In this study we investigated patterns of referral and appropriateness of referrals to specialist oral and maxillofacial surgery services, using postal questionnaires and referral letters. The most common reasons for ...
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In this study we investigated patterns of referral and appropriateness of referrals to specialist oral and maxillofacial surgery services, using postal questionnaires and referral letters. The most common reasons for referral were the expected difficulty of the operation, the medical condition of the patient and the lack of facilities for general anaesthesia, Most referrals were made to the oral and maxillofacial surgery department of a general hospital but almost three-quarters of the respondents stated that they would refer patients to specialist surgical dentistry practices in the future. Few referrals to a university department of oral and maxillofacial surgery were considered to be inappropriate, nor were requests for a particular type of anaesthesia. Any future transfer from secondary to primary care for oral surgery may be hindered by the reduction in facilities for general anaesthesia in the primary care setting.
Efficient use of hospital resources is essential if waiting lists are to be reduced. We undertook this study because there seems to be little information on the use of theatre time for dentoalveolar surgery under gene...
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Efficient use of hospital resources is essential if waiting lists are to be reduced. We undertook this study because there seems to be little information on the use of theatre time for dentoalveolar surgery under general anaesthesia. The time taken for each sequence of events (from start of case, induction, operation to recovery, and so on) for each patient was recorded. Of the 30 lists examined, 22 lists (73%) finished on time or early, and 8 lists (27%) ran late, The time spent operating occupied less than 50% of theatre time available, The 'total time' for each case was increased (by about 10 minutes a patient) when a junior anaesthetist was anaesthetizing rather than a consultant. The overall time used per list was 79% with the remaining 21% of the list being 'unused', Where these lists did over-run, then this was usually because the operation took longer, although grade of anaesthetist was a factor. We identified several areas in which efficiency could be improved.
The aim was to examine oral surgeons' assessment of the indications for removal of mandibular third molars. Questionnaires were distributed to seven oral and maxillofacial surgery clinics. The oral surgeons were a...
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The aim was to examine oral surgeons' assessment of the indications for removal of mandibular third molars. Questionnaires were distributed to seven oral and maxillofacial surgery clinics. The oral surgeons were asked to record whether or not there was associated disease. Three other factors were recorded: patient's age, and angular position and extent of eruption of the molars. The strength of the indication for removal was rated on a visual analogue scale (VAS) where 0 = weakest and 100 = strongest indication for removal. The results were based on data from 666 molars: 118 (18%) had no disease, 465 (70%) had one associated disease, 77 (11%) had two and 6 (1%) had three. The indication for removal as expressed by the mean VAS for molars with no disease was assessed to be weaker (P < 0.05) than that for molars with one, two, or three diseases. The only;factor that influenced the indication for removal in molars with no disease was the patient's age.
OBJECTIVE: (i) To analyse the consistency of a group of orthodontists' treatment decisions and (ii) to identify factors that may influence this consistency. DESIGN: Cross-sectional observational study. SUBJECTS: T...
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OBJECTIVE: (i) To analyse the consistency of a group of orthodontists' treatment decisions and (ii) to identify factors that may influence this consistency. DESIGN: Cross-sectional observational study. SUBJECTS: Ten orthodontists. METHODS: The orthodontists examined 60 case vignettes and recorded their treatment decisions on two separate occasions. MAIN MEASURE: Inter- and intra-examiner agreement was evaluated with the Kappa statistic. RESULTS: The consistency within each orthodontist was moderate. However, between-orthodontist consistency was poor. CONCLUSION: It appears that there is marked variation between orthodontists in treatment planning decisions and this may reflect the lack of evidence for the effectiveness of competing treatments.
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