 6 weeks. The root was in a high risk position for complications such as sinusitis, mucocoele formation and the more serious septic thrombosis of the cavernous sinus. This case report describes its safe endoscopic removal and highlights the importance of prompt referral and treatment for similar cases.

CPD/Clinical Relevance: Displaced roots in the maxillary antrum during routine extraction can result in complications ranging from sinusitis to more severe complications if not managed appropriately.
A new perspective on dentine hypersensitivity – guidelines for general dental practice
Authors: Gillam David G
Published: August 2017

The aim of this review is to update dental professionals on the issues and challenges associated with the clinical management of dentine hypersensitivity (DH) and to provide simple guidelines based on presenting clinical features that may help them successfully manage the condition in their day-to-day clinical practice. Details on the management of DH have been previously published in Dental Update which indicated that there was a need for such guidelines. The authors of these guidelines also suggested that, despite the various published clinical studies, there does not currently appear to be one ideal desensitizing agent that can be recommended for treating DH. A joint working relationship between the dental professional and the patient in changing the patient's behaviour is therefore essential if the condition is to be successfully treated.

CPD/Clinical Relevance: Dentine hypersensitivity is a persistent and a troublesome clinical condition which at times is under diagnosed by dental professionals who may struggle to resolve the problem to their patients' satisfaction successfully. The recent UK Forum guidelines on the management of DH, based on the presenting features of the condition, provide practical recommendations, helping dental professionals to manage this persistent problem correctly.
The limitations of short-term orthodontics and why we still need specialists – a review of the current literature
Authors: Luqmani Sana
Published: August 2017

Short-term orthodontics (STO) serves to align anterior teeth. It has become popular in cosmetic dentistry as an alternative to destructive veneers and lengthy conventional orthodontics. The aim of this article is to raise awareness of the clinical limitations of STO and highlight some of the difficulties encountered with orthodontic retention. It also gives an overview of accredited training available to dentists who wish to develop their orthodontic skills.

CPD/Clinical Relevance: Greater awareness of the clinical limitations of short-term orthodontics will aid GDPs in appropriately selecting their cases and obtaining informed consent from patients. In addition, the article serves as encouragement for those GDPs wishing to develop their orthodontic skills and pursue further accredited training.
Gingival depigmentation by free gingival autograft: a case series
Authors: Pakhare Vikas V , Bajaj Pavan , Bhongade ML , Shilpa BS
Published: August 2017

A pleasing smile is desired by all, and forms the main focus of aesthetic dentistry. However, pigmented gums can be a major cause of embarrassment for patients, especially those with a gummy smile. Attempts have been made to meet these cosmetic demands by various methods such as using a surgical blade, diamond burs, electrosurgery, cryosurgery or a laser, but with limited results. Therefore, in the present case series, a free gingival autograft was used for treating gingival melanin hyperpigmentation with a follow-up of six months with no signs of repigmentation.

CPD/Clinical Relevance: This review outlines a method of free gingival autograft as a treatment modality for gingival pigmentation.
Thank you to our reviewers
Authors: Burke FJ Trevor
Published: August 2017

Every paper in Dental Update is considered by two reviewers. I would like to thank all those on the list below for giving their time and expertise in checking the validity of the papers published in Dental Update in 2015 and making suggestions on how papers might be improved.
Severe fluorosis treated by microabrasion and composite veneers
Authors: Hoyle Philippa , Webb Lyndsey , Nixon Peter
Published: August 2017

Dental fluorosis results from excessive intake of fluoride either from water resources or products in early childhood. It results in varying degrees of discoloration and pitting of the teeth. This article aims to highlight the conservative management techniques available for managing the aesthetic impact of fluorosis and highlights what can be achieved conservatively with the use of adhesive dentistry.

CPD/Clinical Relevance: Fluorosis can have a huge impact on dental aesthetics, depending on its extent. This in turn can affect a patient's confidence and daily life immensely. In the past, severe fluorosis may have been managed in a more destructive manner with indirect restorations.
Periodontal treatment in patients with learning disabilities part 2: professional mechanical intervention
Authors: Kaka Shazia , Dickinson Chris
Published: August 2017

The first part of this two part series discussed the potential barriers and risk factors that may lead to an increased incidence and severity of periodontal disease amongst patients with learning disabilities. Additionally, preventive strategies and tools that can be used by general dental practitioners, oral health promotion teams as well as specialists within the field to control and prevent disease progression were explored. To prevent periodontal disease progression and attain optimal periodontal health, a combination of prevention and professional mechanical instrumentation is usually required. The second part of the series concentrates on the role of the dental professional in implementing professional mechanical instrumentation to attempt to reduce the burden of disease further in this patient group.

CPD/Clinical Relevance: Although research continues into which professional techniques for instrumentation are the most successful amongst patients with periodontal disease, very little data specifically explore the needs of patients with learning disabilities, despite their high unmet needs. This paper aims to report on any available data present to produce suggestions for care.
Inaccurate dental charting in an audit of 1128 general dental practice records
Authors: Brown Nathan L , Jephcote Victoria EL , Morrison James N , Sutton Jessye E
Published: August 2017

Fourteen dentists at different practices in the UK assessed the dental charts of 1128 patients who were new to the dentist but not new to the practice; 44% of the dental charts were found to be inaccurate. Inaccuracy of the individual practice-based charts ranged between 16% for the best performing practices to 83% for the worst: 5% of dental charts had too many teeth charted and 5% had too few teeth charted; 13% of charts had missed amalgam restorations and 18% had missed tooth-coloured restorations; 5% of charts had amalgam restorations recorded but with the surfaces incorrect (eg an MO restoration charted but a DO restoration actually present); 9% of charts had tooth-coloured restoration surfaces incorrectly recorded. For 7.5% of charts, amalgams were charted but not actually present. Other inaccuracies were also noted. The authors reinforce the requirements of the GDC, the advice of defence organizations, and the forensic importance of accurate dental charts.

CPD/Clinical Relevance: Dental charting forms part of the patient's dental records, and the GDC requires dentists to maintain complete and accurate dental records.
Antibiotic guardians: the role of the dental profession
Authors: Cope Anwen L , Lewis Michael AO
Published: August 2017

The increasing emergence of antibiotic resistance is a major international public health problem. As a consequence, it is essential that steps are taken to conserve the effectiveness of existing antimicrobial agents. Consumption of antibiotics is the prime contributor to the development of resistance. General dental practitioners write almost 1 out of 10 prescriptions for antibiotics in primary care within the UK and therefore the prudent prescribing of antibiotics in dentistry has never been more vital. This paper outlines the impact of antimicrobial resistance on modern healthcare, describes the current use of antibiotics in general dental practice, and recommends pragmatic ways in which dental practitioners can evaluate and optimize their prescribing.

CPD/Clinical Relevance: Dental professionals have a responsibility to both their patients and the wider community to prescribe antibiotics appropriately.
Diagnosis and management of chronic and aggressive periodontitis part 1: periodontal assessment and diagnosis
Authors: Chatzistavrianou Despoina , Blair Fiona
Published: August 2017

Periodontal disease remains one of the most common diseases that affect the oral cavity. The differential diagnosis between chronic and aggressive periodontitis can be complex for some clinicians and the correct diagnosis is a key element in disease management. The three-part series will review periodontal clinical assessment and diagnosis, periodontal management and finally will discuss two clinical cases. This paper will focus on periodontal disease pathogenesis, periodontal clinical assessment and diagnosis.

CPD/Clinical Relevance: This paper aims to provide the general dental practitioner with an understanding of periodontal disease pathogenesis and to highlight elements in the clinical assessment which will help to establish the diagnosis.
An implant-retained obturator – a case study
Authors: Puryer James , Forbes-Haley Claire
Published: August 2017

This case describes the oral rehabilitation of a patient following maxillary hemi-section due to squamous cell carcinoma of the palate. Planned treatment was construction of a maxillary implant-supported obturator. Two dental implants were placed in his maxilla to aid the support and retention of an obturator. However, owing to bone availability, their angulation was suboptimal and compromised the retention of the obturator. This case describes alternative implant attachments to aid the retention and stability of implant-retained dentures constructed in cases with suboptimal implant placement.

CPD/Clinical Relevance: This case highlights the importance of careful planning for implant placement, and reinforces the need to plan the prostheses before implant surgery. This case highlights possible difficulties that can arise if implants are non-ideally angulated, and how to adapt restorations to manage such difficulties in cases with maxillary removable prostheses.
The UK soft drinks industry levy: implications for dental health
Authors: Jones Colwyn , Craig Neil , Anand Neil
Published: August 2017

A Soft Drinks Industry Levy on sugar-sweetened beverages (SSBs) was announced in the Westminster budget on 16 March 2016. The UK Government plans to introduce the SSB levy in 2018, with legislation enacted in 2017. The aim of the levy is ‘…..to give companies plenty of space to change their product mix’.

The levy is a banded duty on soft drinks with less than 5 g/100 ml being classed as tax exempt, drinks with between 5−8 g/100 ml taxed at a basic level tax at 18 pence per litre, and drinks with greater than 8 g/100 ml taxed at a higher level of 24 pence per litre. The Office for Budget Responsibility forecast that the Soft Drinks Industry Levy will attract revenue of £500 million for 2019–2020, the second year of implementation. Unusually, the expected revenue raised will be hypothecated to fund physical activity and breakfast clubs in English schools.

CPD/Clinical Relevance: The UK Soft Drinks Industry Levy on SSBs has the potential to reduce both childhood obesity and the prevalence and severity of tooth decay, although precise estimates of effect are unclear. The levy should be welcomed by the dental profession as a structural fiscal policy to improve both general and dental health.
A case for the defence!
Authors: Craig Aubrey
Published: August 2017

This paper discusses the work of a mutual dental defence organization in assisting its members who request support in relation to professional difficulties. Various cases are discussed in terms of help and support provided, including an explanation of the outcome and how, where adverse, this could have potentially been prevented by the member.

CPD/Clinical Relevance: To assist the dental profession's understanding of the work of a dental defence organization.
A randomized clinical trial comparing the efficacy of ibuprofen and paracetamol in the control of orthodontic pain
Authors: McGuinness Niall
Published: August 2017

Bradley RL, Ellis PE, Thomas P, Bellis H, Ireland, A, Sandy JR. American Journal of Orthodontics and Dentofacial Orthopedics 2007; 132: 511–517.
Primary failure of eruption in siblings: discussion of two cases
Authors: Merrett Sarah J , Brown Angharad , Crandon Tomos W
Published: August 2017

Primary failure of eruption (PFE) is a condition where there is eruptive failure in the permanent dentition with no obvious mechanical cause. The aetiology is believed to be an autosomal dominant pattern of inheritance with variable expression. This paper reports on Asian siblings who presented with PFE of their posterior teeth, and illustrates the main presenting features of patients with PFE and the treatment modalities available to the clinician.
Book review
Authors: Gardner Alastair
Published: August 2017

Orthodontic Miniscrew Implants: Clinical Applications 1st edn. By Cheol-Ho Paik, In-Kwon Park, Youngjoo Woo, Tae-Woo Kim. London: Elsevier, 2008. (£85.49). ISBN 978-0-7234-3402-3.
Orthodontics and the ideal occlusion – a review
Authors: Seehra Jadbinder , Fleming Padhraig S , DiBiase Andrew T
Published: August 2017

Occlusion still remains a contentious issue, with the presence of occlusal interferences during mandibular movements being postulated to be detrimental to the health of the masticatory system. Orthodontic treatment plans are generally aimed at achieving an ideal static occlusion with the assumption that an ideal functional occlusion will follow. The following is an overview of both static and functional occlusion and its relevance to orthodontics, the evidence behind both types of occlusion, whether the attainment of an ideal occlusion is achievable clinically and the possible negative consequences of a non-ideal occlusion.
Assessment of enamel damage after removal of ceramic brackets.
Authors: McGuinness Niall
Published: August 2017

Kitahara-Céia FM, Mucha JN, Marques dos Santos PA. American Journal of Orthodontics and Dentofacial Orthopedics 2008; 134: 548–555.
The use of implants in modern orthodontics
Authors: Bates Claire J , Chung Lucy
Published: August 2017

Recent advances in the use of implants in orthodontics have greatly expanded the scope of tooth movement for the practising orthodontist. Not only in routine high anchorage demanding cases, but also in complex cases where few teeth are available to act as anchors.

Implants in orthodontics are fast becoming another tool for the astute contemporary orthodontist to consider when providing anchorage reinforcement. Perhaps a growing evidence base may suggest that implants, as part of anchorage management, are the future, and that headgear may become consigned to history.
Dilacerated lateral incisor
Authors: Seehra Jadbinder , Fleming Padhraig S , DiBiase Andrew T
Published: August 2017

A case of maxillary lateral incisor dilaceration is presented. The appearance and timing of the dilaceration suggest that the buccally placed maxillary canine, which was intimately related to the incisor root during its development, may have had a role in its development. The aetiology, management and clinical significance of dilacerations are discussed.
Treatment of a unilateral crossbite with no mandibular displacement using a modified quad helix
Authors: O'Malley Paul , Willis Paul , Sandler P Jonathan
Published: August 2017

This paper describes the treatment of a malocclusion involving a unilateral crossbite where there was no mandibular deviation into maximum intercuspation. Treatment involved the use of a modified quad helix which was active mainly on the affected side. This modification allowed arch expansion in the area where it was required.
Concurrent dilacerated central incisor and mesiodens: a case report
Authors: Jones Timothy , Taylor Helen
Published: August 2017

Supernumerary teeth and dilaceration are two common aetiological factors for unerupted maxillary incisors. A case is described where both factors were present relating to the same tooth. Treatment involved removal of the badly dilacerated incisor and orthodontic repositioning of the conical supernumerary followed by restorative procedures to provide optimum aesthetics.
Standard edgewise technique and its relevance in contemporary fixed appliance therapy part 2
Authors: McGuinness Niall JP
Published: August 2017

The first paper in this series examined the development of the edgewise appliance, and looked initially at torque in individual teeth. This second paper will examine archwire formation, placement of torque using a loper turret, and the placement of first and second order bends.
Transposition of maxillary canines with first premolars: a case study of the orthodontic treatment of two sisters
Authors: Flett Andrew MC , Barry GRP
Published: August 2017

The uncommon prevalence of transposition of teeth is well documented and described as a multifactorial process. Whilst not fully understood, transposition has been associated with certain dental anomalies and a fundamental genetic aetiology. This paper describes the orthodontic diagnosis and subsequent treatment of two sisters with transposed and impacted canines together with missing lateral incisors.
Synchronous straight-wire part 1: theory
Authors: Cole Charles , Hammond Jon
Published: August 2017

Synchronous Straight-Wire (SSW) is the trademark of the authors Charles Cole and Jon Hammond. This paper is split into two parts. Part one introduces the SSW technique, explains the reasons for its development and outlines theory. Part two illustrates the technique and compares it to others. The aim of this paper is to introduce the SSW technique, which is designed to produce simultaneous synchronized movement and thereby improve efficiency. Complex concurrent movements require planning and co-ordination. An Appliance Configuration Table (ACT) facilitates this and enables the clinician to plan the required movements to correct tooth position fully before linking these to required forces for resolution. Forty cases treated using SSW are compared with other techniques. Efficiency of tooth movement is monitored using a treatment efficiency index (TEI). When compared with other techniques, SSW demonstrates improved efficiency. The technique offers a more efficient means of undertaking fixed appliance treatments and highlights the advantages of pre-programming the entire appliance (not just the brackets) and of using a coherent mechanism to facilitate 3-dimensional movements.

Clinical Relevance: The Synchronous Straight-Wire (SSW) technique is a means of organizing simultaneous treatment events by synchronizing, rather than sequencing, tooth movement.
Synchronous straight-wire part 2: application
Authors: Cole Charles , Hammond Jon
Published: August 2017

Synchronous Straight-Wire (SSW) is the trademark of the authors Charles Cole and Jon Hammond. In part one the SSW technique was introduced, the reasons for its development were explained and the theory outlined. The aim of this second paper is to demonstrate the SSW technique. A case is presented to demonstrate the technique, all aspects of the malocclusion being addressed concurrently. The case is then treated in 11 visits, reducing the PAR score from 38 to 0, giving a Treatment Efficiency Index (TEI) of 3.45. The conclusions that can be drawn are that the technique offers a more efficient means of undertaking fixed appliance treatments and highlights the advantages of pre-programming the entire appliance and using a coherent mechanism to facilitate 3-dimensional movements.

Clinical Relevance: This paper demonstrates a means of organizing simultaneous treatment events by synchronizing, rather than sequencing, tooth movement, thereby giving greater efficiency than other techniques. It requires a radically different approach to treatment mechanics and a fundamental shift in thinking.
The migration of a mesiodens over eight years: a case report
Authors: Shafi Imran , Gardner Alastair , Brocklebank Laetitia
Published: August 2017

The term mesiodens describes a conical supernumerary tooth located between the maxillary central incisors. Complications of these teeth include: disturbance of the eruption pattern of neighbouring teeth; spacing; crowding; displacement or total failure of eruption. Finally, they can migrate and cause damage to neighbouring structures. This case report describes a clinical case in which a mesiodens migrated over an eight-year period distally from the anterior of the maxilla along the palate. Radiographic techniques of plain radiography and Cone Beam Computed Tomography were used to locate its exact position.

Clinical Relevance: This paper discusses briefly the aetiology and complications of mesiodentes, and highlights the fact that they can migrate in the maxilla significant distances from their original position. This raises the question as to whether or not their position should be monitored.
A complication with orthodontic fixed retainers: a case report
Authors: Abudiak Hani , Shelton A , Spencer RJ , Burns L , Littlewood SJ
Published: August 2017

Fixed retainers are a popular method of maintaining incisor position following orthodontic treatment. This paper reviews the complications reported with fixed retainers and reports a case in which suspected activation in a multistrand bonded retainer had caused severe unwanted movement of two teeth in the upper labial segment.

Clinical Relevance: This paper stresses the importance of passive fixed retainers and the need for long-term review of patients wearing bonded retainers.
Cone beam computed tomography – tales of the unexpected
Authors: Ahmed Nadia M , Nazir Mariyah
Published: August 2017

This case report highlights the benefit of Cone Beam Computed Tomography (CBCT) in the diagnosis of incisor root resorption. Management of a 13-year-old patient, who was referred for an orthodontic assessment of an unerupted maxillary canine which was in complete transposition with the upper lateral incisor, is discussed. CBCT highlighted root resorption of the lateral incisor, as well as the central incisor, and provided additional diagnostic information to that shown by plain radiographic films.

Clinical Relevance: To demonstrate the efficacy of CBCT in detecting incisor root resorption secondary to maxillary canine impaction.
Multidisciplinary care – how should we manage the complex orthodontic/paediatric dentistry case? part 1
Authors: Parvizi Farnaz , John Rebecca , Crawford Peter JM , Atack Nikki
Published: August 2017

These two articles aim to outline the importance of combined paediatric dentistry-orthodontic planning in the management of complex cases of the developing dentition. They will use case studies to highlight those patients who would most benefit from such a combined approach.

Clinical Relevance: For patients who present with complex needs in the developing dentition, it is important that the paediatric and orthodontic teams work closely in order to achieve optimum patient care at the appropriate time.
Useful concepts for critical appraisal: 2. considering chance
Authors: Suchak Archna , Johal Ama , Wade Angie
Published: August 2017

There is an increasing volume of research undertaken within orthodontics and with this comes a need to evaluate what is available. This short series aims to help the orthodontist revise basic concepts of critical appraisal and pertinent statistics.

Clinical Relevance: Critical appraisal skills are valuable tools that can aid clinical decision-making. In this article, we cover concepts including basic descriptive statistics, significance testing and confidence intervals.
Achieving early bond strength: a solution
Authors: Attia Khaled H , Enein Karim Aboul
Published: August 2017

The purpose of this in vitro study was to investigate the effect of the deproteinizing agent NaOCI on sheer bond strength of orthodontic brackets.

Clinical Relevance: It was found that the application of NaOCI significantly increases the initial bond strength of orthodontic brackets.
The dilemma of commissioning: the isle of wight orthodontic managed clinical network: a 3-year review part 1: patterns of referrals
Authors: Lammiman Elizabeth , Robinson Stephen , Ireland Robert
Published: August 2017

The key objective of developing the Isle of Wight orthodontic service managed clinical network (IOWOS MCN) was to create an integrated service measuring the referral patterns and, ultimately, the current orthodontic need. The first part of this two part series will describe the referrals to the integrated service during the period 2006–2009. A total of 2801 referrals was analysed of which 80% of the 11–18 year-old cohort referrals were considered to have high need for treatment, 8.5% were of moderate need and 11.8% of referrals were considered inappropriate. There was a high level of appropriate referral for orthodontic treatment within the IOWOS MCN but the method of calculating orthodontic need is complex.

Clinical Relevance: This first part of a two part series provides an insight into some of the complexities of commissioning orthodontic care by reference to the referral data collected over the first three years of a recently established orthodontic managed clinical network on the Isle of Wight.
Accidental ingestion of orthodontic band loop
Authors: Jena Ashok Kumar , Singh Satinder Pal , Utreja Ashok , Verma Raj Kumar
Published: August 2017

Any object routinely placed into or removed from the oral cavity during dental or surgical procedures can be aspirated or swallowed. Handling of small instruments or appliances requires special care, particularly when the patient is supine or semi-supine. Prevention of such incidence by the mandatory use of precautions during all dental procedures is the best approach. This case report describes an accidental swallowing of a piece of orthodontic band material and its management, and up-to-date knowledge on prevention and management of foreign body ingestion.

Clinical Relevance: Many complications can arise during regular dental care procedures. Aspiration or ingestion of foreign bodies has the potential of resulting in acute medical and life-threatening emergencies as it can be a cause of accidental death. Also, in supine or semi-supine patients, the risk of aspiration or ingestion is increased. Readers should understand that aspiration or ingestion of foreign bodies is a significant medical emergency and should keep themselves updated on how to avoid and manage such an emergency.
Bonded orthodontic retainers
Authors: Patel Amish , Naini Farhad B , Gill Daljit
Published: August 2017

Bonded orthodontic retainers have gained in popularity during recent years to maintain tooth positions upon completion of active tooth movement. This article aims to give an overview of the use of bonded retainers, discuss the different techniques for placement and review the different types of bonded retainers that are available.

Clinical Relevance: This article reviews a number of methods and materials used to construct bonded retainers and also provides evidence of failure rates.
What factors might affect the success of fixed appliance therapy in adolescent patients? part 1
Authors: Williams Julie C , Atack Nicola E , Sandy Jonathan , Ireland Anthony
Published: August 2017

The success of orthodontic treatment can be judged in a number of ways, two of which are treatment efficiency and occlusal outcome. Treatment efficiency can be measured in terms of length of treatment and number of visits, whilst occlusal outcomes can be both dynamic and static. The factors that affect success can be considered under three headings, namely patient factors, operator factors and appliance factors. This article will consider outcome and the patient factors which might affect treatment success in our adolescent patients, whilst Part 2 will consider operator and appliance factors.

Clinical Relevance: The conversational model of consent requires that clinicians disclose all of the appropriate information to patients prior to them making the decision whether to accept or decline treatment. 1 Understanding factors that could affect the outcome with respect to both treatment efficiency and occlusal result will therefore help inform this consent process.
Tooth reshaping as an integral part of orthodontic treatment
Authors: Griffiths Sarah E , Sandler P Jonathan
Published: August 2017

Tooth reshaping is becoming an integral part of orthodontic treatment to maximize the aesthetic outcome. The removal of incisor mamelons with Sof-Lex™ discs is a straightforward, easy and minimally invasive way of dramatically improving the appearance of previously unworn incisors. This method can be used during the finishing stages of orthodontic treatment.

Clinical Relevance: The dental team often encounters patients with misshapen and malformed teeth. Reshaping teeth is fast becoming an integral part of orthodontic treatment. When used in appropriate cases, tooth reshaping can be an effective, minimally invasive technique to achieve a highly aesthetic result
Clinical efficacy of the damon (self-ligation) system in a borderline case
Authors: Doshi Jigar R , Trivedi Kalyani , Shyagali Tarulatha
Published: August 2017

For many years, orthodontists have ligated brackets with wire or elastomeric ties. Much of our treatment planning and mechanics have been dictated by a mechanical system incorporating significant amounts of friction. This article will present a nearly friction free system using high-tech brackets and wires, which is claimed to reduce the need for auxiliary expanders significantly.

Clinical Relevance: Self-ligation systems have the advantage of low friction mechanics; this may produce significant expansion in the premolar and molar regions. In addition, very low forces for orthodontic tooth movement are applied when compared to conventional brackets.
The control of unwanted tooth movement — an overview of orthodontic anchorage
Authors: Naish Hywel J , Dunbar Claire , Atack Nikki E , Williams Julie C , Sandy Jonathan R , Ireland Anthony J
Published: August 2017

The success of orthodontic treatment relies upon careful treatment planning, for both desired and unwanted tooth movement. The theory behind anchorage reinforcement will be considered and the current means of anchorage support and creation will be described. Methods by which the orthodontist can reduce anchorage demand and measure anchorage loss will also be discussed.

Clinical Relevance: To understand the clinical applications of the theory of unwanted orthodontic tooth movement and be able to give examples of planned means of increasing anchorage and decreasing anchorage demands.
Transpalatal, nance and lingual arch appliances: clinical tips and applications
Authors: Almuzian Mohammed , Alharbi Fahad , Chung Lucy Lai-King , McIntyre Grant
Published: August 2017

Transpalatal arches (TPAs) are widely used in clinical orthodontics. The versatility of the TPA makes it an extremely useful adjunct to both conventional and contemporary fixed appliance treatment. This paper describes the history, the variety of designs and the clinical steps and laboratory methods for TPA construction. The range of clinical applications of the TPA are presented using a series of cases.

Clinical Relevance: The TPA is widely used in clinical orthodontics but published information is scarce with no review article having been published to date.
Beginner's guide to becoming a successful consultant - a personal experience of the first year
Authors: Patel Anjli
Published: August 2017

This article aims to outline some of the things one can do to ease the transition into becoming a contented and successful consultant. The first part concentrates on how to be appointed to the post you would like. The second part focuses on how to steer your career once you have been appointed to your dream post.

Clinical Relevance:
Distalizing maxillary molars – how do you do it?
Authors: Almuzian Mohammed , Alharbi Fahad , White Jill , McIntyre Grant
Published: August 2017

Maxillary molar distalization has been used in orthodontics for over 100 years. This technique has been used to gain space in the maxillary arch for relief of crowding, correction of a Class II molar relationship and reduction of an increased overjet. A plethora of appliances have been developed over the years with each having advantages and disadvantages. This article details the indications and contra-indications for maxillary molar distalization and details the various appliances that are available to clinicians, presenting the available evidence supporting the use of these various appliances.

Clinical Relevance: Clinicians should be familiar with the clinical indications for maxillary molar distalization, the potential unwanted effects and how these can be minimized. Clinicians should also appreciate how molar distalization can be incorporated with other aspects of orthodontic care.
Adult orthodontic patients in primary care and their motivation for seeking treatment
Authors: Singh Parmjit
Published: August 2017

The study aims to provide information on why adults seek orthodontic treatment in a primary care setting. One hundred patients self-completed a questionnaire previously validated in a secondary care setting. Females accounted for 73% (n = 73) of respondents and the mean age for respondents was 29 years (range 17–50). The main reasons for wanting orthodontic treatment were to straighten their teeth (85%) followed by wanting to improve their smile (79%). The main perceived benefits of orthodontic treatment were an improved appearance (79%), being less likely to be self-conscious about their own smile (57%) and improved self-confidence and/or self-esteem (52%).

Clinical Relevance: Knowledge of motivating factors of adults seeking orthodontic treatment may help reduce patient dissatisfaction with treatment outcomes.
Root resorption during fixed appliance therapy – mechanism, risk factors and prognosis
Authors: Fahey Triona , Stephenson Pamela
Published: August 2017

This article examines the prevalence, mechanism and risk factors associated with orthodontically induced root resorption. The long term prognosis for those who suffer severe root resorption is also discussed.

CPD/Clinical Relevance: Root resorption is an inevitable consequence of treatment with fixed appliances. This article indicates risk factors which may be identified prior to treatment, and measures which may be taken to minimize shortening during treatment.
The aberrant central incisor
Authors: Mittal Tarun K , Atack Nikki E , Williams Julie C , Puryer James S , Sandy Jonathan R , Ireland Tony J
Published: August 2017

The maxillary permanent central incisor develops early in life and forms part of an aesthetic smile. Disruption of the formation or eruption of the permanent central incisor has multiple aetiological factors. Treatment options depend to some extent on the cause of failure of eruption of the central incisor. Generally, the earlier treatment is provided, the higher the likelihood of success and the less the complexity. This article gives an overview of the possible aetiology and treatment of the aberrant central incisor.

CPD/Clinical Relevance: Unerupted central incisors are a clinical complication that occurs commonly in orthodontic practice. The clinician should be aware of the aetiology and possible treatment options.
Distinguishing Science from Non-Science: Preservice Elementary Teachers’ Perspectives on Evolution, Creationism, and Intelligent Design
Authors: Binns Ian C. , Bloom Mark A.
Published: August 2017

Biological evolution stands out as critically important content for K-12 education as it is considered a cornerstone of the biological sciences. Yet, it remains one of the most socially controversial topics related to science education. In this exploratory study, we are seeking to understand the ways elementary preservice teachers (PSTs) use their views of science to justify including or excluding alternative explanations to evolution in the science curriculum. This investigation included 76 PSTs who were enrolled in an elementary science methods course. Data came from an activity designed by the authors entitled “Science in the Public Schools – School Board Scenario.” The scenario proposed that the local school board was considering a motion to alter the science curriculum by introducing creationism and intelligent design (ID) to the unit on biological evolution and the PSTs had to offer their informed recommendations. The two researchers independently read and coded the data using an inductive, constant comparative approach. Findings revealed that 32 would not add creationism or ID, 26 would add both, 9 would add creationism, 6 would add ID, and 3 would only mention them. PSTs came up with diverse explanations for their decision on if to include alternative explanations when teaching evolution. Common rationales emerged within each group and are further explored.
Enhance Learning through BrainDance Movements: An Empirical Study
Authors: Chiang Linda H. , Griego Orlando
Published: August 2017

The purpose of this study was to compare and associate BrainDance activity to a control group on reading scores as well as social, learning, and negative behavior. A total of 40 students in two classrooms participated in this study. A Likert scale and words per minute   reading scores followed by quantitative analysis using a t-test to document and assess students’ behaviors and reading scores. The findings indicated no significant difference in reading fluency, but the BrainDance group improved in four specific areas—focus, use of sense, multiple senses, and restlessness. There were positive correlations of social and learning behaviors, but negative correlations for learning and negative behaviors in addition to social and negative behaviors.
The Use of New Technologies in Basic Education: An Approach to Profile of Indigenous Ecuadorians
Authors: Stefos Efstathios , Castellano José Manuel , Marchán Andrés Bonilla , Biloon Julia Raina Sevy
Published: August 2017

This article aims to define the profile of Ecuadorian indigenous students who study at different levels of basic education in Ecuador in the context of the application and use of emerging technologies in the last five years. This approach focuses on a comparative analysis between indigenous and non-indigenous students, based on the national data from the National Survey of Employment, Unemployment and Underemployment of Ecuador (ENEMDU) 2006, 2011 and 2015, along with the contribution of other statistical sources, such as the 2001 and 2010 Census of the National Statistics Institute of Ecuador (INEC). The results show a significant difference in the use of ICTs between indigenous students and non-indigenous students, the majority of whom are mixed mestizo with minorities of montubios, blacks, whites, mulattos, afro-Ecuadorians and others. The interest in acquiring knowledge about one of the most precarious social sectors of Ecuadorian society, the indigenous population, is justified by the absence of studies about this subject, by the need to know the possible limitations or barriers, geographic, cultural and economic, and in the characterization of its profile, which will allow in future studies to deepen the process of appropriation of information and communication technologies in the applications, management and impact of ICTs and in the educational process of Ecuadorian indigenous students.
Understanding Interest and Self-Efficacy in the Reading and Writing of Students with Persisting Specific Learning Disabilities during Middle Childhood and Early Adolescence
Authors: Abbott Robert , Mickail Terry , Richards Todd , Renninger K. Ann , Hidi Suzanne E. , Beers Scott , Berninger Virginia
Published: August 2017

Three methodological approaches were applied to understand the role of interest and self-efficacy in reading and/or writing in students without and with persisting specific learning disabilities (SLDs) in literacy. For each approach students in grades 4 to 9 completed a survey in which they rated 10 reading items and 10 writing items on a Scale 1 to 5; all items were the same but domain varied. The first approach applied Principal Component Analysis with Varimax Rotation to a sample that varied in specific kinds of literacy achievement. The second approach applied bidirectional multiple regressions in a sample of students with diagnosed SLDs-WL to (a) predict literacy achievement from ratings on interest and self-efficacy survey items; and (b) predict ratings on interest and self-efficacy survey items from literacy achievement. The third approach correlated ratings on the surveys with BOLD activation on an fMRI word reading/spelling task in a brain region associated with approach/avoidance and affect in a sample with diagnosed SLDs-WL. The first approach identified two components for the reading items (each correlated differently with reading skills) and two components for the writing items (each correlated differently with writing skills), but the components were not the same for both domains. Multiple regressions supported predicting interest and self-efficacy ratings from current reading achievement, rather than predicting reading achievement from interest and self-efficacy ratings, but also bidirectional relationships between interest or self-efficacy in writing and writing achievement.  The third approach found negative correlations with amygdala connectivity for 2 reading items, but 5 positive and 2 negative correlations with amygdala connectivity for writing items; negative correlations may reflect avoidance and positive correlations approach. Collectively results show the relevance and domain-specificity of interest and self-efficacy in reading and writing for students with persisting SLDs in literacy.
Stereotyped fans and social critique: Miguel de Cervantes’s Don Quixote and Eminem’s ‘Stan’
Authors: Cox Annabel
Published: August 2017

This article compares two very different texts, but important similarities can be established between Cervantes’s Don Quixote and Eminem’s ‘Stan’. These include shared explorations of fandom and influence. However, whilst Eminem discusses the dangers of his own music, Cervantes addresses the influence of an entire genre: the Chivalric Romance. Still, inherent to Cervantes’s critique of poorly written Romances is recognition of his own accountability as an author. Therefore, both texts’ creators consider the responsibilities that their influential position entails, examining this in reference to an apparently stereotypically drawn ‘pathological fan’.

Jensen argues that the pathologizing of fans masks ‘an implicit critique of modern life’ (2003: 9), but both ‘Stan’ and Don Quixote’s social critique is quite explicit. This is despite Cervantes’s novel being produced before the modern era (as the age of mass media), and the relevance of other arguments made by Jensen – for example, those concerning stigmatization, compensation and understandings of the fan versus the aficionado – are also examined in reference to Don Quixote as a ‘pre-modern’ text. Nevertheless, fan characterization as a tool of social critique remains the central focus of this analysis, as it is through this that the allegedly negative stereotype of the fan depicted by both Cervantes and Eminem can be re-evaluated.
Clawing through the fourth wall: Interactions between the fans and creators of MTV’s Teen Wolf
Authors: Thomas Emily
Published: August 2017

The question of interactions between media creators and their fanbases has been an especially multifaceted and polarizing topic across many fandoms. Pierre Bourdieu described culture as an economy, with different types of culture in turn producing various commodities. It is possible to be both a creator and a consumer of these cultural commodities, particularly in a world where social media has rendered the barriers between media creators and their fans thinner than ever. This relative ease of communication has had the two-pronged effect of allowing creators to explore the marketability of their fans and fans realizing they can make their voices heard, all in the time it takes to compose a tweet. Both the production team and the fandom for MTV’s Teen Wolf serial took abundant advantage of this, with the show’s creators making a concerted effort to reach out to the subsets of its fanbase that were using social media as a vessel to engage Teen Wolf cast and crew members in discussions about race, homophobia, and queer representation. This analysis regards the Teen Wolf fan/creator dialogue through the lens of a world steeped in social media, and in doing so examines the notion of boundaries between consumers and creators, and the point at which fandom ceases to belong to either group exclusively.