ORTHO risks, benefits + IOTN

Question 1

What are the benefits of ortho tx?

Answer 1

aesthetics
straight teeth easier to clean
reduced risk of trauma

Question 2

what are the risks of ortho tx?

Answer 2

demineralisation/ caries
relapse
length of tx
root resorption
pain/ discomfort
consequences of doing nothing
appliance breaking
failure to achieve desired tooth movements
gingivitis
ulceration

Question 3

what does IOTN (or PAR) assess?

Answer 3

compares quality of orthodontic outcome before and after treatment

Question 4

what is IOTN?

Answer 4

index of orthodontic treatment need

Question 5

what are the 2 components to IOTN?

Answer 5

dental health component (DHC)
aesthetic component (AC)

Question 6

how is the aesthetic components of IOTN measured?

Answer 6

10-point scale using a series of photographs
rating is allocated for overall attractiveness rather than specific similarity to photographs

Question 7

what is the dental health component of IOTN?

Answer 7

it records various traits of the malocclusion that would increase the morbidity of the dentition

Question 8

how is DHC scored?

Answer 8

grade 1, 2 - no or little need
grade 3 - borderline need
grade 4, 5 - need treatment

Question 9

give examples of grade 5 scores for DHC?

Answer 9

large overjets
impacted teeth
cleft palate

Question 10

what are the 2 aids which help us use IOTN?

Answer 10

MOCDO
IOTN ruler

Question 11

what does MOCDO stand for?

Answer 11

missing
overjet
crossbite
displacement
overbite

Question 12

give reasons for missing teeth?

Answer 12

ectopic (impeded eruption)
hypodontia (congenital absence)

Question 13

what incisor classification results in an overjet?

Answer 13

class II div II

Question 14

why is DHC recorded in a heirarchial scale?

Answer 14

only the most severe single worst occlusal trait is recorded

Question 15

how is hypodontia scored in IOTN?

Answer 15

3rd molars excluded
one tooth in a quadrant = 4h
two or more teeth in a quadrant = 5h

Question 16

how are retained deciduous teeth scored?

Answer 16

5i
(will most likely have an impacted permanent)

Question 17

how is impaction/ impeded eruption scored?

Answer 17

5i

Question 18

what measurement would score an overjet a 5a?

Answer 18

> 9mm

Question 19

what measurement would score a reverse overjet 5m/4m? what differentiates between 5m and 4m?

Answer 19

> 3.5mm
depends if there are speech/ mastication difficulties

Question 20

what type of crossbite scores 4c?

Answer 20

anterior crossbite or unilateral crossbite with mandibular displacement >2mm

Question 21

what type of crossbite scores 4L?

Answer 21

scissors bite in one or both buccal segments

Question 22

what symptom is common with an edge-edge occlsuion?

Answer 22

mandibular displacement

Question 23

how is contact point displacement scored?

Answer 23

> 4mm = 4d
2-4mm = 3d
1mm but <2mm = 2d

*spacing not recorded
*displacements due to rotations not recorded

Question 24

what teeth is overbite measured of?

Answer 24

lateral or central incisors
the largest vertical discrepancy is recorded

Question 25

how are overbites scored?

Answer 25

traumatic overbite = 4f
deep and complete overbite = 3f
anterior open bite/ lateral open bite = 4e, 3e, 2f depending on size) *>4mm = 4e

Question 26

list additional features that merit a score of 5 on the DHC of IOTN?

Answer 26

cleft lip and/or palate = 5p
submerging deciduous molar = 5s

Question 26

what IOTN do hospital departments generally treat?

Answer 26

4 or 5

Question 27

what is the use of indices in IOTN?

Answer 27

audit
research
prioritising treatment
NHS not funding cases with IOTN grades <3.6