Knierim Kristin, Roberts W Eugene, Hartsfield James
Section of Orthodontics, School of Dentistry, Indiana University, Indianapolis, Ind 46202, USA.
Am J Orthod Dentofacial Orthop. 2006 Nov;130(5):648-55, 655.e1-3. doi: 10.1016/j.ajodo.2006.07.014.
Based on an initial 3-year study (1998-2000) of clinical outcomes, specific changes were made in the clinical protocol in the orthodontic clinic at Indiana University, Indianapolis, Ind. To evaluate these adjustments, a follow-up study with the same methods assessed the clinical outcomes for the next 3 years (2001-2003).
The 3 changes introduced in 2000 were assessment of prefinish records, education of residents about previous outcomes, and more frequent practice evaluations by the program director. The American Board of Orthodontics (ABO) objective grading system (OGS) and a supplemental comprehensive clinical assessment (CCA) were used to evaluate the results for all patients completed by the classes of 2001 through 2003 (n = 437).
The mean ABO OGS, CCA, and combined scores were 25.19 +/- 11.16, 4.38 +/- 2.74, and 29.57 +/- 13.01, respectively. A progressive improvement was noted from 2001 to 2003. The ABO OGS and the combined scores were significantly (P <.001) improved in 2001 through 2003 compared with 1998 through 2000. The CCA score tended to improve, but it was not significantly different. Significant improvements were seen for maxillary and mandibular first order, mandibular second order, mandibular third order, overjet, occlusal contacts, occlusal relationships, and root angulations (P <.001). As with the previous study, excessive treatment times correlated with worse clinical outcomes.
Changes implemented by the graduate program were effective for improving treatment outcomes. Cast scores were more amenable to improvement than other more comprehensive outcomes.
基于一项最初为期3年(1998 - 2000年)的临床结果研究,印第安纳大学印第安纳波利斯分校正畸诊所对临床方案进行了特定更改。为评估这些调整,采用相同方法进行了一项后续研究,以评估接下来3年(2001 - 2003年)的临床结果。
2000年引入的3项更改包括对完成记录的评估、向住院医师讲解既往结果以及项目主任更频繁的实践评估。使用美国正畸委员会(ABO)客观评分系统(OGS)和补充性综合临床评估(CCA)来评估2001年至2003年毕业班级完成治疗的所有患者(n = 437)的结果。
ABO OGS、CCA和综合评分的平均值分别为25.19±11.16、4.38±2.74和29.57±13.01。2001年至2003年有逐步改善。与1998年至2000年相比,2001年至2003年ABO OGS和综合评分有显著改善(P <.001)。CCA评分有改善趋势,但无显著差异。上颌和下颌一阶、下颌二阶、下颌三阶、覆盖、咬合接触、咬合关系和牙根角度有显著改善(P <.001)。与之前的研究一样,治疗时间过长与较差的临床结果相关。
研究生项目实施的更改对改善治疗结果有效。模型评分比其他更综合的结果更易于改善。