Functional and social discomfort during orthodontic treatment--effects on compliance and prediction of patients' adaptation by personality variables.
(25/412)
During the course of treatment orthodontic patients frequently endure a number of functional complaints and are anxious about their appearance. The aims of this longitudinal study were to follow the progress of patients' adaptation to discomfort, to elucidate the putative relationship between the type of appliance worn and functional and social discomfort experienced, to study potential predictability by their attitude to treatment and to evaluate the effects of discomfort as predictors of patients' compliance. Eighty-four patients undergoing either removable, functional, or fixed appliance treatment monitored their complaints during the first 7 days of treatment and rated them retrospectively 14 days, and 3 and 6 months after appliance insertion. The most frequent complaints were impaired speech, impaired swallowing, feeling of oral constraint and lack of confidence in public. A significant reduction in the number of complaints was observed between 2 and 7 days after insertion of the appliance. No further differences were revealed after longer periods of appliance wear. The type of appliance had an effect on impaired speech and swallowing. Patients' expectations of favourable treatment performance and appreciation of dental aesthetics were predictive of reported feeling of oral constraint and lack of confidence in public. There was a relationship between the complaints and acceptance of the appliance, as well as between lack of confidence in public and compliance with treatment. The results of this study highlight the importance of patients' attitudes to treatment and of functional and social discomfort associated with appliance wear for the theory and practice of the management of orthodontic patients, and the necessity for early intervention by clinicians. (+info)
A comparison of health state utilities for dentofacial deformity as derived from patients and members of the general public.
(26/412)
The cost-utility approach is a method of economic evaluation, which assigns a ratio of cost to benefit, based on utility values of the health state in question. It allows efficient use of health care resources and is a useful method in that it permits comparison of a wide range of medical interventions, including those which are life saving and those that improve quality of life. This study obtained utility values for dentofacial deformity from orthognathic patients and members of the general public using three recognized methods--rating scale (RS), standard gamble (SG), and time trade-off (TTO). There were no significant differences between the utility values for the two groups of respondents. Method agreement between the TTO and the SG (the 'gold standard') was better than that between the RS and SG. In addition, the SG and TTO were found to have greater repeatability than the RS. (+info)
A survey of the delegation of orthodontic tasks and the training of chairside support staff in 22 European countries.
(27/412)
This paper reports on a survey which was undertaken to investigate the delegation of orthodontic tasks and the training of chairside support staff in Europe. Two questionnaires were posted to all members of the EURO-QUAL BIOMED II project together with an explanatory letter. The first dealt with the delegation of nine clinical tasks during orthodontic treatment. The second with the types of chairside assistant employed in each country and the training that they are given. Completed questionnaires, which were subsequently validated, were returned by orthodontists from 22 countries. They indicated that there was no delegation of clinical tasks in six of the 22 countries and delegation of all nine tasks in five countries. The most commonly delegated tasks were taking radiographs (in 14 of the 22 countries) and taking impressions (in 13 of the 22 countries). The least commonly delegated tasks were cementing bands (in five of the 22 countries) and trying on bands (in six of the 22 countries). Seven of the 22 countries provided chairside assistants with training in some clinical orthodontic tasks. Eighteen of the 22 countries provided general training for chairside assistants and offered a qualification for chairside assistants. Four of these 18 countries reported that they only employed qualified chairside assistants. Of the four countries which reported that they did not provide a qualification for chairside assistants, two indicated that they employed chairside assistants with no formal training and two that they did not employ chairside assistants. It was concluded that there were wide variations within Europe as far as the training and employment of chairside assistants, with or without formal qualifications, and in the delegation of clinical orthodontic tasks to auxiliaries was concerned. (+info)
Relationship between occlusion and satisfaction with dental appearance in orthodontically treated and untreated groups. A longitudinal study.
(28/412)
The aims of this study were to assess the relationship between occlusion, satisfaction with dental appearance, and self-esteem at the ages of 11 (T1) and 15 years (T2), and to study perceived treatment effects. Separate questionnaires were completed by children and their parents to determine their attitude. The dental casts of 224 children were collected at T1 and T2, and assessed by the Aesthetic Component (AC) and Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN), and Peer Assessment Rating (PAR) Index. At T2, 16 children had been treated with removable and 51 with fixed appliances, while 157 were untreated. The children in the fixed appliance group had better dental aesthetics (AC) and occlusion (DHC) than those in the two other groups. Average PAR score reduction was 71.6 per cent (T1-T2) and satisfaction with own or child's dental appearance increased significantly. The untreated group showed increased malocclusions. In spite of that, the children expressed higher satisfaction with their own dental appearance at T2 than at T1, while the parents' satisfaction level was unchanged. For the total group, orthodontic concern at T1, AC at T2, and gender accounted for 18.0 per cent of the variation in the children's satisfaction with their own dental appearance. Parents' concern at T1 and AC at T2 accounted for 32.2 per cent of the variation in parents' satisfaction. Improvement in self-esteem from 11 to 15 years was not correlated with treatment changes. A gender difference was found. The answers to the questionnaire indicated that both children and parents rate pleasant aesthetics as an important factor for psychosocial well being. (+info)
Temporomandibular dysfunction in patients treated with orthodontics in combination with orthognathic surgery.
(29/412)
Fifty-two patients with malocclusions underwent orthodontic treatment in combination with orthognathic surgery involving a Le Fort I and/or sagittal split osteotomy. Approximately 5 years after surgery, the patients were examined for signs and symptoms of temporomandibular disorders (TMD). The frequencies were found to be low in comparison with epidemiological studies in this field. The aesthetic outcome and chewing ability were improved in most patients (about 80 per cent). Some of the patients had reported recurrent and daily headaches before treatment. At examination, only two patients had reported having a headache once or twice a week, while all the others suffered from headaches less often or had no headache at all. Eighty-three per cent of the patients reported that they would be prepared to undergo the orthodontic/surgical treatment again with their present knowledge of the procedure. This study shows that orthodontic/surgical treatment of malocclusions not only has a beneficial effect on the aesthetic appearance and chewing ability, but also results in an improvement in signs and symptoms of TMD, including headaches. (+info)
Congenitally missing maxillary lateral incisors and orthodontic treatment considerations for the single-tooth implant.
(30/412)
Implant restorations have become a primary treatment option for the replacement of congenitally missing lateral incisors. The central incisor and canine often erupt in less than optimal positions adjacent to the edentulous lateral incisor space, and therefore preprosthetic orthodontic treatment is frequently required. Derotation of the central incisor and canine, space closure and correction of root proximities may be required to create appropriate space in which to place the implant and achieve an esthetic restoration. This paper discusses aspects of preprosthetic orthodontic diagnosis and treatment that need to be considered with implant restorations. (+info)
1999 Optident prize and William Houston Medal of the Royal College of Surgeons of Edinburgh.
(31/412)
This paper describes the clinical orthodontic treatment of three cases which were awarded the 1999 Optident prize and the William Houston Medal. (+info)
The integration of functional and fixed appliance treatment.
(32/412)
This article describes a functional appliance system to correct Class II problems, which is clipped on to bands, cemented to the teeth. This appliance has several advantages, as the patient cannot remove it. It acts on the teeth and jaws for 24 hours each day, patient co-operation is not a problem, and as a result the treatment time is short. Any fixed appliance system can be added while the functional phase is being completed so allowing full integration of the two treatment systems. (+info)