scholarly journals Factors influencing orthodontic treatment outcome in South East Wales and implications for service commissioning

2019 ◽  
Vol 46 (4) ◽  
pp. 311-322
Author(s):  
Stacey Quach ◽  
Hashmat Popat ◽  
Anup Karki ◽  
Rebecca Playle ◽  
Stephen Richmond
Keyword(s):  
Treatment Outcome ◽  
Predictive Factors ◽  
Orthodontic Treatment ◽  
Dental Health ◽  
Peer Assessment ◽  
Dental Services ◽  
Need For Treatment ◽  
Good Treatment Outcome ◽  
Fixed Appliances ◽  
Treatment Use

Aim: To determine factors that may influence the outcome of orthodontic treatment undertaken in General Dental Services/Personal Dental Services in South East Wales. Design and setting: A retrospective study of a requested 20 consecutively treated cases (for the year 2014–2015) provided by 26 performers in South East Wales. Method: Performer and patient information was obtained by use of a questionnaire and FP17OW forms, respectively. A calibrated investigator recorded the Index of Orthodontic Treatment Need (IOTN), Peer Assessment Rating (PAR) and the Index of Complexity, Outcome and Need (ICON) on start- and end-study models for each case. Descriptive and regression analyses were undertaken to identify any predictive factors of a good treatment outcome. Results: Two respondents completed < 20 cases, so all of their cases were assessed. A total of 495 cases were assessed. The overall achieved mean end-PAR score of 5 is collectively a good occlusal outcome. Predictive factors of a good quality of occlusal outcome (end-PAR score being ⩽ 5) were: dual arch treatment; use of functional with fixed appliances; treatment undertaken in non-corporate practices; and treatment undertaken by registered specialists ( P < 0.001). Predictive factors for occlusal improvement (change in PAR score) were: IOTN aesthetic component (AC); IOTN dental health component (DHC) (1–3 or 4–5); and number of arches treated and malocclusion type ( P < 0.001). Conclusions: Dual arch fixed appliances undertaken by orthodontic specialists in non-corporate environments produced the highest quality orthodontic outcomes. Those who have the highest need for treatment according to IOTN DHC and AC benefit most in terms of improvement achieved in PAR score.

Assessment of General Dental Services Orthodontic Standards: The Dental Practice Board's Gradings Compared to PAR and IOTN

1996 ◽  
Vol 23 (3) ◽  
pp. 211-220 ◽  
Author(s):  
Elizabeth A. Turbill ◽  
Stephen Richmond ◽  
Jean L. Wright
Keyword(s):  
Orthodontic Treatment ◽  
Peer Assessment ◽  
Dental Practice ◽  
Dental Services ◽  
Good Reliability ◽  
Treatment Need ◽  
Need For Treatment ◽  
Peer Assessment Rating Index ◽  
Overall Performance ◽  
Case Basis

The subjective grading of cases at the Dental Practice Board of England and Wales was compared to the Peer Assessment Rating Index (PAR) and Index of Orthodontic Treatment Need (IOTN) in assessing 1505 cases sampled at the Board between Late 1990 and mid-1991. Whilst some criteria are common to both systems, case by case there is only limited agreement; sources of disagreement are evaluated. The indices are essentially epidemiological tools; whilst they have shortcomings in assessing individual cases, they are related to peer opinion, and show good reliability when used on samples of cases. They can be readily updated, as findings of research or future peer opinion may dictate. Use of PAR and IOTN at the Board, instead of subjective gradings, would require a departure from decisions on withholding payment on a case by case basis. If, however, they were used onsamples of practitioners' caseloads to assess reduction of malocclusion, and residual malocclusion and need for treatment, practitioners fees could be up- or down-graded periodically according to their overall performance, to encourage more to adopt higher standards. Allowances could be made, however, for ‘limited objective treatments’ and cases where poor co-operation had impaired the result.

Retrospective Study to Determine the Change in Referral Pattern to St George's Hospital Orthodontic Department before and after the 2006 NHS Dental Contract Changes

2010 ◽  
Vol os17 (3) ◽  
pp. 111-114 ◽  
Author(s):  
Maryam Izadi ◽  
Daljit S Gill ◽  
Farhad B Naini
Keyword(s):  
Retrospective Study ◽  
Orthodontic Treatment ◽  
Dental Health ◽  
Referral Pattern ◽  
Dental Services ◽  
Treatment Need ◽  
South West ◽  
Number Of Patients ◽  
Dental Practitioners ◽  
Before And After

Aim The aim of this study was to determine the possible effects of the 2006 National Health Service General Dental Services contract changes on the referral pattern to the orthodontic department at St George's Hospital, South West London. Method This study was carried out on a retrospective basis. The notes of consecutive patients referred between 1st May and 30th September in 2005 and 2008 were assessed, and the patient's Index of Orthodontic Treatment Need (IOTN) and the source of referral noted. Results The total numbers of referrals increased from 260 in 2005 to 405 in 2008. The number of referrals from general dental practitioners decreased slightly from 165 to 156, as did the numbers of referrals from other sources, such as tertiary referrals. The number of referrals made by specialist practitioners increased from 41 in 2005 to 207 in 2008, representing an increase from 16% to 51% of overall referrals. Overall, the number of patients being referred with an IOTN dental health component grade of 5 increased from 27% to 55%. Conclusion The increase in referrals from specialist practitioners may be partly due to the changes brought to the commissioning of orthodontic services for specialist practitioners. Overall, the number of cases being referred with IOTN grades 4 and 5 remains high at St George's Hospital, indicating that appropriate referrals are being made.

scholarly journals Anterior tooth alignment: A comparison of orthodontic retention regimens 5 years posttreatment

2014 ◽  
Vol 85 (3) ◽  
pp. 353-359 ◽  
Author(s):  
Ragnar Bjering ◽  
Kari Birkeland ◽  
Vaska Vandevska-Radunovic
Keyword(s):  
Treatment Outcome ◽  
Orthodontic Treatment ◽  
Peer Assessment ◽  
Anterior Tooth ◽  
Significant Deterioration ◽  
Par Index ◽  
Significant Difference ◽  
Posttreatment Period ◽  
Component Scores ◽  
Time Point

ABSTRACT Objective:  To assess orthodontic treatment outcome at debonding and at 3 and 5 years after orthodontic treatment and to investigate the influence of different retention protocols on anterior tooth alignment. Materials and Methods:  Using the Peer Assessment Rating (PAR) Index, 169 patients (74 boys, 95 girls) were analyzed at four stages: pretreatment (T0), posttreatment (T1), 3 years posttreatment (T3), and 5 years posttreatment (T5). The PAR anterior component scores (ACSs) were compared between groups with different retention protocols. In the maxilla, protocols were removable retainer until T3 (MAX1), removable and fixed retainer until T3 (MAX2), and removable retainer until T3 and fixed retainer until T5 (MAX3). In the mandible, protocols were no retainer (MAND1), fixed 3-3 retainer until T3 (MAND2), and fixed 3-3 retainer until T5 (MAND3). Results:  Mean weighted improvement in PAR score was 88.3% at T1, 86.4% at T3, and 82.1% at T5. The ACS for the maxilla showed no significant differences between the retention protocols at any time point. In the mandible, the group without retention showed a gradual but not significant deterioration in ACS throughout the posttreatment period. At T5 there was a significant difference in ACS between the group that had the retainer removed at T3 and the group that kept the retainer. Conclusion:  The 5-year treatment outcome, as measured by the PAR Index, was good. Stability of the maxillary anterior alignment 5 years posttreatment did not appear to be influenced by choice of retention protocol. Mandibular anterior alignment was significantly better for the group using a fixed retainer compared with the group where the retainer was removed 3 years posttreatment.

Normative and perceived orthodontic treatment need of senior year dental students

2013 ◽  
Vol 9 (1) ◽  
Author(s):  
Kolawole Kikelomo Adebanke ◽  
Agbaje Hakeem Olatunde ◽  
Otuyemi Olayinka Donald
Keyword(s):  
Orthodontic Treatment ◽  
Dental Health ◽  
Dental Students ◽  
Moderate Correlation ◽  
Senior Year ◽  
Treatment Need ◽  
Need For Treatment ◽  
Perceived Need ◽  
Elective Treatment ◽  
The Aesthetic

Objective: The purpose of this study was to determine perceived and normative orthodontic treatment need of senior year dental students using the Index of Orthodontic Treatment Need (IOTN) and Dental Aesthetic Index (DAI). Materials and Methods: Ninety-nine senior year students of the Faculty of Dentistry, Obafemi Awolowo University Ile-Ife, Nigeria, participated. Normative assessment of occlusal characteristics was car¬ried out using IOTN and DAI while the Aesthetic Component (AC) scale of IOTN was used by the students to assess perceived need. Results: With the AC scale of IOTN, 6.1% of the students expressed “borderline need” and 2% “great need” for treatment, while normative need was 41.4% for “borderline need” and 11.1% for “great need”. The Dental Health Component found 37.4% and 24.2% in these categories, respectively. The DAI gave 26.3%, 13.1% and 15.1% in the elective treatment, highly desirable treatment and mandatory treatment categories respectively. No gender-dependent differences were found. Moderate correlation was observed between perceived and normative need (r=0.643), which was significant (p<0.001). Conclusions: Over half of the dental students had orthodontic treatment need with both indices. Normative and perceived treatment need differed significantly. The perception of treatment need is not only influenced by knowledge and severity of malocclusion, as psychosocial factors acting on individuals may be involved.

A Comparison of Three Orthodontic Treatment Indices with Regard to Angle Classification

2016 ◽  
Vol 40 (2) ◽  
pp. 169-174
Author(s):  
Emine Kaygisiz ◽  
Fatma Deniz Uzuner ◽  
Lale Taner
Keyword(s):  
Orthodontic Treatment ◽  
Peer Assessment ◽  
Class Ii ◽  
Class I ◽  
Kappa Statistics ◽  
Class Iii ◽  
Treatment Need ◽  
Need For Treatment ◽  
Spearman Correlation Test ◽  
Positive Correlations

Objectives: To calculate the agreement between the Dental Aesthetic Index (DAI) and the Index of Complexity, Outcome and Need (ICON) in assessing orthodontic treatment need and to determine correlations between the Peer Assessment Rating (PAR) and DAI and ICON scores according to Angle classification among patients referred for orthodontic evaluation. Study Design: This study included 457 randomly selected patients between 9 to17 years of age. Patients were divided into four groups according to Angle classification [Class I (n=154), Class II division 1(Class II/1) (n=155), Class II division 2(Class II/2) (n=52) and Class III (n=96)]. Relationships between PAR scores and ICON and DAI scores were evaluated with the Spearman correlation test. Unweighted kappa statistics were used to analyse agreement between the ICON and DAI on the need for treatment, according to Angle classification. Results: Class I malocclusions scored significantly lower than other Angle classifications in all indices. Both the ICON and DAI showed significant positive correlations with the PAR in the general study population. For Class II/2 patients, no correlation was found between PAR and DAI scores. There was significant agreement between the ICON and DAI on treatment need among Class I, Class II/1 and Class II/2 patients however, no agreement was found for Class III malocclusions. Conclusions: The ICON, DAI and PAR produce similar results and can be used interchangeably for the general orthodontic patient population. However, based on Angle classification, prominent differences exist in scoring certain occlusal features.

The Seven-year Outcome of an Early Orthodontic Treatment Strategy

2008 ◽  
Vol 87 (6) ◽  
pp. 584-588 ◽  
Author(s):  
H. Kerosuo ◽  
M. Väkiparta ◽  
M. Nyström ◽  
K. Heikinheimo
Keyword(s):  
Public Health ◽  
Health Care ◽  
Treatment Strategy ◽  
Orthodontic Treatment ◽  
Dental Health ◽  
Peer Assessment ◽  
Treated Group ◽  
Public Health Care ◽  
Treatment Need ◽  
Peer Assessment Rating Index

The benefits of early orthodontic treatment are continuously discussed, but studies are few. We examined whether definite need for orthodontic treatment could be eliminated in public health care by systematically focusing on early intervention. One age cohort living in a rural Finnish municipality (N = 85) was regularly followed from ages 8 to 15 years, and persons with malocclusions were treated according to a pre-planned protocol. Treatment need was assessed according to the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need, and treatment outcome by the Peer Assessment Rating Index (PAR). Fifty-two percent of the cohort received treatment, and definite treatment need decreased from 33% to 9%. In the treated group, the mean PAR score reduction was 63%, and 51% showed more than 70% improvement. The results suggest that an early treatment strategy may considerably reduce the need for orthodontic treatment in public health care with limited specialist resources.

scholarly journals The Need for Orthodontic Treatment among Vietnamese School Children and Young Adults

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Son Minh Nguyen ◽  
Minh Khac Nguyen ◽  
Mare Saag ◽  
Triin Jagomagi
Keyword(s):  
School Children ◽  
Primary Schools ◽  
Orthodontic Treatment ◽  
Dental Health ◽  
Contact Point ◽  
Basic Research ◽  
Class Iii ◽  
Treatment Need ◽  
Need For Treatment ◽  
Children And Young Adults

Objective. The aim of this study was to evaluate the need for orthodontic treatment among 12-year-old school children and 18-year-olds from Da Nang, Vietnam.Basic Research Design. A random representative sample of 200 12-year-old children from primary schools in Da Nang city was gathered. In addition, 200 18-year-old students were randomly selected from among the 4000 students studying at Da Nang University of Medical Technology and Pharmacy, Vietnam. All the subjects were evaluated according to Angle’s molar relationship, the presence of malocclusion, and the components of the Index of Orthodontic Treatment Need (Dental Health Component, DHC, and Aesthetic Component, AC).Results. The DHC of index of orthodontic treatment need (IOTN) for 12-year-olds was in 60% of casesno or little, in 21% of casesmoderate, and in 19% of casesdefinitive, while the prevalence of moderate and definitive need for treatment among the 18-year-olds was 24% and 30.5%, respectively. The prevalence of class III malocclusion, contact point displacement, and crossbite was higher in 18-year-olds than among the 12-year-olds, while the prevalence of increased overjet and increased overbite had decreased in 18-year-olds compared to the group of 12-year-olds.Conclusions. There is a strong need for orthodontic treatment in Vietnam’s population. The need for orthodontic treatment was determined by contact point displacement, crossbite, increased overjet, and increased overbite.

scholarly journals Predictive Factors for Successful Percutaneous Sclerotherapy of Venous and Lymphatic Malformations

2013 ◽  
Vol 19 (1) ◽  
pp. 29-42
Author(s):  
Anchalee Churojana ◽  
Laksanawadee Mahiwan ◽  
Dittapong Songsaeng ◽  
Rujimas Khumtong ◽  
Saowanee Homsud
Keyword(s):  
Treatment Outcome ◽  
Predictive Factors ◽  
Venous Malformation ◽  
Treatment Result ◽  
Focal Lesions ◽  
Lymphatic Malformations ◽  
Sclerosing Agents ◽  
Percutaneous Sclerotherapy ◽  
Good Treatment Outcome ◽  
Sclerosing Therapy

Objectives: To determine the predictive factors for good response outcome of venous (VMs) and lymphatic malformations (LMs) by percutaneous sclerosing therapy and to compare the complications associated with bleomycin versus alcohol treatment. Methods: A retrospective analysis of 225 patients with lymphatic and venous malformation who had treated by percutaneous sclerotherapy using alcohol and/or bleomycin was performed The treatment outcome was graded from 0-3, in orderly of clinical responsiveness by using visual assessment of changing in size and subjective improvement of symptoms. Predictive factors of good treatment outcome were determined by uni- and multivariate analysis which were conducted on sex, age, onset of disease, location, type, characteristic of lesion and sclerosant usage. Results: Of 225 patients, 87.6% were VMs and 12.4% were LMs. VMs were predominating in female (6.2:3.8). Between ethanol and bleomycin, there was no statistical significant of treatment sessions, dose and treatment outcome. (p= .42) Sclerosing therapy provided better response on VMs than LMs. (49.2% and 21.4% respectively, p=.002), and had more effective on focal lesions than diffuse patterns (64.9% and 26.1% respectively p<.001) The gender, onset of disease, locations, characteristic on venography and preceding treatment showed no correlation with treatment result. Major complications of ethanol occurred in 38.6%,including hematuria, gangrene, facial paralysis, pulmonary embolism and death. Minor adverse reactions of bleomycin encountered in 19.8% with hyperpigmentation, flu-like symptom and localized fibrosis. Conclusion: Both absolute alcohol and bleomycin were effective sclerosing agents for percutaneous treatment of venous malformations, but no serious complications encountered with bleomycin. The characteristic of focal single lesion, at any region of body part, can be a predictor for good response.

scholarly journals Kebutuhan perawatan ortodonsi berdasarkan index of orthodontic treatment need pada siswa usia 12-13 tahun di SMP Negeri 1 Wori

e-GIGI ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Fanessa E. Kolonio ◽  
P. S. Anindita ◽  
Christy N. Mintjelungan
Keyword(s):  
Orthodontic Treatment ◽  
Periodontal Diseases ◽  
Dental Health ◽  
Sampling Technique ◽  
Physical And Mental Health ◽  
Cross Sectional ◽  
Treatment Need ◽  
Purposive Sampling ◽  
Need For Treatment ◽  
Cross Sectional Design

Abstract: Malocclusion is a form of occlusal disorders caused by irregular teeth growthas well as sizes and position of teeth. Malocclusion could create some disturbances in both physical and mental health of a person including problems in oral function, mastication, highly risk of trauma, periodontal diseases, and caries. Esthetically, malocclusion could affect a person’s appearances and psychological development especially in adolescent. Orthodontic treatment is performed to fix the malocclusion that could affect one’s oral health. The needs of orthodontic treatment itself can be leveled by using Index of Orthodontic Treatment Need (IOTN). This study was aimed to obtain the needs of orthodontic treatment based on IOTN among students aged 12-13 years old at SMPN 1 Wori. This was an observational descriptive study with a cross sectional design. There were 30 respondents obtained by using purposive sampling technique. The need of treatment was leveled by using IOTN consisted of two components: aesthetic component (AC) and dental health component (DHC). The needs of orthodontic treatment measured with AC, 27 person (90%) were as follows: no need or little need for treatment in 27 students (90%); borderline need in 2 students (6.7%); and treatment required in 1 student (3.3%). The needs of orthodontic treatment based on DHC were as follows: no need or little need for treatment in 18 students (60%); borderline need in 8 students (26.7%); and treatment required in 4 students (13.3%).Keywords: malocclusion, needs of orthodontic treatment, IOTN. Abstrak: Maloklusi merupakan penyimpangan oklusi akibat tidak teraturnya pertumbuhan, posisi, serta ukuran gigi. Maloklusi dapat menyebabkan gangguan kesehatan fisik dan psikis, antara lain dapat mengganggu fungsi oral, mastikasi, berisiko tinggi terhadap trauma, penyakit periodontal, dan karies. Maloklusi secara estetis juga dapat memengaruhi penampilan wajah seseorang dan perkembangan psikologis terutama pada remaja. Perawatan ortodonsi ditujukan untuk memperbaiki maloklusi yang dapat memengaruhi kesehatan gigi dan rongga mulut. Perawatan ortodonsi yang tepat dapat dilihat dari tingkat kebutuhan perawatan ortodonsi yang diukur dengan Index of Orthodontic Treatment Need (IOTN). Penelitian ini bertujuan untuk mengetahui kebutuhan perawatan ortodonsi berdasarkan IOTN pada siswa berusia 12 - 13 tahun di SMP N 1 Wori. Jenis penelitian ialah deskriptif observasional dengan desain potong lintang. Subjek penelitian berjumlah 30 siswa diperoleh dengan teknik purposive sampling. Kebutuhan perawatan ortodonsi menggunakan Index of Orthodontic Treatment Need (IOTN) dengan dua komponen, yaitu Aesthetic Component (AC) dan Dental Health Component (DHC). Kebutuhan perawatan ortodonsi berdasarkan AC yaitu: 27 orang (90%) tidak atau butuh perawatan ringan; 2 orang (6,7%) perawatan borderline; dan 1 orang (3,3%) sangat butuh perawatan. Kebutuhan perawatan ortodonsi berdasarkan DHC yaitu: 18 orang (60%) tidak atau butuh perawatan ringan; 8 orang (26,7%) perawatan borderline, dan 4 orang (13,3%) sangat butuh perawatan. Kata kunci: maloklusi, kebutuhan perawatan, IOTN

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