Objectives: To evaluate tooth development and calculate dental maturity score in prematurely born children and to compare the findings with full-term born children. Material and methods: Nine-year-old preterm children were selected from the Swedish Medical Birth Register. One group consisted of 36 extremely preterm children (born before week 29), and the other included 38 very preterm children (born during weeks 29 to 32). Panoramic radiography was performed on each child and the preterm children were compared with 42 full-term born children. Five observers independently assessed the tooth development stages for all teeth in the left mandible (31–37) on the panoramic radiographs according to the method described by Demirjian et al. (Hum Biol 45:211–227, 1973). Data from tooth development stages were compiled and converted into a dental maturity score for each group. Kappa values were calculated for intra- and inter-observer agreement. Results: When the different development stages for each individual tooth were compared, all observers presented a significant delay in the maturity of tooth 37 for the extremely preterm group (p ≤ 0.002). The extremely preterm group had a significantly lower dental maturity score than the full-term group, as assessed by each observer (p ≤ 0.006). Kappa values for inter-observer agreement varied between 0.31 and 0.71 depending on tooth and intra-observer agreement was between 0.16 and 1.0. Conclusions: At age 9, the extremely preterm children had a general delay in tooth development. Clinical relevance: The increased survival rate of extremely preterm babies adds a new group of children to society. Dental clinicians should be aware that the delay in tooth development could impact the timing of orthodontic diagnostics and potential treatment.

Objectives: To evaluate measurability and reliability of measurements of root length and marginal bone level in CBCT, periapical (PA) and bitewing (BW) radiographs. Methods: CBCT of both jaws, PA of maxillary incisors and posterior BW radiographs of 10 adolescents (mean age 13.4) were selected. The radiographs comprised part of the baseline examinations of a trial of orthodontic treatment. Six raters assessed measurability and measured root length and marginal bone level. Three raters repeated their assessments. Measurability was expressed as frequency of interpretable sites and reliability as intraclass correlation coefficient (ICC). Results: Measurability was 100 % in CBCT and 95 % in PA of maxillary incisors for root length measurements. For marginal bone level, measurability was 100 % in CBCT, 76 % in PA and 86 % in posterior BW. Mean ICC for interrater reliability for root length measurements in CBCT was 0.88 (range 0.27–0.96 among different teeth) and 0.69 in PA of maxillary incisors. For marginal bone level measurements, mean ICC was 0.4 in CBCT, 0.38 in PA of maxillary incisors and 0.4 in posterior BW. Intrarater reliability varied among methods, root length or marginal bone level and among raters, except for root length measurements in CBCT, which presented high reliability (above 0.8) for all raters. Conclusions: As measurability and reliability were high for root length measurements in CBCT, this may be the method of choice for scientific analyses in orthodontics. For clinical praxis, we recommend PA following the “as low as diagnostically acceptable” principle, as clinical decisions seem to be influenced only when severe root resorption occurs.

Objectives:To compare self-reported pain levels across various treatment phases using passive self-ligating (Damon) and conventional (Victory) standardized fixed appliance systems. Materials and Methods: Adolescents (12-17 years old) with crowding and displaced teeth, planned for non-extraction treatment, were recruited from four orthodontic clinics. They were randomized into stratified blocks (1:1 ratio) using concealed allocation to receive Damon Q (TM) (34 boys, 28 girls) or Victory (TM) (39 boys, 31 girls). Pain and analgesic intake were assessed on seven different occasions with validated self-report questionnaires using a 10-grade scale. Results: Of the 132 patients included, six were lost to follow up. Clinically relevant mean pain scores (>= 4) were registered in both groups after bonding upper and lower arches and after insertion of 0.019 x 0.025 stainless steel archwire. The highest mean scores were reported on day two after bonding the upper arch (Damon 5.96, Victory 7.18, P = .011). In both groups, at least 40% reported taking analgesics during various treatment phases. The Damon group reported a lower intake of analgesics on days one and two (P = .042 and .037) after treatment initiation. In the entire sample, boys reported significantly higher mean pain scores than girls on the second and third days after bonding (P = .008 and .026, respectively). Conclusions: Lower pain levels were reported from the Damon group after bonding. In general, boys reported higher pain than girls did. Clinicians and adolescents need to be aware that clinically relevant pain levels can be expected not only after bonding but also in later phases.

Background: To evaluate oral health-related quality of life (OHRQoL) over a period of five years using the Oral Health Impact Profile (OHIP-14) questionnaire in a population of Swedish adolescents born preterm and full term. Methods: In a longitudinal study of adolescents aged 12–14 and 17–19, changes over time in OHRQoL were measured by using OHIP-14. The OHIP-14 score, self-reported chronic illness, temporomandibular disorder (TMD pain) and subjective orthodontic treatment need were compared between 98 extremely and very preterm born (< 32 gestational week) and 93 full-term controls (≥ 37 gestational week) at two ages. The chi-square test was used for comparisons within the extremely-, very-, and full-term control groups, and to contrast the differences of mean scores of OHIP-14, the ANOVA test was used for comparisons within the study groups of extremely preterm, very preterm and full term-born adolescents. Results: All adolescents reported a good self-perceived OHRQoL. No significant differences in the comparisons of the total mean scores were revealed between the groups, between gender or in domain-specific scores over the 5-year period. Very preterm adolescents with reported chronic illness at 12–14 years of age showed significantly higher mean scores of OHIP-14 compared with those without chronic illness (p = 0.015). At age 17–19, significantly higher mean scores of OHIP-14 were reported by very preterm adolescents with TMD pain compared to those without TMD pain (p = 0.024). Significantly higher mean scores of OHIP-14 were found among the extremely preterm (p = 0.011) and very preterm born adolescents (p = 0.031) with a subjective need of orthodontic treatment compared with those without orthodontic treatment need. Conclusions: Poor OHRQoL measured with OHIP-14 in very preterm adolescents aged 12–14 was related to chronic illness and aged 17–19 to TMD pain. In addition, extremely and very preterm-born adolescents with subjective orthodontic treatment need at 17–19 years of age also reported poor OHRQoL. To improve the dentist–patient relationship and achieve more successful treatment results, it is important for dental clinicians to understand the impact that chronic illness, TMD pain and orthodontic treatment need has on OHRQoL in preterm-born adolescents.

Licensure exams play a crucial role in ensuring the competence of individuals entering a profession, thereby safeguarding the public and maintaining the quality and integrity of the profession. In Sweden, dentists educated outside the European Union seeking to practise dentistry must undergoa re-certification process. The re-certification process includes a theoretical examination where pass marks are set using a three-level Angoff method. This study aimed to determine the consistency of the Angoff ratings using independent panels at two Swedish universities. Two cohorts of panellists were included in the study: one reference and one external. The reference panel was responsible for rating the upcoming theoretical examinations in the proficiency test, which were used to set the pass mark. The external panel, recruited from a dental school at a university in another region in Sweden, provided ratings after the examinations. Three examinations during 2019–2020 were included in this study (267 items in total). There was a strong correlation (ρ ≥ 0.70, p < .001) between the ratings of the two independent panels, with no significant differences in item ratings across the full exams, dental disciplines, and professional qualifications analysed. This suggests that the three-level Angoff method reliably produces similar standards for assessing the competence of the minimally qualified dentist across different institutions. The expectations of the minimally qualified but still acceptable dentist were comparable between the two independent panels across the three theoretical examinations explored. The alignment between the panels indicates valid, reliable standards across institutions, despite the independent syllabi of the two study programmes. However, while there is an alignment, differences in ratings remain. Consequently, involving multiple institutions in future standard-setting processes could help ensure that the standards reflect a broader range of educational practices, supporting the credibility of licensure examinations.