Validation of the Risk Of Malocclusion Assessment (ROMA) index.

AIM: The aim of this study was to validate the ROMA (Risk Of Malocclusion Assessment) Index, verifying both its reproducibility and its ability to determine treatment priority. MATERIALS AND METHODS: The levels of treatment priority assessed for 75 children examined at the Gemelli General Hospital Orthodontic Service (Rome) ranged from grade 3 to grade 5 of the index. Multivariate analysis was conducted to verify the influence of covariates on the dependent variable. Moreover, the DHC of the IOTN was assessed for all patients, and a bivariate analysis was carried out to investigate its relationship with the ROMA Index. Intra- and inter- examiner reliability was calculated on a sample of 20 children, and the reproducibility of the index was evaluated using the Kappa statistic as a measure of concordance. RESULTS: It arose that there is an inverse relation between risk grades and the time interval from the first examination and start of treatment. According to the index, patients at extreme risk require immediate treatment, whereas priority is lower in case of great or moderate risk. In statistical terms, the study revealed a significant correlation between the ROMA Index and the DHC of the IOTN. With regard to intra- and inter-examiner reliability, the data collected by the two examiners showed a high level of agreement. CONCLUSION: The ROMA index appears quick to apply, reproducible, reliable and sensitive as a mean for carefully identifying different dento-skeletal problems. Furthermore, it is able to determine the priority of every risk grade and the corresponding timing of treatment.     

The use of the Index of Orthodontic Treatment need (IOTN) in a school population and referred population

The aim of this study is to assess the need for orthodontic treatment in a Turkish school population and a group of population referred for orthodontic treatment. The study groups were 250 school children, 11-14 years of age, and 250 patients, 11-14 years of age, referred to the department of orthodontics. The Index of Orthodontic Treatment Need (IOTN) was used by two examiner in order to estimate the treatment need. The differences between the IOTN values for the boys and girls were also not statistically significant in both groups. When the dental health component of IOTN is considered, 38.8 per cent of Turkish school population showed great need treatment, 24.0 per cent moderate need treatment and slight or no need was 37.2 per cent. On the other hand, the referred population represented an 83.2 per cent great need treatment, 12.0 per cent moderate need treatment, 4.8 per cent no need treatment according to the DHC. The AC of IOTN in school population resulted in 4.8 per cent great need, 4.8 per cent moderate need, 90.4 per cent no need. These percentage were 36.8 per cent great need, 17.6 per cent moderate need, 45.2 per cent no need in referred population. Grade 8 was 28.8 per cent out of the 36.8 per cent great need percentage in referred population. Therefore, it can be concluded that the ectopic canines were the driving factor for the referred population.     

The Use of the Index of Orthodontic Treatment Need (IOTN) in a School Population and Referred Population

Abstract

The aim of this study is to assess the need for orthodontic treatment in a Turkish school population and a group of population referred for orthodontic treatment. The study groups were 250 school children, 11–14 years of age, and 250 patients, 11–14 years of age, referred to the department of orthodontics. The Index of Orthodontic Treatment Need (IOTN) was used by two examiner in order to estimate the treatment need. The differences between the IOTN values for the boys and girls were also not statistically significant in both groups. When the dental health component of IOTN is considered, 38?8 per cent of Turkish school population showed great need treatment, 24?0 per cent moderate need treatment and slight or no need was 37?2 per cent. On the other hand, the referred population represented an 83?2 per cent great need treatment, 12?0 per cent moderate need treatment, 4?8 per cent no need treatment according to the DHC.

The AC of IOTN in school population resulted in 4?8 per cent great need, 4?8 per cent moderate need, 90?4 per cent no need. These percentage were 36?8 per cent great need, 17?6 per cent moderate need, 45?2 per cent no need in referred population. Grade 8 was 28?8 per cent out of the 36?8 per cent great need percentage in referred population. Therefore, it can be concluded that the ectopic canines were the driving factor for the referred population.     

The use of index of orthodontic treatment need in an Iranian population

This study aims to evaluate the need for orthodontic treatment between 11 and 14 year old school children in Shiraz. A sample of 2000 students consisting of 1200 boys and 800 girls from various parts of the city was selected. The index of orthodontic treatment need (IOTN) was used by two calibrated examiners. The data was recorded in questionnaires to assess dental health components (DHC). Aesthetic components (AC) were evaluated both by students (AC) and examiners (ACE). The results for DHC of IOTN were: 18.39% of population showed severe and very severe need for treatment, 25.8% were in border line category, 48.1% had a slight need and the percentage for no need to treatment was 7.63%. In evaluating AC, 91.93% were in no need or little need, 3.91% in moderate need and 4.11% in great need to treatment group. Where as ACE resulted in: 91.31% no need and little need, 2.44% moderate need and 6.21% great need to treatment. There was a slight statistical correlation (0.54) between AC and ACE, but a very weak correlation between DHC and AC was observed. According to DHC, boys showed more need for treatment than girls (P=0.001). Grade 8 showed the most percentage in great need category in both AC and ACE (3.41% of 4.11% and 5.74% of 6.21%, respectively). The results indicate that the need for orthodontic treatment was less than other studies and most of the students were in the category of little need for treatment.     

Orthodontic treatment need and demand in Senegalese school children aged 12-13 years. An appraisal using IOTN and ICON

OBJECTIVE: To assess the normative need, knowledge of, and demand for orthodontic treatment in Senegalese schoolchildren aged 12-13 years. MATERIALS AND METHODS: The sample consisted of 665 Senegalese schoolchildren randomly selected from different ethnic and socioeconomic backgrounds. The normative orthodontic treatment need was assessed using the Dental Health Component (DHC) and the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and the Index of Complexity, Outcome, and Need (ICON). Knowledge of and demand for orthodontic treatment were assessed with a questionnaire. RESULTS: The DHC and the AC of the IOTN and the ICON classified respectively 42.6%, 8.7%, and 44.1% of the children as having a definite need for orthodontic treatment. There were no ethnic or gender differences with respect to normative orthodontic treatment need. The mean ICON score ranged from 42.31 to 44.46 according to the ethnic group. Only 10% of the children had some knowledge of orthodontics. However, between 17% and 30% of the children clearly expressed a need for orthodontic treatment, and the distribution between ethnic groups was significant. In contrast, there were no significant gender differences concerning this demand for treatment. CONCLUSIONS: The present study shows that the need for orthodontic treatment far exceeds the actual available supply.     

Prevalence of temporomandibular disorder pain,jaw noises and oral behaviours in an adult Italian population sample

To evaluate the prevalence of temporomandibular disorder pain (TMD‐pain), temporomandibular joint (TMJ) noises, oral behaviours in an Italian adult population sample, their possible association with gender, oral behaviours, self‐reported facial trauma and orthodontic treatment. Subjects older than 18 years were recruited from general population in public spaces during their daily life. A specific questionnaire was developed to collect data on TMD‐pain, TMJ noises, oral behaviours, orthodontic treatment and facial trauma. A total of 4299 subjects were included in the study. The most common symptom in the sample was TMJ clicking (30.7%), followed by TMD‐pain (16.3%) and TMJ crepitus (10.3%). Oral behaviours were reported in 29% of the sample; 43.6% of the sample reported a previous or ongoing orthodontic treatment. TMD‐pain and TMJ clicking were significantly associated to gender, oral behaviours and a positive history of previous facial trauma. Crepitus was significantly associated to oral behaviours, facial trauma and higher age. Ongoing orthodontic treatment was significantly associated to TMD‐pain and TMJ sounds. In a general Italian adult population sample, TMD‐pain is associated to female gender and is less prevalent than TMJ clicking. TMDs are associated to trauma and oral behaviours.     

Prevalence of malocclusion and orthodontic treatment need in 10-year-old New Zealand children

The need for orthodontic treatment was determined in a random sample of 10-year-old Dunedin, New Zealand schoolchildren using the Dental Aesthetic Index (DAI); an index based on the social acceptability of dental appearance. When absent or unerupted teeth were disregarded, orthodontic treatment was considered to be "mandatory" for one-third of the children. The remaining children were almost equally divided into the three other treatment-need groups: "highly desirable", "elective", and "not necessary". The majority of the children had crowding and spacing in at least one incisor segment, and a molar occlusion other than Angle Class I. In this predominately mixed-dentition sample, more children were considered to need orthodontic treatment than older children in studies using the DAI. This raises some questions about the suitability of the DAI as a tool to assess orthodontic treatment need in mixed-dentition samples.     

Orthodontic treatment need in Nigerian children

OBJECTIVE: The purpose of this study was to assess the need for orthodontic treatment among Nigerian children aged 12-14 years old in Benin City, south-southern region of Nigeria. RESEARCH DESIGN: The sample consisted of 261 randomly selected school children, 122 boys (47%) and 139 girls (53%) with mean age of 12.9 +/- 0.1. The survey was conducted by clinical examination and both components of the Index of Orthodontic Treatment Need (IOTN) were used to determine the need for orthodontic treatment. RESULTS: The results revealed that 50 (19.2%) of the children had a definite need for orthodontic treatment according to dental health component while aesthetic component of IOTN indicated definite need in 12 (4.6%). Increased overjet, severe contact displacements and impeded eruption of teeth were the common occlusal features in the definite treatment need group. CONCLUSION: This study provided data on the need for orthodontic treatment among Nigerian school children which is useful to plan and prioritise orthodontic care and services.     

Orthodontic status and treatment need of 12-year-old children in South Africa using the Dental Aesthetic Index.

OBJECTIVE: The aim of this study was to determine the prevalence and severity of malocclusion and orthodontic treatment needs in a sample of 12-year-old South African school children using the Dental Aesthetic Index (DAI), and to assess the relationship between malocclusion and certain socio-demographic variables. METHODOLOGY: The sample comprised 6142, 12-year-old children attending school in seven of the nine provinces of South Africa. For each subject the standard demographic information such as gender, population group, location type and employment status of the parents was collected, after which an intra-oral examination for occlusal status using the DAI was performed. Before the survey, the examiners were calibrated and trained and only examiners with an agreement score greater or equal to 80 per cent were included in the final study. RESULTS: The results showed that 47.7 per cent of the children in the sample presented with good occlusion or minor malocclusion, just over 52.3 per cent presented with identifiable malocclusion, a DAI score larger than 26. Of these, 21.2 per cent had definite malocclusion, 14.1 per cent had severe malocclusion and 16.9 per cent had very severe or handicapping malocclusion. Malocclusion as defined in this study was found to be significantly associated with the different population groups in South Africa, with gender and with dentition stage, but not with the location type or the employment status of parents. CONCLUSIONS: The results of this study show a high prevalence of malocclusion in 12-year-old South African children. The findings provide reliable base-line data regarding the prevalence, distribution and severity of malocclusion as well as useful epidemiological data on the orthodontic treatment needs of 12-year-old children in South Africa.     

A comparison of two methods of assessing orthodontic treatment need in the mixed dentition: DAI and IOTN

This paper assesses the unmet orthodontic treatment need in a random sample of 10-year-old schoolchildren, using two indices: the Dental Aesthetic Index (DAI) and the Index of Orthodontic Treatment Need (IOTN). The DAI scores were adjusted by omitting the missing teeth component of the index because many children were in the mixed dentition with unerupted permanent teeth. Although both indices assessed the same number of children with malocclusions requiring orthodontic treatment, not all were ranked similarly by each index.     

错畸形对重庆市8~10岁儿童自尊的影响

目的:调查错畸形对重庆市8~10岁儿童自尊的影响。方法:参考第四次全国口腔健康流行病学调查实施方案,采用多阶段、分层、整群、随机抽样方法,于2018年10—12月间抽取重庆市3城区及3区县共12 所学校 1 588 名儿童,采用正畸治疗需要指数（IOTN）的牙健康部分对其错情况进行口腔健康检查,采用IOTN美观部分、儿童自我知觉问卷对其主观正畸治疗需要、整体自尊进行问卷调查。采用SPSS 20.0软件包对结果进行统计分析。结果:主观正畸治疗需要IOTN-AC（中度、重度）、深覆盖（重度：6~9 mm,>9 mm）、前牙反、开、位于前牙区的龋齿与自尊呈显著负相关（P<0.05）。结论:主观正畸治疗需要以及对美观影响较大的错畸形明显影响儿童自尊,需要加大早期矫治的投入和宣教。     

Early interceptive treatment of asymmetry

Severe asymmetry in pre-adolescent children usually arises either from congenital anomalies, such as unilateral condylar hypoplasia, or as a result of juvenile rheumatoid arthritis, condylar hyperplasia or early fracture of the mandible. Early surgical and orthodontic interceptive treatment of the asymmetry is important for normal development of the face and jaws.     

Factors influencing the decision about orthodontic treatment

The aims of the study were to evaluate the attitude towards orthodontic treatment among 11-(T1) and 15-year-old children (T2) and their parents, to present the distribution of referral rate and treatment uptake by a treatment need index assessed at T1 and to elucidate factors influencing the decision about orthodontic treatment in the period from T1 to T2. A group of 359 children and their parents answered separate questionnaires at T1, and 293 families responded to a follow-up study 4 years later. For the clinical examination, 224 children participated after exclusion of children in active treatment. The dental study casts were assessed by the Index of Orthodontic Treatment Need (IOTN). The mean referral rate was 56%, with a variation from 40% to 71% among different dental clinics. About 44% of the children had completed or were undergoing orthodontic treatment at T2. No significant sex differences among referred and treated children were discovered. Aesthetic motives were the most frequently reported subjective reason for orthodontic care. The untreated group expressed diminishing treatment desire in the follow-up period. The logistic regression analysis selected Dental Health Component (DHC) grades as a strong predictor for treatment uptake, followed by parents' concern and attitude to braces, while the 11-year-olds' own orthodontic concern was less significant. Children in the untreated group with late treatment decisions (T2) were best predicted by Aesthetic Component (AC) changes from T1 to T2. The results indicate that dentists play a key role in determining orthodontic treatment levels. High referral rates secured low risk of denying care to some patients. Treatment decision may be guided by the orthodontist. However, individual variation in attitude and desire influence treatment uptake even among children with great need.     

Objective and subjective need for orthodontic treatment in Stockholm County

The objective and subjective need for orthodontic treatment according to a modified version of the treatment priority index of the Swedish National Board of Health and Welfare (index scores 0 to 4), was studied in 1281 children and teenagers, aged between 8 and 16 years and living in the Stockholm area. Furthermore, differences between different parts of the Stockholm County with respect to need for orthodontic treatment, and the subjective demand for treatment were also recorded. Five areas with varying population structures were studied. The results showed that the prevailing objective and subjective need for treatment varied in the areas studied. The prevalence of objective need for treatment varied between 23.8% and 28.9%. The subjective need for treatment ranged from 21.6% to 30.3%. The highest prevalence of treatment need was found in areas with a large immigrant population. In all the investigated areas was the subjective demand for treatment 1-1.5% less than the objective need for treatment. On the basis of the present data, it can be concluded that neither the objective, nor the subjective need for orthodontic treatment exhibits any tendency to decline. The results do not, therefore, support the policy that the public financial resources for orthodontic treatment could be reduced due to a lowered need for treatment. Severe malocclusions may result in impaired craniomandibular function and have an unfavourable influence on facial and dental attractiveness, which may in turn have psychosocial implications. There is an obvious risk that the frequency of such problems may increase in the population, if children with great or very great need for treatment are denied adequate orthodontic care due to lack of sufficient resources.     

乌鲁木齐562例汉族青少年正畸需要量的研究

目的确定乌鲁木齐市汉族青少年正畸治疗的需要量.方法根据随机化原则,按分层整群抽样的方法选取562例11～19岁汉族青少年的硬石膏模型,应用错严重程度指数(MSI)确定是否需要正畸治疗的量.结果男性MSI分值为21.91±17.09,女性MSI分值为22.28±17.26,无性别差异(P＞0.05).根据MSI的分数分类,男性需正畸治疗者为54.55%,女性为55.40%.结论乌鲁木齐市汉族青少年中需要正畸者较多,应加强防治力量.错严重程度指标是确定正畸需要量的一个准确、可信、使用简便的指数,值得推广应用.     

Hypodontia in 9-year-old Norwegians related to need of orthodontic treatment

The present study reports on the prevalence of hypodontia in a Norwegian population and classifies children with hypodontia according to need of orthodontic treatment. Orthopantomograms of 1953 children (960 girls and 993 boys) at the age of 9 were available for examination. Of the boys registered with hypodontia of second premolars at the age of 9, 11.3% showed late mineralization between the ages of 9 and 12. Only 2.9% of the girls showed late mineralization. The corrected prevalence of hypodontia, excluding third molars, in the girls was 7.2%, in the boys 5.8%, and in both sexes combined 6.5%, the difference between sexes not being statistically significant. Of the children with hypodontia, 86.6% lacked only one or two permanent teeth. The most frequently missing teeth were the mandibular second premolars, the maxillary second premolars, and the maxillary lateral incisors, in that order. Classification of children with hypodontia according to need of orthodontic treatment showed that about two-thirds had hypodontia only of single posterior teeth with a moderate need of treatment. About one-third had hypodontia involving anterior teeth, and only 3.1% had hypodontia of two or more teeth in the same quadrant with a great need of treatment.     

Normative and self-perceived orthodontic treatment need in Nigerian school children

Abstract

Objective. The aim of this study was to assess the normative and self-perceived need for orthodontic treatment in Nigerian children, and to evaluate distribution of orthodontic treatment need according to gender and age. Materials and methods. The sample consisted of 441 randomly selected school children, aged 11–18 years in Benin City, Nigeria. The subjects were further sub-grouped according to gender (229 males and 212 females) and age (246 11–13 years old and 195 14–18 years old). The Dental health Component (DHC) and Aesthetic Component (AC) of Index of Orthodontic Treatment Need (IOTN) were used to assess orthodontic treatment need normatively. Self-perceived need was evaluated by asking the subjects to rate their dental aesthetics on the Aesthetic Component scale of IOTN. Chi-square tests were used to evaluate gender and age differences in distribution of treatment need. Results. A definite need for orthodontic treatment was found among 21.5% (grades 4–5 of DHC) and 6.3% (grades 8–10 of AC) of the subjects; 3.9% of the subjects perceived a definite need for orthodontic treatment (grades 8–10 of AC). There were no statistically significant gender and age differences in distribution of orthodontic treatment need among the subjects (p > 0.05). Conclusion. The study revealed a need for orthodontic treatment in slightly more than one fifth (21.5%) of this sample of Nigerian children. The sample population has a lower need on aesthetic grounds and their normative and self-perceived orthodontic treatment needs were not influenced by gender and age.