How Do Dental Professionals and Students Assess Orthodontic Case Complexity?

Accurately diagnosing and assessing orthodontic case complexity is essential for treatment planning, estimating therapy duration, and determining required expertise. Various indices, such as the American Board of Orthodontics Discrepancy Index (ABO DI), provide objective evaluations. This study explores how different dental professionals perceive case complexity and compares their assessments to the ABO DI.

Thirty pre-treatment orthodontic records from patients aged 6 to 42 years were classified as mild, moderate, or complex based on DI scores. An online survey was sent to 1289 dental professionals (students, general dentists, orthodontic specialists, and residents), who rated the 35 cases on a complexity scale from 0 (simple) to 10 (complex). The respondents' rating was then compared with the ABO DI score to assess the perception of orthodontic case complexity.

A total of 131 respondents participated, including 31 students, 68 general dentists, 20 orthodontic specialists, and 12 residents. The sample included 86 men and 45 women, with an average age of 34 years. General dentists tended to overestimate complexity compared to specialists and residents. Specialists perceived cases as more challenging than residents, while students rated cases as more complex than both. Across all groups, 57% of ratings aligned with DI scores, with general dentists achieving the highest agreement (63%). Specialists, residents, and students showed approximately 50% alignment.

Variability in perceived complexity underscores the importance of specialised training for accurate diagnosis. The findings emphasise the need for enhanced orthodontic education for general dentists to improve diagnostic precision and treatment outcomes.