Gherunpong Sudaduang, Tsakos Georgios, Sheiham Aubrey
Department of Community Dentistry, Chulalongkorn University, Thailand.
Eur J Orthod. 2006 Aug;28(4):393-9. doi: 10.1093/ejo/cji114. Epub 2006 May 24.
Traditional methods of assessing orthodontic treatment need using mainly clinical measures are inadequate and would be improved by integrating normative, oral health-related quality of life (OHRQoL), and behavioural propensity measures. This study aimed to develop and test a socio-dental system of orthodontic needs assessment, and to compare normative and socio-dental estimates of orthodontic need. The socio-dental system integrates three types of need: normative need (NN), impact-related need (IRN) and propensity-related need (PRN). A cross-sectional survey of all 1,126 children aged 11-12 years in Suphanburi, Thailand, was carried out to test the new system. The dental health component of the Index of Orthodontic Treatment Need was used to assess NN, and the simplified oral hygiene index for oral hygiene status. Oral impacts were assessed using the child-Oral Impacts on Daily Performances (child-OIDP) index. A self-administered questionnaire recorded information on demographic and oral health-related behaviour. Treatment needs were assessed according to the developed socio-dental system. The socio-dental approach to assess orthodontic needs was easy to use and readily accepted by the children. The estimates of orthodontic need assessed normatively and socio-dentally differed markedly. The prevalence of NN and IRN was 35.0 and 10.5 percent, respectively, thus representing a reduction of approximately 70 percent in the volume of treatment need according to the new method. Children with IRN had different levels of propensity for orthodontic treatment, and therefore required appropriate treatment plans according to their PRN. Of the 10.5 percent with IRN, 6.9 percent had high or medium-high PRN, while 3.6 percent were at medium-low and low levels of propensity.
传统的正畸治疗评估方法主要采用临床测量，存在不足，若能整合规范性、口腔健康相关生活质量（OHRQoL）和行为倾向测量指标，将会得到改进。本研究旨在开发并测试一种社会口腔正畸需求评估系统，并比较正畸需求的规范性评估和社会口腔评估。该社会口腔系统整合了三种需求类型：规范性需求（NN）、影响相关需求（IRN）和倾向相关需求（PRN）。对泰国素攀武里所有11至12岁的1126名儿童进行了横断面调查，以测试该新系统。正畸治疗需求指数的牙齿健康部分用于评估NN，简化口腔卫生指数用于评估口腔卫生状况。使用儿童日常表现口腔影响指数（child-OIDP）评估口腔影响。一份自填问卷记录了人口统计学和口腔健康相关行为的信息。根据所开发的社会口腔系统评估治疗需求。社会口腔评估正畸需求的方法易于使用，且儿童易于接受。正畸需求的规范性评估和社会口腔评估结果存在显著差异。NN和IRN的患病率分别为35.0%和10.5%，因此根据新方法，治疗需求总量减少了约70%。有IRN的儿童正畸治疗倾向水平不同，因此需要根据其PRN制定适当的治疗计划。在有IRN的10.5%儿童中，6.9%的儿童PRN为高或中高，而3.6%的儿童PRN为中低和低水平。
