The objective of this study was to evaluate parents’ preferences of the appearance and attire of orthodontists. Six subjects were asked to pose for photographs wearing various combinations of attire (casual, scrubs, white coat, formal), hairstyle and nametag. Survey participants were presented with choice sets and asked to select the most and least preferred provider photographs. A total of 77 parents of orthodontic patients participated in the computer-based survey. The results indicated that there were significant differences due to provider sex (P = 0.0013), provider age (P < .0001), dress (P < .0001), nametag (P = 0.0065) and hair (P < .0001). The most preferred providers were the younger female and the older male. Formal attire or scrubs was the most preferred style of dress. There was also a preference for the use of a nametag and for the provider to have his/her hair in a controlled style.

An anonymous online survey of Canadian orthodontists was used to evaluate orthodontic practice management related background, training, needs and practices. Program directors of Canadian graduate orthodontic programs were contacted for details regarding their programs educational opportunities in practice management. The survey response rate was 19% (136/713). Four out of five program directors responded. The majority of survey respondents expressed an opinion that their graduate programs business exposure was insufficient, and more structured training would have been preferable. A structured course in practice management may best be contained within current program lengths, or with a short program length extension. Room for additional teaching time may be made in orthodontic programs by way of internal restructuring including reallocation of free time, research time and other didactic exposure, however respondents here did not feel a reduction in clinical exposure to make room for a structured practice management course was acceptable.

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The purpose of this study was to investigate differences in case confidence, treatment management, and Invisalign® expertise between orthodontists and general dentists. A survey was mailed to 1,000 randomly selected orthodontists and general dentists, respectively, who are Invisalign® providers, and results were analyzed. The results indicated that orthodontists treated significantly more Invisalign® cases and received more Invisalign® training than general dentists (P

Magister Scientiae Dentium - MSc(Dent) / Influence of orthodontic caregiver behaviour on the perceived satisfaction of patients during orthodontic treatment. Dr. F.J. du Raan M.Sc. (Orthodontics) thesis, Department of Orthodontics, University of the Western Cape. In this thesis I interviewed patients that are busy with orthodontic treatment, as well as those that have undergone orthodontic treatment at the department of Orthodontics at the University of the Western Cape, with the aid of four questionnaires. Patients completed questionnaires to provide general and demographic information, quantify their satisfaction with the orthodontic treatment process, their perception of the orthodontic clinician's behavioural traits and lastly they completed the NEO-FFI personality questionnaire to determine their own personality profile. All these questionnaires were used in previous studies, or they were slightly modified to be applicable to orthodontics. The information gained was used to determine if there are correlations between the patient’s perceived satisfaction of the treatment process with patient specific treatment variables (as acquired from the General information and Demographics Questionnaire ), demographic factors, clinician's behavioural traits and patient specific personality traits and any combination of the above mentioned. We wanted to determine which behavioural traits of the orthodontic caregiver influences the perceived satisfaction with the treatment to the greatest extent. Furthermore, we wanted to determine if certain personality traits of the patients would influence their perceived satisfaction with the treatment process or their perception of the clinician's behavioural traits. The only aspect from the General Information and Demographics Questionnaire that had any correlation to satisfaction with the treatment process or the perception of the clinician's behavioural traits, was whether the patient was treated by a single registrar or multiple registrars. Patients treated by multiple clinicians had a lower average score for satisfaction and orthodontist behaviour. Results from the study shows that all the clinician's behavioural traits do have statistically significant influence on the perceived satisfaction with the treatment process, but certain behavioural traits have a greater influence. Result showed Empathy and Care to have the strongest influence on perceived satisfaction, whereas Motivation has the lowest influence. The NEO-FFI personality questionnaire was used to register each patient's personality profile. Scoring for the following personality traits created the personality profile: Neuroticism, Extraversion, and Openness to Experience, Conscientiousness and Agreeableness. Patient personality profiles were shown to have no significant influence on the patient's perceived satisfaction with the treatment process.Neuroticism was shown to have a weak negative correlation with the Professionalism sub-category of the Orthodontic Clinician Behaviour Questionnaire. Conscientiousness has been shown to have a weak positive correlation with all categories of the Orthodontic Clinician Behaviour Questionnaire It is put forth by the researcher that more time and effort has to be put into improving all aspects of the clinician's behaviour, as it will positively influence the perceived satisfaction of the orthodontic treatment process.Even though there are no significant correlations, patients needs to be screened to determine their personality profiles, as this may lead to slight improved scoring on certain behavioural aspects which may in turn lead to greater patient satisfaction. It may be especially worthwhile to recognise the neurotic patient and treat them on a more personal level, as this may improve their overall satisfaction.

Objectives: Little is known about the treatment standards and expectations of Invisalign treatment outcomes between orthodontists and general practitioners (GP). The objective of this qualitative research project was to explore how orthodontists and GPs perceive Invisalign treatment outcomes, and to determine which criteria they use to judge successful treatment.   Methods: Open-ended interviews were conducted with three orthodontists and two GPs. These interviews were recorded, transcribed, coded and analyzed by the conventional phenomenological qualitative research protocol. Each clinician selected four Invisalign cases that they treated and perceived as successful outcomes. To augment qualitative methods, quantitative data were generated to determine pre-treatment Discrepancy Index (DI) and post-treatment Objective Grading System (OGS) scores as calculated by OrthoCAD software.   Results: Independent sample T-tests showed no significant difference in total DI score (p=0.287) and total OGS score (p=0.840) between the orthodontist (n=12) and GP (n=7) cases. Orthodontists perceive incisor torque and smile esthetics as important criteria for successful Invisalign outcomes. In contrast, GPs do not. Orthodontists and GPs unanimously perceive that Class I occlusion is an important criterion for successful treatment. GPs perceive extraction cases as a challenge to obtain successful outcome with Invisalign whereas, orthodontists do not. Conclusions: Differences exist between orthodontist and GP perceptions of what constitutes successful Invisalign treatment. Currently employed standards of excellence can be found in a wide spectrum of finishes; however, they are incapable of defining the excellence of finish. Selective standards differentiate the GPs from orthodontists, but agreement exists for ambition to finish in Class I occlusion. Esthetics and torque are valued higher by the orthodontists than are by the GPs. The utility of current standards- of-care need to be questioned and redefined. / Oral Biology

Introduction: Lateral cephalometric superimpositions (LCS) are used to measure dental and skeletal changes that occur in the craniofacial complex over time. Orthodontists use LCSs to assess treatment outcomes. The purpose of this study was to conduct an assessment of the measured displacement of defined dental landmarks across digital and analog methods of mandibular regional serial superimposition as compared to an implant-registered superimposition reference. The data used in this study was derived from the Mathew's Acquisition Group implant sample; the first United States longitudinal study of growing children with maxillary and mandibular Björk type metallic implants. Methods: Sixty-six lateral cephalometric radiographs were selected from twenty-two children. Three cephalometric tracings were completed for each subject that were then superimposed pairwise (T1 vs. T2, T2 vs. T3) across four separate methods of superimposition, two analog: Implant, Structural; and two digital: Dolphin, Quick Ceph. Each superimposition was then imported into Adobe Photoshop where the images were scaled and the displacement of defined dental structures was measured. Defined dental structures included: (1) first molar mesial contact point, (2) first molar apical root bisection, (3) central incisor root apex, and (4) central incisor crown incisal edge. A random-effects, generalized linear model was used to contrast dental landmark displacement measurements. Results: There was no difference between the mean displacement of defined dental structures between different methods (p=0.145). There was no difference between the different methods by defined dental structure (p=0.150). Conclusions: Our study demonstrated that there are no statistically significant differences among three methods of mandibular regional superimposition in comparison to an implant-registered (reference) method (analog: Structural, Implant; digital: Dolphin, and Quick Ceph). The historical data set utilized in our study, limited by the small sample size, resulted in a relatively low power (0.15). A low power increases the likelihood of incorrectly failing to reject a null hypothesis that is actually false. which must be considered in our study.

With the advent of cephalometrics in the 1930s, numerous studies have focused on the profile of a face to achieve a more esthetic orthodontic treatment outcome. With such heavy emphasis on facial esthetics, a shift in focus from the profile view to the oblique view has become necessary as the smile in the oblique view is what the general public evaluates. The purpose of this pilot study was to determine whether the current tools for diagnosis and treatment evaluation are sufficient. Currently, 2-dimensional composite photographs are utilized in evaluating the soft tissue. At Temple University, 3-dimensional images, which show all sides of the patient's face, are used adjunctively to 2-dimensional composite photographs. In this study, faculty members at the Temple University Department of Orthodontics were asked to complete surveys after viewing two different image modalities, 2-dimensional images and a 3-dimensional video of the same patient. They were asked to fill out the soft tissue goals for specific facial landmarks. Patient photos were in the smiling view as current literature lacks studies on this view. Faculty members' responses from analyzing the 2-dimensional images and 3-dimensional video for each patient were compared to determine which areas had frequent discrepancies from using two different image modalities. During the survey, a voice recorder captured any comments regarding the images. The ultimate goal of this qualitative pilot study was to identify when 3-dimensional imaging is necessary in treatment planning and evaluation, with an added hope to further advance research in 3-dimensional imaging and its vast possibilities to advance the field of orthodontics. Based on the data collected, the following conclusions were made: 1. The qualitative data highlighted that 3-dimensional imaging would be necessary in cases with skeletal deformities. 2. In the oblique view, 3-dimensional imaging is superior than 2-dimensional imaging by showing more accurate shadow, contour, and depth of the soft tissue. 3. Further improvement is necessary to create a virtual patient with treatment simulation abilities. 4. The comfort level among orthodontists of 2-dimensional imaging was higher than 3-dimensional imaging. With more widespread use of 3-dimensional imaging, more orthodontists may gradually reach a higher comfort level in using this relatively new technology. 5. Faculty members expressed high willingness to use 3-dimensional imaging if improvement in new technology could allow for more manipulation and accurate soft tissue prediction. 6. 3-dimensional imaging is superior in its efficiency, quick capture time, and lack of need for multiple images. Implementation of 3-dimensional imaging could streamline the records process and help with practice efficiency without compromising the image quality. 7. Both patients and orthodontists may benefit from using 3-dimensional imaging. Patients can see an accurate representation of themselves and possibly view their own treatment simulation upon further improvement in current technology. Orthodontists would benefit with much more accurate images that may serve as the virtual patient. 8. Besides the exorbitantly high cost, faculty members thought that more advances were needed and the current benefit was not great enough to justify the investment. The results were consistent with other studies that used the oblique view in that the 2-dimensional oblique view lacks depth and does not provide adequate information. With further improvement in current 3-dimensional imaging, this technology can benefit orthodontists in visualizing their patients. In addition, patients can benefit by hopefully seeing a live and accurate simulation of themselves instantly as a virtual patient. With these benefits of 3-dimensional imaging, it may one day be the new standard in patient records in the field of orthodontics. / Oral Biology

In order to obtain perspectives of Canadian dentists on the quality of the undergraduate education received in orthodontics and the extent of orthodontic services provided, a descriptive survey was constructed. Methods An anonymous, web-based survey was created using Survey Monkey® (Palo Alto, USA), and distributed to registered dentists in Canada via links in newsletters and mass emails. Results There were 427 respondents. Results showed that 71% of dentists provide some orthodontic treatment, and 33% of them offered only space maintainers. A total of 23% treated most of their patients requiring interceptive treatment, compared to 15% for those requiring comprehensive treatment. A driving time greater than 1 hour to the closest orthodontist resulted in a 16% increase in the provision of orthodontic treatment by the general dentists. The undergraduate orthodontic education was deemed above average by 21.4% to 50.5% of the respondents. Conclusions The percentage of dentists currently providing orthodontic services to their patients is similar to previous reports. A driving time of more than 1 hour is an influencing factor on the provision of orthodontic treatment by Canadian general dentists. The quality of undergraduate orthodontic education provided has improved over the last 25 years, although some amelioration may be beneficial.

A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry. Objective: This study aimed to determine and compare the esthetic preference of the general public, dentists, orthodontists and prosthodontists in relation to the width of the most anatomically variable tooth in the mouth, the maxillary lateral incisor. Background: The general public today places more importance on facial esthetics than they have in the past and their esthetic preferences are evolving. The smile is a main feature of facial esthetics and its attractiveness is based in part on the size and proportion of the anterior teeth. The lateral incisors are the most variable in size and there is a continuing debate in the literature with conflicting reports about how wide they should be in proportion to their neighboring teeth. Methods: Two sets of seven images of frontal and oblique (three-quarter) smile views were created with Adobe Photoshop Elements 10 by morphing two "Master Smile" images. The seven images within each set had different width proportions of lateral incisors. However, they were identical in every other aspect such as differences in lip thickness or tooth shape to diminish the impact of compounding variables between photographs. A link to an online survey was distributed by email to four groups: laypeople, general dentists, orthodontists and prosthodontists. Subjects taking the survey ranked the seven photographs in each set from the most to the least esthetic based on their personal preference. The results were studied to ascertain whether the general public has an esthetic preference in the width of lateral incisors and, if that preference exists, whether it is different from that of trained dental professionals. Results: In a frontal view of a smile, the global preference for the width of a lateral incisor falls into the range of 62.5-72.5% of the width of the central incisor. The probability that the most preferred choice is 67.5% or greater is 66%. In the frontal view there was no statistically significant difference between professions. Non-Hispanic white respondents preferred slightly more narrow laterals than other ethnicities in the frontal view. Respondents older than forty preferred slightly wider laterals than respondents under forty in the frontal view. In the oblique view, there was a 69% probability that the most preferred choice was the largest option: a lateral incisor 91.5% of the width of the visible width of the central incisor. In the oblique view, the three groups of dental professionals were more likely than the general public to select a wider incisor as the most esthetic option. Conclusion: Preference for smile attractiveness can be significantly influenced by the width of lateral incisors in a frontal and oblique view. Orthodontist, general dentists, and prosthodontists were shown to be in general agreement with the public in preferring a wider lateral incisor viewed from a frontal smile. In an oblique view, their professions had a statistically significant impact on the difference between their choices compared to laypeople in that they preferred a slightly wider lateral incisor. All groups preferred significantly wider laterals than is proscribed by the Golden Proportion.