IOTN training presentation


Published on

  • Be the first to comment

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

IOTN training presentation

  1. 1. Index of Orthodontic Treatment Need modified for use in Epidemiological Surveys : Modified IOTN
  2. 2. <ul><li>Written by </li></ul><ul><li>Donald Burden and Cynthia Pine </li></ul><ul><li>  </li></ul><ul><li>with assistance </li></ul><ul><li>from the BASCD Working Party on Orthodontics </li></ul>
  3. 3. Modified IOTN consists of two components: 1. Aesthetic Component 2. Dental Health Component
  4. 4. Aesthetic Component Grades 1-7 No Definite Need for treatment Grades 8-10 Definite Need for treatment
  5. 5.
  6. 6. <ul><li>Recording the Aesthetic Component </li></ul><ul><li>Ask subject to close on their back teeth </li></ul><ul><li>Retract lips </li></ul><ul><li>Grade the dental attractiveness of the anterior teeth </li></ul>
  7. 7. <ul><li>Recording the Aesthetic Component </li></ul><ul><li>The grade awarded is for overall dental attractiveness rather than specific morphological similarity to the photographs </li></ul><ul><li>First impressions are usually correct </li></ul><ul><li>Main aim is to differentiate those at </li></ul><ul><li>8 - 10 </li></ul>
  8. 8. Dental Health Component IOTN has been simplified to two categories:  Definite Need for Treatment  No Definite Need for Treatment The subject is examined for specific conditions and if one is found, a Definite Need for Treatment is recorded and no further conditions are sought.
  9. 9. <ul><li>Recording the DHC </li></ul><ul><li>Examine each subject for: </li></ul><ul><li>M issing teeth </li></ul><ul><li>O verjets </li></ul><ul><li>C rossbites </li></ul><ul><li>D isplacement of contact points </li></ul><ul><li>O verbites </li></ul><ul><li>= MOCDO </li></ul>
  10. 10. Recording the DHC <ul><li>Examine the subject using the ‘MOCDO’ scale </li></ul><ul><li>As soon as a definite treatment need threshold is reached, then the examination is stopped </li></ul>
  11. 11. ‘ MOCDO’ <ul><li>Missing teeth </li></ul><ul><li>Overjets </li></ul><ul><li>Crossbites </li></ul><ul><li>Displacement of contact points </li></ul><ul><li>Overbites </li></ul>
  12. 12. Missing Teeth (teeth not visible) <ul><li>Congenital absence/traumatic loss </li></ul><ul><li>Ectopic teeth </li></ul><ul><li>Impacted teeth </li></ul>
  13. 13. Missing Teeth <ul><li>Palatally ectopic canines </li></ul><ul><li>Is the canine palpable in the buccal sulcus? </li></ul><ul><li>If not, it is ectopic = Need for Treatment </li></ul>
  14. 14. Missing Teeth <ul><li>IMPACTED if 4mm or less space is available between adjacent teeth </li></ul><ul><li>Impacted = Need for Treatment </li></ul>
  15. 15.
  16. 16. Missing Teeth <ul><li>(Congenital absence/traumatic loss) </li></ul><ul><li>In your opinion, is orthodontic treatment required to open or close the space? </li></ul><ul><li>If yes = Need for Treatment </li></ul>
  17. 17. ‘ MOCDO’ <ul><li>Missing teeth </li></ul><ul><li>Overjets </li></ul><ul><li>Crossbites </li></ul><ul><li>Displacement of contact points </li></ul><ul><li>Overbites </li></ul>Original Slide No.15
  18. 18. Measuring Overjets Increased overjets (Class II) and reverse overjets (Class III) are measured using the metal ruler
  19. 19. Second line (red) – 6mm Positive overjets
  20. 20.
  21. 21. Measuring Overjets <ul><li>Measure to the labial aspect of the most prominent incisor </li></ul><ul><li>Only record Need for Treatment if the overjet extends beyond the 6mm line </li></ul>
  22. 22.
  23. 23.
  24. 24. Measuring Reverse Overjets <ul><li>All four incisors must be in lingual occlusion </li></ul>
  25. 25. Measuring Reverse Overjets <ul><li>If the reverse overjet falls exactly on the 4mm (white line) record in the Definite Need for Treatment category </li></ul>
  26. 26. First line (white) – 4mm Crowding Reverse overjets Open bites
  27. 27.
  28. 28. ‘ MOCDO’ <ul><li>Missing teeth </li></ul><ul><li>Overjets </li></ul><ul><li>Crossbites </li></ul><ul><li>Displacement of contact points </li></ul><ul><li>Overbites </li></ul>
  29. 29. Crossbites <ul><li>Can be anterior or posterior, but mostly posterior. </li></ul><ul><li>Check for displacement on closure. </li></ul><ul><li>If displacement on closure = Need for Treatment </li></ul>
  30. 30. ‘ MOCDO’ <ul><li>Missing teeth </li></ul><ul><li>Overjets </li></ul><ul><li>Crossbites </li></ul><ul><li>Displacement of contact points (crowding) </li></ul><ul><li>Overbites </li></ul>
  31. 31. Crowding <ul><li>Only applies to crowding between permanent teeth </li></ul><ul><li>Measure between the contact points of the two most crowded teeth </li></ul>
  32. 32. First line (white) – 4mm Crowding Reverse overjets Open bites
  33. 33.
  34. 34. ‘ MOCDO’ <ul><li>Missing teeth </li></ul><ul><li>Overjets </li></ul><ul><li>Crossbites </li></ul><ul><li>Displacement of contact points </li></ul><ul><li>Overbites </li></ul>
  35. 35. Overbite <ul><li>Deep overbite </li></ul><ul><li>Open bite </li></ul>
  36. 36. Deep Overbite <ul><li>Deep overbite causing gingival or palatal traumatic injury </li></ul>= Definite Need for Treatment
  37. 37.
  38. 38. Other Points of the Modified IOTN <ul><li>Generalised spacing is not recorded in the Dental Health Component </li></ul>