Index of Orthodontic Treatment Need Modified for Use in ...

Index of Orthodontic Treatment Need Modified for Use in ...

Index of Orthodontic Treatment Need modified for use in Epidemiological Surveys : Modified IOTN 1

Written by Donald Burden and Cynthia Pine with assistance from the BASCD Working Party on Orthodontics 2 Modified IOTN consists of two

components: 1. Aesthetic Component 2. Dental Health Component 3 Aesthetic Component Grades 1-7

No Definite Need for treatment Grades 8-10 Definite Need for treatment 4 5

Recording the Aesthetic Component Ask subject to close on their back teeth Retract lips Grade the dental attractiveness of the anterior teeth 6

Recording the Aesthetic Component The grade awarded is for overall dental attractiveness rather than specific morphological similarity to the photographs First impressions are usually correct Main aim is to differentiate those at

8 - 10 7 Dental Health Component IOTN has been simplified to two categories: Definite Need for Treatment No Definite Need for Treatment

The subject is examined for specific conditions and if one is found, a Definite Need for Treatment is recorded and no further conditions are sought. 8 Recording the DHC Examine each subject for:

Missing teeth Overjets Crossbites Displacement of contact points Overbites = MOCDO 9

Recording the DHC Examine the subject using the MOCDO scale As soon as a definite treatment need threshold is reached, then the examination is stopped 10

MOCDO Missing teeth

Overjets Crossbites Displacement of contact points Overbites 11 Missing Teeth (teeth not visible)

Congenital absence/traumatic loss Ectopic teeth Impacted teeth 12 Missing Teeth

Palatally ectopic canines Is the canine palpable in the buccal sulcus? If not, it is ectopic = Need for Treatment 13

Missing Teeth IMPACTED if 4mm or less space is available between adjacent teeth Impacted = Need for Treatment 14

15 Missing Teeth (Congenital absence/traumatic loss) In your opinion, is orthodontic treatment required to open or close the space?

If yes = Need for Treatment 16 Original Slide No.15 MOCDO

Missing teeth Overjets Crossbites

Displacement of contact points Overbites 17 Measuring Overjets Increased overjets (Class II) and reverse overjets (Class III) are

measured using the metal ruler 18 Second line (red) 6mm Positive overjets 19

20 Measuring Overjets Measure to the labial aspect of the most prominent incisor Only record Need for Treatment if the overjet extends beyond the 6mm line

21 22 23 Measuring Reverse Overjets

All four incisors must be in lingual occlusion 24 Measuring Reverse Overjets If the reverse overjet falls exactly on the 4mm (white line)

record in the Definite Need for Treatment category 25 First line (white) 4mm Crowding

Reverse overjets Open bites 26 27 MOCDO

Missing teeth Overjets

Crossbites Displacement of contact points Overbites 28 Crossbites Can be anterior or posterior, but

mostly posterior. Check for displacement on closure. If displacement on closure = Need for Treatment 29 MOCDO

Missing teeth Overjets Crossbites

Displacement of contact points (crowding) Overbites 30 Crowding Only applies to crowding between permanent teeth

Measure between the contact points of the two most crowded teeth 31 First line (white) 4mm

Crowding Reverse overjets Open bites 32 33 MOCDO

Missing teeth Overjets

Crossbites Displacement of contact points Overbites 34 Overbite Deep overbite

Open bite 35 Deep Overbite Deep overbite causing gingival or palatal traumatic injury

= Definite Need for Treatment 36 37 Other Points of the Modified IOTN

Generalised spacing is not recorded in the Dental Health Component 38

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