The Peer Assessment Rating (PAR) index is a British occlusal index that measures the severity of dental malocclusion and has been used in several investigations that have evaluated the effectiveness of orthodontic treatment provision in Europe. As part of its development, the PAR index was validated for malocclusion severity, by using the opinions of a panel of 74 dentists and orthodontists. The present investigation was carried out to validate the PAR index, by using the opinion of an American panel of orthodontists. Eleven orthodontists examined a sample of 200 sets of study casts and rated them for malocclusion severity and perceived treatment difficulty. Multiple regression techniques were used to evaluate the predictive power of the components of malocclusion on the panel's scores. Weightings were calculated from the partial regression coefficients and, when these weightings were applied to the PAR index, the association between the panel's opinion and the PAR index scores was increased.
The purpose of this study was to evaluate changes in nasal resistance to airflow in persons undergoing rapid maxillary expansion and to reevaluate the responses at a 1-year follow-up. Nasal resistance measurements, assessed in four modes (natural state, anterior nares dilation with Tygon tubing, following administration of decongestant, and nares dilation with tubing and decongestant), were taken on a group of 38 patients receiving rapid maxillary expansion and compared with a control group not receiving expansion. Thirty-three of the patients were reevaluated 9 to 12 months after expansion was completed. Eighteen subjects in the control group were also reevaluated. Oral/nasal airflow rates (percent nasality) were recorded for the control group and for some of the expansion patients. Results indicated that some subjects receiving rapid maxillary expansion had a significantly higher nasal resistance than the control group. There was a significant median reduction in nasal resistance following rapid maxillary expansion, measured in the natural state only, and this appeared to be stable up to 1 year after maximum expansion was obtained. Rapid maxillary expansion appeared to effect an expansion at the anterior nares, which contributes to nasal resistance reduction. Individual variation in nasal resistance values was considerable and hence the median response for the group was not a reliable estimate of individual response. Due to the high individual response variability, rapid maxillary expansion is not a predictable means of decreasing nasal resistance.
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