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Biomedical subjects

C D Stephens

Publications and source records attributed to C D Stephens.

At least 19 recordsLinked to original sources
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

Optical disguising of orbital deformity with prism and cylinder lenses.

This paper describes the way in which prism and cylinder lenses may be used to disguise orbital dystopia when the affected eye is blind. The lenses used can correct the height of the eye, the opening of the eyelids or the rotation or slant of the eye. Four cases are presented to illustrated this technique, which may be used either instead of, or as an adjunct to orbital surgery. An investigation of these effects is described using a mannikin head fitted with an optician's trial frame, with measuring by the reflex metrograph. This revealed that an inferiorly displaced eye may be elevated by 4 to 5 mm, that the vertical eyelid opening may be widened (or narrowed) by just under 20% and that an adverse slant of the eye may be rotated in either direction by about 4 degrees.

Adolescent↗
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

The ranking of facial attractiveness.

A method of assessing facial attractiveness is described in which facial photographs were ranked by adults in order from the most to the least attractive. The rankings of a group of normal 10-year-old children were compared to those given to a group of similarly aged patients with repaired clefts. Most previous methods have grouped patients into categories, but this tends to obscure individual differences in facial attractiveness: patients with small differences in appearance are generally placed in the same group. In the ranking technique described in this paper these individual differences were not obscured. Those individuals with repaired clefts were consistently judged as being less attractive than those in the normal group. It is suggested that this method could be further developed to assess the cosmetic benefit produced by treatment of facial deformity.

Child↗
PubMed1992

A modification to the incisor classification of malocclusion.

During the study of two-hundred orthodontic cases under treatment in the General Dental Service, four clinicians showed only moderate agreement using the British Standard Classification of Incisor Malocclusion. Cohen's Kappa statistic was used to measure the inter-examiner agreement. The 35 cases in which there was high disagreement between the examiners were scrutinized to determine the source of this disagreement. Following discussion, revised definitions were produced which included the introduction of a Class II-intermediate group. After an interval of 2 months these 35 cases were reclassified using the new definitions. Increased inter-examiner agreement was found. Four examiners (three of whom were common to the original study) then used the modified classification to describe the incisal relationship of 100 cases referred for treatment at Bristol Dental Hospital. The inter-examiner and the intra-examiner agreement were both found to be good. It is recommended that the Incisor Classification of Malocclusion be extended to include a Class II-intermediate group.

Humans↗
PubMed1992

Storage of orthodontic study models in hospital units in the U.K.

Orthodontic study models form an essential part of the dental records of patients undergoing diagnosis and treatment. In order to ascertain the problems encountered by hospital orthodontic units in the utilization and storage of study models, a questionnaire was circulated in February 1991 to members of the Consultant Orthodontists Group. All respondents took pretreatment study models, while 9 per cent took their final study models at some time other than the end of active treatment; 85.5 per cent of respondents stored their study models in their units, but most were beginning to experience difficulties in this regard. There was a wide range for storage times, and only 10 per cent of employing authorities had a stated policy on the storage of study models. There was a highly significant difference (P much less than 0.001) between the time that models are stored at present, and the desired storage times. Most respondents appeared to be rather uncertain about the precise medico-legal requirements concerning model storage. The implications for audit and medico-legal matters are discussed in the light of these findings.

Dental Records↗
PubMed1991

Quality control in orthodontics: indices of treatment need and treatment standards.

Two reliable and valid occlusal indices have been developed to assess treatment need (Index of Treatment Need, IOTN) and the standard of treatment (The PAR Index, Peer Assessment Rating). The IOTN assesses both dental aesthetics and dental health need. The PAR index provides a single summary score for the overall alignment and occlusion. The difference between the pre- and post-treatment scores reflects the degree of improvement and the success of orthodontic intervention and active treatment. Several practical uses of the indices are described: the estimation of treatment need in an unselected and a referred population and the assessment of the standard of treatment in the Hospital and General Dental Services. It has been suggested that the use of the occlusal indices would offer several advantages: (1) uniformity in prescribing patterns, (2) safeguards for the patient, (3) patient counselling and (4) monitoring and promoting standards.

Discriminant Analysis↗
PubMed1991

The initial use of a computer-controlled expert system in the treatment planning of Class II division 1 malocclusion.

A computer based expert system for providing orthodontic advice for Class II Division 1 malocclusion has been developed and evaluated. Treatment plans produced by the system for 31 non-prior approval cases drawn from material provided by the Dental Practice Board were compared with the treatments actually carried out by the practitioners. The shortcomings of the system are discussed.

Decision Trees↗
PubMed1989

Report of a survey conducted by the Consultant Orthodontists Group. The nature and distribution of clinical assistant posts in orthodontics in the United Kingdom in 1987.

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.

Attitude of Health Personnel↗
PubMed1989

Regional variation in the provision and cost of General Dental Service orthodontic treatment in England and Wales.

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.

Adolescent↗
PubMed1989

The use of natural spontaneous tooth movement in the treatment of malocclusion.

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.

Child↗
PubMed1988

Three-dimensional measurement: the accuracy and precision of the reflex metrograph.

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.

Cephalometry↗