Re: The present state of orthodontic departments.
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Biomedical subjects
Publications and source records attributed to C D Stephens.
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This paper describes and discusses the results of a survey, conducted by the Consultant Orthodontists Group in the United Kingdom in 1987, which examined the nature and distribution of clinical assistant posts, and consultants' attitudes to the concept of appointing orthodontic auxiliaries. This survey demonstrated a large regional variation in the number of clinical assistant posts and in the number of 'specialist practitioners' and community orthodontists. More than 90% of consultants teach their clinical assistants how to use removable appliances, headgear and simple fixed appliances. More than 70% of consultants also teach their clinical assistants how to use multi-bracketed techniques and functional appliances. Ninety-one per cent of consultants would give their support to developing regional training schemes for clinical assistants in orthodontics. Eighty-eight per cent of consultant orthodontists favoured the appointment of orthodontic auxiliaries to carry out intra-oral work, and 75% believed that they already had a member of staff capable of doing these duties with some further training.
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The regional distribution of orthodontic treatment provision through the General Dental Service was examined, with reference to, per capita spending, cost per case and treatment rate; a marked regional variation in these variables was detected. The regional distributions of the specialist orthodontic practitioner and the General Dental Practitioner were calculated; and also exhibited a marked regional variation. The relationships between the regional distributions of manpower treatment rate and spending on orthodontic treatment were calculated. It was found that there were significant relationships between the regional distribution of manpower and treatment rate and per capita spending, but not cost per case. Possible explanations are discussed.
The natural mechanisms of eruption, mesial migration, soft tissue pressure and occlusal forces can be used by the dentist to treat malocclusion in the growing child. The author describes how planned extractions of deciduous and permanent teeth can be employed to resolve crowding, promote spontaneous alignment, and avoid centreline displacement.
The Reflex Metrograph is an optical plotter which is linked directly to a microcomputer and allows direct three-dimensional measurements of irregular shaped objects up to 300 mm maximum dimension without contacting the object. This study shows that it is possible to generate reproducible results with an operator measurement error of less than 0.2 mm for linear distances on objects up to 200 mm maximum dimension. The Reflex Metrograph tends to undermeasure by 0.67% or by up to 2.00 mm per 300 mm and is very slightly less accurate in the vertical plane. The potential use of this measuring instrument is discussed.
The Reflex Microscope is an optical plotter which is linked directly to a microcomputer and allows direct three-dimensional measurements of irregular shaped objects up to 100 mm maximum dimension. This study shows that it is possible to generate reproducible results with an operator measurement error of less than 0.15 mm for linear distances. The Reflex Microscope tends to undermeasure by 0.28% or by up to 0.14 mm per 50 mm. There was no detectable difference in accuracy between the three planes X, Y and Z. In planes X and Y the two-dimensional accuracy at high magnification of a 1.000 mm scale was 1.004 mm in X and 1.008 mm in Y planes.
The records of 200 orthodontic patients accepted for treatment by the Orthodontic Department of the Bristol Dental Hospital in 1977 were compared with 200 taken on in 1985 in order to determine whether there had been any change in the proportion of referred cases requiring more complex procedures. Within each sample, cases were categorized as follows: (a) suitable for removable appliance treatment by an undergraduate or general practitioner; (b) requiring simple one arch fixed appliance treatment such as might be attempted by a general practitioner after a period of further training; (c) needing specialist treatment such as full multibracketed fixed appliances or orthognathic surgery. It was found that there had been no change in the proportions of simple and complex cases referred during the 8-year period although the proportion of patients now receiving complex treatment had increased greatly. Possible explanations and implications are discussed.
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Two instances are described in which the cutting of distal sections of archwires using current clinical methods has proved hazardous.
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This paper deals with the orthodontic aspects of a wider survey undertaken to determine the use of radiographs in general dental practice in the county of Avon. During the sample week 218 patients had radiography for orthodontic purposes of whom 184 were below the age of 15 years. There were marked differences in the radiographs used by general practitioners and specialist orthodontists and the possible reasons for these differences are discussed.