The development of an objective orthodontic treatment-need index

Abstract

The development of an objective system for orthodontic service prioritization is a complex challenge, since complex trade offs are required to balance equity, freedom of choice, comprehensiveness and cost containment. This project was designed to test the ability of the Dental Aesthetic Index (DAI) to objectively categorize and prioritize the orthodontic treatment-need of patients from publicly-funded resources. A two-stage assessment process was used to test the standard-DAI; both involved the assessment of thirty-eight randomly selected pre-treatment records (study models, lateral cephalograph, panorex, photographs) from a much larger sample of cases previously submitted for publicly-funded orthodontic treatment approval. The initial selection criteria included a wide range of malocclusions in subjects without psychological or social complications. The sample comprised thirty cases approved and eight cases not approved for orthodontic treatment. In addition, thirty-three of the cases exhibited a permanentdentition while five cases exhibited a mixed dentition. Initially, 16 Manitoba Orthodontic specialists were required to independently quantify the malocclusion severity of each case by a pre-determined analog system. Subsequently, these same records were independently evaluated relative to the standard Dental Aesthetic Index (DAI) by six Graduate Orthodontic students. (Abstract shortened by UMI.)