Original article
Exploring the perception of orthodontic treatment need using the Dental Aesthetic Index and Index of Orthodontic Treatment Need

https://doi.org/10.1016/j.ajodo.2019.01.020Get rights and content

Highlights

  • Index of Orthodontic Treatment Need and Dental Aesthetic Index assess orthodontic treatment need differently.

  • For low treatment need, the agreement was high.

  • For high treatment need, the concordance was low.

Introduction

This study aimed to explore the perception of orthodontic treatment need by using the Dental Aesthetic Index (DAI) and the Index of Orthodontic Treatment Need (IOTN).

Methods

A cross-sectional study was conducted on a representative random sample (N = 248) of adolescents aged 12 years. The DAI and both components of IOTN were used to evaluate malocclusion. The association between the Dental Health Component of the IOTN with gender and ethnic group were analyzed by chi-square test. The concordances between the indexes were analyzed by the kappa statistic, with 95% confidence intervals (CIs).

Results

The prevalence of adolescents with high severity and orthodontic treatment need was 10.5% (95% CI, 6.7-14.3), 36.5% (95% CI, 32.3-44.3), and 73.4% (95% CI, 67.9-78.9) for the Aesthetic Component of the IOTN, Dental Health Component of the IOTN, and DAI, respectively. The indexes showed high agreement for the cases with low treatment need, whereas low concordance was observed for the cases with high treatment need.

Conclusions

The perception of orthodontic treatment need was assessed differently using DAI and IOTN.

Section snippets

Material and methods

The Brazilian National Research Ethics Committee approved the study (protocol 759.321/2014). This cross-sectional study was conducted in municipal schools in the city of Araras (São Paulo, Brazil), with 12-year-old school children. The minimum sample calculated was 240 individuals, considering a test power higher than 80% for a significance level of 5% and prevalence of 50% (exposure/nonexposure ratio of 1:1; Epi Info software, Centers for Disease Control and Prevention, Atlanta, Ga). Excluded

Results

The studied population comprised 248 school children. There were 136 girls (54.8%) and 112 boys (45.2%). Gender and ethnicity did not have a statistically significant association with IOTN-DHC (P <0.05; Table I).

The concordance between IOTN-DHC, IOTN-AC, and DAI is presented in Table II. The prevalence of adolescents with high severity and orthodontic treatment need was 10.5% (95% CI, 6.7-14.3), 36.5% (95% CI, 32.3-44.3) and 73.4% (95% CI, 67.9-78.9) for IOTN-AC, IOTN-DHC, and DAI,

Discussion

The DAI and IOTN are established epidemiological occlusal indexes that have previously been used in different populations to determine the prevalence and orthodontic treatment need. Although several studies have objectively compared orthodontic treatment need indexes, different levels of agreement between DAI and IOTN have been reported,2, 4, 12, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 31, 32, 33 which continue to raise doubts about the degree of association between them.

Previous studies

Conclusions

The perception of orthodontic treatment need was assessed differently when using DAI and IOTN. In addition, self-perception of orthodontic treatment need using IOTN-AC was the same as the clinicians' assessment using IOTN-DHC.

References (33)

  • N.C. Cons et al.

    Utility of the dental aesthetic index in industrialized and developing countries

    J Public Health Dent

    (1989)
  • P.H. Brook et al.

    The development of an index of orthodontic treatment priority

    Eur J Orthod

    (1989)
  • D. Manzanera et al.

    Diagnostic agreement in the assessment of orthodontic treatment need using the Dental Aesthetic Index and the Index of Orthodontic Treatment Need

    Eur J Orthod

    (2010)
  • R.B. Lima et al.

    An analysis of reproducibility of DAI and IOTN indexes in a Brazilian scene

    Cien Saude Colet

    (2010)
  • A.B. Almeida et al.

    Dissatisfaction with dentofacial appearance and the normative need for orthodontic treatment: determinant factors

    Dent Press J Orthod

    (2014)
  • C.A. Feldens et al.

    Desire for orthodontic treatment and associated factors among adolescents in southern Brazil

    Angle Orthod

    (2015)
  • Cited by (13)

    View all citing articles on Scopus

    All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and none were reported.

    View full text