The aim of this study was to evaluate the cost-effectiveness of extraction compared with restorative treatment of first permanent molars (FPMs) affected by Molar–Incisor Hypomineralisation (MIH) in 11-year-olds in Sweden. Seventy-five patients from the GuREx-MIH project were included. Of these, 43 were randomised to the Restorative treatment group (ReTG) and 32 to the Extraction treatment group (ExTG). Healthcare costs were calculated from dental records, while non-healthcare costs, were collected through surveys. Effectiveness was measured using the Child Perceptions Questionnaire (CPQ11-14) and the proportion of patients achieving a minimally important difference (MID). Incremental cost-effectiveness ratios (ICERs) were calculated as the difference in costs divided by the difference in effectiveness between groups. The ExTG incurred higher mean healthcare (€1,417 vs. €1,051; p = 0.029) and total costs (€2,950 vs. €2,161; p = 0.029) compared with the ReTG, almost entirely due to general anaesthesia (GA), while non-healthcare costs were (€1,531 vs. €1,111; p = 0.117). When patients treated under GA were excluded, the ExTG became less costly, with lower healthcare costs (€868 vs. €1,051; p = 0.039), fewer visits (9.2 vs. 11.4; p = 0.025), and shorter chair time (324 vs. 401 min; p = 0.040). ICERs showed that with GA, extraction was associated with higher incremental costs per MID responder (€2,593 healthcare; €6,110 total). Without GA, extraction was either dominant when only healthcare costs were considered or showed a cost of €4,201 per MID responder when considering total costs. Compared with restorative treatment, extraction was associated with higher healthcare and total costs, primarily due to general anaesthesia, but also linked with a greater proportion of patients achieving clinically meaningful improvements in oral health-related quality of life at the age of 11 years. The study was retrospectively registered on ClinicalTrials.gov 29th of January 2024, registration number: NCT06228989.

To assess the efficacy in relation to costs of three retention techniques: vacuum-formed retainers (VFR) with lingual-bonded braided and multistranded wire retainers in the mandible. A total of 93 participants, aged 12–21 years at the start of the retention phase (median age: 16 years; 66% females) were assessed. Analysis included retainer survival rate, costs associated with retention procedures, degree of mandibular incisor irregularity, and patient satisfaction. The cost-minimization analysis accounted for direct costs (material and production expenses, utility costs, and chair time based on personnel wages). The survival rate of retainers was 74% for VFR, 71% for rectangular wire retainers, and 62% for round wire retainers, with no significant differences among groups. Incisor alignment relapse was minimal overall but was highest in the VFR group compared to both wire types (p < 0.001). No differences in satisfaction were observed between groups. However, total retention costs varied significantly (p = 0.001), with the VFR group showing the lowest median cost (34.39 €) and rectangular wire group the highest (44.61 €). The retainers demonstrated similar survival rates, provided equal patient satisfaction, and maintained alignment effectively, with differences in stability remaining below evidence-based thresholds. However, VFR incurred 21–23% lower costs than fixed retainers, a finding with practical relevance for public or resource-limited settings. ClinicalTrials.gov, NCT05121220. Registered 02 October 2021.

Abstract Background/Objectives Molar-Incisor Hypomineralisation (MIH) affects 14% of the global population, often leading to compromised first permanent molars (FPM). Early extraction of severely affected FPMs may temporarily affect proper eruption and alignment of second permanent molars (SPM) and second premolars (SP). This study aimed to evaluate the eruption patterns of SPMs and SPs, and the overeruption of opposing FPMs, after early FPM extraction using panoramic radiographs in 11-year-old patients. A secondary aim was to assess radiographic quality for these evaluations. Subjects and Methods This split-mouth trial included patients aged 6–9 with severe MIH requiring FPM extraction. Panoramic radiographs were taken pre-extraction (T0) and at age 11 (T1) to measure eruption length and angulation of SPMs and SPs. Radiographs were analysed using Facad software, and imaging errors were recorded. Paired t-tests compared extraction and non-extraction sides. Results Among 47 patients, 31 had maxillary and 25 mandibular FPM extractions. At T0, eruption length and angulation of SPMs and SPs were similar between sides. At T1, maxillary SPMs erupted faster (13.5mm vs. 10.8mm, p < 0.001) and more upright (72.9° vs. 62.1°, p < 0.001) on the extraction side, while SPs showed increased mesial angulation (82.5° vs. 89.3°, p < 0.05). Mandibular SPMs and SPs showed no differences. No overeruption of opposing FPMs was observed. Measurement reliability was excellent (ICC: 0.997–0.999), despite 75 of 94 radiographic contained errors. Limitations The three-year follow-up limits long-term insights, and radiographic distortions may affect reliability. Conclusions Early FPM extraction impacts maxillary but not mandibular SPM and SP eruption patterns without causing overeruption of opposing FPMs by age 11. Radiographic techniques are essential to minimize incorrect patient positioning, as such factors may impact measurement reliability.

Objectives The aims this research were to analyze self-reported oral health-related quality of life (OHRQoL) and dental fear and anxiety (DFA) in 11-year-old patients after either restorative treatment or after extraction of first permanent molars (FPM) affected by severe molar incisor hypomineralization (MIH). The research question focused on whether these treatments lead to different outcomes of DFA and OHRQoL over time. Materials and methods GuREx-MIH, a multicenter trial, was conducted involving 83 children aged 6–9 years who were diagnosed with severe MIH in FPMs. Patients were randomly assigned to receive either restorative treatment with resin composite or extraction. Patient comfort was assessed through OHRQoL and DFA, using the Swedish version of the Child Perceptions Questionnaire (CPQ11-14) and the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS), which were administered before treatment (T0) and at follow-up when patients were 11 years old (T1). Descriptive statistical analyses were conducted and comparisons between the restorative and extraction groups were performed using T-tests. Results A total of 79 patients completed the study, with 43 allocated to restorative treatment and 36 to extraction. At follow-up, the mean OHRQoL score was 8.9 (standard deviation [SD] 7.3) for patients in the restorative group and 9.6 (SD 6.7) for those in the extraction group (p: 0.337, T-test). The mean DFA score was 21.5 (SD 5.5) for the restorative group and 23.1 (SD 6.8) for the extraction group (p: 0.130, T-test). Conclusions Restorative treatment and extraction of FPMs affected by MIH lead to similar impact on DFA and OHRQoL at 11 years of age.

BACKGROUND As artificial intelligence within digital processes continues to advance and replace conventional manual workflows, it is crucial that digital data are consistent with analog data. The aim was to evaluate the validity and time efficiency of digital cast analysis on digital models in comparison with the manual, gold standard, cast analysis on plaster models. METHODS Cast analysis was performed on 30 patients in three various methods: manually measured variables on plaster models (MP), manually measured variables on digital three-dimensional models (MD), and automatically measured variables on digital three-dimensional models (AD) on digital models. Digital cast analysis was performed in CS Model+. Analyses included metrical and categorical variables and the required work time. Measurements in MD and AD were validated to MP. Validity of the metrical variables was analyzed with Bland-Altman, Dahlberg's formula, and paired sample t test. Categorical variables were validated by Cohen's Kappa. Work time was analyzed with Wilcoxon signed-rank test. RESULTS Metrical variables had measurement errors ranging 0.4 to 1.4 mm between MP-MD, and 0.6 to 3.2 mm between MP-AD. Observations of categorical variables had a moderate to strong (0.65 to 0.9) level of agreement between MP-MD, and a weak to moderate (0.4 to 0.68) level of agreement between MP-AD. Data for dental stage, vertical, and transversal relation was not provided in AD. Cast analysis was performed quicker digitally, P ≤ 0.05. CONCLUSIONS Digital cast analysis is consistent with manual cast analysis for metrical variables. Analyses of categorical variables show a weak level of agreement with automatic digital analysis, such as space conditions and midline assessments. Digital cast analysis optimizes time compared with manual cast analysis, with automatic analysis being the fastest.

The aim of this study was to investigate attitudes and preferred therapy choice for first permanent molars (FPM) with Molar-Incisor Hypomineralization (MIH). An online questionnaire was sent out to general dentists (n = 559) working in the Public Dental Service in Region Västra Götaland, orthodontists (n = 293), and pediatric dentists (n = 156) (members from each interest association), in Sweden. The questionnaire contained three parts: general questions regarding the respondents, patient cases, and general questions regarding extraction of FPMs with MIH. Statistics were carried out using Chi-squared tests, with a significance level of 5%. A response rate of 36% was obtained. Orthodontists and pediatric dentists were more prone to extract FPMs with both moderate and severe MIH, compared to general dentists. When restoring FPMs with moderate MIH, resin composite was preferred. Compared to the general dentists, the pediatric dentists were more prone to choose glass-ionomer cement in the FPMs with severe MIH. The most common treatment choice for FPMs with mild MIH was fluoride varnish. “When root furcation is under development of the second permanent molar on radiographs” was chosen as the optimal time for extracting FPMs with severe MIH, and the general dentists based their treatment decisions on recommendations from a pediatric dentist. Extraction of FPMs with moderate and severe MIH is considered a therapy of choice among general dentists and specialists, and the preferred time of extraction is before the eruption of the second permanent molar.

BACKGROUND Orthodontic retention is the most important factor after successful orthodontic treatment. The use of thermoplastic retainers has increased in recent years, but information is lacking about the product materials and orthodontists' awareness of the products they use. The aim of this survey was to map the retention protocols among Scandinavian orthodontists, particularly their use of thermoplastic retainers. Furthermore, the aim was to investigate their knowledge of thermoplastic materials and record any possible adverse effects. METHODS An online questionnaire was prepared, and 667 orthodontists in Norway, Sweden, and Denmark were invited to take the survey. The survey was sent to all members of the national orthodontic associations using Nettskjema in Norway and Microsoft Forms in Sweden and Denmark. Data were collected anonymously and analyzed using chi-square and correlation coefficients. RESULTS Of the 667 orthodontists, 432 (64%) responded (59% female). The most common retention protocol (51%) was fixed retainer in both maxilla and mandible and thermoplastic retainer in the maxilla. Two-thirds of the orthodontists were unaware of the thermoplastic material used, and 58% did not acquire knowledge of the materials. Only 1% of the respondents had registered adverse reactions to thermoplastic retainers, and none were aware of the type of material that was used. CONCLUSIONS Scandinavian orthodontists use similar retention protocols, with the most common being fixed retainer in the mandible and dual retention, fixed, and thermoplastic retainer in the maxilla. Orthodontists' knowledge about thermoplastic materials was insufficient, but adverse effects related to thermoplastic retainer use were rare.

This clinical randomized study aimed to evaluate the early plaque formation on nonresorbable polytetrafluoroethylene (PTFE) membranes having either a dense (d‐PTFE) or an expanded (e‐PTFE) microstructure and exposed to the oral cavity.

BACKGROUND Prefabricated myofunctional appliances (PMAs) are widely advocated for correcting Class II division I malocclusion. However, their effectiveness is associated with a high amount of uncertainty within contemporary literature. OBJECTIVES The aim of this review was to systematically examine the available literature regarding the effectiveness of PMAs in treating Class II division 1 malocclusion in children and adolescents. SEARCH METHODS Comprehensive unrestricted electronic searches in multiple databases as well as manual searches were conducted up to August 2018. SELECTION CRITERIA Randomized controlled trials (RCTs) and non-randomized studies (NRS) matching the eligibility criteria. DATA COLLECTION AND ANALYSIS Two independent review authors were directly involved in study selection, data extraction, and bias assessment. The Cochrane risk of bias tool and the ROBINS-I tool were used for assessing the risk of bias. Quantitative pooling of the data was undertaken with a random-effects model with its 95% confidence interval (CI). RESULTS Three RCTs comparing PMAs to activators and three NRS comparing PMAs to untreated controls met the inclusion criteria. On a short-term basis, exploratory quantitative synthesis indicated that the activators were more effective than the PMAs in correcting overjet with a mean difference of (1.1 mm; 95% CI: 0.44 to 1.77). On a long-term basis, there were no significant differences between the two appliances. Qualitative synthesis indicated less favorable soft tissue changes as well as patient experiences and compliance with the PMAs when compared to the activators. However, PMAs were associated with reduced costs compared to customized activators and modest changes when compared to untreated controls. CONCLUSIONS On a short-term basis, low quality of evidence suggests that PMAs were generally less effective than the activators in treating Class II division 1 malocclusion. The main advantage of PMAs seems to be their reduced costs. These results should be viewed with caution, as a definitive need for high-quality long-term research into this area is required. REGISTRATION PROSPERO (CRD42018108564).