Bergström K, Halling A
Orthodontic Clinic, Växjö, Sweden.
Swed Dent J. 1996;20(1-2):51-60.
The orthodontic treatment outcomes of 350 19-year-old individuals in three Swedish counties (A, G, and W) with different orthodontic resources and geographic structures were analyzed. The aim was to evaluate the qualitative outcome of orthodontic treatment provided by general practitioners or specialists. In a small rural area (county G), with most specialist resources, the standard of the treatments was high in both specialist treated as well as in nonspecialist treated individuals. The possibilities for the specialists to supervise the nonspecialist care and to treat individuals in need of specialist treatment were good. In an urban area (county A), with less specialist resources (than county G), the standard of the treatments provided by the specialists was high, and higher than the untreated individuals in the same county. The standard of the treatments provided by general practitioners was, however, low. The lack of specialist resources had implied a greater restriction on starting treatments, and the treatments were performed in a higher age than in the other two counties. In a large rural area (county W), with the fewest specialist resources, the standard of the treatments was in general lower than in the other two counties and did not attain the standard of the untreated individuals in county W. Attempts to compensate for a sparsity of orthodontic specialists by an extended engagement of general practitioners resulted in a generous attitude of providing orthodontic treatments, and a lower standard of the treatments in general. The orthodontic treatments substantially improved the malocclusions, especially treatments provided by specialist. The standard of the treatments in the counties showed a good correlation with the available resources in terms of orthodontic specialists and the ability to supervise the treatments of general practitioners. The lack of sufficient supervision of non-specialist orthodontic treatment had negative influence on the quality.
分析了瑞典三个县（A、G和W）350名19岁个体的正畸治疗结果，这三个县的正畸资源和地理结构各不相同。目的是评估全科医生或专科医生提供的正畸治疗的质量结果。在一个小型农村地区（G县），拥有大多数专科资源，专科医生治疗的个体以及非专科医生治疗的个体的治疗标准都很高。专科医生监督非专科护理以及治疗需要专科治疗的个体的可能性很大。在一个城市地区（A县），专科资源比G县少，专科医生提供的治疗标准很高，且高于同一县内未接受治疗的个体。然而，全科医生提供的治疗标准很低。专科资源的缺乏意味着开始治疗受到更大限制，且治疗在比其他两个县更高的年龄进行。在一个大型农村地区（W县），专科资源最少，治疗标准总体上低于其他两个县，且未达到W县未接受治疗个体的标准。试图通过增加全科医生的参与来弥补正畸专科医生的稀缺，导致了提供正畸治疗的态度较为宽松，总体治疗标准较低。正畸治疗显著改善了错牙合畸形，尤其是专科医生提供的治疗。各县的治疗标准与正畸专科医生的可用资源以及监督全科医生治疗的能力呈现出良好的相关性。对非专科正畸治疗缺乏充分监督对质量有负面影响。
