Abstract
Objective: The aim of the present study was to investigate possible relations between anticipated overall treatment complexity (AOTC) of an orthodontic case and malocclusion characteristics. Methods: Two groups of orthodontists (groups A and B) were asked to define perceived treatment complexity (PTC) of orthodontic cases based on 16 characteristics of malocclusion by means of a questionnaire. Each question was answered on a six-point ordinal scale, with one "not applicable" option (score 0). Group A was also asked to give the AOTC of the specific case on a five-point ordinal scale. The index of orthodontic treatment need (IOTN) score of the specific cases as well as the malocclusion characteristics were assessed by one author. Results: There is a significant relationship between IOTN and AOTC (p< 0.0001), 22% of variability is explained by differences in IOTN. Adding objective characteristics of malocclusion to explain AOTC does not significantly increase the explained variability (p = 0.086). In judging interobserver agreement, a weighted Kappa of 0.60 for group A and 0.56 for group B was found. The weighted Kappa for agreement in AOTC equals 0.06. Conclusion: The relation between IOTN and AOTC was found to be significant. Moderate agreement on PTC among observers and a low level agreement regarding AOTC were found in the present study.
Highlights
Interest in developing an index of orthodontic treatment complexity has increased over the years, as such an index could be used to assign resources and determine appropriate financial compensation for treatment
The study casts were scored using the index of orthodontic treatment need (IOTN) which determines treatment need based on the dental health condition (Dental Health Component) as well as the aesthetic appearance (Aesthetic Component) of the dentition
A significant relation was found between IOTN and anticipated overall treatment complexity (AOTC) (Spearman rho = 0.34, p = 0.0007) (Fig 2). 22.24% of variability is explained by differences in IOTN
Summary
Interest in developing an index of orthodontic treatment complexity has increased over the years, as such an index could be used to assign resources and determine appropriate financial compensation for treatment. ICON has been shown to be a reliable and valid index used to assess orthodontic treatment need.[4,5] ICON has its limitations. The index of orthodontic treatment complexity (IOTC) was developed to measure treatment complexity.[2] IOTC is based on the Peer Assessment Rating index by applying different weighting to each component.[7] The authors suggest that IOTC shows sufficient promises to warrant further development, but no other publications about it appeared ever since. Given the contradictions of different studies regarding the development of an orthodontic treatment complexity index to evaluate several aspects of orthodontic treatment, further investigation is necessary to unravel the whole issue and take a step closer to the development of an orthodontic treatment complexity index
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