O L Williams | PubMed Health

PubMed1992

Patient discomfort levels at the time of debonding: a pilot study.

Several investigations have evaluated the degree of discomfort that patients experience during orthodontic treatment, but most of the research centered on tactile sensory (touch) threshold, reaction to spacers used to separate the teeth or reaction to the initial leveling wires, and the periodic adjustment of the appliances. The purpose of this investigation is to determine the discomfort threshold for patients undergoing orthodontic treatment at the time immediately before appliance removal. Such information will be useful in determining the force levels that patients can tolerate during debonding. From the findings in this study the following can be concluded: (1) The threshold of patient discomfort, at the time of debonding, is significantly influenced by two factors: the mobility of the tooth and the direction of force application. Sex and tooth type differences also influence the discomfort threshold but to a lesser degree. (2) At the time of debonding, patients can withstand intrusive forces significantly more than forces applied in a mesial, distal, facial, lingual, or an extrusive direction. The clinical implications of these findings are discussed.

Analysis of Variance↗

PubMedDate not supplied

Teleradiology: opportunities, problems, implementation.

With the introduction of computerized tomography and magnetic resonance imaging in the early 1970s, computers became integral to the imaging process. Shortly thereafter, scanners that create digitized images from film were introduced and teleradiology--images transmitted in real time--became possible. In the early 1980s, the idea of a picture archiving and communications system (PACS) began to develop. It promised to retrieve, connect and store every kind of image, from x-ray to CT, and render film obsolete. However, inflated expectations and inadequate technology hindered PACS implementation. Digital imaging offers the following benefits over film-based systems: - Less space is needed to store imaging studies. - Digital imaging files can be faster and easier for referring physicians to retrieve than film and are not susceptible to loss and damage. - Digital images can be enhanced, contrasted, colored and otherwise manipulated to maximize available information. - There are no chemicals to dispose of. While telemedicine promises to increase the efficiency and effectiveness of medical professionals, wide-scale implementation faces the following obstacles: - It has been difficult to establish a uniform standard that allows file transfer among systems made by different vendors. - There are unresolved legal questions about "interstate" medical practice as it occurs in teleradiology and about standards of care and image quality. - Any system available on a network is vulnerable to unauthorized users who may invade the database or operation of the system, and it is very difficult to detect fraud--data that has been tampered with--in digital records. - Connections to remote locations depend on local telephone lines, which may be slow. Other options are available, but they may be too expensive for facilities in the rural areas that need them the most. - Digital imaging equipment is still very costly to acquire and install. The future of telemedicine rests now with those who implement it. Once instituted, it will surpass traditional medicine by reducing the expense of storage and misplaced information and allowing faster and more accurate diagnoses.

Computer Security↗