Indiana University-Purdue University Indianapolis (IUPUI) / Indices to assess malocclusion have been developed for either rating the 'severity of malocclusion' or for prioritizing a patient's need for orthodontic treatment. Most of these indices evaluate the malocclusion through examination of one or two of the following diagnostic records: dental casts, photographs, or clinical exam. However, no prior research had attempted to incorporate all of the above pretreatment orthodontic diagnostic records routinely taken for treatment evaluation. Pretreatment records (dental casts, intra-oral photographs, extra-oral photographs, panoramic radiograph, and a cephalogram, of sufficient quality to be reliably assessed) of 50 completed subjects treated at IUSD Graduate Orthodontic Clinic were evaluated. Subject criteria were a complete set of pretreatment orthodontic records, white non-Hispanic descent in the permanent dentition, absence of any craniofacial anomalies and known pathology. The 3M Unitek TM cephalometric protractor and electronic digital calipers accurate to the nearest tenth of a millimeter were used for measurements. Thirty-six measurements (11 cephalometric, 4 panoramic, 13 dental cast, and 8 photographic) were scored and combined into a total score that represents the new index. The peer assessment rating index (PAR Index) and a subjective ranking of 3 experienced orthodontists (each having more than 20 years of clinical orthodontic experience) were completed on all subjects for determining validity of the new index. All scoring methods were repeated on a subset of 10 random subjects to determine reliability. Statistical analysis showed significant correlations for the ability of the new index to detect severity of malocclusion. Also, the study showed a higher correlation for the new index in representing the experts' rankings than did the PAR index. It is the conclusion of this investigation that the new index is a valid index of malocclusion that more closely reflects experienced orthodontists rankings than the PAR index.

Indiana University-Purdue University Indianapolis (IUPUI) / Indices to assess malocclusion have been developed to serve a multitude of functions, from rating 'severity of malocclusion', to prioritizing orthodontic treatment for patients. These indices have been established and used, but many with significant inadequacies in their methods. Very few indices quantitatively look at characteristics of a patient to objectively assess treatment difficulty. No current published index uses all of the pretreatment diagnostic records in its assessment. A complete index of malocclusion with the objective analysis of all pretreatment records is needed to accurately quantify treatment need. Recently, an index of malocclusion was developed and validated at IUSD that evaluates a complete set of diagnostic records. Initially this index was found to be a valid measure of patients of non-Hispanic white descent in the permanent dentition. Later it was validated to patients of both mixed and permanent dentitions of various racial profiles. In the present study, pretreatment records (dental casts, intra-oral photographs, extra-oral photographs, panoramic radiograph, and a cephalogram) of 100 patients (48 mixed dentition, 52 permanent dentition) from the Indiana University Graduate Orthodontic Department were evaluated. The patients were selected from a group of completed cases that had been previously scored with the discrepancy index (DI). This data was used to select a group of patients that, as closely as possible, represented a comprehensive range of severity. Thirty-six measurements were scored and combined into a total score representing the new index for the permanent dentition. Thirty-three characteristics were totaled in a similar fashion for patients in the mixed dentition. The scores of the new index were compared to the average examiner scores of four experienced orthodontists. Statistical analysis showed significant correlations of the new index to the average examiner scores, as well as to the DI scores. It is the conclusion of this study that the new IUSD index is a valid measure of severity of malocclusion that correlates well with DI and reflects the rankings of experienced orthodontists.