Selection of criteria for assessment of occlusal acceptability

Abstract

There is no general agreement on criteria that could be applied to distinguish between orthodontically acceptable and non-acceptable occlusions after the completion of dental development. The aim of the present study was to analyse morphological and functional features that could be used as an index to define an acceptable occlusion in young adults. Three expert panels representing specialists in orthodontics and stomatognathic physiology participated in a modified Delphi method. Each panel responded to a questionnaire concerning the usefulness of various occlusal features, and a set of characteristics was selected on the basis of the responses; thereafter, applicability of the chosen characteristics and their cut-offs for an acceptable non-acceptable dichotomy was tested clinically. To obtain a consensus level of 100%, the last panel session was completed with a group discussion. Assessments made using the morphological criteria were compared with those made with the dental health component of the Index of Orthodontic Treatment Need. The selected morphological characteristics consisted of overjet, overbite, canine relationship, crossbite, scissors bite and midline deviation. The functional evaluation comprised assessments of discrepancy between the centric relation and the intercuspal position, working- and non-working-side contacts and protrusion contacts. The dental health component and our morphological criteria showed different sensitivity to contact point displacements, interdigitation in buccal segments and increased overbite. This study provides a set of morphological and functional indicators reflecting the current consensus opinion of Finnish professionals. Further studies are needed to analyse the reproducibility of assessment of the characteristics included.

Professional consensus on orthodontic risks: What orthodontists should tell their patients

“…Delphi methods were deemed appropriate as healthcare professionals' communication of risk involves a blend of scientific evidence, social values and expert judgement. 17 The Delphi technique has been used to investigate risk disclosure for medical procedures, 18 develop clinical guidelines 19 and criteria to assess orthodontic outcomes 20 and assess the impact of reducing orthodontic treatment availability 21 . Other consensus development methods include the nominal group technique and consensus conferences.…”

Acceptability of Dental Appearance in a Group of Finnish 16- to 25-Year-Olds

“…13,15 Group I consisted of subjects from three secondary schools and one vocational school in central Finland (n ϭ 116) aged between 16 and 25 years. Group II comprised 15-to 18-year-old subjects from the catchment area of one municipal health center in eastern Finland (n ϭ 192), and Group III comprised 16-year-old adolescents from a rural municipality in southwest Finland (n ϭ 126).…”

“…7,9,10 In a series of investigations, clinical criteria that could be used in the assessment of occlusal acceptability were analysed. [11][12][13][14] Consequently, a new index, the Occlusal Morphology and Function Index (OMFI), was developed, based on the assessment of six morphological and four functional criteria. 15,16 The OMFI is intended to be used as a tool eg, in studies monitoring the outcome of orthodontic care at population level.…”

Evaluation of the Dental Health Component, of the Index of Orthodontic Treatment Need, by Swedish orthodontists

“…In comparison with traditional screening methods, a study by Burden and Mitropolous (1992) showed that the use of the IOTN would increase the number of patients who would be selected for treatment. Swedström-Oristo et al (2002) found several dental criteria that differ between Finnish professionals and the DHC. The use of the DHC would therefore result in treating 50 per cent of the cases that they had rated as being acceptable (no treatment).…”