indices 2 / dental crown & bridge courses /certified fixed orthodontic courses by Indian dental academy

INDICES

www.indiandentalacademy.com

1

INDIAN DENTAL ACADEMY
Leader in continuing dental education


2

Index
According to Russell, an index is defined as
‘A numerical value describing the relative status
of the population on a graduated scale with definite
upper and lower limits which is designed to permit and
facilitate comparison with other population classified
with the same criteria and the method.’
In the orthodontic context index is described as –
‘A rating or categorizing system that assigns a
numeric score or alpha numeric label to a person’s
occlusion.’

3

Requirements of ideal orthodontic index are –
(Jamison H.D. and Mc Millan R.S )
1. Simple, reliable and reproducible.
2. Objective and yield quantitative data.
3. Differentiate b/w handicapping and non
handicapping malocclusions.
4. Measure degree of handicap.
5. Quick examination.
6. Amenable to modifications.
7. Usable either on patient or on study model.

4

Types of Indices ( according to WHO)
 Occlusal Classification
– Angle’s classification by Angle in 1899
– Incisor classification by Ballard and Wayman, 1964
 Skeletal classification by Houston et al, 1993
 Malocclusion
– Occlusal index by Summers 1966
– Handicapping Malocclusion Assessment Record
(HMAR) by Salzmann, 1968
– Index of Treatment Need by Evans and Shaw 1987

5

 Treatment assessment
– Little’s irregularity index by Little 1975
– Peer Assessment rating by Richmond et al, 1987
 Cleft Outcome
– Goslon Yardstick by Mars et al, 1987
– 5Year olds’ Index by Atack et al ,1997
 Periodontal
– Plaque Index by Stilness & Loe , 1964
– Gingival Index. by Loe & Stilness, 1963


6

Peer Assessment Rating Index
(PAR index)
by Richmond et al., 1987


Developed by 10 experienced British orthodontists.



Its developed mainly to assess effectiveness of
Orthodontic treatment.



Assigns scores to different occlusal traits.



Study models used.



A scoring system and a ruler.

7


8

5 components-

Weighting
1. Upper & lower anterior segment - 1
2. Left and right buccal segments 1
3. Over jet
- 6
4. Overbite
- 2
5. Centerlines
- 4
 Individual scores are summed to get a final score..
 Index is applied to both the start and end of treatment
study casts, and change in total score reflects the success
of treatment.

9


1.
2.




Change expressed as:
Reduction in weighted PAR score : 22 point
reduction – Greatly improved
% reduction in weighted PAR score:
< 30% reduction – worse/ no better
> 30% reduction – Improved.
Indicator of clinical performance.
Limitations of PAR
1. Generic weightings of Over jet and overbite.
2. Sensitive to malocclusion with high over jet.
3. Overbite low weighting..
4. Facial profiles not considered Eg. Bimaxillary
protrusion

10

TheValidation of PAR for Malocclusion severity
and Treatment Difficulty
De Guzman,bahiraei, Vig, Weyant and O’Brien – AJO-DO 1995

 11 American Orthodontists examined a sample of 200
sets of study casts and rated them for malocclusion
severity and perceived treatment difficulty.

 The results of this study made it possible to derive a set
of weightings for the PAR index, for malocclusion
severity and treatment difficulty, according to
perceptions of panel of Orthodontists.


11


12

Index of Treatment Need (IOTN)
by Brook &Shaw - 1987

 Index has two components1. Dental Health component – derived from
occlusion and alignment – Dental casts.
2. Aesthetic component – Derived from
comparison of dental appearance to standard
photographs. – direct examination


13


14

A special ruler summarizes the information
needed for dental health component.
 Assessed in order :
1. Missing teeth
2. Overjet
3. Crossbites
4. Displacements (Contact point)
5. Overbite


15


16

Esthetic Index
 Grades 8 – 10 =
definite need for
treatment.
 5 – 7 = moderate/
borderline need
 1 – 4 = No/ slight
need


17

Limitations
1.
2.
3.

In aesthetic component ,Class III not considered.
Facial profile not considered.
Class I bimaxillary protrusion not considered.


18

Index of Complexity Outcome and Need
(ICON)

 A single assessment method to record
complexity, outcome and need.
 Based on expert opinions of 97 orthodontists
from various countries.
 For use on patients and Dental casts.

19

ICON Scoring Method


20

1. Aesthetic component


21


22

Limitations
1.
2.
3.

Overjet not considered.
Lower anterior crowding/spacing not considered.
Midline shift not taken in account.


23

Goslon yardstick :A new system of assessing
dental arch relationships in childeren with UCLP – Michael
Mars, Dennis A. Plint : 1987 A cleft Palate journal
 The Goslon Yardstick is a clinical tool that allows
categorization of the dental relationships in the late
mixed and or early permanent dentition in to 5 discrete
categories.
 Objective : 1. To categorize malocclusions in patients
with UCLP to represent severity of malocclusion and the
difficulty of correcting it.
2. To compare long term results of different approaches
to the early treatment of children with UCLP.

24


1.
2.
3.

Development of Yardstick – Clinical features
considered most important in characterizing
malocclusion in children with UCLP are –
A- P arch relationship –Class III incisor
relationship> class II div I
Vertical labial segment relationship – Open bite>
Reduced overbite > deep overbite.
Transverse relationship – Canine crossbites > molar
crossbites.



To test the application of these subjective criteria
study models of 30 cases were taken.



These models were ranked by 4 orthodontists and
separated in 5 groups , which then formed basis for
yardstick.

25

 Group 1 – excellent





Group 2 – good
Group 3 – fair
Group 4 – poor
Group 5 – very poor

 Group 1 or 2 - simple orthodontic treatment/ no
treatment
 Group 3 – complex orthodontic treatment
 Group 4 – limit of orthodontic treatment without
orthognathic surgery
 Group 5 – Orthognathic surgery

26


27


28


29


30


31

References:
1.
2.
3.

Contemporary Orthodontics – Proffit
M Ortho Journal – Bristol University
Longitudinal evaluation of the Treatment Priority
Index (TPI) AJO-DO 1989

:

4.

Goslon yardstick A new system of assessing dental
arch relationships in childeren with UCLP – Michael
Mars, Dennis A. Plint : 1987 A cleft Palate journal

5.

The Development of PAR Index – S. Richmond


32

6. Handicapping Malocclusion assessment to establish
treatment Priority J A Salzmann – AJO –1964
7. The use of Occlusal Indices : A European prospective –
AJO-DO 1995
8. The validation of PAR for malocclusion severity and
treatment difficulty AJO-DO 1995
9. The effectiveness of ClassII div I treatment – AJO-DO
1995


33

Thank you
Leader in continuing dental education


34

indices 2 / dental crown & bridge courses /certified fixed orthodontic courses by Indian dental academy

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Similar to indices 2 / dental crown & bridge courses /certified fixed orthodontic courses by Indian dental academy

Similar to indices 2 / dental crown & bridge courses /certified fixed orthodontic courses by Indian dental academy (20)

More from Indian dental academy

More from Indian dental academy (20)

Recently uploaded

Recently uploaded (20)

indices 2 / dental crown & bridge courses /certified fixed orthodontic courses by Indian dental academy