Occlusal Index Scores Research Articles

Relationship of 3 indexes of orthodontic treatment need used by Medicaid and oral health–related quality of life

This study aimed to assess the relationship between 3 indexes of orthodontic treatment need that are used by Medicaid, namely the Salzmann Index (SI), the handicapping labiolingual deviation (HLD) Index, and the HLD California Modification Index, and oral health-related quality of life (OHRQOL). The orthodontic records of 100 participants aged 11-14 years were used to calculate occlusal index scores. The condition-specific oral impacts on daily performances (OIDP) index questionnaire was used to quantify OHRQOL and to identify detriments attributable to malocclusion-related conditions (MRCs). The relationship between occlusal index scores and OHRQOL was analyzed using descriptive statistics, Spearman rank-order and biserial correlations, and logistic regression. The mean index scores were: SI, 15.4; HLD, 13.2; and HLD California Modification, 15.8. Ninety percent of participants did not have normative orthodontic treatment need according to current index criteria. OIDP scores were not normally distributed, and the mean score was 3.1. Of those participants who reported an impact, 83% attributed at least 1 of those impacts to MRCs; however, 90% of these were of mild or moderate intensity. Smiling was the performance most impacted by MRCs. The only statistically significant correlation between an occlusal index and OIDP scores was for the SI, though this association was weak (r= 0.27). None of the variables used in the logistic regression model (age, sex, 3 index scores) were significant predictors of OHRQOL. No meaningful association exists between the 3 indexes studied and OHRQOL. These findings challenge the validity of current systems for the allocation of Medicaid-funded orthodontic treatment.

Influence of surgical technique and timing of primary repair on interarch relationship in UCLP: A randomized clinical trial.

To compare dental arch relationships in children with unilateral cleft lip and palate (UCLP) between two surgical techniques for repair of cleft lip/palate and two ages of palate repair. Dental models were taken for a group of 448 subjects at a mean age of 7years and were evaluated by means of the Goslon Yardstick. The patients studied consisted of an initial group of 673 infants with complete UCLP randomized into 8 study groups according to lip repair procedures (Millard versus Spina techniques); palate repair procedures (von Langenbeck versus Furlow techniques); and palate repair timing (early: 9 to 12months versus late: 15-18months). Four surgeons performed all surgeries. Dependent variables included the following: lip repair technique, palate repair technique, age at time of palate repair and surgeon; with sex as an independent variable. The data were analysed using a general linear model (P<.05). There were no significant differences for occlusal index scores as a function of lip or palate surgical technique, palatal repair timing and sex. Significant differences were found for occlusal index scores as a function of the surgeon. Dental arch relationships were not influenced by lip and palatal repair techniques or patient age at palatal repair. The surgeon was the major factor that influenced the dental arch relationship outcome.

The psycho-social impact of malocclusions and treatment expectations of adolescent orthodontic patients.

To evaluate the short- and long-term orthodontic treatment (OT) expectations, malocclusion severity, and oral health-related quality of life (OHRQoL) status of adolescent patients using qualitative and quantitative methodology. Adolescents (n = 105; 42 males and 63 females) aged between 12 and 17 years participated in this interview and questionnaire-based study. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and the Oral Impacts on Daily Performances (OIDP) scale evaluated OHRQoL status. Study casts were analysed using the Dental Aesthetics Index (DAI) and the Index of Complexity, Outcome and Need (ICON). Mann-Whitney test and Spearman's correlations tested various univariate variables. With similar index-determined OT need (DAI, P = 0.371 and ICON, P = 0.932) females tended to have worse OHRQoL status (PIDAQ scores, P-values ranged from 0.006 to 0.0001 and scores for the OIDP question related to smiling, laughing, and showing teeth without embarrassment, P-value = 0.015). Occlusal index scores did not have statistically significant associations with the OHRQoL scales. Better dental appearance was expected by 85 per cent of the adolescents in the short-term and by 51 per cent in the long-term after OT. The associated psycho-social expectations were: 1. improved dental self-confidence, 2. positive psychological impact/improved self-worth, and 3. positive social impact. Female adolescent patients tended to experience worse psycho-social impacts related to their malocclusions compared with males with similar index-determined OT need. Index-determined OT need scores did not correlate with the OHRQoL scales. Adolescent patients expected OT to improve their dental appearance and QoL aspects.

An investigation of treatment provided in the General Dental Service for patients with Class II division 1 malocclusions.

The study models of a sample of 51 cases with Class II division 1 malocclusions treated in the General Dental Service in Scotland, were investigated and analysed with respect to the changes which had taken place in the overjet, overbite and incisor alignment. Residual spacing in the arches was also measured. Occlusal Index scores were calculated at the start and finish of treatment. The results suggest that only a limited measure of success was achieved; they indicate a need to improve orthodontic treatment standards.

The occlusal index used to assess orthodontic treatment.

Search of the literature has failed to reveal any previous objective analysis of changes produced by treatment. Using the Occlusal Index a survey was carried out on study models of patients accepted for treatment in the Orthodontic Department of The London Hospital, over a nine year period (1963–71). The spread of severity of malocclusion of these patients was assessed to see if there had been a gradation in severity through the period as reflected by a trend in the yearly mean values of the Occlusal Index scores. Analysis of the results failed to show any discernible trend. The Occlusal Index was used to gain an objective and quantitative assessment of change produced by treatment and subsequently to correlate this change with the use of fixed and removable appliances. A slight but statistically significant difference was apparent in treatment results. Fixed appliance cases showed superiority to removable appliance cases, producing a better end result and greater degree of improvement. The difficulties in the use of application of the Occlusal Index to British cases are discussed and suggestions are made for modification.

The occlusal index: A system for identifying and scoring occlusal disorders

Because a lack of agreement prevails among investigators concerned with measuring occlusion for epidemiologic purposes, an attempt has been made to develop an index of occlusion which would serve for these purposes. This index was called the Occlusal Index (OI). The methods of scoring the nine characteristics used in the OI have been presented. These characteristics included dental age, molar relation, overbite, overjet, posterior cross-bite, posterior open-bite, tooth displacement (actual and potential), midline relations, and missing permanent maxillary incisors. The scoring mechanism was briefly utilized. The OI was tested for validity, validity during time, and intra-examiner reliability. The OI appears to correlate highly (r s = 0.920) with the clinical standard, indicating high validity; the OI also appears to be valid during time, since the average group scores did not decrease during time. Intra-examiner reliability was very high (r s = 0.963). A subjective classification of occlusion which could be used to interpret the OI scores was devised. This subjective classification and a suggested range for each class were described.

Malocclusion severity assessment

This study aimed to assess the relationship between 3 indexes of orthodontic treatment need that are used by Medicaid, namely the Salzmann Index (SI), the handicapping labiolingual deviation (HLD) Index, and the HLD California Modification Index, and oral health–related quality of life (OHRQOL).The orthodontic records of 100 participants aged 11-14 years were used to calculate occlusal index scores. The condition-specific oral impacts on daily performances (OIDP) index questionnaire was used to quantify OHRQOL and to identify detriments attributable to malocclusion-related conditions (MRCs). The relationship between occlusal index scores and OHRQOL was analyzed using descriptive statistics, Spearman rank-order and biserial correlations, and logistic regression.The mean index scores were: SI, 15.4; HLD, 13.2; and HLD California Modification, 15.8. Ninety percent of participants did not have normative orthodontic treatment need according to current index criteria. OIDP scores were not normally distributed, and the mean score was 3.1. Of those participants who reported an impact, 83% attributed at least 1 of those impacts to MRCs; however, 90% of these were of mild or moderate intensity. Smiling was the performance most impacted by MRCs. The only statistically significant correlation between an occlusal index and OIDP scores was for the SI, though this association was weak (r = 0.27). None of the variables used in the logistic regression model (age, sex, 3 index scores) were significant predictors of OHRQOL.No meaningful association exists between the 3 indexes studied and OHRQOL. These findings challenge the validity of current systems for the allocation of Medicaid-funded orthodontic treatment.