Introduction: The peer assessment rating (PAR) index was used to self-audit 4 years of completed pre-adjusted edgewise appliance cases treated by a single orthodontist in a government clinic. The objectives of this study were to evaluate orthodontic treatment standards and factors which may influence treatment outcomes and treatment time.
Methodology: Pre and post-treatment study models were scored using the PAR index by the author. 17 models were re-examined for intra-examiner reliability using intra-class correlation coefficient (ICC). ICC was excellent for pretreatment (0.96), post-treatment (0.98) and reduction in PAR (0.96) scores.
Results: There were 173 cases (51 males; 122 females) with mean age 17.6 (SD 5.75) years. Mean treatment time was 18.6 (SD 6.47) months with range between 5-40 months. There was no statistically significant difference between one-arch and two-arch cases and between routine and compromised cases. Treatment time in extraction cases (mean 19.5, SD 6.17) was significantly different (p=0.000) compared with non-extraction cases (mean 11.6, SD 4.10) although this accounted for 15% of the variation only (r=0.388). 76.3% cases were ‘greatly improved’, 22.0% ‘improved’ and 1.7% ‘worst/ no different’. Mean pretreatment, post-treatment and reduction in PAR score was 34.1(SD 9.68), 6.4 (SD 6.84) and 27.9 (SD 9.69) respectively. Mean percentage PAR score reduction was 82.0% (SD 1.96). Pretreatment (p=0.000), post-treatment (p=0.000) and reduction (p=0.489) in PAR scores was significantly different between routine and compromised cases. There was significant difference (p=0.000) between category of improvement and pretreatment scores but not with treatment time.
Conclusion: Severe malocclusions had larger reduction in PAR scores and required longer treatment time. Extraction cases took longer to complete and routine cases had better outcomes than compromised cases with severe skeletal discrepancy.
The objective of this pilot cross-sectional study was to assess effcacy of training dental officers (DO) and nurses (DN) in the Index of Orthodontic Treatment Need (IOTN). A conventional training method of lectures, manual; and md5,0n* exettise was used for bath Lest groups. 30 study models in all grades in the Aesthetic component (AC) and dental health component (DHC) were graded by 27 subjects (13 DO, 14 DN) after training. Results were cnrrlparedfor agreement with an exper; group, Kappa statistic: was used to assess strength in agreement in correct grouping of AC and DHC in the Categorie; gf treatment need, Wilcoxon Rank sum test was used to compare mean kappa and % 0 correct res ames in the test. Spearman rank correlation was used to test association of 11g experience with mean kappa values. There was ‘m0demte’ agreement in correct groupingfor ojjqcers in AC (K=O.5l) and DHC (K`=O.4l); Cmd 'fair’ j‘0'f TluTS€S in AC (K=O.40) and DHC (K:O,34). There was no significant difference between groups. Subjects were better at identifying cases with definite need than little/ borderline need for treatment. There was more inaccurate grading in DHC Gmde+qualifier for both groups (p
Aim: Orthodontic treatment duration is variable and associated with many factors Very few studies looks at operator changes influencing treatment duration and outcome. This study aims to evaluate the influence of operator changes on treatment time and quality.
Methodology: This is a 4-year cross-sectional retrospective study of preadjusted Edgewise two-arch appliance cases treated by single/ multiple operators and finished/debonded by the author. 60 singleoperator (Group 1) and 82 multiple-operator (Group 2) cases were selected and the Peer Assessment Rating (PAR) Index was used to measure treatment outcome.
Results: Group 1 (2.31 years, SD.86) had statistically significantly shorter treatment time than Group 2 (3.25 years, SD1.23). Mean % reduction in PAR scores was high (88.7%), although single operators (92%) showed a slightly higher (p=.04) reduction than multiple-operator cases (86.2%). Post-treatment PAR score was slightly higher in Group 2 (4.6, SD5.4) compared with Group 1 (2.6, SD2.9). There was no significant difference in post-treatment PAR scores with operator changes from within and outside the clinic although there was difference in treatment duration (p=.0001). Possible predictors of treatment duration included number of failed/changed appointments, extractions and pre-treatment PAR. Multiple linear regression model showed significant association of treatment time with failed/changed appointments (p=.0001) and number of operators (p=.0001) although this contributed to 57.5% of possible factors (r=.762) .
Conclusion: Change of operator contributes to increased treatment time by 11.3 months. Although standard of treatment was high in both groups there was slightly better outcomes in single operators. The reduction in PAR score can be predicted more accurately in single operators.