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Orthodontics > IOTN and PAR > Flashcards

IOTN and PAR Flashcards

1
Q

Aim and Objective of IOTN?

A
  • what it is
  • How it works
  • practical uses
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2
Q

Use of health index

A
  • To identify treatment need
  • To identify priority group
  • To identify treatment change
  • To plan healthcare service
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3
Q

Why have Indices?

A
  • Health cost
  • Manpower
  • Benefit to patient of treatment
  • Outcome measure
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4
Q

What are the requirement health index?

A
  • Reliable- Can be used repeatedly
  • Valid- measures what it is meat to
  • Acceptable- Profession and public
  • Requires minimum of judgement/easy to learn
  • Administratively simple - Cheap to use
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5
Q

What is IOTN?

A
  • Ranks occlusal traits according to their severity
  • Attempts to identify patients who would most likely benefit from orthodontic treatment
  • A means by which patient are assessed as to whether they qualify for NHS Orthdontic treatment
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6
Q

How many components of IOTN?

A

2
- Dental health Component (DHS)
- Asthetic Component (AC)

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7
Q

Dental Health Component

A
  • 5 Categories of severity
    1- No need
    2- Little / no need
    3- Moedrate / Boderline need
    4- Need
    5- Severe need
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8
Q

DHC- Hierarchical Scale

A
  • MOCDO
  • Missing (h)
    -Overjet (a)
    -Crossbite, Displacement of contact point (d)
  • Overbite (f)
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9
Q

IOTN Conventions
CROWDING

A
  • Contact point displacement
  • Anatomical contact point
  • Not measured b/w deciduous teeth
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10
Q

Impacted 5i

A
  • Space for unerupted tooth </= 4mm
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11
Q

Impeded eruption (4t)

A
  • If tooth has erupted but short of space so tip against neighbouring tooth scored.
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12
Q

Spacing

A
  • Not measured unless tooth deviate from line of arch
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13
Q

Submerging Deciduous teeth 5s

A
  • 2 Cusps still visible or tip to adjacent teeth
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14
Q

Reverse Overjet

A
  • All 4 incisors in lingual occlusion to record reverse Overjet
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15
Q

Aesthetic Component ( Evan’s and Shaw)

A
  • 1987
  • Scored out of 10
  • 1-4 None/ slight
  • 5-7 Moderate / borderline
  • 8-10 Need
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16
Q

Good Point

A
  • Valid
  • Reliable
  • Easy to use
17
Q

Bad point

A
  • Class II div 1 - AC
  • Complexity not assessed
  • Some version of crowding - no score
  • Evidence for DHC
18
Q

4x

A
  • Presences of supernumerary teeth
19
Q

4b

A
  • Reverse Overjet greater than 3.5 mm with no speech or masticatory difficulties.
20
Q

4m

A
  • Reverse Overjet greater than 1 least than 3.5mm with speech and masticatory difficulties
21
Q

4e

A
  • Lateral and anterior open bite greater than 4mm
22
Q

4l

A
  • Lingual crossbite with no function occlusal contact in one or both buccal segment
23
Q

4f

A
  • Increased and compete overbite with gingival / palatal trauma
24
Q

4t

A
  • Partial erupted teeth , Tip and impacted against adjacent teeth
25
Q

PAR Index. (Richmond. Manchester)
Peer assessment rating

A
  • Objective
  • Quatitative
  • Malocclusion and treatment effect
  • Use study model - Pre Tx - Post Tx
26
Q

How to score study model ?

A
  • Labial segment
  • Buccal segment
  • Overjet
  • Overbite
  • Centreline
27
Q

Labial Segment

A
  • Score 0- 5
    0 - 0-1
    1 - 1.1-2
    2 - 2.1- 4
    3- 4.1- 8
    4- >8
    5- Impacted
28
Q

Buccal segment

A
  • Anterior posterior
  • vertical
    Transverse
29
Q

Buccal segment - Anterior posterior

A
  • 0- Good interdigitation
  • 1 - less than 1/2 unit
    2 - 1/2 unit
30
Q

Vertical

A
  • 0- No open bite
    1- greater than 2mm lat open bite
31
Q

Transverse

A
  • 0- No crossbite
  • 1-Crossbite tendency
  • 2–Single tooth cross bite
  • 3 greater than 1tooth crossbite
    4- greater than 1 tooth scissor bite
32
Q

PAR- Overjet

A

0 0-3mm no crossbite
1 3.1-5mm edge to edge
2- 5.1- 7 single tooth crossbite
3- 7.1- 9 2 teeth crossbite
4- >9 greater than 2 teeth crossbite

33
Q

PAR- centreline

A
  • 0 - Coincidence 1/4 width lower incisor
    1 - 1/4- 1/2 lower incisor width
    2- > 1/2 lower incisor
34
Q

Weighing value

A
  • Labial Segment x 1
  • Buccal segment x1
  • Overjet x6
  • overbite x2
    Central line x4

Total

35
Q

What’s the target of PAR

A
  • 70% Reduction
  • End of treatment score <5
36
Q

National Audit suggest

A

-75% cases reduced >70% greatly improved
- 3 % cases reduced < 30% worse / no difference

37
Q

PAR NHS requirement

A
  • All ortho must submit their cases for PAR evaluation
  • 20 cases per year
  • 10% of remainder case load

Orthodontics (53 decks)

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