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Biomedical subjects

W C Shaw

Publications and source records attributed to W C Shaw.

At least 55 records · Page 3Linked to original sources
PubMed1994

An 8-year study of changes in oral hygiene and periodontal health during adolescence.

This study reports data collected from a cohort of 405 South Wales adolescents examined at the ages of 11-12, 15-16 and 19-20 years. Dental plaque and gingivitis scores decreased markedly between the ages of 11-12 and 15-16 years, and to a lesser extent between 15-16 and 19-20 years. There was a decrease in the mean depth of the gingival sulcus between the ages of 11-12 and 15-16 years, perhaps reflecting a decrease in false pocketing and gingival oedema associated with puberty and tooth eruption. Conversely, there was an increase in the mean depth of the gingival sulcus between the ages of 15-16 and 19-20 years, possibly indicating the initiation of periodontal breakdown and the appearance of true pocketing. Gender was found to be an important determinant of the level of oral hygiene practised, the boys having consistently poorer oral hygiene than did the girls. At the commencement of adolescence this was not reflected in higher gingivitis scores, but by the age of 15-16 years the boys exhibited significantly more gingivitis than did the girls.

Adolescent↗
PubMed1994

Incisal overjet as an outcome measure in unilateral cleft lip and palate management.

The Goslon Yardstick is a clinical tool used to rank dental study casts of persons with cleft lip and palate in the late mixed or early permanent dentition into one of five categories. It has been successfully used to investigate the outcomes of the surgical treatment of these anomalies as well as the effects of these deformities on untreated individuals. In this study, 40 study casts ranked by the Goslon Yardstick were digitized using a reflex metrograph. The overjet, overbite, and incisal angulation, and the crossbites of the canines and molars were calculated for each of the sets of casts. Multiple regression analysis was used to determine the predictive value of these variables upon the Goslon scores. The overjet was found to explain 87% of the variance of the Goslon score (p < .0001). No other component had a significant predictive value. The range of overjet associated with the different Goslon scores was calculated from the regression equation. In conclusion, the advantages of using overjet as an indicator of outcome as an alternative to the Goslon Yardstick were discussed.

Child↗
PubMed1993

Orthodontics in the general dental service of England and Wales: a critical assessment of standards.

Out of a sample of 1210 orthodontic patients treated within the General Dental Services in England and Wales, a high proportion showed no improvement. Upper and lower fixed appliances had the greatest influence on the outcome of treatment in terms of aesthetics, dental health need and standards. When treatment was analysed according to the appliance used, there were no statistically significant differences in the standard of treatment undertaken by specialist orthodontists and general dental practitioners. Methods for improving British orthodontic standards are considered.

Analysis of Variance↗
PubMed1993

Consultant opinion on orthodontic treatment plans used by dental practitioners: a pilot study.

Prior to 1987, dental practitioners in England and Wales intending to carry out all but the simplest orthodontic treatment within the National Health Service, were required to submit pretreatment study models, details of the orthodontic assessment and the proposed treatment plan to the Dental Estimates Board prior to starting treatment. Models taken at the end of treatment were required by the Board to enable payment to be made. In this pilot study, the acceptability of orthodontic treatment plans used by practitioners working in the General Dental Services was assessed by eight hospital consultants, using information about 40 cases submitted to the Dental Estimates Board in 1987/88. All consultants considered a high proportion of plans to be unacceptable, but agreement between the consultants was variable and some agreed with one another on very few plans. A single scorer used the weighted PAR (Peer Assessment Rating) index to assess the degree of departure from normal occlusion of both pre- and post-treatment models. Using accepted standards, only nine cases were greatly improved (PAR reduction > 70%) and the mean percentage reduction in PAR score was low. Consultant opinion on the appropriateness of treatment planning was not related to the outcome of orthodontic treatment.

Clinical Competence↗
PubMed1993

The use of occlusal indices in assessing the provision of orthodontic treatment by the hospital orthodontic service of England and Wales.

This retrospective study was carried out to assess the need for orthodontic treatment and the standard of treatment provided by a sample of 17 hospital-based orthodontic departments. A total of 1630 sets of patients records were collected and analysed for orthodontic treatment need and standard of treatment with the Index of Orthodontic Treatment Need and the PAR index, respectively. The data were analysed with a variant of analysis of covariance using linear modelling techniques. In general terms it appeared that the hospital service provided treatment of a high standard, in terms of dento-occlusal change, to a caseload of patients that were in need of treatment. The effectiveness of treatment provision was influenced by the grade of operator, the choice of treatment methods and by the departmental attitudes and aspirations.

Appointments and Schedules↗
PubMed1992

Orthodontics in the General Dental Services of England and Wales: the provision of treatment.

A survey has been undertaken on a representative sample of 1210 patients collected from a 5% sampling procedure employed by the Dental Practice Board. Discontinued cases were excluded from the study. It was revealed that the majority of orthodontic treatment was undertaken by practitioners who had in general been qualified for at least 10 years and, in the main, did not possess an orthodontic qualification. The greater proportion of treatment was undertaken using removable appliances, although fixed appliances were used in 43% of prior approval cases and treatments attracted an average fee of 171 pounds (1988 prices). There was a marked variation in the proportion and type of treatment carried out in the various regions within the General Dental Services.

Certification↗
PubMed1992

The development of the PAR Index (Peer Assessment Rating): reliability and validity.

The PAR Index has been developed to provide a single summary score for all the occlusal anomalies which may be found in a malocclusion. The score provides an estimate of how far a case deviates from normal alignment and occlusion. The difference in scores between the pre- and post-treatment cases reflects the degree of improvement and, therefore, the success of treatment. Excellent reliability was exhibited within and between examiners (Intraclass Correlation Coefficient, R greater than 0.91). The components of the PAR Index have been weighted to reflect current British orthodontic opinion and is flexible in that the weightings could be changed to reflect future standards and standards currently being achieved in other countries. The PAR Index offers uniformity and standardization in assessing the outcome of orthodontic treatment.

Bicuspid↗
PubMed1992

A survey of craniomandibular disorders in 800 15-year-olds. A follow-up study of children with malocclusion.

Seven-hundred-and-ninety-one 15-year-olds were subjected to an anamnestic and clinical examination of craniomandibular disorders. These individuals had been examined at the age of 12 years and this is one section of an extensive longitudinal investigation into the effects of malocclusion, and the effectiveness of orthodontic treatment. The children were originally selected on the basis of presence of malocclusion. Signs of CMD were found in about half of the subjects. The proportion of individuals without any signs of CMD had decreased during the 4-year period. However, the number of subjects with severe signs remained very small. Changes in severity of CMD according to Helkimo's index of clinical dysfunction were mainly attributed to an increased prevalence of impaired TMJ function. An increase in prevalence of reported symptoms was found involving headache and joint sounds. The other recorded symptoms did not show any significant increase in prevalence. Mandibular mobility showed only minor changes from 12 to 15 years of age.

Adolescent↗
PubMed1992

The PAR Index (Peer Assessment Rating): methods to determine outcome of orthodontic treatment in terms of improvement and standards.

In orthodontics it is important to objectively assess whether a worthwhile improvement has been achieved in terms of overall alignment and occlusion for an individual patient or the greater proportion of a practitioner's caseload. An objective measure is described that has been validated against the subjective opinions of 74 dentists. Using the weighted PAR Index it was revealed that at least a 30 per cent reduction in PAR score is required for a case to be considered as 'improved' and a change of 22 PAR points to bring about 'great improvement'. For a practitioner to demonstrate high standards the proportion of an individual's case load falling in the 'worse or no different' category should be negligible and the mean reduction should be as high as possible (e.g. greater than 70 per cent). If the mean percentage reduction in PAR score is high and the proportion of cases that have been 'greatly improved' is also high, this indicates that the practitioner is treating a great proportion of cases with a clear need for treatment to a high standard.

Discriminant Analysis↗
PubMed1992

Glove use by orthodontists: results of a survey in England and Wales.

Attitudes to glove wearing during treatment of patients were tested by distribution of a questionnaire to 2000 dentists known to be practising under the National Health Service regulations in England and Wales. Of the dentists who replied, 41 specialist orthodontists, representing approximately one-sixth of all orthodontists working in the general dental services in England and Wales, were identified. Results indicate that 39 per cent of these orthodontic respondents wore gloves routinely for all patients and procedures, while 49 per cent wore gloves for some patients or procedures, with 12 per cent never wearing gloves. Reasons given by the occasional glove wearers for not wearing gloves routinely included loss of tactile sensation, perceived small risk, lack of comfort, and restriction of movement. Six per cent of those who replied had experienced skin irritation considered to be associated with glove wearing, while latex gloves were preferred by 78 per cent of respondents who wore gloves.

Attitude of Health Personnel↗
PubMed1992

Aesthetic tooth modification for patients with cleft lip and palate.

Alongside orthodontic treatment, tooth shape modification may be indicated for teeth associated with clefts of the lip and alveolus, and in non-carious teeth, minimal tooth preparation techniques appear to be most appropriate. Two methods of tooth shape modification are described. In one, hybrid composite materials, bonded to tooth enamel using the acid-etch technique, may be considered to provide a permanent, low cost, aesthetically satisfactory result, often without tooth preparation and with minimal operating time. Alternatively, indirect veneers may be appropriate for treatment of more severely malformed teeth.

Anodontia↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 1. Principles and study design.

This article describes the design of an intercenter comparative study of treatment outcome in the treatment of children with a unilateral complete cleft of the lip and palate. The rationale and aims of this study are defined and treatment schemes of the participating centers are described. The findings are presented in a series of three papers (Parts 2, 3, and 4) dealing with the comparison of craniofacial form, dental arch relationships, and nasolabial appearance. In Part 5, conclusions and general recommendations regarding future research are discussed.

Child↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 2. Craniofacial form and soft tissue profile.

The craniofacial morphology and the soft tissue profile were evaluated in this part of the intercenter study of the European Cleft Lip and Palate Research Group. The sample was comprised of cephalometric x-rays of the full cohort of 151 cases from the six European cleft palate centers. The facial morphology in complete unilateral cleft lip and palate patients was evaluated by means of roentgen cephalometry. Approximately 25 consecutive cases from each of six European cleft palate centers were compared. Only one center showed notable and consistent differences from the others. A contributing factor for these differences may be an inconsistent treatment regimen with many surgeons involved. Analysis of the soft tissue profile between the centers showed more pronounced differences than analysis of the skeletal profile. The treatment outcome in centers with more complex or expensive programs was no better than those centers using simpler management approaches.

Analysis of Variance↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 3. Dental arch relationships.

One hundred and forty-nine dental casts of subjects with complete unilateral clefts of the lip and palate from six European cleft palate centers were assessed by means of the Goslon Yardstick. The Yardstick proved capable of discriminating between the quality of the dental arch relationships between the six centers. Two centers showed especially poor results. Three centers obtained satisfactory results although differing surgical techniques were used in these centers. One of the centers showing satisfactory dental arch relationships employed a more complex and expensive treatment program than the other two centers, which both used simpler centralized treatment regimens.

Analysis of Variance↗
PubMed1992

A six-center international study of treatment outcome in patients with clefts of the lip and palate: Part 4. Assessment of nasolabial appearance.

One hundred and fifteen frontal and profile photographs of the nasolabial area of subjects with complete unilateral clefts of the lip and palate from six European centers were assessed. Four components of the nasolabial area were rated separately by a panel of judges using a five-point scale of attractiveness. The Tukey multiple comparison test showed significant differences between the centers. The relative position of the six centers in this study followed a similar pattern to their respective positions in the cephalometric and dental cast studies.

Child↗