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Prof Stephen Richmond 

Position:Head of Applied Clinical Research and Public Health

Telephone:+44 (0)29 2074 2451

Research Theme

Applied Clinical Research & Public Health

Research Group

Epidemiology and Applied Clinical Research

Research Interests

  1. Epidemiology  – prevalence of malocclusions and facial features in populations.
  2. Clinical outcomes and clinical effectiveness in orthodontic provision – The use of occlusal indices to assess the quality of orthodontic treatment.
  3. The use of three-dimensional imaging to assess facial growth in children
  4. The use of biomechanical modelling to mimic facial structures.


Selected Projects

1. The use of facial features to explore health and wellbeing.  

In collaboration with the University of Bristol I have captured 4747 3D facial images of 15 ½ -year-old children who are part of the Avon Longitudinal Study of Parents and Children (ALSPAC).  We are exploring genotype/phenotype/environmental associations in relation to facial features. We have discovered some interesting genotype/phenotype associations.  We are also exploring face shape in the context of anti-social behaviour, psychosis, asthma and metabolic disorders.

Morphological presentation of the lips

An example showing different morphological presentation of the lips.


2. Facial growth in a population of 11 to 18 year olds in Welsh, Finnish and Slovenian populations.  A cohort of patients have been followed for 5 years and 2 phases of growth have been identified.



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The movie shows two phases of growth which appears to be related to the Tanner staging of secondary sexual characteristics.

3. The development of a realistic biomechanical head model.  

In collaboration with colleagues in Computer Science (David Marshall and Paul Rosin), Cardiff University Brain Imaging Centre (CUBRIC – Derek Jones), John Middleton Dental Radiology (Nicholas Drage) and ARUP we have been developing a realistic biomechanical head model.  Using Diffusion Tensor Imaging we are able to determine the orientation of facial muscle fibres.

Muscle orientation

Using DTI the orientation of the facial muscles fibres can be identified.

From previous work we can mimic simple facial actions.  We are currently refining the model to be patient specific using DTI.

Please click on the link in the Related links at the bottom of the page to view the biomechanical simulation of a patient smiling.


4. Perspective on orthodontic provision around the world.  

I have been working in the research area of orthodontic treatment provision for 20 years and have undertaken and continue to undertake research projects with colleagues around the world.  It is pleasing to know that the outcome of my research work has been taken up and used!  I have developed and implemented many occlusal Indices:

Index of Complexity Outcome and Need (ICON)
The Peer Assessment Rating (PAR)
Index of Orthodontic Treatment Need (IOTN)

The ICON is acknowledged as one of the best indices “The ICON can be used in place of the PAR and the ABO-OGS for assessing treatment outcome and in place of the DAI for assessing treatment need” (Onyeaso CO, Begole EA, 2007).

Training and calibration in the use of occlusal indices is provided in Cardiff in the first week of December every year.  Further details can be obtained from either Catherine Roberts or Beverley Jones.  A manual and occlusal index aids are available.


ISBN-10: 0954967011
ISBN-13: 978-0954967017

A web based data entry system for the above indices is available for all specialist orthodontists in Europe on the EFOSA web page.  A brief description on how the indices are applied is also available.

Over the last 20 years I have produce reports on the provision of orthodontic treatment in England and Wales.  The latest report on the provision of orthodontic treatment in Wales is available.



In a quest to reduce the number of lateral cephalograms taken to record incisor inclinations and to improved the outcome of treatment in respect to the inclination and angulation of the teeth I developed the Tooth Inclination Protractor (TIP: United States Patent 6945779).  The Tooth Inclination Protractor is available from Principality Medical.

Upper incisor inclinationThe TIP is used here to assess the upper incisor inclination.