Peer Assessment Rating Scores Research Articles

Directly printed aligner therapy: A 12-month evaluation of application and effectiveness

Directly printed aligners (DPAs) are gaining in popularity, potentially streamlining manufacturing, decreasing environmental waste, and offering enhanced adaptation and tailoring. This transition has been facilitated by advances in materials, software, and production. Although DPAs may have enhanced versatility and application in the management of more complex malocclusions, there is little research evaluating their effectiveness. A total of 54 patients undergoing treatment with DPAs were evaluated for occlusal improvement, overall treatment duration, and adverse effects. Regression models were fit to evaluate the association between the need for refinement, final peer assessment rating (PAR) score, and independent variables, including the total number of aligners and treatment indications. The mean number of aligners in the initial plan was 7.1 ± 2.9 and 5.1 ± 4.3 in maxillary and mandibular arches. Refinement was required in 40.8% (n= 20). The pretreatment PAR score of 17.01 ± 7.93 showed a significant improvement (86.6%), with a final PAR score of 2.25 ± 1.15. Minor complications were noted in 3 participants. The need for refinement was unrelated to the total number of aligners (odds ratio, 1.05; 95% confidence interval, 0.94-1.18; P= 0.36). There was weak evidence of an association between the final PAR score and the total number of aligners (odds ratio, -0.03; 95% confidence interval, -0.07 to 0.003, P= 0.07). On the basis of this preliminary retrospective evaluation, DPAs may be used to manage mild-moderate malocclusion, producing a significant reduction in PAR score. Nevertheless, additional prospective research is required to confirm these findings and compare the relative merits of DPAs to alternatives.

Orthodontic treatment protocol versus Peer Assessment Rating: Assessing the quality of orthodontic treatment.

To apply the Peer Assessment Rating (PAR) to cases that have been assessed by the NHS Business Service Authority (NHSBSA) using the orthodontic treatment protocol (OTO), then compare the NHSBSA outcome assessment with weighted (W) and unweighted (U) PAR scores. Cross-sectional study. UK. Anonymised orthodontic cases submitted to the NHSBSA. A sample of 30 reports from 2021/2022 were randomly selected to include different standard of treatment grades. The records were de-identified and the pre- and post-treatment study models were PAR scored by a calibrated assessor. The mean percentage change in PAR was higher in cases from green reports (W: 78%; U: 79%) than amber (W: 68%; U: 67%) and red reports (W: 65%; U: 65%). Alignment and poor buccal segment interdigitation were the most reported concerns for cases included in the red and amber graded reports. A residual increased overjet was the most common occlusal feature leading to PAR scores not being more than 70% improved. Only slight agreement was shown between OTP and PAR using the kappa statistic, and the chi-square statistical test found that outcome measures are statistically significantly different. There are fundamental differences between OTP and PAR, and general agreement between them has not been demonstrated. The NHSBSA Report provides a more critical outcome assessment than PAR, identifying elements that are not assessed or measured by the PAR index.

Orthodontic aligner therapy outcomes in children with autism spectrum disorder.

Children with autism spectrum disorder (ASD) face unique challenges in oral care. Aligner therapy offers a promising alternative to conventional approaches for this patient group. To evaluate orthodontic aligner therapy outcomes in children with ASD using the Peer Assessment Rating (PAR) Index and the Index of Complexity, Outcome, and Need (ICON), and to investigate whether concomitant disorders affect ICON, PAR scores, and treatment duration. Two calibrated observers assessed digital dental casts and intraoral pictures of 37 children with ASD before (T0) and after (T1) their treatment. At T0, the participants' average age was 12.9 years (SD = 1.68); at T1, post-therapy, the average age was 14.9 years (SD = 1.51). All participants underwent orthodontic aligner therapy. Statistical methods employed in this study included descriptive analysis, Wilcoxon tests, and univariate linear regression. Posttreatment, median ICON scores decreased significantly from 74 to 14, and median PAR scores from 36 to 8 (p < .0001), demonstrating "excellent to substantial" improvement in 89.2% (n = 33) of the children. Comorbidities, present in 62% of patients, did not significantly affect treatment duration (22.6 ± 11.02 months). Children with ASD significantly benefit from orthodontic aligner therapy, emphasizing the need for tailored orthodontic care.

Knowledge differences between general practitioners and orthodontists about Invisalign clear aligner treatment – a cross-sectional survey-based study

ABSTRACT Purpose This study investigated the knowledge differences between general practitioners and orthodontists about the Invisalign system. Materials and methods A web-based survey regarding 10 Invisalign treatment domains was distributed to 161 orthodontists and 213 general practitioners. The responses were ranked using a Likert-type scale and analysed with the Chi-square test and Bonferroni adjustment. Results The response rate was 52.1% for general practitioners and 63.4% for orthodontists. Comparing Invisalign to conventional fixed appliances, orthodontists agreed/strongly agreed that Invisalign aligners are suitable for all types of cases (p = 0.001). Orthodontists also agreed that it causes less tooth discomfort (p = 0.01) and an increased number of attachments can affect its esthetic perception (p = 0.014) but general practitioners opted for the ‘Do Not Know’ option (p ≤ 0.01). General practitioners also responded ‘Do Not Know’ to whether Invisalign treatment finishes in a shorter duration (p = 0.001), achieves all types of tooth movement (p < 0.001) and results in better periodontal health (p = 0.001). Orthodontists were more likely to disagree/strongly disagree that Invisalign treatment results in less tooth root resorption (p = 0.008), better American Board of Orthodontics Objective Grading System and Peer Assessment Rating scores (p < 0.001) and low risk of relapse (p < 0.001), while general practitioners opted for the ‘Do Not Know’ option (p < 0.0001, p < 0.0001 and p < 0.0001, respectively). Conclusion Regarding Invisalign treatment, this study found that orthodontists were generally evidenced-based but general practitioners lacked such knowledge, suggesting that general practitioners must be provided with relevant evidenced-based information.

Striving for Perfection: How Stable Is Orthodontic Treatment When Excellent Outcomes Are Achieved? A 9-Year Post-Treatment Retrospective Study.

(1) Aims: The main objective of this retrospective study was to assess the long-term stability of difficult orthodontic treatments treated to an excellent result and to correlate stability to possible prognostic factors. Secondary objectives were to observe the changes in retention protocol over time and to assess Oral Health-related Quality of Life (OHRQoL) after a long-term post-treatment follow-up. (2) Methods: Cases presented for final examination by orthodontic postgraduate students were retrospectively screened for eligibility. Eligible patients were recalled for a post-treatment recall appointment (T2), consisting of a clinical examination and intraoral scan, and were asked to complete the Oral Health Impact Profile-14 (OHIP-14-DK). Gender, age at treatment commencement (T0), treatment modality and duration, and retention protocol were extracted from the records. At T2, the duration of the retention period was recorded, and retainers in place were clinically compared to the original retention protocol. The following variables were assessed on the sets of models at T0, T1 (end of treatment), and T2: arch length and width, overjet and overbite, Dental Aesthetic Index (DAI), Peer Assessment Rating score (PAR), and Little's Irregularity Index (LII). Multiple regression models were conducted. (3) Results: Eighty-five subjects attended T2. The mean post-treatment follow-up was 9.4 years +/- 2.4. In the upper arch, at T1, 74 patients had a combination of fixed and removable retainers, while at T2, 55 had a fixed retainer only. In the lower arch, at T1, 67 patients had a fixed retainer only, with this number increasing to 76 at T2. From T0 to T1, the PAR score improved by 96.1%, with the improvement remaining at 77.5% at T2. The stability of lower inter-canine and upper inter-premolar widths was significantly correlated with the extent of changes during treatment. The presence of a lower fixed retainer at T2 and a low LII at T1 were prognostic factors for stability. The mean weighted total OHIP-14 score at T2 was very low (1.6 ± 2.4 points). (4) Conclusions: In a sample with an initial high-severity malocclusion and treated to an excellent outcome, long-term stability was very good. Good stability can be retained when a lower fixed retainer is present at T2 and when a low LII is achieved at T1.

Outcome measures of the surgery first approach for orthognathic correction of dentofacial deformities

In the surgery-first approach (SFA), orthognathic surgery is performed without the need for presurgical orthodontic treatment. This study was aimed at assessing the treatment durations and occlusal outcomes for a consecutive cohort of patients, with a range of dentofacial deformities, who had completed orthognathic treatment using SFA. The duration of orthognathic treatment was measured. The overall change in occlusion, and the quality of the final occlusion, were evaluated using the patients’ study casts. A single, independent, calibrated operator carried out the occlusal scores, using the validated Peer Assessment Rating (PAR) index. This was repeated to test intraoperator reliability. A total of 51 patients completed surgery-first treatment during the study period. The mean (range) age at surgery was 23.3 (15–47) years. The pre-treatment skeletal jaw relationship was Class III in 39 cases, and Class II in 12 cases. The mean (SD) overall treatment duration was 11.7 (5.7) months. The intraexaminer reliability of assessing the occlusion was high. The PAR scores confirmed a significant improvement in the quality of occlusion at the completion of treatment, which compares favourably with previous studies on the conventional orthodontics-first approach. The surgery first approach can be effective at correcting both Class II and Class III malocclusion types with reduced treatment times.

Extraction vs nonextraction orthodontic treatment: a systematic review and meta-analysis.

To compare four first premolar extraction and nonextraction treatment effects on intra-arch width, profile, treatment duration, occlusal outcomes, smile aesthetics and stability. An electronic search of the literature to June 2, 2023 was conducted using health science databases, with additional search of gray literature, unpublished material, and hand searching, for studies reporting nonsurgical patients with fixed appliances regarding sixteen sub-outcomes. Data extraction used customized forms, quality assessed with ROBINS-I (Risk Of Bias In Non-randomized Studies-of Interventions) and Cochrane RoB 2 (risk-of-bias) tool. GRADE (Grading of Recommendations Assessment, Development and Evaluation) assessed certainty of evidence. Thirty (29 retrospective studies, 1 randomized controlled trial) studies were included. Random-effect meta-analysis (95% CI) demonstrated maxillary (MD: -2.03 mm; [-2.97, -1.09]; P < .0001) and mandibular inter-first molar width decrease (MD: -2.00 mm; [-2.71, -1.30]; P < .00001) with four first premolar extraction; mandibular intercanine width increase (MD: 0.68 mm; [0.36, 0.99]; P < .0001) and shorter treatment duration (MD: 0.36 years; [0.10, 0.62]; P = .007) in the nonextraction group. Narrative synthesis included three and five studies for upper and lower lip-E plane, respectively. For American Board of Orthodontics Objective Grading System and maxillary/mandibular anterior alignment (Little's irregularity index), each included two studies with inconclusive evidence. There were no eligible studies for UK Peer Assessment Rating (PAR) score. Class I subgroup/sensitivity analyses favored the same results. Prediction interval indicated no significant difference for all outcomes. Four first premolar extraction results in maxillary and mandibular inter-first molar width decrease and retraction of upper/lower lips. Nonextraction treatment results in mandibular intercanine width increase and shorter treatment duration. There was no significant difference between the two groups regarding maxillary intercanine width, US PAR score, and posttreatment smile esthetics. Further high-quality focused research is recommended.

Does orthodontic treatment improve the Oral Health-Related Quality of Life when assessed using the Malocclusion Impact Questionnaire-a 3-year prospective longitudinal cohort study.

To assess the change in Oral Health-Related Quality of Life (OHRQoL) following orthodontic treatment using the Malocclusion Impact Questionnaire (MIQ) and to test the responsiveness of MIQ to treatment-associated changes. A longitudinal prospective cohort study, in an orthodontic postgraduate centre, Kerala, India. Patients under 18 years were invited to complete the MIQ before the start of treatment (T0) and 1 month after treatment completion (T1). TheIndex of Orthodontic Treatment Need and Peer Assessment Rating (PAR) scores were assessed at both time periods as well as a global transition judgement at T1. Two hundred and ten participants were recruited and 162 completed both questionnaires (45.1% males; 54.9% females; age = 12-18 years, mean = 16.8; SD = 1.7). There was large reduction in MIQ scores from T0 (mean = 28.1, SD = 6.1) to T1 (mean = 3.7, SD = 2.6). 53% reported a large improvement in oral health and related life quality after treatment, 32% minimal change, and 15% no change. None reported worsening in OHRQoL at T1. There was a significant positive correlation between change in MIQ score and change in PAR score (r = 0.358), pretreatment aesthetic component (rho = 0.467) and dental health component (rho = 0.491) of the index of orthodontic treatment (IOTN-DHC), and treatment time (rho = 0.502). Regression analysis revealed the change in PAR score and pretreatment IOTN-DHC to be independent predictors of change in MIQ score. Standardized effect size (4.0) and standardized response mean (2.9) were large and the minimal important difference was 7.7. Receiver operating characteristic analysis reported a high diagnostic accuracy of MIQ. There was a significant improvement in OHRQoL following orthodontic treatment when assessed using a condition-specific measure for malocclusion. MIQ was found to be responsive to changes associated with orthodontic treatment.

Assessment of the outcomes and stability after mandibular incisor extraction in orthodontic patients: A systematic review and meta-analysis.

This study assessed the stability of the outcomes after mandibular incisor extraction (MIE) using intercanine width and peer assessment rating (PAR) scores in orthodontic patients. PubMed, Cochrane Library, Science Direct, Google Scholar, Ovid, and SciELO were systematically searched without restrictions until August 2022. A risk of bias assessment was performed using Newcastle-Ottawa Scale (NOS). The Grading of Recommendations, Assessment, Development, and Evaluation tool was used to assess the quality of evidence. Random effects meta-analysis was performed using RevMan software. Seven retrospective studies met the inclusion criteria and were included. Meta-analysis identified a statistically significant reduction in intercanine width with MIE after the retention period. The mean difference in post-retention changes concerning intercanine width (MD=0.14, 95% CI: -2.17-1.89; P<0.00001) was significantly higher in premolar extraction (PE) compared to incisor extraction and significantly less in non-extraction compared to incisor extraction (MD=0.72, 95% CI: -0.59-2.03; P<0.00001). Improvements in PAR scores from the start of treatment to the retention period indicated a high outcome standard (>70%) with MIE treatment, with no significant difference in the reduction percentage compared to premolar and non-extraction groups. With the existing retrospective studies of limited evidence, treatment outcomes with MIE were found to show good improvements in PAR scores. Some reduction in the intercanine width was evident after the retention period, which was observed even with the other two treatment modalities that were compared. Hence, with careful evaluation, MIE could be considered a valid treatment option.

Long-term stability of mandibular incisor alignment in patients treated nonextraction with or without interproximal enamel reduction

This study aimed to compare long-term mandibular incisor stability in nongrowing patients with moderate crowding treated nonextraction with and without interproximal enamel reduction (IPR). Forty-two nongrowing patients with Class I dental and skeletal malocclusion with moderate crowding were divided into 2 groups with an equal number of patients depending on whether IPR was used (IPR group) or not (non-IPR group) during treatment. All patients were treated by the same practitioner and used thermoplastic retainers full-time for 12 ± 1 months at the end of the active treatment. Changes in Peer Assessment Rating scores, Little's irregularity index (LII), intercanine width (ICW), and mandibular incisor inclination (IMPA and L1-NB°) were evaluated using pretreatment, posttreatment, and 8 ± 1 years postretention dental models and lateral cephalograms. At the end of the treatment, Peer Assessment Rating scores and LII decreased, and ICW, IMPA, and L1-NB° increased significantly (P<0.001) in both groups. At the end of the postretention period, in both groups, LII increased, and ICW decreased significantly (P<0.001) compared with posttreatment values, whereas IMPA and L1-NB remained stable. When treatment changes were compared, increases in ICW, IMPA, and L1-NB were significantly (P<0.001) higher in the non-IPR group. When postretention changes were compared, the only significant difference between 2 groups was observed in ICW. The decrease in ICW was significantly higher in the non-IPR group. Long-term stability of mandibular incisor alignment in Class I nongrowing patients with moderate crowding treated nonextraction with and without IPR was similar.

Longitudinal trends in temporomandibular joint disorder symptoms, the impact of malocclusion and orthodontic treatment: A 20-year prospective study.

Studies on the association between malocclusion and temporomandibular joint disorder (TMD) have reported conflicting results. To determine the impact of malocclusion and orthodontic treatment on symptoms of TMD. At 12 years, 195 subjects fulfilled a questionnaire regarding TMD symptoms and participated in an oral examination including preparation of dental casts. The study was repeated at ages 15 and 32. The occlusions were assessed by applying the Peer Assessment Rating (PAR) Index. Associations between the changes in PAR scores and TMD symptoms were analysed with the chi-square test. A multivariable logistic regression was used to calculate the odds ratios (OR) and 95% confidence intervals (CI) of TMD symptoms at 32 years predicted by sex, occlusal traits and orthodontic treatment history. One in three subjects (29%) was orthodontically treated. Sex was associated with more self-reported headaches by females at 32 years (OR 2.4, 95% CI 1.05-5.4; p = .038). At all time points, any crossbite was significantly associated with greater odds for self-reported temporomandibular joint (TMJ) sounds at 32 years (OR 3.5, 95% CI 1.1-11.6; p = .037). More specifically, association occurred with posterior crossbite (OR 3.3, 95% CI 1.1-9.9; p = .030). At 12 and 15 years, boys whose PAR score increased were more likely to develop TMD symptoms (p = .039). Orthodontic treatment had no impact on the number of symptoms. Presence of crossbite may increase the risk of self-reported TMJ sounds. Also, longitudinal changes in occlusion may have an association with TMD symptoms while orthodontic treatment is not associated with the number of symptoms.

Long-term (≥ 15years) outcome quality after ClassII:1 bionator or Herbst multibracket appliance treatment : Acomparison.

To compare the long-term outcome quality (≥ 15years) of ClassII:1 treatment using either abionator (BIO) or aHerbst-multibracket appliance (HMB). Patients who underwent functional treatment during the ideal treatment period for the respective approach (prepuberty vs. peak/postpeak) were assessed. Inclusion criteria were overjet ≥ 4 mm, skeletal ClassII and availability of study casts from before, after and ≥ 15years after treatment. The study casts were assessed using the Peer Assessment Rating (PAR) index and standard orthodontic cast measurements. During treatment, PAR score, overjet and sagittal occlusal relationship improved significantly in all groups. Long-term, there was asignificant increase of incisor irregularity in the upper (HMB) and lower (BIO) arch and asignificant decrease of lower arch width 3 - 3 (BIO). PAR score, overjet, and sagittal occlusal relationship remained stable long-term. Intergroup comparisons revealed significant differences between the BIO and HMB groups in terms of lower arch width (6 - 6), upper and lower arch width (3 + 3/3 - 3) as well as sagittal molar relationship. The achieved improvement in PAR score, overjet, and sagittal occlusion remained comparably stable long-term in all groups. The long-term changes are probably aconsequence of natural aging.

Comparison of maxillary anterior tooth movement between Invisalign and fixed appliances

This research project aimed to compare the number of maxillary incisors and canine movement between Invisalign and fixed orthodontic appliances using artificial intelligence and identify any limitations of Invisalign. Sixty patients (Invisalign, n= 30; braces, n= 30) were randomly selected from the Ohio State University Graduate Orthodontic Clinic archive. Peer Assessment Rating (PAR) analysis was used to indicate the severity of the patients in both groups. To analyze the incisors and canine movement, specific landmarks were identified on incisors and canines using an artificial intelligence framework, two-stage mesh deep learning. Total average tooth movement in the maxilla and individual (incisors and canine) tooth movement in 6 directions (buccolingual, mesiodistal, vertical, tipping, torque, rotation) were then analyzed at a significance level of α= 0.05. Based on the posttreatment Peer Assessment Rating scores, the quality of finished patients in both groups was similar. In maxillary incisors and canines, there was a significant difference in movement between Invisalign and conventional appliances for all 6 movement directions (P<0.05). The greatest differences were with rotation and tipping of the maxillary canine, along with incisor and canine torque. The smallest statistical differences observed for incisors and canines were crown translational tooth movement in the mesiodistal and buccolingual directions. When comparing fixed orthodontic appliances to Invisalign, patients treated with fixed appliances were found to have significantly more maxillary tooth movement in all directions, especially with rotation and tipping of the maxillary canine.

Assessment of the occlusal outcomes in patients treated with orthognathic surgery and clear aligners.

This retrospective two-centre study aimed to evaluate the occlusal outcomes in patients undergoing orthognathic surgery with clear aligners. A retrospective chart review and occlusal outcomes for 15 patients (10 females and five males) with different types of dentofacial deformities in the anteroposterior, vertical and transverse dimensions, who underwent orthognathic surgery in conjunction with clear aligners were evaluated. Weighed Peer Assessment Rating (PAR) index scores of the pre-treatment and post-treatment digital models were used to assess initial complexity, final occlusal outcomes and degree of improvement with surgery and clear aligners. The mean post-treatment PAR score was 3.5± 2.54, which was a statistically significant improvement from the pre-treatment PAR score of 27.63 ± 12.09, an 87% improvement was achieved. All subcategories of the PAR index showed statistically significant improvement except for midline assessment component. Occlusal outcomes with aligners showed great improvement as indicated with the PAR index scores. Orthognathic surgical cases can be treated efficiently with aligners and future studies should compare occlusal outcomes between orthognathic surgical patients treated with clear aligners and those treated with fixed appliances.

Assessment of malalignment factors related to the Invisalign treatment time aided by automated imaging processes.

To identify predictors regarding the type and severity of malocclusion that affect total Invisalign treatment duration based on an intraoral digital scan. The subjects of this retrospective clinical cohort were 116 patients treated with Invisalign. A deep learning method was used for automated tooth segmentation and landmark identification of the initial and final digital models. The changes in the six degrees of freedom (DOF), representing types of malalignment, were measured. Linear regression was performed to find the contributing factors associated with treatment time. In addition, the Peer Assessment Rating (PAR) score and a composite score combining 6 DOF were correlated separately to the treatment time. The number of trays differed between sexes (P = .0015). The absolute maximum torque was marginally associated with the total number of trays (P = .0518), while the rest of the orthodontic tooth movement showed no correlation. The composite score showed a higher correlation with the total number of trays (P = .0045) than did individual tooth movement. Pretreatment upper and lower anterior segment PAR scores were positively associated with the treatment time (P < .001). There is not enough evidence to conclude that certain types of tooth movement affect the total aligner treatment time. A composite score seems to be a better predictor for total treatment time than do individual malalignment factors in aligner treatment. Upper and lower anterior malalignment factors have a significant effect on the treatment duration.

Assessment of orthodontic treatment efficacy of Clarity Aligners using the Peer Assessment Rating index and the American Board of Orthodontics Cast-Radiograph Evaluation

3M Oral Care Solutions (St Paul, Minn) has recently introduced Clarity Aligners into the market. This cohort study evaluated the orthodontic treatment efficacy of this clear aligner system using the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation (CR-Eval). Pretreatment and posttreatment dental models of 87 subjects who had undergone orthodontic treatment using Clarity Aligners in both arches to align their teeth to a target setup were independently evaluated by 4 examiners using the PAR index and the American Board of Orthodontics CR-Eval. Changes in CR-Eval and PAR scores from pretreatment to posttreatment were calculated, with PAR score reductions also expressed as percentages. Treatment with Clarity Aligners reduced the CR-Eval scores from 39.05 ± 14.98 to 30.34 ± 8.76, resulting in a statistically significant difference of 8.76 ± 11.45 between pretreatment and posttreatment scores. Similarly, aligner treatment reduced the weighted PAR scores from 13.40 ± 9.26 to 5.80 ± 4.84, resulting in a statistically significant difference of 7.50 ± 7.56 between pretreatment and posttreatment scores. The overall median PAR reduction was 53%, with 94% of the subjects having reduced PAR scores after treatment. Seventy-eight percent of subjects had>30% PAR reduction, 57% had>50% PAR reduction, and 33% had>70% PAR reduction. The results suggest that Clarity Aligners may be an effective treatment modality in mild to moderate malocclusions.

Comparative assessment of customized (insignia) and non-customized bracket systems (Damon Q) for clinical effectiveness and efficiency-A clinical study

The study's goal was to compare and contrast the effectiveness and efficiency of customized and non-customized orthodontic brackets. 10 patients (Group A) were treated with a Customized section System (Insignia USA) and 10 patients (Group B) were treated with a Non-customized Bracket system (Damon).Gathering this data, the clinical effectiveness and efficiency was measured by estimating Initial Peer Assessment Rating (PAR) and Final PAR scores, assessing the complete therapy time, number of scheduled appointments, number of examination visits, number of loose brackets and pain rating during the treatment which was recorded with a numerical rating scale. The Insignia group outperformed the Damon group in terms of clinical efficiency, but there was no difference in PAR score reduction so overall clinical effectiveness of the Insignia and Damon groups was identical. Orthodontists would be able to give high-quality treatment in less time with fewer appointments and less chair time if they use the optimum bracket system.

Did the coronavirus disease 2019 pandemic affect orthodontic treatment outcomes? A clinical evaluation using the objective grading system and Peer Assessment Rating index

IntroductionThis study aimed to compare the treatment outcome of patients whose orthodontic treatment was completed before or during the coronavirus disease 2019 pandemic.MethodsPretreatment and posttreatment models of 100 patients treated with fixed orthodontic appliances were evaluated using the peer assessment rating (PAR) index. Posttreatment models and panoramic radiographs were measured and scored with the objective grading system (OGS). All patients had their treatment plans before the coronavirus disease 2019 pandemic, but the orthodontic treatment finishing date was before (prepandemic: group 1, n = 50) or during (pandemic: group 2, n = 50) the pandemic. Intergroup comparisons were tested with an independent samples t test or Mann-Whitney U test. Chi-square test statistics and Fisher exact test were used to compare categorical variables.ResultsSignificant higher posttreatment weighted maxillary alignment score was found in group 2. However, no significant difference was found between the groups concerning the mean total weighted PAR reduction (29.8 ± 9.9 vs 25.6 ± 8.7) and posttreatment total weighted PAR scores (1 vs 2). The PAR index score improvement (%) was similar between the groups (93.7 ± 7.1 vs 89.9 ± 13.0). No statistically significant difference was found between the groups for the total OGS score (32 vs 33). A lower score for marginal ridge height (4 vs 3) and a higher score for buccolingual inclination (7 vs 11), and a lower score for occlusal relationship (3 vs 1) were found in group 2. Canceled appointments (1.1 ± 0.7 vs 4.8 ± 1.6) and the number of missed appointments (0.6 ± 0.5 vs 1.1 ± 0.8) were statistically higher in group 2, whereas the total number of appointments (27.3 ± 8.8 vs 21.8 ± 5.4) were statistically less. The treatment duration was comparable in both groups.ConclusionsReduced and irregular appointments during the pandemic resulted in significantly higher posttreatment weighted maxillary alignment and worsening of the buccolingual inclination. However, the PAR score improvement, total OGS score, and treatment duration were not affected.

Quality of Life Before and After Orthodontic Treatment in Adult Patients with Malocclusion: A Quasi-experimental Study

Introduction: In adult patients seeking orthodontic treatment, some common reasons include unesthetic appearance and functional impairment such as difficulty in speaking or breathing. Thus, malocclusion and orthodontic care have become a Quality of Life (QoL) issue. Aim: To investigate the oral health-related quality of life in adults before and after orthodontic treatment. Materials and Methods: This quasi-experimental study was conducted in Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, India over a 2 year period from December 2014 to October 2016. Finally, 34 patients were included in the study. Longitudinal data which included OHRQoL(Oral Health-Related Quality of Life) and study casts for assessing the outcome by the Peer Assessment Rating (PAR) index was collected from two periods: (i) pretreatment data (T1), and (ii) post-treatment data (T2) collected 1 month after fixed orthodontic appliance debonding. Pretreatment and post-treatment Oral Health Impact Profile (OHIP-14) and PAR scores were compared using Paired t-test. Correlations between occlusal indices (PAR) and OHRQoL (OHIP-14) were determined by Spearman’s rank correlation coefficient. Results: Total of 42 patients were included in the study, out of which 34 patients responded to the questionnaire in which 11 were males and 23 females in the age range 18-30 years. From pre to postorthodontic treatment mean OHIP-14 summary score had significantly improved (score reduced) from 30.3 to 16.0. Similarly, mean PAR scores had reduced from 17.62 to 3.44. Significant correlation (p-value&lt;0.05) existed between improvement in OHRQoL scores and improvement in occlusion after orthodontic treatment. Conclusion: The present study concluded that there was an improvement in oral health following fixed orthodontic treatments which were associated with changes in OHRQoL, PAR scores and changes in occlusion.

Does quality of orthodontic treatment outcome influence post-treatment stability? A retrospective study investigating short-term stability 2 years after orthodontic treatment with fixed appliances and in the presence of fixed retainers.

The present study aimed to evaluate stability 2years after orthodontic treatment and to investigate the influence of various pre-treatment and post-treatment prognostic factors on stability. Consecutive patients treated with full fixed appliance and retained with fixed retainers were retrospectively assessed for eligibility. Digital models were analysed at treatment start (T0), end of treatment (T1) and 2years post-treatment (T2). The Peer Assessment Rating (PAR) index, Little's Irregularity Index (LII), arch width and length, overjet, overbite and presence of unexpected post-treatment changes were assessed. Multiple regression analyses were conducted to model the relationship of all outcomes with several prognostics simultaneously. The sample consisted of 287 subjects (mean treatment time: 25.1months, standard deviation [SD] 7.5; mean post-treatment follow-up: 27.5months, SD 6.1) with a mean weighted PAR score of 29.5 (SD 8.6) at T0, 1.8 (SD 2.9) at T1 and 3.2 (SD 3.6) at T2. At T1, 95% of the subjects had a perfect LII versus 86% at T2. An increased LII at T1 correlated with increased LII and PAR changes from T1 to T2. PAR at T1 as well as overjet at T0 was a significant prognostic factor for PAR at T2. At T2, five cases (1.7%) showed unexpected post-treatment changes related to fixed retainers. Short-term post-treatment stability with fixed retainers was very good. Prognostic factors for stability included LII and PAR at T1, suggesting that high-quality treatment outcome in the presence of fixed retainers may ensure post-treatment stability.