Relationship between Four Epidemiological Indexes - indexes of complexity, outcome and need, dental aesthetic index, peer assessment rating index, and American Board of Orthodontics objective grading system: A Comparative study

Toshit, Kumar (2011) Relationship between Four Epidemiological Indexes - indexes of complexity, outcome and need, dental aesthetic index, peer assessment rating index, and American Board of Orthodontics objective grading system: A Comparative study. Masters thesis, Tamil Nadu Government Dental College and Hospital, Chennai.


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INTRODUCTION: A malocclusion is considered to be a variation from the norm rather than an acute condition and the dental, functional, and psychological benefits of orthodontic treatment to correct it are largely unknown. This in turn leads to difficulty in determining orthodontic treatment need (Shaw, 1989)5. It has been shown that both providers‘ and patients‘ perceptions of orthodontic treatment need are influenced by many variables, but the decisive factor for the patient is usually poor aesthetics. Historically, orthodontic diagnosis of malocclusion has been taught and practiced as a descriptive, qualitative subject and it is not well suited to quantification. However, in response to an external need for information on the prevalence of malocclusions and for a method to objectively quantify the severity of the various features of malocclusion, several indices have been proposed. Generally, the goal of the quantification is to assign limited resources (e.g., personnel, facilities, and financial) to the most severe malocclusions. The usefulness of occlusal indexes in audit, research, decision making, and assessing orthodontic treatment need and outcome is well accepted internationally. These indices purport to measure severity of malocclusion objectively, either as a deviation from normal/ideal occlusion or in terms of perceived treatment need. AIMS AND OBJECTIVES: The aim of this study was 1. To determine whether the ICON can replace these indexes as a measure of orthodontic treatment complexity, outcome, and need instead of using different indexes for the various facets of orthodontic treatment. 2. To study the relationship between Indexes of complexity, outcome and need, Dental Aesthetic Index, Peer assessment rating index, and American Board of Orthodontics objective grading system, and The indexes used in this study assessed need only Dental Aesthetic Index, outcome only (PAR and ABO-OGS), and both need and outcome (ICON). MATERIALS AND METHODS: CASE SELECTION CRITERIA: The sample of the study consisted of Pre and Post Study models and Orthopantomograph of 80 patients who got treatment in Department Of Orthodontics and Dentofacial Orthopaedics, Tamilnadu Government Dental College and Hospital, Chennai. Criteria for patient selection: 1) The patients were in permanent dentition with all the tooth in dentition was erupted except third molars. 2) The age groups of the samples were selected to be between 13 years to 20 years of age. 3) The sample consists of 40 males and 40 females selected randomly. 4) All the patients got treated with pre-edgewise fixed appliance mechanotherapy by post graduate student under the supervision of experienced professors of Department of Orthodontics and Dentofacial Orthopaedics. Exclusion criteria: 1. Cases in which any tooth are unerupted, or impacted except third molar. 2. Cases in which any tooth are extracted due to dental caries or periodontal disease or other than for orthodontic treatment purpose. 3. Patient who have attrition or abraded tooth due to various pathology. 4. Cases in which treatment are not finished satisfactorily. RESULTS: STATISTICAL ANALYSIS: The findings of measurements of the dental casts were statistically analysed. The arithmetic mean and standard deviation were calculated for all the measurements using NPar test. The level of significance was set at P< 0.05. The differences between the gender were evaluated using a student 't' tests. The correlation between the 4 indices was tested by using spearman correlation coefficient. Table 1 shows the intraexaminer reliabity assessment of the indexes with the spearman rank order correlation coefficient. It shows that all the measurement is significant at 0.01 levels. Table 2 shows no differences in each index between male and female. Each index was carried out on 40 males and 40 females study cast and student 't' test was done to check for any differences between two which was found none. Table 3 shows the descriptive statistics for the indexes. The pre-treatment mean ICON score was 55.15± 15.086(SD). The post-treatment mean ICON score was 12.13±5.349 (SD). The pre-treatment mean PAR score was 32.85± 13.230(SD). The post-treatment mean PAR score was 6.80±5.110 (SD). The pre-treatment mean DAI score was 38.18± 6.114(SD). The post-treatment mean ABO-OGS score was 22.19±3.323 (SD). As pre-treatment score of PAR and ICON is higher than post-treatment score of the same. It shows that there is definitive improvement by treatment. Table 4 shows the correlation between ICON, DAI, PAR and ABO-OGS using spearman rank order coefficient correlation test. The highest correlation was found between ICON vs PAR post-treatment scores (r = 0.784, P<0.001), followed by ICON vs DAI pre-treatment scores (r =0.659, P<0.001). There was no significant positive correlation was found between PAR vs ABO-OGS (r =0.006, P =0.958). All the indexes showed statistically significant positive correlations with the ICON. Table 5 showed the distribution of orthodontic treatment needs and outcome for the study sample according to 4 indexes. According to ICON 14 and DAI 10 cases was in treatment need. According to ICON 6, PAR 4 AND ABO-OGS 10 cases had unacceptable outcome. CONCLUSION: The ICON can substitute for the DAI to measure orthodontic treatment need. A value greater than 43 for the ICON defines need for treatment, as does a DAI score of 26 or above. The relationship between these 2 indexes was statistically significant (P _.001). 1. The PAR had a close relationship with the ICON in this study; thus, the ICON can be used to assess orthodontic treatment outcome. 2. The ABO-OGS requires more stringent standards than the PAR or the ICON for assessing the outcome of orthodontic treatment. A case report that loses more than 30 points will fail and loses less than 20 points will pass. 3. Overall agreement between the ICON and the other indexes assessed in this study was good. Therefore, the ICON appears to be a reasonable means of assessing the standard of orthodontic treatment in terms of complexity, need, and outcome rather than using various indexes. Use of the ICON will encourage international comparison and professional standardization.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Four Epidemiological Indexes, indexes of complexity, outcome and need, dental aesthetic index, peer assessment rating index, American Board of Orthodontics objective grading system.
Subjects: DENTAL > Orthodontics and Dentofacial Orthopedics
Depositing User: Kambaraman B
Date Deposited: 24 Jan 2018 03:54
Last Modified: 12 May 2018 06:49

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