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1.	Abdulraheem, Salem, et al. (author) Hawthorne effect reporting in orthodontic randomized controlled trials : truth or myth? Blessing or curse? 2018 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 40:5, s. 475-479 Research review (peer-reviewed)abstract Objective To investigate in 10 orthodontic journals how many randomized controlled trials (RCTs) considered the Hawthorne effect, and if considered, to determine whether it was related to the patients or the therapists involved in the trial and, finally, to discuss the Hawthorne effect in an educational way. Materials and methods A search was performed on the Medline database, via PubMed, for publication type ‘randomized controlled trial’ published for each journal between 1 August 2007 and 31 July 2017. The American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist, Australian Orthodontic Journal, Dental Press Journal of Orthodontics, European Journal of Orthodontics, Journal of Orthodontics, Journal of Orofacial Orthopedics, Korean Journal of Orthodontics, Orthodontics and Craniofacial Research and Progress in Orthodontics were assessed. Two independent reviewers extracted the data and identified whether the Hawthorne effect was considered or discussed in the articles and whether the Hawthorne effect was related to the behaviour of the patients, the therapists, or both. Results The initial search generated 502 possible trials. After applying the inclusion and exclusion criteria, 290 RCTs were included and assessed. The Hawthorne effect was considered or discussed in 10 of 290 RCTs (3.4%), and all were related to the patients’ and none to the therapists’ behaviour. Conclusions The Hawthorne effect reported in orthodontic RCTs was suboptimal. The researchers’ lack of knowledge about this phenomenon is evident, despite evidence that the Hawthorne effect may cause over-optimistic results or false-positive bias.
2.	Abdulraheem, Salem, et al. (author) Teeth movement 12 years after orthodontic treatment with and without retainer : relapse or usual changes? 2020 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 42:1, s. 52-59 Journal article (peer-reviewed)abstract AIMS: To identify if lower incisor movements after orthodontic treatment are due to the relapse of the orthodontic treatment or due to natural growth. SUBJECTS AND METHODS: The subjects consisted of 92 patients who have had orthodontic treatment, divided into three groups, group 1: 38 individuals had no retainer in the lower jaw. Group 2: 24 individuals had a retainer 0.028 inch, a spring hard wire bonded to the mandibular canines only. Group 3: 30 individuals had a 0.0195-inch Twist-Flex wire, bonded to all mandibular incisors and canines. Study models before orthodontic treatment (T0), immediately after orthodontic treatment (T1), 6 years after orthodontic treatment (T2), and 12 years after orthodontic treatment (T3) were used for the measurements. The wires in groups 2 and 3 were removed after mean 2.6 years (SD 1.49). Little Irregularity Index (LII), inter-canine distance, available mandibular anterior space, and number of crowded incisors were registered. A Tooth Displacement Index (TDI) was developed to measure the tooth displacement directions at T0 and T3. RESULTS: The LII showed equal values before treatment (T0) and at the follow-up registrations (T2 and T3). But about 25 per cent of the tooth displacements at T2 and T3 did not exist before treatment, at T0. This indicates usual growth changes and not relapse of the orthodontic treatment. CONCLUSION: As about 25 per cent of the displaced incisors can be considered as an effect of natural growth, not a relapse of the orthodontic treatment, it is valuable to use a displacement index in combination with other variables for investigations of stability after orthodontic treatment. Importance of the present study is that it is possible to differ between relapse and usual growth changes.
3.	Abdulraheem, Salem, et al. (author) The reporting of blinding in orthodontic randomized controlled trials : where do we stand? 2019 In: European Journal of Orthodontics. - : Oxford Academic. - 0141-5387 .- 1460-2210. ; 41:1, s. 54-58 Journal article (peer-reviewed)abstract Objective: To analyse in 10 orthodontic journals how many randomized controlled trials (RCTs) performed 'single-', 'double-', 'triple-', or 'outcome assessors blinding' and to evaluate, from the number of RCTs that did not conduct blinding, how many could actually have achieved it. Material and methods: Randomized controlled trials published in 10 orthodontic journals between 1 September 2012 and 28 February 2018 were included. A search was performed in PubMed and conducted for publication type 'randomized controlled trial' for each journal. Two reviewers independently analysed each RCT and registered that blinding was performed and included which specific type. It was also evaluated whether misclassifications of blinding items occurred and whether it was possible to achieve blinding among the RCTs that did not perform blinding. Results: After applying the inclusion criteria, 203 RCTs were assessed, and 61.6 per cent of them had used blinding, with the main type being 'outcome assessors blinding' (40.4%) followed by 'single-blinding' (15.3%), 'double-blinding' (2.5%), and 'triple-blinding' (3.4%). In 38.4 per cent of the trials, no blinding was performed; however, 79.4 per cent of them could have achieved blinding. Fifteen RCTs (7.3%) misclassified the blinding in relation to single-, double-, or triple-blinding. Journals followed the CONSORT (AJODO, EJO, JO, OCR) published together significantly more RCTs that performed blinding than journals not following the CONSORT. Conclusions: Blinding of outcome assessors was the most frequent type, as orthodontic trials are often of intervention design and thereby difficult to mask for patients and trial staff. The misclassifications of blinding items may indicate suboptimal knowledge among researchers and peer-reviewers regarding the definitions for diverse blinding types.
4.	Abrahamsson, Cecilia, et al. (author) Masticatory function in patients with dentofacial deformities before and after orthognathic treatment : a prospective, longitudinal, and controlled study 2015 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 37:1, s. 67-72 Journal article (peer-reviewed)abstract OBJECTIVES: The aim of this study was to investigate the self-estimated masticatory ability and masticatory performance in patients with dentofacial deformities before and after orthognathic treatment; in comparison to an age- and gender-matched control group. SUBJECTS AND METHODS: The masticatory ability and masticatory performance were evaluated in 121 consecutive patients (treatment group), referred for orthognathic treatment. Eighteen months after treatment, 98 patients (81%) completed a follow-up examination. Masticatory ability was assessed on a visual analog scale, while the masticatory performance was evaluated by a masticatory test using round silicon tablets. Signs and symptoms of temporomandibular disorders (TMD) were registered by a clinical examination and a questionnaire. The control group comprised 56 age- and gender-matched subjects who were examined at baseline. RESULTS: At the baseline examination, the treatment group had a significantly lower masticatory ability and performance compared with the control group. After treatment, the masticatory ability significantly improved in the treatment group and reached the same level as in the control group. The masticatory performance index increased significantly but was still lower than in the control group. Both the masticatory ability and masticatory performance were affected by the number of occlusal contacts during maximal biting pressure and by the self-estimated overall symptoms of TMD. CONCLUSIONS: Patients with dentofacial deformities, corrected by orthognathic treatment, have a significant positive treatment outcome in respect of masticatory ability and masticatory performance. Furthermore, the occlusion and symptoms of TMD have an impact on both masticatory ability and masticatory performance.
5.	Afacan, B, et al. (author) Effect of orthodontic force magnitude on cytokine networks in gingival crevicular fluid: a longitudinal randomized split-mouth study 2019 In: European journal of orthodontics. - : Oxford University Press (OUP). - 1460-2210 .- 0141-5387. ; 41:2, s. 214-222 Journal article (peer-reviewed)
6.	Ahlqvist, Jan, et al. (author) The effect of projection errors on angular measurements in cephalometry. 1988 In: European Journal of Orthodontics. - 0141-5387 .- 1460-2210. ; 10:4, s. 353-61 Journal article (peer-reviewed)
7.	Ahlqvist, Jan, et al. (author) The effect of projection errors on cephalometric length measurements 1986 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 8:3, s. 141-148 Journal article (peer-reviewed)abstract The magnitude of projection errors, calculated theoretically on length measurements in cephalometry was studied. Rotation of the object by up to 5° from the proper position, resulted in errors in length measurements that were usually less than one percent. Rotations of more than 5° may increase the error but imply misalignments of the head that should be evident when positioning the patient. The advantage of extremely long focus film distances seems doubtful.
8.	Al-Taai, Nameer, et al. (author) Craniofacial changes from 13 to 62 years of age 2022 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 44:5, s. 556-565 Journal article (peer-reviewed)abstract Background In long-term studies of orthodontic, orthognathic, and prosthodontic treatments, control subjects are needed for comparison. Objectives To study the craniofacial (skeletal, soft tissue, and dental) changes that occur in untreated subjects with normal occlusion between 13 and 62 years of age. Materials/Methods Thirty subjects with a Class I normal occlusion and harmonious facial profile were studied. X-ray examinations were performed at 13 (T1), 16 (T2), 31 (T3), and 62 (T4) years of age, and data were obtained from cephalograms. In total, 53 angular and linear parameters were measured using superimposition-based and conventional cephalometric methods to describe the craniofacial changes. Results The jaws showed significant anterior growth from T1 to T2, and significant retrognathism from T3 to T4. The anterior face height and jaw dimensions increased significantly until T3. Significant posterior rotation of the mandible and opening of the vertical jaw relation, in addition to significant retroclination of the incisors and straightening of the facial profile, were found from T3 to T4. Limitations Given the small sample size at T4, it was not possible to analyse the gender dimension. Conclusions/Implications Craniofacial changes continue up to the sixth decade of life. These changes are consistent, albeit to a lesser extent, with the adolescent growth patterns for most of the studied parameters, with the exceptions of incisor inclination, sagittal jaw position, vertical jaw relation and inclination, and posterior face height.
9.	Al-Taai, Nameer, et al. (author) Dentoskeletal and soft tissue changes after treatment of crowding with premolar extractions: a 50-year follow-up 2023 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 45:1, s. 79-87 Journal article (peer-reviewed)abstract Background The long-term effects on dentofacial morphology of interceptive treatment with premolar extractions, in the absence of subsequent orthodontic treatment, have not been fully explored. Objective The aim was to investigate the effects of premolar extractions (without subsequent orthodontic treatment) on the dentoskeletal and soft tissue profile of patients aged between 12 and 62 years with Class I malocclusion with severe crowding, as compared to untreated controls. Materials and methods The Extraction group (N = 30 with Class I crowding malocclusion) had their first premolars removed in early adolescence without subsequent orthodontic treatment. The Control group included 30 untreated subjects with Class I normal occlusion. Cephalograms were taken at 12 (T1), 15 (T2), 30 (T3), and 62 (T4) years of age. A superimposition-based cephalometric method was used to assess the dentoskeletal and soft tissue changes. Results There were no significant differences between the Extraction and Control groups in terms of skeletal sagittal relation, incisor inclination, and protrusion, or most of the soft tissue parameters throughout the observation period. However, significant differences were observed between the groups with respect to the vertical relations in T2-T3, such that the Extraction group showed more-pronounced decreases in the ML/NSL, ML/NL, and Gonial angles and more-pronounced increases in facial heights. Conclusions and implications Treatment for subjects with Class I malocclusion with severe crowding by the extraction of four premolars, without subsequent orthodontic treatment, does not affect the long-term dentoskeletal and soft tissue profile, as compared to an untreated Control group. The degree of crowding, rather than changes in dentofacial morphology, is crucial in deciding on extraction therapy.
10.	Algharbi, Muteb, et al. (author) Do Different Maxillary Expansion Appliances Influence the Outcomes of the Treatment? 2018 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 40:1, s. 97-106 Research review (peer-reviewed)abstract Background and objectives: There is no consensus in the literature regarding which rapid maxillary expansion (RME) design or activation rate benefits the patients the most. Therefore, the primary aim of this systematic review was to see whether there is a difference in the skeletal and dentoalveolar effects of different RME appliances in children and growing adolescents. The secondary aim was to see whether these effects are different when using different activation protocols for these appliances. Data collection and analysis: The search was done in three databases (PubMed, Cochrane Library, and Web of Science). The following inclusion criteria were used: randomized controlled trial, prospective controlled studies, 15 or more patients in each study, human subjects up to 18 years of age, and RME effects had to be assessed by computed tomography/cone beam computed tomography. Study appraisal and synthesis methods: Quality of the methodology was classified according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines as high, moderate, or low. Results: The search resulted in 145 titles and abstracts; 109 of them were excluded based on pre-established criteria. Thirty-six full-text articles were assessed for eligibility and 18 of which satisfied the inclusion criteria. Finally, seven articles were deemed eligible for full inclusion and revealed that all appliances and protocols showed significant expansion in the mid-palatal suture. No evidence was found for the cause of dental tipping. Limitations: In this systematic review, having different age groups in each study and using different anatomical landmarks and outcome measures for assessing the skeletal and dental effects made it difficult to conduct a meta-analysis. Conclusions: There is moderate evidence that all designs produce significant expansion at the mid-palatal suture. However, lack of studies comparing appliances and protocols has been found. Finally, no evidence-based conclusions could be drawn about the appliance effect on teeth tipping.
11.	Almotairy, N, et al. (author) Dental age comparison in patients born with unilateral cleft lip and palate to a control sample using Demirjian and Willems methods 2018 In: European journal of orthodontics. - : Oxford University Press (OUP). - 1460-2210 .- 0141-5387. ; 40:1, s. 74-81 Journal article (peer-reviewed)
12.	Almuhizi, Y, et al. (author) Correlation between the modified Huddart and Bodenham index and the GOSLON yardstick for assessing occlusal characteristics at 5 and 10 years of age in individuals born with unilateral cleft lip and palate 2016 In: European journal of orthodontics. - : Oxford University Press (OUP). - 1460-2210 .- 0141-5387. ; 38:4, s. 359-365 Journal article (peer-reviewed)
13.	Antonarakis, Gregory, et al. (author) Bite force and its association with stability following Class II/1 functional appliance treatment 2013 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 35:4, s. 434-441 Journal article (peer-reviewed)abstract The aims of this study were to investigate the value of pre-treatment maximal molar bite force as a predictive variable in determining post-treatment changes and stability following functional appliance treatment in Class II malocclusion children. Twenty-eight Class II malocclusion children having undergone functional appliance treatment were followed for at least 1 year post-treatment. Maximal molar bite force measurements, lateral cephalograms, and study casts were taken before treatment, after treatment, and after post-treatment follow-up. Relationships between pre-treatment maximal molar bite force and dental or cephalometric changes post-treatment were examined. Patients were divided into stable and unstable groups, based on dental sagittal changes (overjet and molar relationship), and differences between the two groups of patients determined. Post-treatment changes varied widely. Thirteen children showed dentoalveolar sagittal relapse, namely a shift in molars towards a Class II relationship and an increase in overjet, while 15 did not. The unstable group demonstrated a lower pre-treatment maximal molar bite force, as well as a more obtuse gonial angle, than the stable group. The gonial angle was found to be negatively correlated to maximal molar bite force and may thus be a cephalometric indicator partly reflecting the functional condition of the masticatory muscles. Children with a lower pre-treatment maximal molar bite force were more prone to dentoalveolar sagittal relapse following functional appliance treatment.
14.	Antonarakis, Gregory, et al. (author) Predictive value of molar bite force on Class II functional appliance treatment outcomes 2012 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 34, s. 244-249 Journal article (peer-reviewed)abstract Sagittal intermaxillary changes brought about by functional appliances show large inter-individual variation. One factor that may in part explain these differences is the masticatory musculature and its functional capacity. The aims of this study were to investigate changes in maximal molar bite force during functional appliance treatment and to assess the influence of pre-treatment maximal molar bite force on treatment outcomes with functional appliances used in Class II malocclusion children. Twenty-five children (17 males and 8 females), aged 9-13 years, with a Class II malocclusion and increased overjet were treated with functional appliances for 1-2 years. Dental casts, lateral cephalograms, maximal molar bite force, and finger force measurements were performed before (T1) and after (T2) treatment. These same measurements were also performed 1-2 years before treatment (T0); the intermediate period before starting treatment served as the control. Multiple regression analyses were used to determine possible correlations between initial maximal molar bite force and dental or cephalometric changes during treatment. Maximal molar bite force, which increased pre-treatment (T0-T1), decreased during functional appliance treatment (T1-T2). Children with a weaker T1 maximal molar bite force showed a larger overjet reduction, greater improvement in molar relationship, greater reduction in ANB angle, and greater augmentation in SNB angle from T1 to T2. Treatment of children with Class II malocclusions with functional appliances seems to lead to more favourable treatment outcomes in those with a weaker maximal molar bite force. This was observed both as regards improvements in dental sagittal relationships, namely overjet and molar Class, as well as skeletal changes due to a decrease in ANB and an increase in SNB angles. © The Author 2011. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved.
15.	Banaie, F, et al. (author) The variable anchorage straight wire technique compared with the straight wire technique in deep overbite correction 2005 In: European journal of orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 27:2, s. 180-185 Journal article (peer-reviewed)
16.	Bayat, J. T., et al. (author) Determinants of orthodontic treatment need and demand: a cross-sectional path model study 2017 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 39:1, s. 85-91 Journal article (peer-reviewed)abstract Objectives: To put forward a model predicting orthodontic treatment need and demand. Furthermore, to explore how much of the variance in treatment demand could be explained by a set of self-assessed measures, and how these measures relate to professionally assessed treatment need. Subjects and methods: One hundred and fifty adolescents, aged 13 years, completed a questionnaire which included a set of self-assessed measures dealing with self-esteem, such as dental and global self-esteem, various aspects of malocclusion, such as perceived malocclusion and perceived functional limitation, and treatment demand. Treatment need was assessed by Dental Health Component of the Index of Orthodontic Treatment Need grading. Path analysis was used to examine the relations between the measures and if they could predict treatment need and demand. Results: The measures proved to be reliable and inter-correlated. Path analysis revealed that the proposed model had good fit to the data, providing a test of the unique effect of all included measures on treatment need and demand. The model explained 33% of the variance in treatment demand and 22% of the variance in treatment need. Limitations: The specific age group could affect the generalizability of the findings. Moreover, although showing good fit to data, the final model is based on a combination of theoretical reasoning and semi-explorative approach. Conclusions: The proposed model displays the unique effect of each included measure on treatment need and demand, explaining a large proportion of the variance in perceived treatment demand and professionally assessed treatment need. The model would hopefully lead to improved and more cost-efficient predictions of treatment need and demand.
17.	Bayat, J. T., et al. (author) Predicting orthodontic treatment need: reliability and validity of the Demand for Orthodontic Treatment Questionnaire 2017 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 39:3, s. 326-333 Journal article (peer-reviewed)abstract Objectives: To identify key measures in predicting orthodontic treatment need and to propose a self-assessment instrument that improves treatment need assessment. Subjects and methods: The study included 150 randomly selected 13-year-olds. A set of measures linked to a previous study on daily life impact of malocclusion was processed, resulting in an instrument, the Demand for Orthodontic Treatment Questionnaire (DOTQ), which was analysed regarding dimensionality, reliability and validity. Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC) grading, representing professionally assessed treatment need, were collected from dental records. The instrument's ability to predict treatment need was tested by randomly splitting the dataset into two subgroups, using multiple regression to predict DHC in one of the groups and the prediction equation to calculate predicted DHC in the other. The outcomes were then correlated to detect the predictive power of the DOTQ, and thereby the validity of the prediction. Results: The DOTQ-measures were reliable and highly inter-correlated. A high, significant correlation was found between assessed and predicted treatment need for the subgroups (r = 0.59 and 0.49), confirming the validity of the prediction. Independent variables (the measures) explained 47 per cent (R = 0.69) of the variance in treatment need. Four measures contributed significantly to the prediction, with Treatment Demand being the most powerful predictor. Limitations: The age group and response rate may raise some questions regarding the generalizability of the findings. Conclusions: The DOTQ is able to predict treatment need as assessed by orthodontic consultants. Its incorporation in the treatment need assessment process will acknowledge patients' self-perceived impact of malocclusion.
18.	Bazargani, Farhan, 1969-, et al. (author) Effects on Nasal Airflow and Resistance Using Two Different RME Appliances : A Randomized Controlled Trial 2018 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 40:3, s. 281-284 Journal article (peer-reviewed)abstract Objectives: To evaluate and compare the effects of tooth-borne (TB) and tooth-bone-borne (TBB) rapid maxillary expansion (RME) on nasal airflow and resistance. Material and methods: Fifty-four consecutive patients who met the eligibility criteria were recruited from September 2010 to December 2015. Of these 54 subjects, 40 agreed to participate in the part of the study involving evaluation of nasal flow and resistance. The 40 subjects were allocated to either the TB group, mean age 9.7 years (SD 1.5), or the TBB group, mean age 10.2 years (SD 1.4). All subjects performed rhinomanometric registration at baseline (T-0), but only 30 attended the post-expansion registration (T-1), of whom 16 had been randomized to the TB group and 14 to the TBB group. The study outcomes, nasal airflow and nasal airway resistance, were evaluated with linear regression adjusted for baseline variable of the outcome to compare the study groups with complete cases strategy as well as after multiple imputation (MI). Randomization: Participants were randomly allocated in blocks of different sizes, using the concealed allocation principle in a 1:1 ratio. The randomization list was computer generated to ensure homogeneity between groups. Blinding: Blinding was done only for outcome assessor due to clinical limitations. The care providers at the ENT unit who conducted all the rhinomanometry examinations were blinded to which group the patients were allocated to. Results: Complete case analysis showed significantly higher post-expansion nasal airflow values for the TBB group compared with the TB group, mean difference 51.0 cm(3)/s (P = 0.018). The evaluation after MI showed a similar significant mean difference, 52.7 cm(3)/s (P = 0.020) in favour of the TBB group when taking into account the missing values from the T-1 examination. Even reduction in nasal airway resistance showed similar pattern in favour of the TBB group. Limitations: Our results represent the short-term effects. A longer follow-up period would have been preferable. Conclusions: The TBB RME induced significantly higher nasal airway flow and lower nasal resistance values than TB RME. It might be wiser to use TBB RME in cases with constricted maxilla and upper airway obstruction.
19.	Bazargani, Farhan, 1969-, et al. (author) Orthodontic Bonding With and Without Primer : A Randomized Controlled Trial 2016 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 38:5, s. 503-507 Journal article (peer-reviewed)abstract To evaluate the incidence of failure of brackets bonded with and without primer. A single-operator, cross-mouth, randomized controlled trial (RCT). The Orthodontic Department at the Postgraduate Dental Education Centre, A-rebro, Sweden. Ethical approval was granted by the Regional Ethical Review Board, Uppsala, Sweden. The protocol was not published before trial commencement. Fifty consecutive patients requiring bimaxillary orthodontic treatment with fixed appliances and with an equal number of teeth on each side of the dental arch, were included in this RCT. A cross-mouth methodology was applied. In each patient, two diagonal quadrants (i.e. upper right and lower left, or vice versa) were randomly assigned to the primer group (control group) and the contralateral diagonal quadrants to the non-primer group (experimental group). The randomization process was as follows: A computer-manufactured block-randomization list was acquired and stored with a research secretary at the Postgraduate Dental Education Centre. Each time a patient gave consent, the secretary was contacted by e-mail, and information about which quadrants were to be bonded with and without primer was obtained. All incidents of bracket failure and debonding noted in patient records during the 2012-14 observation period were compiled by the other co-author, whom was blinded to the study and did not perform any orthodontic treatment on the study patients. Number of bracket failures over 18 months. Failure rate without primer was 5.5 per cent and with primer 3.1 per cent; P = 0.063, odds ratio (OR) 1.89 [95% confidence interval (CI) 0.97-3.68] in the adjusted model. Younger ages (10-13 years), boys, and mandible were significantly associated with higher failure rates. Interaction tests indicated that younger patients had significantly higher failure rates without (12.1 per cent) than with primer (4.1 per cent), P < 0.001, OR 3.51 (95% CI 1.93-6.38) in the adjusted model. No failure rate differences between study settings were found for older patients (14-18 years). The difference between two groups was powered at 5 per cent. Some clinicians may consider a difference less than 5 per cent clinically significant. Bonding Victory Series (TM) brackets with Transbond (TM) XT with or without Transbond (TM) MIP primer seems overall to work equally well in a clinical setting, except in younger children where lower failure rate was found in the primer setting.
20.	Bazargani, Farhan, 1969-, et al. (author) Palatally displaced maxillary canines : factors influencing duration and cost of treatment 2013 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 35:3, s. 310-316 Journal article (peer-reviewed)abstract The purpose of this retrospective study was to assess the relationship between the initial position of palatally displaced canines (PDCs) on panoramic radiographs and the duration of the orthodontic treatment and further to estimate the costs of the treatment. Data from panoramic radiographs and patient records of 66 consecutive patients (mean age 14.9 +/- 1.7 years) with PDC were analysed. The initial position of the canine, the distance between the canine cusp tip and the occlusal plane, and the inclination of the canine were significantly associated with treatment duration both unadjusted and adjusted for background characteristics. The average estimated cost of the treatment of PDC was euro3200 per case. The total annual cost for treatment of PDC in Sweden may therefore be estimated at euro600 0000. In this study, duration of treatment averaged 17 months for canines displaced in impaction zone 1 or 2, 2.6 [95% confidence interval (CI) -1.0 to 6.2] months longer for those in impaction zone 3, and 7.6 (95% CI 4.1-11.1) months longer for canines displaced in impaction zone 4 or 5. This information makes it easier, through study of the panoramic radiograph, to estimate the duration of treatment and to give patients more precise information about the expected length of their treatment.
21.	Bazargani, Farhan, 1969-, et al. (author) Skeletal and dentoalveolar effects using tooth-borne and tooth-bone-borne RME appliances : a randomized controlled trial with 1-year follow-up 2021 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 43:3, s. 245-253 Journal article (peer-reviewed)abstract OBJECTIVES: To evaluate and compare the skeletal and dentoalveolar effects of tooth-borne (TB) and tooth-bone-borne (TBB) rapid maxillary expansion (RME).MATERIALS AND METHODS: Fifty-two consecutive patients who met the eligibility criteria were recruited and allocated to either the TB group, mean age 9.3 years [standard deviation (SD) 1.3], or the TBB group, mean age 9.5 years (SD 1.2). Cone-beam computed tomography (CBCT) records and plaster models were taken before (T0), directly after (T1), and 1 year after expansion (T2). Dentoalveolar and skeletal measurements were made on the CBCT images. The dental expansion was also measured on the plaster models.RANDOMIZATION: Participants were randomly allocated in blocks of different sizes using the concealed allocation principle in a 1:1 ratio. The randomization list was also stratified by sex to ensure homogeneity between groups.BLINDING: Due to clinical limitations, only the outcomes assessors were blinded to the groups to which the patients were allocated.RESULTS: Skeletal expansion in the midpalatal suture and at the level of the nasal cavity was significantly higher in the TBB group. However, the magnitude of the expansion in the midpalatal suture was around 1 mm [95 per cent confidence interval (CI) 0.5-1.7, P = 0.001] more and perhaps not clinically significant. The magnitude of the expansion at the level of the nasal cavity was almost two times higher in the TBB group (95 per cent CI 0.7-2.6, P = 0.001). The dental expansion, alveolar bending, tipping of the molars, and stability 1 year post-expansion did not show any statistically significant differences between the groups. The actual direct cost of the treatment for the TBB group was approximately €300 higher than TB group.LIMITATIONS: Double blinding was not possible due to the clinical limitations.CONCLUSIONS: In young preadolescents with constricted maxilla and no signs of upper airway obstruction, it seems that conventional TB RME achieves the same clinical results with good stability 1 year post-expansion at lower cost.TRIAL REGISTRATION: The trial was not registered.
22.	Bazargani, Farhan, 1969-, et al. (author) Three-dimensional comparison of tooth-borne and tooth-bone-borne RME appliances : a randomized controlled trial with 5-year follow-up 2023 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 45:6, s. 690-702 Journal article (peer-reviewed)abstract Objectives: To compare the long-term skeletal effects of tooth-borne (TB) and tooth-bone-borne (TBB) rapid maxillary expansion in growing children, using 3D imaging.Materials and methods: In total, 52 consecutive patients who met the eligibility criteria were recruited and allocated to either the TB group, mean age 9.3 years (SD 1.3), or the TBB group, mean age 9.5 years (SD 1.2). Cone-beam computed tomography records and plaster models were taken before (T-0), directly after (T-1), 1 year after (T-2), and 5 years after expansion (T-3).Randomization: Participants were randomly allocated in blocks of different sizes, using the concealed allocation principle in a 1:1 ratio. The randomization list was also stratified by sex to ensure homogeneity between groups.Blinding: Due to clinical limitations, only the outcome assessors were blinded to the groups to which the patients were allocated.Results: At T-1, the midpalatal suture at its anterior part showed a statistically significant difference between the groups with a mean of 0.6 mm (CI 0.2-1.1) more expansion in the TBB group (P < 0.01). This difference was also more evident in boys at T-1 with a mean of 0.8 mm (CI 0.2-1.4) (P < 0.01). These differences, however, blotted out at T-2 and T-3. The nasal width also showed similar differences between the groups, with a significantly larger expansion in the TBB group by a mean of 0.7 mm (CI 0.1-1.4) (P = 0.03). This group difference in favour of the TBB group was maintained at T-2 (1.6 mm) and T-3 (2.1 mm) (P < 0.01 T-2 and T-3, respectively).Conclusions: Skeletal expansion in the midpalatal suture was significantly higher in the TBB group; however, the magnitude of this expansion was around 0.6 mm more and may not be clinically significant. Skeletal expansion at the level of the nasal cavity was significantly higher in the TBB group. There were no differences between boys and girls with regard to skeletal expansion.
23.	Bergstrom, K, et al. (author) Orthodontic care from the patients' perspective: perceptions of 27-year-olds 1998 In: European journal of orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 20:3, s. 319-329 Journal article (peer-reviewed)
24.	Bergstrom, K, et al. (author) Treatment difficulty and treatment outcome in orthodontic care 1998 In: European journal of orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 20:2, s. 145-157 Journal article (peer-reviewed)
25.	Björksved, Margitha, 1964-, et al. (author) Closed vs open surgical exposure of palatally displaced canines : surgery time, postoperative complications, and patients' perceptions 2018 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 40:6, s. 626-635 Journal article (peer-reviewed)abstract Background: Closed and open surgical techniques are two different main approaches to surgical exposure of palatally displaced canines (PDCs). Because there is insufficient evidence to support one technique over the other, there is a need for randomized controlled trials.Objectives: To compare surgery time, complications and patients' perceptions between closed and open surgical techniques in PDCs.Trial design: The trial was a multicentre, randomized, controlled trial with two parallel groups randomly allocated in a 1:1 ratio.Material and methods: Study participants were 119 consecutive patients from 3 orthodontic centres, with PDCs planned for surgical exposure, randomly allocated according to a computer-generated randomization list, using concealed allocation. Full-thickness mucoperiosteal flap was raised, and bone covering the canine was removed in both interventions. In closed exposure, an attachment with a chain was bonded to the canine and the flap was sutured back with the chain penetrating the mucosa. In open exposure, a window of tissue around the tooth was removed and glass ionomer cement placed on the canine crown, to prevent gingival overgrowth during spontaneous eruption. Patient perceptions were assessed with two questionnaires, for the evening on the day of operation and 7 days post-surgery.Blinding: It was not possible to blind either patients or care providers to the interventions. The outcome assessors were blinded and were unaware of patients' intervention group.Results: Seventy-five girls and 44 boys, mean age 13.4 years (SD 1.46) participated in the study and got either of the interventions (closed exposure, n = 60; open exposure, n = 59). Surgery time did not differ significantly between the interventions. Complications though were more severe in bilateral cases and the patients experienced more pain and impairment in the open group.Conclusion: There were no statistically significant differences regarding surgery time between the groups. Postoperative complications were similar between the groups in unilateral PDCs, but more common in the open group in bilateral cases. More patients in the open group experienced pain and impairment compared to the closed group.Trial registration: Trial registration: ClinicalTrials.gov, ID: NCT02186548 and Researchweb.org, ID: 127201.
26.	Björksved, Margitha, 1964-, et al. (author) Open and closed surgical exposure of palatally displaced canines : a cost-minimization analysis of a multicentre, randomized controlled trial 2021 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 43:5, s. 498-505 Journal article (peer-reviewed)abstract Objective: To evaluate the costs of open and closed surgical exposure and subsequent orthodontic treatment for the correction of palatally displaced canines (PDCs).Trial Design: A multicentre, two-arm parallel group randomized controlled trial.Methods: One hundred twenty adolescents between 9 and 16 years of age, from three orthodontic specialist centres, were randomized to one of the two surgical exposure interventions. The randomization was conducted according to a two-arm parallel group 1:1 allocation ratio, using computerized lists with block randomization. In both the surgical techniques, whole mucoperiosteal flaps were raised, and bone covering the PDCs was removed. In the open technique, glass ionomer was built up on the PDC crown - reaching above the mucosa through a hole punched in the flap - to allow the canine to erupt autonomously. After eruption, the canine was orthodontically moved above the mucosa. In the closed technique, an eyelet was bonded onto the PDC, the flap was repositioned and the canine was orthodontically moved beyond the mucosa. The trial ended when the PDC was successfully aligned in the dental arch.Cost analysis was performed including costs for surgery, orthodontic treatment, emergency visits, and material, as well as costs for transports and time spent in connection with every appointment.Blinding: Patients and caregivers could not be blinded due to obvious limitations of the clinical setting, while outcome assessors and data analysts were blinded.Results: A cost-minimization analysis was performed since both exposure groups succeeded equally well in terms of treatment effects. The two different surgical exposures and following orthodontic treatments did not differ significantly in terms of costs.Generalizability and Limitations: Costs are estimated in the Swedish setting, which needs to be considered if applying the results in other settings. Calculations of total cost do not include finishing, debonding, retention, and follow-up.Conclusion: There is no significant difference in costs between closed and open surgical exposure with following orthodontic treatments in PDCs.
27.	Björksved, Margitha, 1964-, et al. (author) Open vs closed surgical exposure of palatally displaced canines: a comparison of clinical and patient-reported outcomes-a multicentre, randomized controlled trial 2021 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 43:5, s. 487-497 Journal article (peer-reviewed)abstract Objectives: To compare treatment time, patients' perceptions during orthodontic treatment, dental fear and side effects, between open and closed surgical exposures in patients with palatally displaced canines (PDCs). Trial design: Multicentre, randomized controlled trial, with random 1:1 allocation of two parallel groups. Materials and methods: One hundred and twenty patients from three different orthodontic centres were randomized into one of the two intervention arms, open or closed surgical exposure. Both techniques had mucoperiosteal flaps raised and bone removed above the PDCs. In open exposure, tissue was removed above the canine, and glass ionomer - reaching above soft tissue - was built on the crown. The canine was then left to erupt spontaneously, prior to orthodontic alignment. At closed exposure, a chain was bonded to the canine and orthodontic traction was applied under the mucosa until eruption. Orthodontic alignment of the canines was undertaken after eruption into the oral cavity, with fixed appliances in both groups. All participants were treated according to intention to treat (ITT). Blinding: Due to the nature of this trial, only outcome assessors could be blinded to the intervention group. Results: One hundred and seventeen patients completed the trial. All PDCs were successfully aligned. Total treatment time was equal in the two techniques, mean difference -0.1 months (95% CI -3.2 to 2.9, P = 0.93). The closed group experienced more pain and discomfort during the active orthodontic traction. Dental fear, root resorption and periodontal status did not show any clinically significant differences between the groups. Generalizability: Results of this randomized controlled trial (RCT) can be generalized only to a similar population aged 9-16 years, if exclusion criteria are met. Conclusion: The closed exposure group experienced more pain and discomfort mostly during active orthodontic traction. All other studied outcomes were similar between the two exposure groups.
28.	Bondemark, Lars, et al. (author) Intention to treat (ITT) analysis as reported in orthodontic randomized controlled trials-evaluations of methodology and recommendations for the accurate use of ITT analysis and handling dropouts 2018 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 40:4, s. 409-413 Journal article (peer-reviewed)abstract Objective To systematically evaluate in five orthodontic journals how many randomized controlled trials (RCTs) use intention to treat (ITT) analysis and to assess the methodological quality of the ITT analysis, and finally, to demonstrate in an academic way how outcomes can be affected when not implementing the ITT analysis. Material and methods A search of the database, Medline, was performed via PubMed for publication type ‘randomized controlled trial’ published for each journal between 1 January 2013 and 30 April 2017. The five orthodontic journals assessed were the American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontics, European Journal of Orthodontics, Journal of Orthodontics, and Orthodontics and Craniofacial Research. Two independent reviewers assessed each RCT to determine whether the trial reported an ITT or not or if a per-protocol analysis was accomplished. Results The initial search generated 137 possible trials. After applying the inclusion and exclusion criteria, 90 RCTs were included and assessed. Seventeen out of 90 RCTs (18.9%) either reported an ITT analysis in the text and/or supported the ITT by flow diagrams or tables. However, six RCTs applied and reported the ITT analysis correctly, while the majority performed a per-protocol analysis instead. Conclusions Nearly all the trials that applied the ITT analysis incorrectly analysed the results using a per-protocol analysis, and thus, overestimating the results and/or having a reduced sample size which then could produce a diminished statistical power.
29.	Bondemark, Lars, et al. (author) Randomized controlled trial : the gold standard or an unobtainable fallacy? 2015 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 37:5, s. 457-461 Journal article (peer-reviewed)abstract Background: This article is the result of a debate at the European Journal of Orthodontics Open Session in 2013 in Reykjavik, Iceland. Objective: The aim of this article is to highlight some of the strengths and weakness of clinical orthodontic research, with particular emphasis on randomized controlled trials (RCT). The ultimate aim of improving clinical orthodontic research in general. Design: This article is organized into two sections with arguments for and against RCTs. The backgrounds to evidence-based evaluation and the level or quality of evidence in trials are discussed. The article emphasises what makes high quality clinical research, and gives practical advice including examples of tips and potential pitfalls for those undertaking clinical research. Results and Conclusion: The overriding message is constructive and it is hoped that the article serves as an aid in evaluating, designing, conducting, and reporting clinical research.
30.	Bondemark, Lars, et al. (author) RCTs are here to stay : Reply 2016 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 38:3, s. 335-335 Journal article (other academic/artistic)
31.	Christell, Helena, et al. (author) The impact of Cone Beam CT on financial costs and orthodontists' treatment decisions in the management of maxillary canines with eruption disturbance 2018 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; :1, s. 65-73 Journal article (peer-reviewed)abstract Background: Examination with Cone Beam CT (CBCT) is common for localizing maxillary canines with eruption disturbance. The benefits and costs of these examinations are unclear. Objectives: To measure: 1. the proportion of orthodontists' treatment decisions that were different based on intraoral and panoramic radiography (M1) compared with CBCT and panoramic radiography (M2); and 2. the costs of producing different treatment plans, regarding patients with maxillary canines with eruption disturbance. Subjects and methods: Orthodontists participated in a web-based survey and were randomly assigned to denote treatment decisions and the level of confidence in this decision for four patient cases presented with M1 or M2 at two occasions for the same patient case. Results: One hundred and twelve orthodontists made 445 assessments based on M1 and M2, respectively. Twenty-four per cent of the treatment decisions were different depending on which method the raters had access to, whereof one case differed significantly from all other cases. The mean total cost per examination was €99.84 using M1 and €134.37 using M2, resulting in an incremental cost per examination of €34.53 for M2. Limitations: Benefits in terms of number of different treatment decisions must be considered as an intermediate outcome for the effectiveness of a diagnostic method and should be interpreted with caution. Conclusions: For the patient cases presented in this study, most treatment decisions were the same irrespective of radiological method. Accordingly, this study does not support routine use of CBCT regarding patients with maxillary canine with eruption disturbance.
32.	Cirgic, Emina, 1978, et al. (author) A cost-minimization analysis of large overjet reduction with two removable functional appliances based on a randomized controlled trial. 2018 In: European journal of orthodontics. - : Oxford University Press (OUP). - 1460-2210 .- 0141-5387. ; 40:4, s. 437-443 Journal article (peer-reviewed)abstract The purpose of this study was to assess and relate the societal costs of reducing large overjet with a prefabricated functional appliance (PFA), or a slightly modified Andresen activator (AA), using a cost-minimization analysis (CMA).A multicentre, prospective, randomized clinical trial was conducted with patients from 12 general dental practices. Ninety-seven patients with an Angle Class II, division 1 malocclusion, and an overjet of ≥6 mm were randomly allocated by lottery to treatment with either a PFA or an AA. The PFA and AA groups consisted of 57 and 40 subjects, respectively. Blinding was not performed. Duration of treatment, number of scheduled/unscheduled appointments, and retreatment were registered. Direct and indirect costs were analysed with reference to intention-to-treat (ITT), successful (S), and unsuccessful (US) outcomes. Societal costs were described as the total of direct and indirect costs, not including retreatments.Treatment with a PFA or an AA.The direct and societal costs were significantly lower for the PFA than for the AA group. The number of visits was lower in the PFA group, when ITT was considered, and for the US cases as well. No difference in retreatment rate could be seen between the groups.Costs depend on local factors and thus should not be generalized to other settings.No harms were detected during the study.The success rate of the both appliances was low. However, the PFA was the preferred approach for reduction of a large overjet in mixed dentition, since it minimized costs and there were no difference in clinical outcomes between PFA and AA.This trial was registered at 'FoU i Sverige' (http://www.fou.nu/is/sverige), registration number: 97131.The protocol was not published before trial commencement.
33.	Cirgic, Emina, 1978, et al. (author) Treatment of large overjet in Angle Class II: division 1 malocclusion with Andresen activators versus prefabricated functional appliances-a multicenter, randomized, controlled trial 2016 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 38:5, s. 516-524 Journal article (peer-reviewed)abstract The purpose of this study was to compare the clinical effectiveness in reducing large overjet between a prefabricated functional appliance (PFA) and a slightly modified Andresen activator (AA). A multicentre, prospective randomized clinical trial was conducted with patients from 12 general dental practices. One hundred and five patients with an Angle Class II, division 1 malocclusion and an overjet of a parts per thousand yen6mm were eligible for the study. Eight patients were excluded due to various reasons and the sample consisted thus of 97 subjects (44 girls, 53 boys) with a mean age of 10.3 years. The study was designed as intention to treat and the patients were randomly allocated by lottery to treatment with either a PFA or an AA. The PFA and AA group consisted of 57 subjects (28 girls, 29 boys) and 40 subjects (16 girls, 24 boys), respectively. Overjet, overbite, lip seal, and sagittal molar relationship were recorded before, at the end of treatment and 1-year post-treatment. Blinding was not performed. The endpoint of treatment was set to overjet a parts per thousand currency sign3mm and after this a 6 months retention period followed. No significant difference was found in overjet, overbite, sagittal relation, and lip seal between the two groups for the total observation period. The treatment of 40 (70 per cent) patients with PFA and 21 (53 per cent) with AA were considered unsuccessful mainly due to poor compliance. No cephalometric records were taken as only patient-centred clinical outcome were used as an indicator for treatment success. The criteria of reduction of overjet to as low as 3mm could have affected the success rate. No difference in effectiveness could be shown between PFAs and AAs in correcting overjet, overbite, sagittal molar relation, and lip seal. The success rate in treatment with both appliances is, however, low. This trial was registered in "FoU i Sverige" (), registration number: 97131.
34.	Dimberg, Lillemor, et al. (author) Letters to the Editor 2016 In: European Journal of Orthodontics. - Oxford, United Kingdom : Oxford University Press. - 0141-5387 .- 1460-2210. ; 38:2, s. 223-223 Journal article (other academic/artistic)
35.	Dimberg, Lillemor, et al. (author) Malocclusions in children at 3 and 7 years of age : a longitudinal study 2013 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 35:1, s. 131-137 Journal article (peer-reviewed)abstract The aim of this longitudinal study was to compare the prevalence of malocclusion at ages 3 and 7 years in a sample of children, exploring the hypothesis that prevalence of malocclusion is higher at 3 than at 7 years of age and may be influenced by sucking habits. The study sample comprised 386 children (199 girls and 187 boys), aged 3 years at study start, sourced from three Public Dental Service clinics in Sweden. Malocclusion was diagnosed by clinical examination, using a specific protocol. Data on allergy, traumatic injuries, sucking habits, and breathing pattern including nocturnal breathing disturbances were obtained by means of a questionnaire answered by child and parent in conjunction with the initial and final clinical examination. The overall prevalence of malocclusion decreased significantly, from 70 to 58% (P < 0.0001): predominantly anterior open bite, excessive overjet, and Class III malocclusion. Although high rates of spontaneous correction were also noted for deep bite, Class II malocclusion and posterior and anterior crossbites, new cases developed at almost the same rate; thus, the prevalence was unchanged at the end of the observation period. Anterior open bite and posterior crossbite were the only conditions showing significant associations with sucking habits. The results confirm the hypothesis of higher prevalence of malocclusion at 3 years of age and clearly support the strategy of deferring orthodontic correction of malocclusion until the mixed dentition stage.
36.	Dimberg, Lillemor, et al. (author) The impact of malocclusion on the quality of life among children and adolescents : a systematic review of quantitative studies 2015 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 37:3, s. 238-247 Research review (peer-reviewed)abstract Background: Among child and adolescent patients, persistent but untreated malocclusions may or may not have psychological and social impacts on the individual's quality of life. Objectives: To gain knowledge of malocclusions and its impact on oral health-related quality of life (OHRQOL), we conducted a systematic review of quantitative studies for evidence regarding the influence of malocclusions on OHRQOL in children and adolescents. Materials and methods: Five databases (MEDLINE via PubMed, EMBASE, Psychinfo, CINAHL, and the Cochrane Library) were searched using specified indexing terms. The following inclusion criteria were used: child or adolescent study population; healthy study participants without syndromes such as cleft lip/palate or severe illness; no previous or ongoing orthodontic treatment among participants; a focus on malocclusions and quality of life; controlled or subgrouped according to malocclusions/no malocclusions; malocclusions and/or orthodontic treatment need assessed by professionals using standardized measures; self-assessed OHRQOL estimated using validated questionnaire instruments; full-text articles written in English or Scandinavian languages. Quality of evidence was classified according to GRADE guidelines as high, moderate, or low. Results: The search produced 1142 titles and abstracts. Based on pre-established criteria, the full-text versions of 70 articles were obtained, 22 of which satisfied the inclusion criteria. After data extraction and interpretation, six publications were deemed eligible for full inclusion. All six were of cross-sectional design, and the quality of evidence was high in four cases and moderate in the remaining two. The four studies with a high level of quality reported that anterior malocclusion had a negative impact on OHRQOL, and the two with a moderate level of quality reported that increased orthodontic treatment need had a negative impact on OHRQOL. Conclusion: The scientific evidence was considered strong since four studies with high level of quality reported that malocclusions have negative effects on OHRQOL, predominantly in the dimensions of emotional and social wellbeing.
37.	Ebrahim, Eman, et al. (author) The impact of premature birth on the permanent tooth size of incisors and first molars 2017 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 39:6, s. 622-627 Journal article (peer-reviewed)abstract Background: Scientific evidence is insufficient to answer the question of whether premature birth causes altered tooth-crown dimensions. Objective: To evaluate permanent tooth-crown dimensions in prematurely born children and to compare the findings with full-term born controls. Subjects and Methods: Preterm children of 8-10 years of age were selected from the Swedish Medical Birth Register. One group consisted of 36 extremely preterm children (born before the 29th gestational week); the other group included 37 very preterm children (born during gestational weeks 29-32). The preterm children were compared with 41 matched full-term born children. Clinical examination and study casts were performed on all children. Permanent maxillary and mandibular first molars, central incisors, and laterals were measured with a digital sliding caliper on study casts. The tooth-crowns were measured both mesio-distal and bucco-lingual. Results: Both the mesio-distal and bucco-lingual measurements in the maxillary and mandibular first molars had a significantly smaller width in the extremely preterm group compared with the full-term group. The central incisors and lower laterals were significantly smaller mesio-distally in the extremely preterm group compared to the full-term group. A reduction in tooth size of 4-9% was found between the extremely preterm group and the full-term group for both boys and girls. The maxillary first molars and mandibular left first molar were also smaller mesio-distally in the extremely preterm group compared to the very preterm group. The results indicate that the more preterm the birth, the smaller the tooth-crown dimensions. Independent of gestational age girls had generally smaller teeth than boys. Conclusion: Premature birth is associated with reduced tooth-crown dimensions of permanent incisors and first molars.
38.	Edman Tynelius, Gudrun, et al. (author) A cost-minimization analysis of an RCT of three retention methods 2014 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 36:4, s. 436-441 Journal article (peer-reviewed)abstract SUMMARY BACKGROUND: There are few cost evaluation studies of orthodontic retention treatment. The aim of this study was to compare the costs in a randomized controlled trial of three retention methods during 2 years of retention treatment. MATERIALS/METHODS: To determine which alternative has the lower cost, a cost-minimization analysis (CMA) was undertaken, based on that the outcome of the treatment alternatives was equivalent. The study comprised 75 patients in 3 groups consisting of 25 each. The first group had a vacuum-formed retainer (VFR) in the maxilla and a cuspid retainer in the mandible (group V-CTC), the second group had a VFR in the maxilla combined with stripping of the incisors and cuspids in the mandible (group V-S), and the third group had a prefabricated positioner (group P). Direct cost (premises, staff salaries, material and laboratory costs) and indirect costs (loss of time at school) were calculated. Societal costs were defined as the sum of direct and indirect costs. RESULTS: The societal costs/patient for scheduled appointments for 2 years of retention treatment in group V-CTC were €497, group V-S €451 and group P €420. Societal costs for unscheduled appointments in group V-CTC were €807 and in group V-S €303. In group P, there were no unscheduled appointments. CONCLUSIONS/IMPLICATIONS: After 2 years of retention in compliant patients, the cuspid retainer was the least cost-effective retention appliance. The CMA showed that for a clinically similar result, there were differences in societal costs, but treatment decisions should always be performed on an individual basis.
39.	Edman Tynelius, Gudrun, et al. (author) Evaluation of orthodontic treatment after 1 year of retention - a randomized trial 2010 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 32:5, s. 542-547 Journal article (peer-reviewed)abstract The aim of this study was to use a randomized controlled trial methodology to evaluate and compare three different retention methods. The capacity of the retention methods to retain orthodontic treatment results was in this first phase analysed on a short-term basis, i.e. after 1 year of retention. The subjects were recruited from adolescents undergoing fixed appliance treatment at an orthodontic clinic in the National Health Service (NHS) in Sweden between 2001 and 2007. Seventy-five patients (45 girls and 30 boys with a mean age of 14.4 years at the start of retention) were randomized into three retention systems; a vacuum-formed retainer in the maxilla and bonded canine-to-canine retainer in the mandible (group V-CTC), a vacuum-formed retainer in the maxilla combined with stripping of the 10 proximal surfaces of the lower mandibular anterior teeth (group V-S), and a prefabricated positioner covering the teeth in the maxilla and mandible (group P). The main outcome measures were: Little's irregularity index (LII), intercanine and intermolar width, arch length, overjet, and overbite. Registrations were made before orthodontic treatment, when the fixed orthodontic appliance was removed, and after 12 months in retention. Differences in means between groups were tested by one-way analysis of variance. After 1 year of retention, no clinically significant difference in retention capacity was found between the three retention methods. Small but significant differences (P < 0.05) were observed between the V-CTC and V-S groups regarding mandibular canine width, mandibular arch length, and overbite. In group P, two patients failed to co-operate.
40.	Edman Tynelius, Gudrun, et al. (author) Five-year postretention outcomes of three retention methods : a randomized controlled trial 2015 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 37:4, s. 345-353 Journal article (peer-reviewed)abstract Objective: Comparison of three different retention strategies 5 years or more postretention. Design, Setting, and Participants: Randomized, prospective, single-centre controlled trial. Forty-nine patients (33 girls and 16 boys) were randomly assigned to one of three retention methods during 2 years by picking a ballot shortly before start of retention treatment. Inclusion criteria were no previous orthodontics, permanent dentition, normal skeletal sagittal, vertical, and transversal relationships, Class I dental relationship, space deficiencies, treatment plan with extractions of four premolars followed by fixed straight-wire appliance. Maxillary and mandibular Little's irregularity index (LII), intercanine and intermolar width, arch length, and overbite/overjet were recorded in a blinded manner, altogether 10 measurements on each patient. Significant differences in means within groups assessed by t-test and between groups by one-way analysis of variance. Interventions: Retention methods: removable vacuum-formed retainer (VFR) covering the palate and the maxillary anterior teeth from canine-to-canine and bonded canine-to-canine retainer in the lower arch (group V-CTC); maxillary VFR combined with stripping of the lower anterior teeth (group V-S); and prefabricated positioner (group P). Results: Maxillary mean LII ranged from 1.8 to 2.6 mm, mean intercanine width 33.6-35.3 mm with a significant difference between groups V-S and P, mean intermolar width 46.8-47.4 mm and mean arch length 21.8-22.8 mm. Mandibular mean LII ranged from 2.0 to 3.4 mm with a significant difference between groups V-S and P, mean intercanine width from 25.4 to 26.6 mm, mean intermolar width from 40.8 to 40.9 mm and mean arch length from 16.9 to 17.3 mm. Mean overbite ranged from 1.8 to 2.7 mm and mean overjet from 3.7 to 4.1 mm. Limitations: A single centre study could be less generalizable. Conclusions: The three retention methods disclosed equally favourable clinical results.
41.	Egermark-Eriksson, I, et al. (author) A longitudinal study on malocclusion in relation to signs and symptoms of cranio-mandibular disorders in children and adolescents. 1990 In: European Journal of Orthodontics. - 0141-5387 .- 1460-2210. ; 12:4, s. 399-407 Journal article (peer-reviewed)
42.	Enerbäck, Hanna, et al. (author) Effect of high-fluoride toothpaste and mouth rinse on the prevention of demineralized lesions during orthodontic treatment: a randomized controlled trial 2023 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 45:5, s. 477-484 Journal article (peer-reviewed)abstract Objective To evaluate the effect of high-fluoride mouth rinse and high-fluoride toothpaste on the development of demineralized lesions (DLs) during orthodontic treatment. Trial design Three-armed parallel-group randomized controlled trial. Methods The trial was performed with 270 adolescent orthodontic patients. Randomization was performed in blocks of 30, enrolling the patients into one of the following groups: the fluoride mouth rinse (FMR) group receiving 0.2% sodium fluoride (NaF) mouth rinse plus 1450 ppm fluoride (F) toothpaste; high-fluoride toothpaste (HFT) group receiving 5000 ppm F toothpaste; and the Control (CTR) group receiving 1450 ppm F toothpaste. Inclusion criteria were patients scheduled for treatment in both arches with fixed appliances and age between 12 and 20 years. The primary outcome variable was the proportion of participants with at least one new demineralized lesion as assessed on digital photos taken before and after treatment, analysed by a blinded clinician. The analysis included all teeth or teeth in the aesthetic zone, i.e. all central incisors, lateral incisors, and canines. A random sample of 30 participants was assessed to check intra- and inter-reliability. For pairwise comparison between groups, Fisher's non-parametric permutation test was used for continuous variables. Blinding was employed during the caries registration and data analysis. Recruitment October 2010 to December 2012 Results In total, 270 patients were randomized, of which 22 were excluded during treatment. Therefore, 248 participants were included in the study. The number of patients with an increase of & GE;1 DL, including only central- and lateral incisors and canines, during orthodontic treatment, was significantly lower in the HFT group, 51/85 60%, compared to the CTR group, 64/82 78%, RR 0.77 (CI 0.62; 0.95), P = .01 and in the FMR group, 47/81 58%, compared to the CTR group, RR 0.74 (CI 0.60; 0.92), P < .01. Conclusions To prevent demineralized lesions in the aesthetic zone, high-fluoride mouth rinse and high-fluoride toothpaste may be recommended. Limitations The protocol was not registered, and the present study did not use a double-blinded design.
43.	Enerbäck, Hanna, et al. (author) Effects of orthodontic treatment and different fluoride regimens on numbers of cariogenic bacteria and caries risk: a randomized controlled trial 2019 In: European journal of orthodontics. - : Oxford University Press (OUP). - 1460-2210 .- 0141-5387. ; 41:1, s. 59-66 Journal article (peer-reviewed)abstract Background: Caries is an undesirable side-effect of treatment with fixed orthodontic appliances. Therefore, it is crucial to understand how orthodontic treatment and different fluoride regimens affect caries risk and individual risk factors. Objective: To evaluate the effects of orthodontic treatment and different fluoride regimens on caries risk and caries risk factors, including cariogenic bacteria. Trial design: Three-armed, parallel group, randomized, controlled trial. Methods: Patients referred to the Specialist Clinic of Orthodontics, Mölndal Hospital, Sweden, were distributed randomly into the following groups: group I (Control group), 1450 ppm fluoride (F) toothpaste; group II, 1450 ppm F toothpaste plus 0.2 per cent sodium fluoride (NaF) mouth rinse; and group III, 5000 ppm F toothpaste. The inclusion criteria were: age 12-20 years; and bimaxillary treatment with fixed appliances. The primary outcome variables were: caries risk; and the numbers of cariogenic bacteria. Radiographs were taken before treatment to determine the caries status. Data were collected before treatment and after 1 year with a fixed appliance. The variables were compiled into a Cariogram to assess the caries risk. Comparisons were made over time within and between the groups. The generation of randomization sequence was performed in blocks of 30. Blinding was employed during the data analysis and the caries registration. Recruitment: The clinical study duration was from October 2010 to December 2012. Results: Overall, 270 patients were randomized, of which 15 were excluded from the study. Therefore, 255 patients were included in the analyses. The caries risk increased significantly during orthodontic treatment in group I (P < 0.0001), whereas groups II and III had unchanged caries risks. All the groups showed statistically significant increases in the numbers of cariogenic bacteria. Harms: No harms were reported during the trial. Conclusions: To avoid an increased risk of caries during orthodontic treatment, everyday use of high-fluoride toothpaste (5000 ppm F) or mouth rinse (0.2% NaF) in combination with ordinary toothpaste is recommended. Registration: The trial was not registered.
44.	Farronato, G, et al. (author) The effect of Teflon coating on the resistance to sliding of orthodontic archwires 2012 In: European journal of orthodontics. - : Oxford University Press (OUP). - 1460-2210 .- 0141-5387. ; 34:4, s. 410-417 Journal article (peer-reviewed)
45.	Feldmann, Ingalill, et al. (author) Orthodontic anchoring techniques and its influence on pain, discomfort, and jaw function--a randomized controlled trial. 2012 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 34:1, s. 102-8 Journal article (peer-reviewed)abstract The aim of this trial was to evaluate and compare perceived pain, discomfort, and jaw function impairment between orthodontic treatments combined with skeletal anchorage and treatment using conventional anchorage with headgear or transpalatal bar. A total of 120 adolescent patients in order to start orthodontic treatment were consecutively recruited and randomized into three groups with different anchorage. Group A underwent installation of a skeletal anchorage (Onplant or Orthosystem implant), group B received headgear, and group C a transpalatal bar. Questionnaires were used to assess pain intensity, discomfort, analgesic consumption, and jaw function impairment from baseline to the end of treatment. Pain scores overall peaked on day 2 and were almost back to baseline on day 7. The site with the highest pain scores during treatment was incisors in contact but with no differences between groups. Pain intensity from molars was significantly less in the skeletal anchorage group A compared to the transpalatal bar group C the first 4 days in treatment and with no sign differences compared to headgear. The results confirm that there were very few significant differences between patients' perceptions of skeletal and conventional anchorage systems during orthodontic treatment. Consequently, these new appliances were well accepted by the patients in a long time perspective and can thus be recommended.
46.	Fontinha, C., et al. (author) Craniofacial morphology and growth in young patients with congenital or childhood onset myotonic dystrophy 2018 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 40:5, s. 544-548 Journal article (peer-reviewed)abstract Background/objectives: This study investigated the craniofacial morphology of young individuals with congenital or childhood onset myotonic dystrophy type 1 (DM 1) compared to healthy subjects. The study also followed growth changes in their facial morphology over a 5-year period. Materials/methods: Lateral cephalograms of the 26 subjects (young patients with DM1 from west and south Sweden) were taken at baseline and after a 5-year period. These radiographs were compared with normal standards based on healthy individuals from the Michigan Growth Study, according to their age and sex, using paired t-tests (P < 0.05). Results: On examination of initial radiographic measurements, patients with DM1 showed, in the sagittal plane, larger ANB and smaller SNPg angles. Analysis of the vertical plane showed the mandibular plane angle (ML-NSL) and the intermaxillary angle (ML-NL) to be larger. During the 5-year follow-up period, the intermaxillary angle (ML-NL) remained the same in the group with DM1 whereas this angle decreased in healthy individuals. Limitations: For ethical reasons, historical cephalometric norms were used to compare the growth and the craniofacial morphology of patients with DM1. Conclusions/implications: Young patients with DM1 had already from the beginning a more retrognathic profile and hyperdivergent skeletal aberration with a steep mandibular plane and large intermaxillary angle when compared with healthy individuals. The intermaxillary angle did not decrease during the observation period, contrary to what was observed in healthy individuals.
47.	Fors, Ronny, et al. (author) Nickel in dental plaque and saliva in patients with and without orthodontic appliances. 2006 In: European Journal of Orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 28:3, s. 292-297 Journal article (peer-reviewed)abstract The aim of this study was to compare the content of nickel in the saliva and dental biofilm in young patients with and without orthodontic appliances. The possible influence of a dietary intake of nickel on recorded nickel levels was examined. Nickel content in unstimulated whole saliva and in dental plaque of 24 boys and girls (mean age 14.8 years) with intraoral fixed orthodontic appliances was compared with 24 adolescents without such an appliance. Sample collection was set up to exclude nickel contamination. Diet intake was recorded for the preceding 48 hours to account for the influence of recent nickel content in food. Saliva and plaque were analysed for nickel content using an electrothermal atomic absorption spectrometric (ETAAS) method. The acidified saliva samples were analysed as Millipore-filtered saliva with filter-retained fractions and plaque following dissolution in acids. No significant difference in nickel content of filtered saliva was found between the test and the control samples (P = 0.607); the median values of nickel content were 0.005 and 0.004 mug/g saliva, respectively. On the other hand, a significant difference was found for the filter-retained fraction (P = 0.008); median values for nickel were 25.3 and 14.9 mug/g, respectively. A significant difference in nickel content between test and control samples was also found in plaque collected at various tooth sites (P = 0.001; median values 1.03 and 0.45 mug/g, respectively). A stronger difference was found when comparing plaque collected from metal-covered tooth surfaces than from enamel surfaces of orthodontic patients. No association could be found between calculated dietary intake of nickel and recorded nickel in the test and control samples. It is concluded that nickel release occurs into the dental plaque and components of saliva of orthodontic patients, a situation that may reflect time dependence of its release from orthodontic appliances into the oral cavity and an aggregation of nickel at plaque sites.
48.	Forsberg, CM, et al. (author) The effect of growth hormone therapy on mandibular and cranial base development in children treated with total body irradiation 2002 In: European journal of orthodontics. - : Oxford University Press (OUP). - 0141-5387 .- 1460-2210. ; 24:3, s. 285-292 Journal article (peer-reviewed)
49.	Frilund, Erik, et al. (author) Patient compliance with Twin Block appliance during treatment of Class II malocclusion: a randomized controlled trial on two check-up prescriptions 2023 In: European Journal of Orthodontics. - : OXFORD UNIV PRESS. - 0141-5387 .- 1460-2210. ; 45:2, s. 142-149 Journal article (peer-reviewed)abstract Background Compliance is crucial for the treatment outcome with removable appliances. Previous studies on treatment with the Twin Block appliance have focused on effectiveness in relation to other treatment methods or wear-time. Studies on different check-up intervals to improve compliance seem to be lacking. Objectives To compare the impact of two different check-up prescriptions on patient compliance and treatment outcome during treatment with Twin Block. Trial Design Two-arm parallel group, single-centre, randomized controlled trial. Materials and Methods Seventy-three patients, 38 boys, and 35 girls, mean age 11.2 years, were included and block-randomized into two groups treated with a Twin Block appliance. Group 1 was called for check-up visit every sixth week and group 2 every fourth week. Compliance was evaluated with a TheraMon (R) microsensor, moulded into the appliance, measuring wear-time. Overjet, overbite, and molar relationships were assessed on study casts before and after treatment. The treatment outcomes were analysed on an intention-to-treat basis. Results In group 1, the reduction of overjet was 5.2 mm and the mean wear-time was 6.9 hours. In group 2, the reduction was 4.7 mm and the wear-time was 6.1 hours. Seventy-four per cent of the patients presented an overjet of 4 mm or less. Wear-time did not correlate to age, gender, or severity of malocclusion. Harms No harm was observed in any patient. Lateral open bites were registered during treatment but were normalized at the end of the treatment. Limitations The trial was a single-centre study and long-term effects were not evaluated. Conclusions During treatment with the Twin Block appliance, a 4-week check-up interval did not improve treatment outcome or increase wear-time, compared to a 6-week check-up interval. The mean wear-time was 6.5 hours per day, even if the recommendation was 12 hours.
50.	Ganzer, Niels, et al. (author) A cost-effectiveness analysis of anchorage reinforcement with miniscrews and molar blocks in adolescents : a randomized controlled trial 2019 In: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 41:2, s. 180-187 Journal article (peer-reviewed)abstract Objective: To analyse cost-effectiveness of anchorage reinforcement with buccal miniscrews and with molar blocks. We hypothesized that anchorage with miniscrews is more cost-effective than anchorage with molar blocks. Trial design: A single-centre, two-arm parallel-group randomized controlled trial. Methods: Adolescents (age 11–19 years) in need of treatment with fixed appliance, premolar extractions, and en masse retraction were recruited from one Public Dental Health specialist centre. The intervention arm received anchorage reinforcement with buccal miniscrews during space closure. The active comparator received anchorage reinforcement with molar blocks during levelling/alignment and space closure. The primary outcome measure was societal costs defined as the sum of direct and indirect costs. Randomization was conducted as simple randomization stratified on gender. The patients, caregivers, and outcome assessors were not blinded. Results: Eighty patients were randomized into two groups. The trial is completed. All patients were included in the intention-to-treat analysis. The median societal costs for the miniscrew group were €4681 and for the molar block group were €3609. The median of the difference was €825 (95% confidence interval (CI) 431–1267). This difference was mainly caused by significantly higher direct costs consisting of material and chair time costs. Differences in chair time costs were related to longer treatment duration. No serious harms were detected, one screw fractured during insertion and three screws were lost during treatment. Generalizability and limitations: The monetary variables are calculated based on a number of local factors and assumptions and cannot necessarily be transferred to other countries. Variables such as chair time, number of appointments, and treatment duration are generalizable. Owing to the study protocol, the benefit of miniscrews as a stable anchorage has not been fully utilized. Conclusions: When only moderate anchorage reinforcement is needed, miniscrews are less cost-effective than molar blocks. The initial hypothesis was rejected. Miniscrews provide better anchorage reinforcement at a higher price. They should be used in cases where anchorage loss cannot be accepted. Trial registration: NCT02644811

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