Biomedical subjects
Publications and source records attributed to L J Green.
The Orthodontic Attitude Survey was designed to assess children's and their parents' attitudes toward malocclusion and orthodontic treatment. Five consistent clusters of attitudes had discriminant validity, and were significantly related to plans for orthodontic treatment and to objective and subjective indicators of the child's occlusal status and appearance.
To reexamine the prevailing concepts of the role of genetic and environmental factors on dental occlusion, individual occlusal traits were studied in 164 pairs of twins. The measured variables were overjet, overbite, crossbite type and extent, buccal segment relationship type and extent, anterior and posterior teeth malalignment, spacing, treatment priority index scores, and the principal components derived from these measures. No association of twin type with the mean of any of the traits could be demonstrated. Further analysis of variance revealed separate sources of twin variance for the set of occlusal variables studied. We were able to detect a significant genetic source of variation for overbite and spacing, and no variance inequality between monozygotic and dizygotic twins. For the majority of the trains (overjet, crossbite, buccal segment relationship, malalignment, and treatment priority index scores), tests of homogeneity of total variance showed inequality between zygosities. The total among-pair and within-pair mean squares were larger for dizygotic than for monozygotic twins. We interpreted the results as evidence for greater environmental influences on the two types of twins. In addition, environmental covariance appeared to be larger for monozygotic than for dizygotic twins with respect to crossbite. In cases where within-pair genetic variance estimates were highly significant, removing the bias due to unequal environmental effects on the two types of twins led to results of no significant genetic variance. These results indicate a further need to explore the sources of environmental variation contributing to the difference. Genetic models that may be used to gain insights into the sources are discussed.
In establishing the validity of an index for identifying individuals needing orthodontic treatment, we must concern ourselves with the construct validity of the measure. Since it is clear that the relevant theory concerning need for treatment must include esthetics and the accompanying social and psychological characteristics, the construct validation of an index to measure need for treatment must include tests of hypotheses with these dimensions. If we consider a child's self-perception of occlusion as a psychological variable and another person's perception of a child's occlusion as a social variable, theory relevant to an index of need for treatment would hypothesize that each should correlate positively with need for treatment. Subjects were eighth and ninth grade students from a metropolitan area in western New York State. Fifty-two of the children were planning to obtain orthodontic treatment, and 102 were not. Data were also obtained, whenever possible, from both parents and from a sibling (if any) nearest in age to the child. Data were collected in one session by a trained interviewer who used a structured interview and also photographed the child's teeth and jaws. In addition, the child was given an orthodontic Treatment Priority Index (TPI) examination by a dentist enrolled in a graduate program in orthodontics, who had previously been trained and standardized in the use of the TPI. In addition, to the TPI, scores obtained included three psychological measures and eight social measures. Each of the psychological and social variables correlated significantly with TPI at the 0.05 level, with values ranging from 0.21 to 0.54 and a median value of 0.42. On the basis of these correlations, evidence is presented for the construct validity of the TPI when measuring need for treatment.
This study examined the decisions patients made about obtaining follow-up care after an initial visit to a psychiatric walk-in clinic. Sixty-nine randomly selected patients who received a variety of ambulatory referrals were questioned by means of structured and ured to, and 70 per cent of the patients given medication took it substantially as prescribed. Completion of the referral was associated with being employed, not abusing drugs and alcohol, having a positive view of the walk-in clinic, and adherence to the medication regimen. Referral success was unrelated to sociodemographic characteristics, social integration, the nature of the intended disposition, or prior medical or psychiatric care. Patients who adhered to the disposition did not necessarily adhere to the medication regimen, and vice versa. Referrals were more successful when the patient had preceded the clinical encounter with an active appraisal of his situation. The decision to adhere was a complex and prolonged one in which the patient weighed many factors, of which the physician's suggested disposition was only one.
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The incidence and types of dental trait anomalies found in individuals with cleft lip or cleft palate or both (cleft group), in siblings of the cleft group, and in a group of individuals without cleft lip or cleft palate (noncleft group) were compared. The cleft group had 1.02 anomalies per individual, the sibling group, 0.38; and the noncleft group, 0.17. The frequency of occurrence of thick-curved maxillary central incisors, incisal fissures, and missing teeth were significantly different among the three groups.
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