Autotransplantation is a treatment option with high reported survival rates to replace failing teeth in the anterior maxilla. This treatment requires a multidisciplinary approach from orthodontists, paediatric dentists, restorative dentists, and oral and maxillofacial surgeons to achieve successful outcomes. Success is dependent on many factors including stage of root development, handling of the periodontal ligament, extra-alveolar time and splinting. This case report presents the novel use of digitally designed and three-dimensional (3D) printed surgical templates to aid intraoperatively and reduce the extra-alveolar time. A preoperative cone-beam computed tomography scan allowed digital planning and construction of surgical templates that replicated the exact root dimensions of impacted maxillary canines. These templates were subsequently 3D printed in resin, sterilised and utilised intraoperatively to aid socket preparation before the surgical autotransplantation.

Objective: To improve the confidence and competence of newly qualified dentists in Wales in undertaking orthodontic assessments and making orthodontic referrals. Design: Quality improvement project. Setting: Study days arranged by the Wales Deanery. Participants: The 2018–2019 cohort of dental foundation trainees (DFTs) and dental core trainees (DCTs) in Wales. Methods: Data were collected prospectively between January and February 2019 utilising a 20-item questionnaire based around knowledge and clinical ability in orthodontic assessment and referrals (Stage 1). In May 2019, the trainees were provided with an e-learning package tailored to the results of the clinical questions and the feedback received in Stage 1. After this, trainees repeated the questionnaire with a simplified Index of Orthodontic Treatment Need (IOTN; Stage 2). Results: There was increased self-reported confidence in ‘conducting orthodontic assessments’ from 67% to 95% and ‘competence in completing orthodontic referrals’ from 81% to 92%. At baseline, this cohort were only able to correctly determine dental age and orthodontic treatment need for 40.7% (mean) of the presented linical cases. Following the teaching intervention, this was improved with an average of 70.9% of clinical cases answered correctly. Conclusion: Despite the noted improvement in the self-reported confidence and competence in undertaking orthodontic assessments and referrals in this cohort, there is still room for improvement. Hands-on orthodontic experience during dental training improved the self-reported confidence and competence with assessments and referrals. The results of this quality improvement project emphasise the need for regular continuing professional development in the field of orthodontics to maintain competence in utilising IOTN and referring appropriately.

Introduction Children with oral clefts often present with dental anomalies which can impact function, aesthetics and complicate the patient's dental treatment and needs. An understanding of potential anomalies, along with early recognition and planning, is thus essential for effective care.Aim This paper is the first in a two-part three-centre series. This paper will assess the dental anomalies identified in 10-year-old patients attending three cleft centres in the UK.Method Retrospective review was undertaken of the clinical notes of 10-year-old patients attending South Wales (SW), Cleft NET East (CNE) and West Midlands (WM) cleft units, for their ten-year audit record appointment in 2016/2017.Results In total, 144 patients were reviewed (SW = 42; CNE = 52; WM = 50). Dental anomalies were recorded for 80.6% of patients (n = 116).Discussion The review gives insight into the dental complexities of UK oral cleft patients. These patients require specialist paediatric dental input and intensive preventive regimes.Conclusion Shared care between cleft team specialists and general dental practitioners is important when providing holistic care for cleft patients.

Introduction In many cases, children with oral clefts present with accompanying medical conditions. These associated conditions can add complexity to the patient's dental management, both in terms of their treatment need and risk. Recognition and careful consideration of associated medical conditions is therefore crucial in providing safe and effective care for these patients.Aim This paper is the second in a two-part three-centre series. It investigates the prevalence of medical conditions affecting cleft lip and/or palate patients attending three cleft units within the UK.Method Retrospective review was undertaken within three cleft units: South Wales (SW), Cleft NET East (CNE) and West Midlands (WM). This was completed via assessment of the 10-year audit record appointment clinical notes for the year 2016/2017.Results In total, 144 cases were reviewed (SW = 42; CNE = 52; WM = 50). Of these, 38.9% of patients (n = 56) had associated medical conditions recorded.Discussion The review highlights the variety and impact of medical conditions affecting UK cleft patients providing insight into the consequent complexity of their dental care.Conclusion An awareness of cleft lip and/or palate patients' associated medical conditions is important for all health care professionals involved in their care. Indeed, understanding of the patient's medical needs by multidisciplinary cleft teams is essential for effective planning and completion of holistic care. Involvement of specialists in paediatric dentistry sharing care with general dental practitioners is vital in providing appropriate oral health care and preventive support.