Factors affecting the outcome of orthodontic treatment within the general dental service.

Fox, Nigel A.; Richmond, Stephen; Wright, Jean L.; Daniels, Claudia

doi:10.1093/ortho/24.3.217

Cited by 34 publications

(19 citation statements)

References 6 publications

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“…The overall level of malocclusion is however more severe than previous estimates from the GDS, which typically have had mean initial PAR scores of 29. 9 The sample, however, was not designed to generalise treatment outcomes in the GDS or hospital sector, but to compare the performance of the new indices. …”

Section: Discussionmentioning

confidence: 99%

A comparison of the Index of Complexity Outcome and Need (ICON) with the Peer Assessment Rating (PAR) and the Index of Orthodontic Treatment Need (IOTN)

Fox

Daniels²,

Gilgrass

2002

Br Dent J

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Aim To evaluate any relationship between ICON, IOTN and PAR. To establish whether or not ICON could replace these indices as a measure of orthodontic treatment complexity, outcome and need. Method The study models of 55 consecutively treated cases were examined and PAR, IOTN and ICON recorded. Results The study showed significant correlations between IOTN and ICON with respect to need and PAR and ICON with respect to outcome. Conclusion It appears that ICON does reflect UK opinion and the current study provides some evidence that ICON may effectively replace PAR and IOTN as a means of determining need and outcome.The PAR Index and IOTN have now become widely used in the UK as orthodontic audit tools. They have provided valuable data to inform political and clinical debate on the quality of GDS orthodontics. The introduction of IOTN in the General Dental Services is currently being considered. In order to assess treatment inputs and outcomes using IOTN and PAR, two different measurement protocols must be learned and this duplication of effort is inefficient.The PAR index has been accused of both undue leniency on poor finishes 1 and undue harshness on treatments with limited aims. 2,3 Experience with IOTN has shown that the need for treatment does not necessarily equate to the complexity of the treatment. It is important to make an assessment of complexity for the following clinical reasons (Richmond et al 4 ):• To identify the most appropriate setting in which a patient should receive treatment.• To allow meaningful assessment of treatment outcomes.• To identify cases that are likely to take longer to treat.• To inform the patient of the likely success.

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Section: Discussionmentioning

confidence: 99%

A comparison of the Index of Complexity Outcome and Need (ICON) with the Peer Assessment Rating (PAR) and the Index of Orthodontic Treatment Need (IOTN)

Fox

Daniels²,

Gilgrass

2002

Br Dent J

Self Cite

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“…7 There was considerable variation within the sample, but treatment 9 although as that was prospective in design, as well as being localised and dependent upon the consent of the participating practitioners, one should be cautious about drawing firm conclusions from comparisons between the two studies.…”

Section: Discussionmentioning

confidence: 99%

A closer look at General Dental Service orthodontics in England and Wales I: Factors influencing effectiveness

1999

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“…The authors of the index have based it on a complete analysis of the available literature [8] and seek to establish important values found in the literature as threshold values. The IOTN has been used in numerous studies to establish treatment need [4, 9-12, 22, 42, 44J or to evaluate treatment outcome [6,19,28,34,36,37,45]. It is also assumed that slight effects on susceptibility to temporomandibular dysfunctions and periodontal disease are also assumed to occur [9].…”

Section: Discussionmentioning

confidence: 99%

Retrospektive Bewertung des Therapieerfolgs bei kieferorthop�discher Behandlung von Erwachsenen

Riedman

Berg

1999

J Orofac Orthop/Fortschr Kieferorthop

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The aim of this study was the retrospective evaluation of the outcome of orthodontic treatment in consecutively treated adult patients. Of 147 adult patients, it was possible to evaluate the records of 88 patients (57 female, 31 male) before (T1) and after treatment (T2), and of 20 of these patients 3.3 years on average after completion of the retention phase (T3). During treatment planning, a nearly "ideal" result was considered attainable (ideal group) for 46 patients, and a "compromise" result (compromise group) was seen as realistic for 42. The assessment was made using the PAR (Peer Assessment Rating) index and the Aesthetic Component (AC) and Dental Health Components (DHC) of the IOTN (Index of Orthodontic Treatment Need). Average length of treatment in the ideal group was 2.4 years, i.e. nearly twice as long as in the compromise group. The PAR score was reduced by an average of 56% (T2); the reduction in the ideal group was 73%, and in the compromise group 37%. Among the 20 patients for whom at least 6 months had elapsed since completion of the retention phase, a statistically significant relapse between T2 and T3 was observed. The evaluation of overjet and overbite and, in the ideal group, of the midline and maxillary front teeth were primarily responsible for the worsening of the PAR scores between T2 and T3. According to the AC, 53 patients (60%) had moderate to definite treatment needs at the beginning of treatment. Following completion of active treatment, 69 patients (78%) no longer demonstrated treatment indications for aesthetic or psychosocial reasons. Based on the DHC, 88% of the patients were in definite or moderate need of treatment (T1); in contrast, treatment was no longer indicated in 84% at T2. In general, a marked improvement of the examined morphological parameters was observed.

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Factors affecting the outcome of orthodontic treatment within the general dental service.

Cited by 34 publications

References 6 publications

A comparison of the Index of Complexity Outcome and Need (ICON) with the Peer Assessment Rating (PAR) and the Index of Orthodontic Treatment Need (IOTN)

A comparison of the Index of Complexity Outcome and Need (ICON) with the Peer Assessment Rating (PAR) and the Index of Orthodontic Treatment Need (IOTN)

A closer look at General Dental Service orthodontics in England and Wales I: Factors influencing effectiveness

Retrospektive Bewertung des Therapieerfolgs bei kieferorthop�discher Behandlung von Erwachsenen

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