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      Orthodontic treatment needs in the western region of Saudi Arabia: a research report

      research-article
      Author(s): 1 ,
      Publication date (Electronic):
      Journal: Head & Face Medicine
      Publisher: BioMed Central

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          Abstract

          Background

          Evaluation of self perceived and actual need for orthodontic treatment helps in planning orthodontic services and estimating the required resources and man power. In the present study, the perceptive need as evaluated by patients and the actual need to orthodontic treatment, as assessed by orthodontists, were evaluated at two types of dental practices in the city of Jeddah using the Index of Orthodontic Treatment Need (IOTN).

          Methods

          A consecutive sample of 743 adults seeking orthodontic treatment at two different types of dental practices in Jeddah; King Abdulaziz University, Faculty of Dentistry (KAAU) (Free treatment) and two private dental polyclinics (PDP) (Paid treatment), was examined for orthodontic treatment need using the dental health component (DHC) of the IOTN. The self-perceived need for orthodontic treatment was also determined using the aesthetic component (AC) of the IOTN. The IOTN score and the incidence of each variable were calculated statistically. AC and DHC categories were compared using the Chi-Square and a correlation between them was assessed using Spearman's correlation test. AC and DHC were also compared between the two types of dental practices using the Chi-Square.

          Results

          The results revealed that among the 743 patients studied, 60.6% expressed no or slight need for treatment, 23.3% expressed moderate to borderline need and only16.1% thought they needed orthodontic treatment. Comparing these estimates to professional judgments, only 15.2% conformed to little or no need for treatment, 13.2% were assessed as in borderline need and 71.6% were assessed as in need for treatment (p < 0.001). Spearman's correlation test proved no correlation (r = -.045) between the two components. Comparing the AC and the DHC between the KAAU group and PDP group showed significant differences between the two groups (p < 0.001).

          Conclusion

          Patient's perception to orthodontic treatment does not always correlate with professional assessment. The IOTN is a valid screening tool that should be used in orthodontic clinics for better services especially, in health centers that provide free treatment.

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          Most cited references33

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          The development of an index of orthodontic treatment priority.

          P Brook, W Shaw (1989)
          The aim of this study was to develop a valid and reproducible index of orthodontic treatment priority. After reviewing the available literature, it was felt that this could be best achieved by using two separate components to record firstly the dental health and functional indications for treatment, and secondly the aesthetic impairment caused by the malocclusion. A modification of the index used by the Swedish Dental Health Board was used to record the need for orthodontic treatment on dental health and functional grounds. This index was modified by defining five grades, with precise dividing lines between each grade. An illustrated 10-point scale was used to assess independently the aesthetic treatment need of the patients. This scale was constructed using dental photographs of 12-year-olds collected during a large multi-disciplinary survey. Six non-dental judges rated these photographs on a visual analogue scale, and at equal intervals along the judged range, representative photographs were chosen. To test the index in use, two sample populations were defined; a group of patients referred for treatment, and a random sample of 11-12-year-old schoolchildren. Both samples were examined using the index and satisfactory levels of intra- and inter-examiner agreement were obtained.
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            The development of the PAR Index (Peer Assessment Rating): reliability and validity.

            J. E. Andrews, C. Roberts, Alison D. O’Brien … (1992)
            The PAR Index has been developed to provide a single summary score for all the occlusal anomalies which may be found in a malocclusion. The score provides an estimate of how far a case deviates from normal alignment and occlusion. The difference in scores between the pre- and post-treatment cases reflects the degree of improvement and, therefore, the success of treatment. Excellent reliability was exhibited within and between examiners (Intraclass Correlation Coefficient, R greater than 0.91). The components of the PAR Index have been weighted to reflect current British orthodontic opinion and is flexible in that the weightings could be changed to reflect future standards and standards currently being achieved in other countries. The PAR Index offers uniformity and standardization in assessing the outcome of orthodontic treatment.
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              The development of the index of complexity, outcome and need (ICON).

              S. Richmond, Bryan Daniels (2000)
              This paper is based on the winning submission for the 1998 Chapman prize awarded by the British Orthodontic Society for an essay on a subject promoting the interests of orthodontics. The aim of the investigation is to develop a single index for assessing treatment inputs and outcomes. An international panel of 97 orthodontists gave subjective judgements on the need for treatment, treatment complexity, treatment improvement, and acceptability on a diverse sample of 240 initial and 98 treated study models. The occlusal traits in the study models were scored according to a defined numerical protocol. Five highly predictive occlusal traits were identified (IOTN Aesthetic Component, crossbite, upper arch crowding/ spacing, buccal segment antero-posterior relationships, and anterior vertical relationship) and then used to 'predict' the panelist's decisions using regression analysis. Cut-off values were determined for the dichotomous judgements by plotting specificity sensitivity and overall accuracy. Twenty percentile ranges were used to determine 5 grades of complexity and improvement. The index prediction of decisions for treatment need, had specificity 84.4 per cent, sensitivity 85.2 per cent, and overall accuracy 85 per cent. When used to predict treatment outcomes, the new index had specificity 64.8 per cent, sensitivity 70.1 per cent, and overall accuracy 68.1 per cent. The index could explain 75.6 per cent of the variance in the mean casewise complexity score and 63.5 per cent of the mean casewise improvement score. A new orthodontic index is proposed to assess treatment need, complexity, and outcome. It is based on international orthodontic opinion.
              Article 0 comments Cited 63 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Head Face Med
                Title: Head & Face Medicine
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1746-160X
                Publication date Collection: 2006
                Publication date (Electronic): 18 January 2006
                Volume: 2
                Page: 2
                Affiliations
                [1 ]P.O. Box 80209, Jeddah 21589, Preventive Dental Sciences Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
                Article
                Publisher ID: 1746-160X-2-2
                DOI: 10.1186/1746-160X-2-2
                PMC ID: 1360662
                PubMed ID: 16420691
                SO-VID: 1697f803-bf96-4cef-875c-6643322a834c
                Copyright © Copyright © 2006 Hassan; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 11 September 2005
                Date accepted : 18 January 2006
                Categories
                Subject: Research

                ScienceOpen disciplines: Orthopedics
                Data availability:
                ScienceOpen disciplines: Orthopedics

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