ABSTRACT
INTRODUCTION: Determination of improvement in orthodontic treatment may depend on the measurement method used and the purpose. METHODS: Improvement after orthodontic treatment (from T1 to T2 [beginning to end of treatment]) was assessed 3 ways from a set of 98 patient records: (1) calculated by subtracting judges' assessments at T2 from T1 for records presented in random order, (2) judged as a holistic impression viewing T1 and T2 records side by side, and (3) determined from proxies (American Board of Orthodontics Discrepancy Index, the American Board of Orthodontics Objective Grading System, and the Peer Assessment Rating index). RESULTS: High levels of intramethod consistency were observed, with intraclass correlation coefficient clustering around an intraclass correlation coefficient of 0.900, and distributions were normal. Calculated and judged improvements correlated at r = 0.606. Calculated or judged improvements were correlated at a lower level with proxies. Calculated improvement was significantly associated with "challenge" (T1) scores and judged improvement associated with "results" (T2) scores. Common method bias was observed, with higher correlations among similar indexes than among indexes at the same time that used various methods. Relative to differences in Peer Assessment Rating scores, calculated improvement overestimated low scores and underestimated high ones. The same effect, but statistically greater, was observed using direct judgment of improvement. CONCLUSIONS: These findings are consistent with decision science and measurement theory. In some circumstances, such as third-party reimbursement and research, operationally defined measures of occlusion are appropriate. In practice, the determination of occlusion and improvement are best performed by judgment that naturally corrects for biases in proxies and incorporates background information.
Subject(s)
Malocclusion , Orthodontics , Dental Care , Dental Occlusion , Humans , Judgment , Malocclusion/therapy , Orthodontics, Corrective , Treatment OutcomeSubject(s)
Delivery of Health Care , Dental Care , Clinical Competence , Comprehensive Dental Care/organization & administration , Continuity of Patient Care/organization & administration , Delivery of Health Care/organization & administration , Dental Care/organization & administration , Dental Care/standards , Dentist-Patient Relations , Empathy , Humans , Patient Care Team/organization & administrationABSTRACT
Few studies have focused on the role of nutrition in periodontal disease. The purpose of this trial was to determine the effect of a nutritional supplement on gingival inflammation, bleeding, probing depth, clinical attachment level, carotenoid antioxidant level, and C-reactive protein. The test supplement, consisting of a standard multivitamin formula, as well as several phytonutrients associated with antiinflammatory/antioxidant effects, provided modest benefits in reducing inflammation; however, further studies with larger populations and longer intervention are warranted.
Subject(s)
Dietary Supplements , Gingivitis/drug therapy , Phytotherapy , Plant Extracts/therapeutic use , Adult , Aged , Analysis of Variance , Anti-Inflammatory Agents/therapeutic use , Antioxidants/analysis , C-Reactive Protein/analysis , Carotenoids/analysis , Female , Gingivitis/blood , Humans , Male , Middle Aged , Minerals/therapeutic use , Periodontal Index , Vitamins/therapeutic use , Young AdultABSTRACT
The gentleman, with the help of his friends, takes responsibility for living at a high standard. Four historical examples are used to illustrate this point: Cicero, Castiglione, Lord Chesterfield, and Adam Smith. These lives span the period from the last half of the century before Christ to the last half of the eighteenth century. Gentlemen of that status are rare today, but the legacy of values, self-image, friendships, manners, and speech remain. These are especially a legacy of the professions.