Turbill E A, Richmond S, Wright J L
Department of Oral Health and Development, University Dental Hospital of Manchester, U.K.
Br J Orthod. 1998 Feb;25(1):47-54. doi: 10.1093/ortho/25.1.47.
Cases from the Dental Practice Board's 2 per cent random sample of completed cases which had been treated by orthodontic practitioners with high gross earnings, were compared to all the cases within the sample from other practitioners. They were assessed using the PAR index and IOTN. High earning orthodontists treated slightly more cases with lower objective need for treatment, but treated no more cases 'Unnecessarily' than other practitioners. They used more fixed appliances, and had marginally better levels of residual need for treatment at finish, although this was at least partially explained by lower levels at start. Generally, their standards were not substantially different to other practitioners. Appliance type had a marked effect on outcome, as did levels of malocclusion and need for treatment at start. Both groups of practitioners performed similarly (better) with dual arch fixed appliances: however, overall standards could only be described as mediocre. There is no justification to single out high earning orthodontists for special scrutiny. However, it may be beneficial if the system of remuneration in the General Dental Services could be modified to give more positive incentive to quality, rather than simply quantity of treatments.
从牙科执业委员会抽取的2%已完成病例的随机样本中选取了由高收入正畸医生治疗的病例，并与样本中其他医生治疗的所有病例进行比较。使用PAR指数和IOTN对这些病例进行评估。高收入正畸医生治疗的病例中，客观治疗需求较低的病例略多一些，但与其他医生相比，“不必要”治疗的病例并不更多。他们使用了更多的固定矫治器，治疗结束时残留治疗需求水平略好一些，不过这至少部分可以用开始时较低的水平来解释。总体而言，他们的治疗标准与其他医生没有太大差异。矫治器类型对治疗结果有显著影响，错颌畸形程度和开始时的治疗需求水平也有影响。两组医生使用双弓固定矫治器时表现相似（较好）：然而，总体治疗标准只能说是中等。没有理由特别挑出高收入正畸医生进行特别审查。不过，如果能修改普通牙科服务的薪酬制度，给予质量而非仅仅治疗数量更积极的激励，可能会有好处。
