评价常用的咬合指数在确定正畸治疗需求中的应用。

Evaluation of commonly used occlusal indices in determining orthodontic treatment need.

机构信息

College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar.

Private Practice, Doha, Qatar.

出版信息

Eur J Orthod. 2020 Jan 27;42(1):107-114. doi: 10.1093/ejo/cjz042.

DOI:10.1093/ejo/cjz042

PMID:31185083

Abstract

OBJECTIVE

The main objective of this study was to validate commonly used occlusal indices in measuring treatment need, irrespective of their original objective: Index of Orthodontic Treatment Need (IOTN) that includes a dental health component (DHC) and an aesthetic component (AC), Peer Assessment Rating (PAR) index, Index of Complexity, Outcome, and Need (ICON), Discrepancy Index (DI), and Facial Aesthetic Index (FAI).

METHODS

The dental casts, x-rays, and photographs of 101 participants were randomly selected among patients whose orthodontic treatment was completed. The indices were validated against the panel assessments of four experts using the receiver operating characteristic curve analysis. The area under the curve (AUC) helped to determine their optimal cut-off points.

RESULTS

The raters exhibited an excellent level of inter-rater reliability in assessing need scores [intra-class correlation coefficients (ICC) = 0.85]. The DHC, AC, ICON, and PAR demonstrated 'good' diagnostic properties (AUC = 0.85, 0.84, 0.83, and 0.82, respectively). Adding the AC and the DHC into a combined index score [our proposed Combined Index of Orthodontic Treatment Need (CIOTN)] yielded the strongest correlation with need (r = 0.79) and the highest AUC value of 88 per cent with 91 per cent sensitivity and 71 per cent specificity. The DI had poor discriminating abilities (AUC = 0.69), however, its dental component was substantially better (AUC = 0.81). The supplemental FAI did not enhance the correlation of indices with need.

CONCLUSION

The DHC, AC, ICON, PAR, and only the dental component of the DI reliably captured treatment need. The newly combined CIOTN had superior diagnostic properties than its components and all other indices, probably because of the cumulative values of its components. The FAI could not be validated as a supplemental measure of treatment need.

摘要

目的

本研究的主要目的是验证常用于测量治疗需求的常用咬合指数，而不考虑其原始目的：包括牙齿健康成分（DHC）和美学成分（AC）的正畸治疗需要指数（IOTN）、同伴评估等级（PAR）指数、复杂性、结果和需求指数（ICON）、差异指数（DI）和面部美学指数（FAI）。

方法

从已完成正畸治疗的患者中随机抽取 101 名患者的牙模、X 光片和照片。使用受试者工作特征曲线分析，根据四名专家的小组评估对这些指数进行验证。曲线下面积（AUC）有助于确定其最佳截断点。

结果

评估者在评估需求评分时表现出极好的组内评分可靠性[组内相关系数（ICC）= 0.85]。DHC、AC、ICON 和 PAR 表现出“良好”的诊断特性（AUC 分别为 0.85、0.84、0.83 和 0.82）。将 AC 和 DHC 添加到联合指数评分中[我们提出的正畸治疗需要综合指数（CIOTN）]与需求的相关性最强（r = 0.79），AUC 值最高为 88%，灵敏度为 91%，特异性为 71%。DI 的鉴别能力较差（AUC = 0.69），但其牙齿成分要好得多（AUC = 0.81）。补充的 FAI 并不能提高指数与需求的相关性。