Korean J Orthod.  2016 Jul;46(4):199-211. 10.4041/kjod.2016.46.4.199.

The Improvement and Completion of Outcome index: A new assessment system for quality of orthodontic treatment

• Hong M
• Kook YA
• Kim MK
• Lee JI
• Kim HG
• Baek SH

• KMID: 2392200
• DOI: http://doi.org/10.4041/kjod.2016.46.4.199

Abstract

OBJECTIVE
Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system-the Improvement and Completion of Outcome (ICO) index-to evaluate the outcome of orthodontic treatment.
METHODS
Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or −1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful.
RESULTS
Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values.
CONCLUSIONS
Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.

Keyword

American Board of Orthodontics Cast-Radiographic Evaluation; Improvement and Completion of Outcome; Orthodontic treatment quality; Peer Assessment Rating Index

MeSH Terms

Chin
Dental Occlusion
Malocclusion
Molar
Orthodontics
Overbite
Treatment Outcome

Figure

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  Figure 1 Case 1: Class I malocclusion with crowding. A, Pre-treatment intraoral photographs. B, Post-treatment intraoral photographs. C, Pre- (left) and post- (right) treatment lateral cephalograms. D, Pre- (upper) and post- (right) treatment panoramic radiographs.

• 

  Figure 2 Changes in the scores for the dental, antero-posterior, vertical and transverse relationship criteria in Case 1. U1-SN, Upper incisor inclination to the anterior cranial base; IMPA, incisor-mandibular plane angle; ANB, Point A-nasion-Point B angle; SN-MP, mandibular plane angle to the anterior cranial base.

• 

  Figure 3 Case 2: skeletal Class III malocclusion. A, Pre-treatment facial and intraoral photographs. B, Post-treatment facial and intraoral photographs. C, Pre- (left) and post- (right) treatment occlusal plane cant. D, Pre- (left) and post- (right) treatment lateral cephalograms. E, Pre- (upper) and post- (lower) treatment panoramic radiographs.

• 

  Figure 4 Changes in the scores for the dental, antero-posterior, vertical and transverse relationship criteria in Case 2. U1-SN, Upper incisor inclination to the anterior cranial base; IMPA, incisor-mandibular plane angle; ANB, Point A-nasion-Point B angle; SN-MP, mandibular plane angle to the anterior cranial base.

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