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Orthodontic Research Presentations: University Teachers Group. BOC 2021. 22nd September 2021. Episode 127

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Hosted by
Farooq Ahmed

University Teachers Group

Join me for this year’s University Teachers Group session at the BOC, which entails presentations of research from trainees / residents in the UK.

 

This year there were 8 presentations covering the topics of; an RCT on bonding rates of tooth surface preparation Vs no preparation, evidence from adverts in orthodontic journals, reporting in RCTs, appropriate sample sizes in orthodontic RCTs, extraction decision making, shared decision making in orthodontics, student perception of face to face Vs virtual learning, gender as a barrier to a career in orthodontics

Randomised Control Trial to compare preparation of molars for orthodontic bonding with and without a tungsten Carbide Bur Miesha K Virdi

Hypothesis

  • Preparation of a molar with a Carbide bur had no effect on failure rate

 

Method

  • Prospective RCT
  • Split mouth technique – Battenburg design
  • 12 month follow up

Results

  • Without bur = 12.8%
  • With bur 7.9% – 5% reduction
  • Maxillary molar fails greater than Mandibular molar – statistically significant ()due to parotid gland)
  • Mainly reduce upper molar debonds, by 10%
  • Gender – no difference in male and female

Conclusion

  • Clinical reduction in Carbide bur, but not statistical difference

 

 

Othman Hameed Advertisement in Orthodontic Journals. Are they evidence-based

 

Aim

  • Assess evidence of claims of clinical superiority

Methods

  • Cross sectional study
  • Validated criteria

Results

  • 35% supported by evidence
  • 65% unsupported by evidence
  • Majority of evidence presented
    • Anecdotal
  • No difference in journals

Conclusion

  • Majority of adverts of clinical superiority of product are not supported
  • 2% support with high level of evidence

 

 

 

 

Correct Labelling of Orthodontics Randomised Control Trials

Georgina Kane

 

Aims

  • Access whether labels are true RCTs (allocation and randomisation described)

Methods

  • Systematic review of orthodontic RCTs

Results

  • N = 173 trials
  • 170 have randomised, 109 described RCTs 64%
  • 30% 51 = unclear
  • 6% not RCTs

Predictors of correct labelling

  • Journal type, country, involvement of statisticition

Outcome

  • 1 in 3 trials inadequate labelling

 

Are treatment effect assumptions in orthodontic studies overoptimistic? Daniel Stonehouse-Smith

 

Background

Sample size – effect size – assumptions can be exaggerated in medicine

A prior statement of clinical significance / sample of convenience

 

Method

Systematic review

 

Results

  • A sample size described in 31.7%
  • Significant difference between the assumed and observed treatment effects suggesting greater values for the assumed effect sizes.

 

Recommendation

Avoid A priori effect size in sample size calculation

 

 

 

A qualitative evaluation of attitudes towards extractions amongst primary care in orthodontics

 

Aims

Evaluate factors affecting extraction choses among orthodontists in extraction

 

Method

  • Qualitative analysis 1:1
  • Topic guide
  • Themes
    1. Patient related factors
      1. Poor dental health = extractions
      2. 3RD Molars greater extractions
  • Adults – avoid extractions due to space closure
  1. Operator related factors
    1. Observing treatment long term = tend to result in more extraction treatment
  2. Setting
    1. Poorer socio-economic factors = greater extractions
    2. Private Vs NHS small factor
  3. Mechanical approaches
    1. Less use of headgear = greater extractions
    2. IPR concerns of use in adolescence, more use in adults
  4. Self directed learning
    • Peer learning

 

 

Shared Decision Making in Adult Orthodontic Patients: A cross sectional study

Farnaz Motamedi-Azari

 

Aims

Adult preferred roles in healthcare decision making

Adult perceived roles in healthcare decision making

 

Method

  • Cross sectional study
  • Control preference scale CPS – validated questionnaire

 

Results

  • Perceived roles more passive then preferred
  • Genders males preferred more passive, females preferred more active roles
  • 45% perceived and preferred roles matched, 55% perceived and preferred roles not matched
  • 35% wanted more active role
  • 16% wanted more passive role

 

Conclusion

  • Patients vary in there preferred role in HDM
  • Gender, females prefer active roles, males prefer passive
  • We may need to educate patients on benefits on shared decision making as it enhances patient outcomes to treatment

 

 

 

 

 

 

 

Postgraduate student perception of face to face and distance education in orthodontics Oliver Johnson King

 

Aims

Compare and contrast face to face Vs distance learning education

 

Method

  • UCL students
  • Focus groups – online, with topic guide
  • Transcribed by professional company
  • 25 students = 83% of students

Thematic analysis

  • Social support Network
    • Distance learning resulted in lack of bonding
  • Technology
    • Quality of the internet connection effected quality of learning
    • Cost of new technology
  • Experience
  • Education
  • Interaction
  • Effective teaching and learning
    • Difficulty learning practical skills
    • Theory, preferred online than face to face

Conclusions

  • Face to face
    • Social peer learning, practice learning
  • Virtual learning
    • Accessibility of resources, convenient, theoretical learning

 

Investigating the barriers and facilitator to an orthodontic career, does gender have an effect Jennifer Jopson

 

 

Background

  • Majority of dentists, orthodontists and academic are female
  • Occluational feminisation

Method

  • Qualitative
    • Purposive sampling, focus group, inductive thematic analysis

Results

  • Motivation
    • Career longevity
    • Financial renumeration
  • Facilitators
    • Mentors – key to Post CCST training
    • Support
  • Barriers
    • National retirement
    • Inflexible training, buy a house, have family, children
    • Finance
    • Fatigue
  • Gender difference
    • Difference in females Vs males
      • Females
        • Balance work with children difficult
        • Career = Guilt at not being able to ‘do it all’ family and job
        •  
      • Males – balance with work and other opportunities
        • Easier to start family
        • Career = based on right place
      • Discussion
        • Significant effect of guilt on working mothers
          • Attitutes of ‘good mothers’ remains present in society

 

Conclusion

  • Pressure points in a career
  • Male and Female have difference career experience
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