Application of occlusal indices in orthodontic practice

Abstract

Introduction. Occlusal indices were designed to improve diagnostic criteria and to enable an objective assessment of malocclusion severity. The aim of this study was to present the most frequently used occlusal indices in orthodontic practice and to determine their reliability when applied to dental models. Material and Methods. Three occlusal indices were selected for analysis: the Index of Orthodontic Treatment Need (IOTN), the Peer Assessment Rating Index (PAR) and the Index of Complexity, Outcome and Need (ICON). Twenty dental models of patients referred to Department of Orthodontics, School of Dentistry, Belgrade, with malocclusions of different type and severity were used in this study. All dental models were measured by three afore mentioned indices twice, two months apart, in order to determine intraexaminer reliability. Results. The results showed that three indices had good reliability. Weighted Kappa was calculated for IOTN (0.72 and 0.79 for the aesthetic and the dental health component, respectively) and root mean square error was calculated for PAR and ICON (2.1 and 4.5, respectively). There was no statistically significant difference in scores between two measurements of these two indices (p lt 0.01). Conclusion. Application of occlusal indices enables orthodontists to determine priorities in patient care, planning of orthodontic service, monitoring and promotion of standards. Occlusal indices are reliable diagnostic criteria.

Uvod. Okluzivni indeksi su uvedeni u praksu sa ciljem da se poboljšaju dijagnostički kriterijumi i omogući objektivna procena težine malokluzije. Cilj ovog rada je bio da se predstave najčešće korišćeni okluzivni indeksi u ortodontskoj praksi i utvrdi pouzdanost njihove primene na studijskim modelima. Materijal i metode rada. Za analizu su odabrana tri okluzivna indeksa: Index of Orthodontic Treatment Need (IOTN), Peer Assessment Rating (PAR) i Index of Complexity, Outcome and Need (ICON). U istraživanju je korišćeno 20 studijskih modela pacijenata Klinike za ortopediju vilica Stomatološkog fakulteta u Beogradu s malokluzijama različitog tipa i težine u stalnoj denticiji. Svi modeli su ocenjeni sa tri pomenuta indeksa dva puta u razmaku od dva meseca radi utvrđivanja pouzdanosti. Rezultati. Rezultati analize su pokazali da je pouzdanost sva tri indeksa bila dobra. Za IOTN pouzdanost je izražena koeficijentom kapa (0,72 za estetski i 0,79 zdravstveni deo indeksa), dok je za PAR i ICON izračunat koren srednje kvadratne greške (2,1 i 4,5). Nije bilo statistički značajne razlike u broju bodova između dva merenja ova dva indeksa (p lt 0,01). Zaključak. Primena okluzivnih indeksa omogućava ortodontima određivanje prioriteta u zbrinjavanju pacijenata, planiranje ortodontske službe, pridržavanje i promociju standarda. Okluzivni indeksi su pouzdani dijagnostički kriterijumi koji mogu značajno uticati na plan lečenja malokluzija.