Date of Award

2018

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Orthodontics

College

College of Dental Medicine

First Advisor

Jing Zhou

Second Advisor

Ricky E. Harrell

Third Advisor

Loring Ross

Abstract

Objective: This project was designed to complete two primary objectives: 1. Evaluate and quantify the usage of relatively new technologies in both a private practice and academic setting and 2. Determine if a discrepancy exists between what is taught in residencies and what is currently used in private practice. In addition, the study will evaluate if different regions of the United States use more or less of the newer technologies and if the length of time practicing (or how long a program has been accredited) are correlated to more or less use of new technology. The data from this research could potentially be used by residency programs to determine how much emphasis their program should place on the newer technologies referenced in this study. The null hypothesis is that a discrepancy does not exist between the amount of time orthodontic residency programs and private practice offices are using the newer technologies researched. Materials and Methods: A survey invitation was emailed to orthodontic residency Chairperson/Program Directors and private practice orthodontists. An email with a link to the survey was sent to all sixty-eight accredited orthodontic residency programs in the United States. For the private practice survey, an invitation was sent to 8,097 orthodontists who were listed as members of the American Association of Orthodontists (AAO). The private practice orthodontists were selected at random from the AAO’s member directory. The invitation emails included a brief summary of the survey, its purpose, an estimation of how long it would take to complete, and a link to the online survey. Participation in the survey was completely voluntary and participants were not financially compensated. Two additional reminder emails were sent to the private practice orthodontists group, and three reminder emails were sent to the orthodontic residency program’s Chair/Program Directors. The format of the survey consisted of multiple choice questions pertaining to the residency or private practice’s location (Region of the United States), length of accreditation or time in private practice, and usage of Invisalign, Suresmile, accelerated orthodontics (including vibration, periodontally accelerated osteogenic orthodontics (PAOO), surgical osteotomy, or lasers), Cone Beam Computed Tomography (CBCT), intraoral scanners, and three-dimensional photography. The survey was formed using the REDCap survey program. Comparisons between the two surveys were made using a Chi-Square test for all except the questions pertaining to the residency/practice location. For those questions, question 1 and 2, a Fisher’s exact test was used due to the smaller cell size. Results: After the two emails were sent to members of the AAO, a total of 1,441 private practice orthodontists and 39 residency programs completed the survey. When responses from residency programs were compared with those from the private practices, there was no statistical difference in the percentage of cases that utilized Invisalign, Suresmile, or accelerated orthodontics. There was, however, a statistically significant difference in the types of accelerated orthodontics offered in residency programs when compared to private practice. 64.10 percent of residency programs offer PAOO as a form of accelerated orthodontics, as compared to 18.39 percent of private offices, which is statistically significant with a p-value of <0.0001. 23.08 percent of residency programs offer surgical osteotomies as a form of accelerated orthodontics, which is statistically significantly higher (p-value = 0.0009) than the 8.05 percent of private offices that offer surgical osteotomies. Overall, 55.24 percent of private offices reported that no accelerated orthodontics is offered, which is statistically significantly higher (p-value = 0.0002) than the 25.64 percent of residency programs that reported not offering any form of accelerated orthodontics. There was a statistically significant difference in the percentage of residency programs that offer CBCT imaging and intra oral scanning, when compared to the percentage of private offices. Conclusions: Overall, the data shows that residency programs are doing an adequate job of staying current with the newer technologies compared in this study. The only significant differences shown were all contributed to a higher usage of the technologies surveyed in residency programs when compared to private practice.

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