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Abstract
Introduction: The American Board of Orthodontics objectively quantifies the complexity of malocclusion before orthodontic treatment. This study aims to assess the complexity of cases as measured by ABO discrepancy index (DI) in the patients under treatment by the orthodontics residents of Kantipur Dental College (KDC). Additional objectives were to 1) Ascertain DI relative to sex, age and race/ethnicity, and 2) Differential analysis of the components of the DI.
 Materials & Method: DI was determined for 220 consecutive cases started by orthodontic residents of KDC in a three-year graduate orthodontics program from 2014-2018. The DI was scored and compared with the patient’s sex and age.
 Result: The DI is not statistically significant to age, sex and race/ ethnicity. The mean DI score (± SD) was 18.65 (±10.521). Differential analysis of the components of the DI showed that the highest scores were for cephalometric measures, followed by overjet, crowding, occlusion, and the lowest scores were for lingual posterior crossbite.
 Conclusion: The DI was a relatively reliable index for measuring malocclusion severity. It is independent of patient’s age and race/ethnicity but is dependent on sex. Area of possible future improvements includes malocclusion sub-categories (Class II div. 1 and 2), and scores for bony and soft tissue impactions.
Highlights
The American Board of Orthodontics objectively quantifies the complexity of malocclusion before orthodontic treatment
Discrepancy Index (DI) has been designed by American Board of Orthodontics (ABO) to provide an objective evaluation of the complexity of a malocclusion. This might lead to a better understanding of difficulty before starting the orthodontic treatment, which improves the compliance of the patient
It includes the evaluations of overjet, overbite, anterior open bite, lateral open bite, crowding, occlusion, lingual posterior crossbite, buccal posterior crossbite, and cephalometric angles i.e. Maxillo-mandibular relationship (ANB), Mandibular plane angle in relation to cranial base (SN-GoGn) and Lower incisor to Mandibular plane angle (IMPA).[2]
Summary
The American Board of Orthodontics objectively quantifies the complexity of malocclusion before orthodontic treatment. The DI is an objective method which is based on the observations and measurements taken from standard pretreatment orthodontic records i.e. study model, lateral cephalogram and panoramic radiographs.[1] It includes the evaluations of overjet, overbite, anterior open bite, lateral open bite, crowding, occlusion, lingual posterior crossbite, buccal posterior crossbite, and cephalometric angles i.e. Maxillo-mandibular relationship (ANB), Mandibular plane angle in relation to cranial base (SN-GoGn) and Lower incisor to Mandibular plane angle (IMPA).[2] The greater the number of these conditions in a patient, the greater severity of the malocclusion and the greater the clinical effort required to achieve optimal treatment.[1, 3]
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