Practical Application of the PAR Index: An Illustrative Comparison of the Outcome of Treatment Using Two Fixed Appliance Techniques

1996 ◽  
Vol 23 (4) ◽  
pp. 351-357 ◽  
Author(s):  
I. B. Buchanan ◽  
J. I. Russell ◽  
J. D. Clark
Keyword(s):  
Treatment Outcome ◽  
Peer Assessment ◽  
Small Error ◽  
Percentage Reduction ◽  
Fixed Appliance ◽  
Retrospective Assessment ◽  
Par Index ◽  
Peer Assessment Rating Index ◽  
The Mean ◽  
High Degree

A retrospective assessment of treatment outcome in a group of 82 orthodontic fixed appliance cases was carried out using the Peer Assessment Rating Index (PAR) in order to explore the usefulness of the PAR index as a means of differentiating the change associated with treatment. Two different fixed appliance techniques, the pre-adjusted Edgewise and the Begg appliance had been used to treat these cases, and all had been under the care of one Consultant Orthodontics. The mean percentage reduction in PAR for the group as a whole was 74 per cent. Comparison of the two different appliance types found that the pre-adjusted Edgewise group achieved a significantly greater reduction in PAR score (81 per cent), than the Begg group (65 per cent). Cases with a low PAE score prior to treatment tended to fare more poorly in terms of percentage reduction and this was more marked for those cases treated with the Begg appliance. Although the PAR index has a high degree of reproducibility, it was found that even the small error present can lead to problems of interpretation if the nomogram categories are used as a method of comparison. Some potential problems in undertaking studies such as this using the PAR index to assess treatment outcome are discussed.

scholarly journals Validity and Reproducibility of the Peer Assessment Rating Index Scored on Digital Models Using a Software Compared with Traditional Manual Scoring

2021 ◽  
Vol 10 (8) ◽  
pp. 1646
Author(s):  
Arwa Gera ◽  
Shadi Gera ◽  
Michel Dalstra ◽  
Paolo M. Cattaneo ◽  
Marie A. Cornelis
Keyword(s):  
Peer Assessment ◽  
Correlation Coefficients ◽  
Minimum Standard ◽  
Digital Models ◽  
Intra Class Correlation ◽  
Par Index ◽  
Peer Assessment Rating Index ◽  
The Mean ◽  
Digital Caliper ◽  
Peer Assessment Rating

The aim of this study was to assess the validity and reproducibility of digital scoring of the Peer Assessment Rating (PAR) index and its components using a software, compared with conventional manual scoring on printed model equivalents. The PAR index was scored on 15 cases at pre- and post-treatment stages by two operators using two methods: first, digitally, on direct digital models using Ortho Analyzer software; and second, manually, on printed model equivalents using a digital caliper. All measurements were repeated at a one-week interval. Paired sample t-tests were used to compare PAR scores and its components between both methods and raters. Intra-class correlation coefficients (ICC) were used to compute intra- and inter-rater reproducibility. The error of the method was calculated. The agreement between both methods was analyzed using Bland-Altman plots. There were no significant differences in the mean PAR scores between both methods and both raters. ICC for intra- and inter-rater reproducibility was excellent (≥0.95). All error-of-the-method values were smaller than the associated minimum standard deviation. Bland-Altman plots confirmed the validity of the measurements. PAR scoring on digital models showed excellent validity and reproducibility compared with manual scoring on printed model equivalents by means of a digital caliper.

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.

scholarly journals PAR Evaluation of Treated Class I Extraction Patients

2008 ◽  
Vol 78 (2) ◽  
pp. 270-274 ◽  
Author(s):  
Karina Maria Salvatore Freitas ◽  
Daniel Salvatore Freitas ◽  
Fabrício Pinelli Valarelli ◽  
Marcos Roberto Freitas ◽  
Guilherme Janson
Keyword(s):  
Treatment Time ◽  
Peer Assessment ◽  
High Standard ◽  
Class I ◽  
Par Index ◽  
Treatment Changes ◽  
The Mean ◽  
Dental Casts ◽  
Peer Assessment Rating

Abstract Objective: To evaluate treatment changes and quality of finishing occlusion in Class I patients treated with four premolar extractions. Material and Methods: Dental casts of 94 subjects (50 males and 44 females) were evaluated. Mean pretreatment age was 13.46 years, and mean treatment time was 2.09 years. The peer assessment rating (PAR) index was obtained from pretreatment and posttreatment dental casts. Results: The mean pretreatment PAR index of 29.46 was reduced to 6.32 at posttreatment stage, achieving a reduction of 78.54% with treatment. There was correlation between the initial PAR and correction during treatment, that is, the more severe the malocclusion the greater the treatment changes. Conclusion: The cases evaluated showed a high-standard orthodontic finishing.

Occlusal Outcome of Orthodontic Treatment for Patients With Complete Cleft Lip and Palate

2021 ◽  
pp. 105566562199611
Author(s):  
Daniel Stonehouse-Smith ◽  
Aida N.A. Abd Rahman ◽  
Jeanette Mooney ◽  
Haydn Bellardie
Keyword(s):  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Treatment Time ◽  
Peer Assessment ◽  
Tertiary Care ◽  
Standard Of Care ◽  
High Volume ◽  
Retrospective Assessment ◽  
Par Index

Aim: To assess occlusal outcomes of orthodontic treatment for patients with complete cleft lip and palate. Design: Retrospective assessment using the Peer Assessment Rating (PAR) index. Setting: Consecutive patients treated by one consultant orthodontist at a tertiary care cleft center. Participants: One hundred twenty-seven patients with either complete unilateral cleft lip and palate (UCLP) or bilateral cleft lip and palate (BCLP) consecutively treated with fixed appliances. Intervention: Fixed orthodontic appliance treatment and orthognathic surgery when required. Outcomes: The PAR index assessment was carried out by a calibrated-independent assessor. Treatment duration, the number of patient visits, and data on dental anomalies were drawn from patient records and radiographs. Results: One hundred two patients’ study models were assessed after exclusions. Mean start PAR score for UCLP (n = 71) was 43.9 (95% CI, 41.2-46.6, SD 11.5), with a mean score reduction of 84.3% (95% CI, 81.9-86.7, SD 10.1). The UCLP mean treatment time was 23.7 months with 20.1 appointments. Mean start PAR score for BCLP (n = 31) was 43.4 (95% CI, 39.2-47.6, SD 11.4), with a mean score reduction of 80.9% (95% CI, 76.3-85.5, SD 12.5). The BCLP mean treatment time was 27.8 months with 20.5 appointments. Conclusion: These results compare well with other outcome reports, including those for patients without a cleft, and reflect the standard of care provided by an experienced cleft orthodontist. As with high-volume surgeons, orthodontic treatment for this high need group is favorable when provided by a high-volume orthodontist. These findings may be used for comparative audit with similar units providing cleft care.

scholarly journals Assessing Treatment Outcomes of a Graduate Orthodontic Program

2018 ◽  
Vol 12 (1) ◽  
pp. 896-903
Author(s):  
Anastasia Pariskou ◽  
Athanasios E. Athanasiou
Keyword(s):  
Treatment Outcomes ◽  
Peer Assessment ◽  
Treatment Plan ◽  
Post Treatment ◽  
Chi Square ◽  
Postgraduate Students ◽  
Par Index ◽  
The Mean ◽  
Group B ◽  
Tooth Extractions

Objectives: To assess treatment outcomes of a graduate orthodontic program during two different periods. Materials and Methods: Consecutive orthodontic patients’ files were selected from the archives of the Graduate Orthodontic Program, Aristotle University of Thessaloniki, Greece. Following the application of certain inclusion criteria, the final sample consisted of 109 patients. The sample was allocated into two groups depending on the time of treatment [Group A: 1998-2003, (n=60); Group B: 2004-2009 (n=49)]. The first period started a few years after the inception of the program and the second 10 years later. All pre- and post-treatment dental casts were blindly assessed by one investigator using the Peer Assessment Rating (PAR) and the Index of Complexity, Outcome and Need (ICON). Statistical analysis included Student’s t-test, Mann-Whitney U test, Pearson Chi-Square test and Spearman correlation coefficient. The level of significance was set at p < 0.05. Results: In Group A, the mean PAR index changed from 28.6 before treatment to 5.5 after treatment and the mean ICON index changed from 71.9 to 23.5. In Group B, the mean PAR index changed from 23.6 before treatment to 4 after treatment and the mean ICON index changed from 62.8 to 19.8. The mean PAR score reduction was 78.4% for the 1st group and 81.4% for the 2nd group, respectively. Ninety percent of the cases of Group A and 89.8% of the cases of Group B had a post-treatment ICON score < 31. The severity of the initial malocclusion was found to be positively correlated with the treatment occlusal outcome. Out of the 109 cases, 68 were considered as substantially or greatly improved, 29 moderately improved, 8 showed minimal improvement and 4 cases were considered as not improved or worse. The mean PAR percentage improvement and the ICON score at the end of treatment were not correlated to the presence or absence of tooth extractions in the treatment plan. There was no correlation between the treatment outcome and the number of graduate residents involved in the therapy. The treatment outcomes were not correlated to the gender or age of patients. Conclusion: Patients treated by graduate orthodontic residents during 1998-2009 demonstrated significant improvement of their occlusion and the quality of the treatment remained constant throughout the years. The outcome of orthodontic treatment was not correlated to the gender and the age of patients, the number of postgraduate students performing the treatment, and the presence of tooth extractions in the treatment plan.

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