Orthodontic Residents Research Articles

Enhanced facial symmetry assessment in orthodontists

Assessing facial symmetry is an evolutionarily important process, which suggests that individual differences in this ability should exist. As existing data are inconclusive, the current study explored whether a group trained in facial symmetry assessment, orthodontists, possessed enhanced abilities. Symmetry assessment was measured using face and nonface stimuli among orthodontic residents and two control groups: university participants with no symmetry training and airport security luggage screeners, a group previously shown to possess expert visual search skills unrelated to facial symmetry. Orthodontic residents were more accurate at assessing symmetry in both upright and inverted faces compared to both control groups, but not for nonface stimuli. These differences are not likely due to motivational biases or a speed–accuracy tradeoff—orthodontic residents were slower than the university participants but not the security screeners. Understanding such individual differences in facial symmetry assessment may inform the perception of facial attractiveness.

The cervical vertebrae staging method's reliability in detecting pre and post mandibular growth

PurposeRecent studies have reported low reliability using the multistage cervical vertebral maturation (CVM) approach, raising concerns about the clinical usefulness of this method. The objective of the present study was to examine the reliability of a 2 stage CVM method. Materials and methodsThirteen orthodontic residents received standard trainings on the CVM methods (5 stage version), and classified the maturation status of 15 CVM radiographs representing all 5 stages of maturation. The radiographs were reevaluated 2 weeks later. The intra- and inter-rater reliability of the residents’ classifications were assessed by percentage agreement, Kendall's W test, weighted kappa (Kw) for the five stage method and simple kappa (K) for the pre vs. post mandibular growth peak phases (2-stage approach). The κw values for the individual stages of the five stage method were also calculated. To assess percentage agreement and Kappa changes caused solely by category reduction (from 5 to 2), percentage agreement and simple Kappa statistics were also calculated for all other possible cut points (i.e. 1–2, 3–4 and 4–5). ResultsBased on 5 stages, the average intra-rater reliability showed 62% for exact agreement and 0.86 for κw, the average inter-rater reliability showed 46.7% for exact agreement, 0.79 for both κw and Kendall's W. The κw for the intra-rater reliability of individual five stages ranged from .06 to .62 with the two highest at the stage 2–3 interface. Based on two stages (pre-post mandibular growth peak), the average intra-rater reliability showed 95% exact agreement and 0.82 for K The average inter-rater reliability showed 91% for exact agreement and 0.76 for K. For all other possible 2-stage cut points, the percentage agreement and Kappa measures were smaller than those from the cut point of pre and post peak growth. ConclusionsThe 2 stage CVM method has excellent reliability in differentiating pre and post peak mandibular growth phases. As such information is necessary for planning growth modification, the CVM method is a useful clinical tool and should be combined with other clinical assessments.

Training and Use of Lasers in Postgraduate Orthodontic Programs in the United States and Canada

This study was designed to determine if orthodontic residents are being trained to use lasers in the postgraduate orthodontic residency programs of the United States and Canada. An anonymous electronic survey was sent to the program director/chair of each of the seventy orthodontic residency programs, and thirty-seven (53 percent) of the programs responded. Of these thirty-seven programs, twenty-eight (76 percent) reported providing patient treatment with lasers in the orthodontic graduate program, eight (22 percent) said they do not provide treatment in the orthodontic graduate program, and one program (3 percent) reported providing laser training but not using lasers on patients. Gingivectomy and canine exposure were reported as the most common procedures that residents perform with a laser, while debonding of orthodontic brackets was the least common procedure performed with a laser. A diode laser was the most common type of laser used. Of the eight programs (22 percent) not offering laser training, four indicated having no plans to begin using lasers or training on their use. The other four indicated that they have plans to incorporate laser use in the future.

Motivations and future practice plans of orthodontic residents in Saudi Arabia

Aims:This study aims to explore the criteria used by graduate students while selecting a career as orthodontists and their future aspirations.Materials and Methods:A list of Saudi Board of Orthodontics (SB-Ortho) residents was obtained from the Central and Western regions of the Kingdom and all orthodontic residents (excluding the 1st year residents) were invited to participate in this survey. Permission to contact the orthodontic residents was obtained from the respective program directors. The final study sample composed of 36 orthodontic residents.Results:About 39% of residents chose orthodontic specialty after graduation, nearly 33% selected the career during the undergraduate education while the rest chose the specialty at other stages. Approximately, 67% of the residents chose orthodontic specialty because it is intellectual challenging. Around 25% of residents choose orthodontic to improve their earning and 39% join orthodontic for job prestige. Around 50% of orthodontic Saudi residents planned to use self-ligating brackets; 63.9% planned to use invisalign; 86.1% plan to use temporary anchorage devices. About 72% of residents plan to use a cone-beam computerized tomography; 89% plan to use a digital imaging program; 39% plan to use indirect bonding; and 28% plan to use lingual orthodontics. More than half of the residents showed interest to participate in the research and about a quarter of them were willing to work in small cities.Conclusions:Most of the orthodontic residents in Saudi Arabia take up this specialty as they felt that it was intellectually challenging. The SB-Ortho program adequately prepares the residents in all the modern aspects of the specialty.

Motivations of Orthodontic Residents in Canada and the United States to Treat Patients with Craniofacial Anomalies, Cleft Lip/Palate, and Special Needs

To determine the motivation of orthodontic residents in Canada and the United States to treat patients with cleft lip/palate (CLP), craniofacial anomalies (CFA), and special needs (SN). In March 2009, an e-mail with a link to a 41-item survey was sent to all orthodontic residents in Canada and the United States (n = 944). Of 944 residents contacted, 339 viewed and 208 completed the survey (22.03%). Using a seven-point Likert scale, residents recognized the importance of treating patients with CLP/CFA/SN. When asked if they plan to treat patients with CLP/CFA/SN, 54.48% responded yes, 13.46% no, and 36.06% were unsure. A total of 38.05% said they would charge the same fee as a typical multiarch case, while 58.05% would charge more, and 60% of fourth-year residents would charge twice the fee. Of the respondents, 43.00% were aware of the established fellowship programs in CLP/CFA/SN. Canadian residents (67.9%) were more enthusiastic about completing a fellowship than Americans were. Of the respondents, 29.33% would complete a 1-year fellowship, while 70.67% would not. A total of 78.4% of male respondents and 77.4% of American residents indicated they would not pursue a fellowship. Residents supported the importance of treating patients with CLP/CFA/SN, and more than 54% indicated they plan to treat these patients. Residents who indicated that they would not treat these patients sited limited experience and inadequate expertise as the reasons. Less than 30% indicated a willingness to pursue a fellowship program.

Motivational Factors and Future Plans of Nigerian Orthodontic Residents

This study was conducted to investigate factors influencing career choice of Nigerian orthodontic residents and to identify their future plans. All orthodontic residents in the Nigerian residency training programs were invited to complete a survey in July 2010. Data were categorized by demographic variables and were analyzed with statistical methods including chi-square analyses. Twenty-eight of the thirty-seven orthodontic residents in Nigeria completed the survey. The most important factor influencing the decision to pursue specialty training in orthodontics was a "passion for orthodontics" (42.9 percent), followed by "intellectual stimulation/challenge" (25 percent). The decision to become an orthodontist was made by 32.1 percent of the respondents while in dental school; 35.7 percent decided after completing dental school during private practice and 14.3 percent during a dental residency, while 3.6 percent had already decided before starting their dental school studies. Eleven residents (39.3 percent) said they plan to work in a private practice environment. Only four residents indicated that they will most likely practice primarily in an academic setting, while ten were undecided. Most residents (85.7 percent) reported planning to practice in an urban setting. A passion for orthodontics was the major attraction for orthodontic residency training for most residents in Nigeria, and few residents were considering academic career choices after graduation.

Assessment of Graduate Orthodontic Programs in North America

This study collected information on four main aspects of U.S. and Canadian orthodontic programs: demographic profiles of residents, requirements for graduation, graduate curriculum, and number of faculty and staff members. Program directors at seventy U.S. and Canadian orthodontic programs were invited to participate in a twenty-question survey and to distribute a ten-question survey to their residents. Twenty program directors and eighty-four residents completed the anonymous, online surveys on Qualtrics.com in July-August 2010. The average age of surveyed residents was 29.6 years of age; 73 percent were non-Hispanic white, with 14 percent Asian/Asian-American, 5 percent Hispanic, and 1 percent African American. A small percentage of residents (13 percent) were foreign-trained. The majority of residents (64 percent) were male. There was a wide variety of clinical and didactic requirements in the programs. Almost all programs emphasized treatment with functional appliances and clear aligners. An average of three full-time and ten part-time faculty members were dedicated to each residency program. This survey reveals a potential shortage of minority orthodontic residents currently being trained in orthodontic programs, in addition to several commonalities and differences among the programs' curricula, graduation requirements, and numbers of faculty and staff members. This preliminary survey will hopefully inspire measures to address the discrepancies revealed, particularly the lack of minority students and full-time faculty members.

Efficacy of identifying maxillofacial lesions in cone-beam computed tomographs by orthodontists and orthodontic residents with third-party software

The purpose of this study was to determine the ability of orthodontists and orthodontic residents to identify nonorthodontic incidental findings and false positives in cone-beam computed tomography scans. Two groups of 10 cone-beam computed tomography scans containing equal numbers of scans with no, 1, or several abnormal nonorthodontic lesions were selected from a database. Eight orthodontists and 8 orthodontic residents screened the 2 groups of scans before and after a basic cone-beam computed tomography training course. The paired t test was used for statistical analyses. In the initial screening, the orthodontists and residents correctly identified 41.1% of the lesions. This lesion-detection rate improved significantly to a mean of 56.7% after the training course (P <0.0005). In parallel with these findings, the mean percentage of correctly identified extragnathic lesions improved significantly, from 22% to 48% (P <0.0005), and correctly identified temporomandibular joint lesions improved from 20% to 55% (P = 0.01) after the training. In contrast, the rate of correctly identified dentomaxillofacial lesions remained largely unchanged before and after the training. Both groups of evaluators had approximately 5 false positives per 10 scans before training and demonstrated significant decreases in false positives after training. Relative to known error rates in medical radiology, both groups of evaluators had high error rates for missed lesions and false positives before and after training. Given these findings and since the most frequent cause of medical radiology malpractice litigation is due to missed lesions, it is recommended that an appropriately trained radiologist should be involved in reading and interpreting cone-beam computed tomography scans.

Interactive Distance Learning in Orthodontic Residency Programs: Problems and Potential Solutions

Sharing resources through distance education has been proposed as one way to deal with a lack of full-time faculty members and maintain high-quality content in orthodontic residency programs. To keep distance education for orthodontic residents cost-effective while retaining interaction, a blended approach was developed that combines observation of web-based seminars with live post-seminar discussions. To evaluate this approach, a grant from the American Association of Orthodontists (AAO) opened free access during the 2009-10 academic year to twenty-five recorded seminars in four instructional sequences to all sixty-three orthodontic programs in the United States and Canada. The only requirement was to also participate in the evaluation. Just over half (52 percent) of the U.S. programs chose to participate; the primary reason for participating was because faculty members wanted their residents to have exposure to other faculty members and ideas. The non-participating programs cited technical and logistical problems and their own ability to teach these subjects satisfactorily as reasons. Although participating distant faculty members and residents were generally pleased with the experience, problems in both educational and technical aspects were observed. Educationally, the biggest problem was lack of distant resident preparation and expectation of a lecture rather than a seminar. Technically, the logistics of scheduling distant seminars and uneven quality of the audio and video recordings were the major concerns of both residents and faculty members. Proposed solutions to these educational and technical problems are discussed.

Interactive distance learning for orthodontic residents: Utilization and acceptability

Sharing resources through distance education has been proposed as 1 way to deal with a lack of full-time faculty in orthodontic residency programs. To keep distance education for orthodontic residents as cost-effective as possible while retaining interaction, we developed a "blended" interactive distance learning approach that combines observation of Web-based seminars with live postseminar discussions. For the 2009-2010 academic year, a grant from the American Association of Orthodontists opened access to the blended learning experience to all orthodontic programs in the United States and Canada. The specific aims of this project were to (1) measure programmatic interest in using blended distance learning, (2) determine resident and faculty interest, (3) determine the seminars' perceived usefulness, and (4) elicit feedback regarding future use. Participants in this project were expected to (1) read all assigned articles before viewing a recorded seminar, (2) watch a 1 to 1.5 hour recording of an actual interactive seminar on a Web site, and (3) participate in a 30-minute follow-up discussion immediately after watching the recorded seminar either with a faculty member at the participating institution or via a videoconference with the leader of the Web-based seminar. The residents and faculty then completed surveys about the experience. Half (52%) of the 63 orthodontic programs in the United States fully participated in this project. The blended approach to distance learning was judged to be effective and enjoyable; faculty members were somewhat more enthusiastic about the experience than were residents. Most residents were not adequately prepared for the seminars (only 14% read all preparatory articles in depth); this impacted their perception of the effectiveness and enjoyability of the experience (P = 0.0016). Prepared residents reported a greater ability to learn from the seminars (P = 0.0035) than those who did not read, and also indicated that they were more likely to use the seminars again (P = 0.0018). Despite feedback regarding the need for technologic improvements of the recorded seminars, such as better editing, more frequent slides, quicker pace, and improved sound quality, most residents and faculty agreed that they would like to use this approach to distance learning again. Blended distance learning is an acceptable method of instruction that allows residents to access various experts, supplement traditional instructor-led training, and ease the strain of current faculty shortages. The content of the recorded seminars needs to remain evidence-based, and some technologic aspects of the recordings should be improved.

Preliminary study of Korean orthodontic residents' current concepts and knowledge of cleft lip and palate management.

ObjectiveA national survey was conducted to assess orthodontic residents' current concepts and knowledge of cleft lip and palate (CLP) management in Korea.MethodsA questionnaire consisting of 7 categories and 36 question items was distributed to 16 senior chief residents of orthodontic department at 11 dental university hospitals and 5 medical university hospitals in Korea. All respondents completed the questionnaires and returned them.ResultsAll of the respondents reported that they belonged to an interdisciplinary team. Nineteen percent indicated that they use presurgical infant orthopedic (PSIO) appliances. The percentage of respondents who reported they were 'unsure' about the methods about for cleft repair operation method was relatively high. Eighty-six percent reported that the orthodontic treatment was started at the deciduous or mixed dentition. Various answers were given regarding the amount of maxillary expansion for alveolar bone graft and the estimates of spontaneous or forced eruption of the upper canine. Sixty-seven percent reported use of a rapid maxillary expansion appliance as an anchorage device for maxillary protraction with a facemask. There was consensus among respondents regarding daily wearing time, duration of treatment, and amount of orthopedic force. Various estimates were given for the relapse percentage after maxillary advancement distraction osteogenesis (MADO). Most respondents did not have sufficient experience with MADO.ConclusionsThese findings suggest that education about the concepts and methods of PSIO and surgical repair, consensus regarding orthodontic management protocols, and additional MADO experience are needed in order to improve the quality of CLP management in Korean orthodontic residents.

Orthodontic care for underserved patientsProfessional attitudes and behavior of orthodontic residents and orthodontists

To explore whether orthodontic residents and orthodontists differ in their attitudes and behavior concerning the treatment of underserved patients and to investigate how background factors such as the providers' gender, ethnicity/race, and age affect these attitudes and behavior. Survey data were collected from 135 residents in US and Canadian graduate orthodontic programs and from 568 active members of the American Association of Orthodontists. Attitudes toward various aspects of treating underserved patients were rated on a five-point scale, with 1 indicating the most negative attitude and 5 indicating the most positive. Orthodontic residents had more positive attitudes about treating poor patients (3.02 vs 1.99; P < .001), pro bono cases (3.87 vs. 3.45; P < .001), and patients with craniofacial anomalies (3.64 vs 3.01; P < .001) or mental retardation (3.13 vs 2.72; P < .001) than orthodontists. However, compared to orthodontists, lower percentages of residents intended to treat pro bono cases (73.5% vs 83%; P = .009) and patients with craniofacial anomalies (63.6% vs 82.9%; P < .001) or mental retardation (55% vs 81.5%; P < .001). The providers' gender did not have an effect on these attitudes and related behavior, while ethnicity/race and age of the providers were relevant. Residents had more positive attitudes concerning the treatment of underserved patients than orthodontists. However, their behavioral intentions did not indicate an increased willingness to provide care for these patients.

Orthodontic education - The times they are a changin'

A resident about to graduate from one of the seventy accredited orthodontic programs in the US and Canada is facing a very different scenario than in previous years due to three factors: the current economic climate, the cost of attending a program and increased student debt. The AAO website provides an online document titled Accredited Schools which in 2003 I exported to Excel and analyzed the results. I repeated the exercise with the latest version of this document and will present some conclusions which are dependent upon the AAO document being up to date and accurate. I have also used another resource, a Bentson Clark and Copple resident survey completed recently which was emailed to 967 current residents and received a total of 461 responses. The cost of attending an orthodontic program has increased significantly for some programs. The numbers presented here represent only those costs associated with the program so living expenses such as housing, meals and transportation must be added. A very interesting fact is that there is a large financial spread among our 70 programs. Today the best financial program pays residents $160,000 over the length of the program while the most costly program charges a residents a total of $240,000 (Table 1). The five highest paying programs are hospital based so most likely the large stipends are available through GME funding assistance. ,Graduate Medical Education Reimbursement and Residency Funding. Since 2003, 20 programs have decreased resident charges (range $644 to $105,112). Two have stayed the same. On the other hand, 48 programs have raised resident charges (range $1740 to $118,153). So we currently have the equivalent of 21 two year programs, 13 two and a half year programs with the majority (36) at three years (Table 2). Changes from 2003 with the addition of new programs and adjusting the number of residents admitted have caused an increase in the number of graduates from 358 to 390, an increase of 32. The Bentson Clark and Copple resident survey has revealed some significant changes that may alter the course of future events for recent graduates. The most striking issue is the fact that in 2010, 34% of our orthodontic residents graduated with more than $300,000 of student debt. Today that percentage remains high at 36%. A recent graduate with a $300,000 debt after a six month grace period would begin paying off this debt of $300,000 over 20 years at 7% which equals $2325.90 paid with after tax earnings. This would equate to $27,910.80 annually in after tax payments which, depending on earnings would likely equate to almost $40,000 in gross income. This creates a possible scenario in which a recent graduate with little or even a negative net worth may not be able to acquire funding to either start a practice or acquire one. Since opportunities are limited to become an associate in a private practice the only remaining possibility for income for this individual may be one of the clinic chains that provides orthodontic care, doing orthodontics for a pediatric dental office or GP group or working for multiple practices doing day work. For those residents with good credit who have found a practice to purchase with good cash flow, they must think big by looking at practices with high net income to cover high expenses. Looking at a small satellite or fixer-upper won’t provide the cash flow to service educational debt and have enough left over for living expenses. Current owners selling to these residents may be required to carry some of the purchase debt in the form of a note, thus sharing the risk with an institutional lender. According to the survey, 53% o the current residents plan to purchase a practice, 25% desire to associate only while only 11% plan to undertake a startup. In July of 2010 according to the AAO’s Practice Opportunities Service there were 132 practices for sale with 674 recent graduates looking for an acquisition. Today that ratio has improved somewhat with 158 practices for sale with 443 individuals looking for an acquisition. It is

Academic Orthodontic Opportunities

This listing of academic opportunities is provided as a free service to the profession and the community.Rank: Orthodontic Residency Program Dir.University of Alabama at Birmingham School of DentistryDept. of Orthodontics, Birmingham, AL 35294-0007Contact: Dr. Chung How Kau, (205) 934-1289FAX: (205) 975-7590 e-mail: ckau@uab.eduRank: 2 Orthodontic InstructorsUniversity of Alabama at Birmingham School of DentistryDept. of Orthodontics, Birmingham, AL 35294-0007Contact: Dr. Chung How Kau, (205) 934-1289FAX: (205) 975-7590 e-mail: ckau@uab.eduRank: Graduate Program Director Full-time positionLoma Linda University School of DentistryProgram for Advanced Education in OrthodonticsContact: Dr. Joseph M. Caruso, ChairLoma Linda, CA 92350Rank: Assistant ProfessorUniversity of Connecticut School of Dental MedicineDept. of Orthodontics, Farmington, CT 06030-1725Contact: Dr. Ravindra Nanda, (860) 679-2550FAX: (860) 679-1920 e-mail: nanda@nso.uchc.eduRank: Full-time Asst/Assoc ProfessorUniversity of Florida College of DentistryDepartment of OrthodonticsGainesville, FL 32610Contact: Dr. John Neubert (352) 273-5687e-mail: jneubert@dental.ufl.eduRank: (Two) Part-time Adjunct Clinical Asst/Assoc ProfessorUniversity of Florida College of DentistryDepartment of OrthodonticsGainesville, FL 32610Contact: Dr. John Neubert (352) 273-5687e-mail: jneubert@dental.ufl.eduRank: Full-time Asst/Assoc ProfessorJacksonville University School of OrthodonticsJacksonville, FL 32211, Contact: Dr. Joseph Pelle(904) 256-7847 - Fax (904) 256-7126 –e-mail: jpelle@ju.eduRank: Dependent upon experience and credentials, Full-time positionIndiana University School of DentistryOrthodontics, Division of the Department ofOral Facial Development, Indianapolis, INContact: Dr. Jeffrey A. Deane-mail: jadean1@iupui.eduandRank: Professor, Assoc Prof, or Cl Assoc/AsstCraniofacial OrthodonticsContact: Dr. Jeffrey A. Deane-mail: jadean1@iupui.eduRank: Full-time, Endowed, Tenure-trackThe University of Iowa, College of DentistryDepartment of Orthodontics, Iowa City, IAApplicants must apply electronically.Go to Jobs@UIowa at http://jobs.uiowa.edu/faculty/view/56457.Rank: Assistant/Associate ProfessorUniversity of Kentucky College of DentistryDivision of OrthodonticsDental Science Building, D-406800 Rose Street, Lexington, KY 40536-0297Contact: Kandace Bright, Department Administratore-mail: knmoor3@email.uky.eduRank: Not stated Full-timeMayo Clinic, RochesterDepartment of Dental SpecialtiesContact: Kevin I. Reid, DMD, Chair200 First Street SW, Rochester, MN 55905Rank: Assistant/Associate Professor Clinical-track or tenure-trackUniversity of Minnesota School of DentistryDivision of OrthodonticsMinneapolis, MNElectronic applications only will be accepted for this position:Clinical-track position URL: employment.umn.edu/applicants/Central?quickFind = 95042Tenure-track position URL: employment.umn.edu/applicants/Central?quickFind = 95041Rank: 2 Full-time, tenure track - all levels Part-time positions – all levelsUMDNJ-New Jersey Dental SchoolDept. of Orthodontics, 110 Bergen StreetPO Box 1709, Newark, New JerseyContact: Dr. Robert E. Binder, Interim Chair(973) 972-6858 FAX: (973) 972-0526e-mail: binderre@umdnj.eduRank: Assistant/Associate ProfessorNew York University College of DentistryGeorge J. Cisneros, DMD, MS, Professor and ChairDept. of Orthodontics, 345 E. 24th Street,New York, NY 10010Rank: Orthodontist (assistant/associate or full professor level)Stony Brook University, School of Dental Medicine146 Rockland HallStony Brook, NY 11794-8700Full position description at: www.stonybrook.edu/jobs(REF: F-4898-08-0)Contact: Patricia Vitale, VP CoordinatorRank: Orthodontics Residency Program Director Required: DMD, DDS degree or equivalent Must be eligible for Ohio licensure Submit: CV and 3 Letters of ReferenceThe Ohio State University, College of DentistryDivision of OrthodonticsRm. 4088 Postle Hall305 W. 12th AvenueColumbus, OH 43210-1267Contact: Dr. Henry W. Fields, Chairfields.31@osu.eduRank: Assistant Professor, Full-time Clinical Educator TrackUniversity of Pennsylvania, School of Dental MedicineDept. of Orthodontics, 240 S. 40th StreetPhiladelphia, PA 19104-6303Contact: Dr. Robert L. Vanarsdall, Chair215-898-5910 FAX: 215-898-0998e-mail: rlv@pobox.upenn.eduRank: Professor and Chair Full-timeUniversity of Pennsylvania, School of Dental MedicineDepartment of Orthodontics, 240 So. 40th St., Levy 436Contact: Dr. Carolyn Gibson, ProfessorPhiladelphia, PA 19104Phn: (215) 898-6660e-mail: GIBSON@BIOCHEM.DENTAL.UPENN.EDURank: Graduate Program Director (1) Full-Time positionTemple University Kornberg School of DentistryDepartment of Orthodontics3223 North Broad StreetPhiladelphia, PA 19140Contact: Dr. Lisa Deem, Chair Search Committee,Admissions and Students AffairsRank: Full-time, tenure trackUniversity of TennesseeDept. of Orthodontics, College of DentistryContact: Dr. James L. Vaden, Chair875 Union Avenue, Memphis, TN 38163

Evaluation of dehiscences using cone beam computed tomography

To validate the use of three-dimensional (3-D) surface rendering (SR) images to quantify the height of alveolar dehiscences. Twenty-four dehiscences were created on 9 incisors, 9 canines, and 6 premolars on 4 cadaver skulls. i-CAT cone beam computed tomography scans (CBCTs) were taken of each skull at .2 mm voxel size. Each dehiscence was quantified by 21 orthodontic residents using 3-D SR. The principal investigator (PI) also quantified each dehiscence using the 2-D multiplanar (MP) image and the 3-D SR image. Results of this study showed an average method error of the residents as a group to be 0.57 mm with an intraclass correlation (ICC) of 0.77%. Residents' method error ranged from 0.45 mm to 1.32 mm, and the ICC ranged from 0.201% to 0.857%. Systematic error was low at -0.01 mm for the direct measurement compared with the residents' average 3-D SR at 1365 density value (DV) measurement. The 3-D SR at 1365 DV images were compared with the MP and 3-D SR images at 1200 DV, and no significant differences in measurements and low systematic error were noted. The method error of the PI was 0.45 mm, 0.45 mm, and 0.41 mm for 3-D SR at 1365 DV, 3-D SR at 1200 DV, and 2-D MP, respectively. 3-D SR and 2D MRP can be used to measure dehiscences of the periodontium with similar levels of accuracy.

In-office distance learning for practitioners

Distance learning studies involving orthodontic residents have shown that, although residents prefer being live and interactive with an instructor, they learn almost as much from watching a recorded interactive seminar followed by a live discussion. Our objective in this study was to test the acceptability and perceived effectiveness of using recorded interactive seminars and video conference follow-up discussions for in-office continuing education. Four small groups of practitioners (total, n= 23) were asked to prepare for, view, and then discuss previously recorded interactive seminars on a variety of subjects; a fifth group (5 previous participants) had live discussions of 3 topics without viewing a prerecorded seminar. All discussions were via video conference through typical broadband Internet connections, by using either WebEx (Cisco, Santa Clara, Calif) or Elluminate (Pleasanton, Calif) software. The participants evaluated their experiences by rating presented statements on a 7-point Likert scale and by providing open-ended responses. Twenty-two of the 23 participants agreed (with varying degrees of enthusiasm) that this was an enjoyable, effective way to learn, and that they would like to participate in this type of learning in the future. Everyone agreed that they would recommend this method of learning to others. The age and experience of the participants had only minor effects on their perceptions of acceptance and acceptability. The use of recorded seminars followed by live interaction through videoconferencing can be an acceptable and effective method of providing continuing education tothe home or office of orthodontists in private practice, potentially saving them both time and travel expenses.

Residents’ journal review

Residents’ journal review

Clinical outcomes assessment of consecutively finished patients in a 24-month orthodontic residency: A 5-year perspective

The purpose of this study was to report on the clinical outcomes of a 24-month orthodontic residency. One examiner scored 1019 consecutive pretreatment records and 714 consecutive posttreatment records annually over 5 years, using the American Board of Orthodontics discrepancy index and objective grading system. The mean discrepancy index scores were 19.63, 14.84, 12.30, 15.72, and 15.39 for years 1 through 5, respectively. The mean objective grading system scores were 31.16, 34.79, 28.55, 26.28, and 22.11 for years 1 through 5, respectively. The residents' completion rates for all cases were 58.9%, 60.5%, 82.7%, 74.4%, 78.2%, and 72.2% for years 1 through 5, respectively. The establishment of an annual objective outcomes assessment benefited patients by improving objective grading system scores and reduced the number of transfers between residents (increased case completion rate), thus reducing faculty time for managing many transfer patients.

Working for another

Working for another

Recorded interactive seminars and follow-up discussions as an effective method for distance learning

Previous studies have suggested that, although orthodontic residents prefer to be live and interactive in a seminar, they learn almost as much when watching a previously recorded interactive seminar and following up with live discussion. Our objective was to test the effectiveness and acceptability of using previously recorded interactive seminars and different types of live follow-up discussions. Residents at schools participating from a distance completed preseminar readings and at their convenience watched streaming video of some or all recordings of 4 interactive seminar sequences consisting of 6 seminars each. Afterward, distant residents participated in 1 of 4 types of interaction: local follow-up discussion, videoconference, teleconference, and no discussion. The effectiveness of the seminar sequences was tested by pretest and posttest scores. Acceptability was evaluated from ratings of aspects of the seminar and discussion experience. Open-ended questions allowed residents to express what they liked and to suggest changes in their experiences. In each seminar sequence, test scores of schools participating through recordings and follow-up discussions improved more than those participating live and interactive. After viewing, residents preferred local follow-up discussion, which was not statistically different from participating live and interactive both locally and from a distance. Videoconference and teleconference discussions were both more acceptable to residents than no follow-up discussion, which was found to be significantly below all methods tested. When residents are live and interactive in a seminar, there does not appear to be a significant difference between being local vs at a distance. Recorded interactive seminars with follow-up discussions are also an effective and acceptable method of distance learning. Residents preferred local follow-up discussion, but, at a distance, they preferred videoconference to both teleconference and no discussion.