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Biomedical subjects

W J Kerr

Publications and source records attributed to W J Kerr.

At least 19 recordsLinked to original sources
PubMed2000

The first orthodontic diploma.

The advent of the Inter-Collegiate Membership in Orthodontics in the year 2000 will mark the end of an orthodontic diploma specific to the Royal College of Physicians and Surgeons of Glasgow. The Diploma in Dental Orthopaedics (RCPS) was the first orthodontic diploma in the United Kingdom. The fact that such a diploma has existed first as a DDO and latterly as the MDO (Membership) for some 50 years is remarkable in view of the relative infancy of most dental specialties and the fact that the General Dental Council has instigated a specialist register in orthodontics as recently as 1998. It was 1965, before other specialty diplomas became available in the British Isles, with the introduction of the FFD by the Royal College of Surgeons in Ireland.

Education, Dental, Graduate↗
PubMed1998

Soft and hard tissue changes in Class III patients treated by bimaxillary surgery.

A cephalometric study of 17 non-growing dentate Class III subjects treated by bimaxillary surgery was undertaken to assess the results of treatment and to evaluate the correlation between soft and hard tissue change. It was concluded that: (i) the orthognathic profiles achieved were brought about by a combination of maxillary advancement and mandibular setback; (ii) a strong correlation in the horizontal direction occurred between all the selected landmarks of the lower lip and chin, but only between superior labial sulcus and point A in the upper lip; highest intra-group correlations were seen between corresponding soft and hard tissue points; the ratios of soft tissue to corresponding hard tissue movements in lower lip and chin approached 1:1; (iii) in the vertical direction, a strong correlation occurred in the lower lip and chin; highest intra-group correlations were not necessarily with corresponding landmarks; and (iv) vertical movement of landmarks on the nasal base and upper lip generally showed poor or weak correlation with corresponding soft tissue points. The most reliable hard tissue predictors of horizontal and vertical soft tissue change are tabulated for application in bimaxillary surgery for the Class III patient.

Adult↗
PubMed1998

The laryngeal mask as an antipollution device.

Anaesthetic pollution is still a problem and recent UK Control of Substances Hazardous to Health (COSHH) recommendations require employers to attempt to control the risk. Fifteen day-case urology operating lists were studied to compare the level of nitrous oxide exposure using face mask or laryngeal mask anaesthesia. Nitrous oxide was avoided in one group until the laryngeal mask was inserted. The use of the laryngeal mask airway showed a significant reduction in the level of pollution, such that recent COSHH recommendations were attained. However, (US) NIOSH levels were only reliably attained by avoiding nitrous oxide until the laryngeal mask was inserted. The laryngeal mask was therefore shown to be a reliable antipollution device.

Air Pollutants, Occupational↗
PubMed1998

Light-curing acrylic resin as an orthodontic baseplate material.

Heat-curing autopolymerizing (self-cure or cold-cure), thermoplastic, and light-curing acrylic resin are the most commonly used orthodontic baseplate materials. While cured acrylic resins present few problems to the patient, in the laboratory acrylic resin has to be sprayed, mixed, or packed in a fume-extraction unit because of the harmful fumes emitted by the raw inflammable chemicals. Light-curing material, on the other hand, is virtually nonflammable and has virtually no aroma. A light-cure technique for the construction of orthodontic baseplates is described. While buildup of the baseplate is slightly slower than for self-cured material, the shorter time involved in trimming and polishing means that overall construction is faster. It is easier to obtain a uniform thickness with light-cured material, and it provides superior fit. These results, however, are subject to more extensive clinical trials. The only apparent disadvantage is the fine powder produced during trimming. Even with a bench equipped with an extraction unit, it is advisable to use a face mask to prevent the inhalation of dust.

Acrylic Resins↗
PubMed1997

CASES--clinical audit; scenarios for evaluation and study.

CASES, an audit and continuing education programme, evaluated aspects of current orthodontic practice and allowed orthodontists to identify areas where their practice differed from regional and national results. Evaluation of the CASES programme verified its value in audit and continuing education and the authors hope it will encourage similar projects in other disciplines too.

Adolescent↗
PubMed1997

Appliance wear: the patient's point of view.

Fifty-two patients (35 female, 17 male) completed questionnaires related to their experiences during the first 7 days of appliance wear (31 fixed, 21 removable) and then after 14 and 90 days. Most problems relating to discomfort and pain resolved within 4-7 days. The problems encountered with fixed appliances were generally more severe than with removable appliances. Swallowing and speech were more difficult with removable appliances and these problems persisted to some degree. Surprisingly, the embarrassment caused by wearing the appliance in public was similar whether it was fixed or removable.

Adaptation, Physiological↗
PubMed1997

How to do it: making audit work.

The orthodontic Audit Working Party of the Faculty of Dental Surgery, Royal College of Surgeons of England, in collaboration with the Centre for Medical Education, Ninewells Hospital and Medical School, Dundee developed an audit project entitled 'Clinical Audit: Scenarios for Evaluation and Study'. The aim of the project was to contribute to the construction of clinical guidelines for orthodontists. This article, the first of a short series, describes the background to and general results of the study. Further articles will study individual aspects of the project.

Adult↗
PubMed1997

Early treatment of Class III malocclusion? Colin's case.

This is the first of six simulated case reports accompanying the questionnaire detailed in the article 'How to Do It: Making Clinical Audit Work' found earlier in this issue. You will find comprehensive discussion of the problem of making a decision about the early treatment of Class III malocclusion.

Age Factors↗
PubMed1997

An extraction dilemma: Cheryl's case.

This article describes treatment options for a teenager with a mild, although aesthetically unpleasing, malocclusion. The opinions of British orthodontists, as obtained through the CASES project, are summarized and the patient's actual treatment is discussed.

Adolescent↗
PubMed1997

Hypodontia: George's case.

Five questions are posed regarding the treatment of a patient with hypodontia. The treatment options are discussed, and the actual treatment carried out demonstrated. The treatment preferences of British Orthodontists, elicited through the CASES project, are also included.

Anodontia↗
PubMed1996

The use of removable orthodontic appliances in the General Dental Service.

One hundred and fifty removable appliance cases consecutively sampled by the Scottish Dental Practice Board were analysed using the PAR index. The cases were assessed as being suited or unsuited to the removable appliance approach based on the presenting features previously shown to be effectively treated by removable appliances. Using chi-squared tests of association, suitable cases were characterised as being in the mixed dentition, had one feature treated and one appliance used. Suitable cases on average showed 3-4 PAR points more improvement as a result of treatment than equivalent unsuitable cases; regression equations are given. Because of the wide variability within the sample it proved impossible to predict accurately the expected duration of treatment in the General Dental Service.

Child↗
PubMed1996

A method of measuring the apical base.

The maxillary and mandibular apical base areas were measured, using a gnathograph, on the study casts of 156 adults and children representing Class II division 1, Class II division 2 and Class III malocclusions. There were significant differences between the groups at each age. The maxillary apical base areas tended to be smaller for the adults than for the children in all three occlusal classes. By contrast, the mandibular apical base areas tended to be larger for the adults than for the children, except in Class II division 1 malocclusion. Following a logarithmic transformation to stabilize the variance, regression lines were fitted to relate the size of the maxillary and mandibular apical bases to one another, for the malocclusion groups within each age group. The method gives additional information regarding the degree of apical base discrepancy in a given case, but more work is required before it can be used as a diagnostic tool.

Adolescent↗
PubMed1996

Factors associated with the standard and duration of orthodontic treatment.

The pretreatment and post-treatment study casts and records of 156 completed fixed appliance and removable appliance cases were analysed, and the influence of various factors on the standard of result, as measured by the change in PAR score produced by treatment and the duration of treatment, was assessed. For the purpose of analysis the sample was divided into two groups; a two-arch fixed appliance group (n = 81) and a removable/mini fixed appliance group (n = 75). Multiple regression procedures were carried out separately for both groups, first, with all gathered data and, secondly, with only information which would be known at the start of treatment. For fixed appliances the initial PAR score was consistently an influential variable on change in PAR score and duration of treatment. Patient compliance, the need to extract a permanent first molar and the presence of an anterior crossbite were also important. The initial PAR score also explained much of the variation in change in PAR for removable/mini fixed appliances, but generally, regression models for this group were less well fitting.

Adolescent↗
PubMed1995

An evaluation of two concentrations of hyaluronidase for supplementation of peribulbar anaesthesia.

We studied the effect of the addition of hyaluronidase to a mixture of lignocaine 2% and bupivacaine 0.75% for peribulbar anaesthesia in 60 patients presenting for elective intra-ocular surgery. Using a randomised, double-blind design, patients were allocated to one of three groups: no hyaluronidase (group A) (n = 20); hyaluronidase 50 iu.ml-1 (group B) (n = 20); hyaluronidase 150 iu.ml-1 (group C) (n = 20). The speed of onset of the block, the presence of akinesia, analgesia and the need for supplementary injections were assessed. The addition of 150 iu.ml-1 of hyaluronidase resulted in a mean (SEM) time to akinesia of 9.2 (0.9) min compared to 10.9 (0.9) min in the control group and 10.7 (1.1) min in those receiving the lower dose. Fewer patients in group C required a further injection (20%) than those in groups A (40%) or B (45%). None of the findings were statistically significant. Hyaluronidase was not associated with any complications.

Aged↗
PubMed1994

Mandibular form and position in 10-year-old boys.

It is unclear whether malocclusion characterized by jaw discrepancy is caused by variations in mandibular position, mandibular size, or a combination of the two. To clarify the situation, the mandibular outlines of 124 10-year-old boys, equally divided among the Angle classes, were generated from cephalograms with a computer plotting technique. The mean plots for each of the groups were superimposed on S-N and Go-Gn. These showed mandibular form and size to be similar in the Class I and Class III groups and in both divisions of Class II. The position of Class III mandibles was more anterior and rotated forward in relation to the cranial base compared with the other groups. Statistical analysis confirmed these findings. There was evidence to support the idea that Class II, Division 2 malocclusion is largely a dentoalveolar rather than a skeletal entity.

Cephalometry↗