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The development of a guide to borderline orthodontic need
Ariane Sampson1, Huw G Jeremiah2, Nicholas N Lai3
1Department of Orthodontics, Clinic 8, Addenbrookes Hospital, Cambridge University Hospital NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK. ariane_sampson@hotmail.com.
Progress in Orthodontics
|April 18, 2022
Summary
Dentists and orthodontists can now better assess orthodontic treatment need in borderline cases using a new guide. The guide helps determine need based on aesthetic grounds, particularly for open bites and reverse overjets.
Area of Science:
- Dental sciences
- Orthodontics
- Public health
Background:
- Assessing orthodontic treatment need in borderline cases (Dental Health Component 3) presents challenges for clinicians.
- Aesthetic considerations significantly influence treatment decisions in orthodontics.
Purpose of the Study:
- To develop a guide for dentists and orthodontists to determine orthodontic treatment need in borderline cases (DHC 3).
- To compare the perceptions of orthodontic, dental, and lay panels regarding treatment need in these cases.
Main Methods:
- A prospective, observational study involving 100 subjects with borderline occlusal traits (DHC 3).
- Photographs were assessed by three panels: 25 orthodontists, 25 dentists, and 25 laypersons, focusing on aesthetic treatment need.
Main Results:
- No statistical difference was found between the perception of orthodontic, dental, and lay panels regarding treatment need (p < 0.001).
- Anterior open bites and reverse overjets were consistently identified as requiring high treatment need on aesthetic grounds.
- Intra-rater agreement varied, with moderate agreement among orthodontists and dentists (k=0.47, 0.45) and fair agreement among laypersons (k=0.26).
Conclusions:
- A consensus exists among orthodontic, dental, and lay panels on the treatment need for DHC 3 cases.
- A 'Guide to Borderline Orthodontic Need' (GBON) was proposed, featuring 8 photographs to aid in unambiguous aesthetic assessments.
- The GBON aims to standardize judgments on aesthetic grounds for borderline orthodontic cases.
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