Magnitude and reproducibility of forces generated by clinicians during laceback placement

Objective: To determine the magnitude and reproducibility of forces generated by clinicians during laceback placement using a force-measuring typodont. Setting: An in vitro investigation. Materials and methods: An in vitro typodont model was developed, which incorporated strain gauges attached to a personal computer to allow measurement of the force generated on application of lacebacks. Ten operators were instructed to place lacebacks five times, on two separate occasions (T1 and T2). Inter-operator and intra-operator forces produced at T1 and T2 were compared. Main outcome measures: Forces generated by laceback placement. Results: The forces generated by clinicians ranged from 0 to 11.1 N. There were significant differences in the mean forces generated by the different operators (P<0.001), with differences between time points not being consistent across all operators (P<0.001). Some operators were more consistent than others in the forces generated. Conclusion: In vitro, there was a large inter-operator variation in the forces produced during laceback placement. With the in vitro model used in this study, few operators applied similar forces when placing lacebacks on two separate occasions.