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Variations in treatment need using four screening methods.

E Freer1, T J Freer

  • 1University of Queensland, Australia.

Australian Orthodontic Journal
|April 6, 2002
PubMed
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This study compared orthodontic treatment need indices, finding the Dental Aesthetic Index (DAI) and Aesthetic Component (AC) often misjudged need. Specific occlusal traits influenced these discrepancies, highlighting limitations in current screening methods.

Area of Science:

  • Dentistry
  • Orthodontics
  • Public Health

Background:

  • Accurate assessment of orthodontic treatment need is crucial for prioritizing care.
  • Several indices exist, but their reliability in identifying specific occlusal traits requires evaluation.

Purpose of the Study:

  • To compare the diagnostic accuracy of the Dental Aesthetic Index (DAI), Dental Health Component (DHC) and Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN), and the Danish Ministry of Health (DMH) system.
  • To identify specific occlusal traits contributing to discrepancies between these indices and expert orthodontic assessment.

Main Methods:

  • Utilized dental models from 100 Grade Seven students.
  • Compared four screening systems (DAI, DHC, AC, DMH) against a consensus assessment by two orthodontists.

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  • Analyzed disagreements to pinpoint specific occlusal characteristics causing variations.

    • Main Results:

    • The DAI underestimated need for crowding, rotations, and increased overbite, but overestimated for increased overjet in aligned arches.
    • DMH guidelines overestimated need for increased overjet and crowded arches.
    • DHC was over-sensitive to increased overjet and significant contact point displacement.
    • AC underestimated need for excessive overjet and buccally displaced canines, while overestimating for spaced arches and deep overbite.

    Conclusions:

    • Existing orthodontic screening indices demonstrate variability in accurately assessing treatment need.
    • Specific occlusal traits, such as canine displacement and overjet severity, significantly impact the reliability of these indices.
    • Further refinement of screening tools is needed to improve diagnostic accuracy in diverse malocclusion types.