Transcript Index of Orthodontic Treatment Need Modified for Use in

Index of Orthodontic
Treatment
Need modified for use in
Epidemiological Surveys :
Modified IOTN
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Written by
Donald Burden and Cynthia Pine
with assistance
from the BASCD Working Party on
Orthodontics
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Modified IOTN consists of two
components:
1. Aesthetic Component
2. Dental Health Component
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Aesthetic Component
Grades 1-7
No Definite Need for treatment
Grades 8-10
Definite Need for treatment
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Recording the Aesthetic
Component
• Ask subject to close on their back
teeth
• Retract lips
• Grade the dental attractiveness of
the anterior teeth
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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
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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.
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Recording the DHC
Examine each subject for:
• Missing teeth
• Overjets
• Crossbites
• Displacement of contact points
• Overbites
= MOCDO
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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
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‘MOCDO’
•
•
•
•
•
Missing teeth
Overjets
Crossbites
Displacement of contact points
Overbites
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Missing Teeth (teeth not visible)
• Congenital absence/traumatic loss
• Ectopic teeth
• Impacted teeth
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Missing Teeth
• Palatally ectopic canines
• Is the canine palpable in the buccal
sulcus?
• If not, it is ectopic = Need for
Treatment
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Missing Teeth
• IMPACTED if 4mm or less space
is available between adjacent
teeth
• Impacted = Need for Treatment
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Missing Teeth
• (Congenital absence/traumatic
loss)
• In your opinion, is orthodontic
treatment required to open or
close the space?
• If yes = Need for Treatment
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Original Slide No.15
‘MOCDO’
•
•
•
•
•
Missing teeth
Overjets
Crossbites
Displacement of contact points
Overbites
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Measuring Overjets
Increased overjets (Class II) and
reverse overjets (Class III) are
measured using the metal ruler
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Second line (red) – 6mm
Positive overjets
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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
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Measuring Reverse Overjets
• All four incisors must be in lingual
occlusion
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Measuring Reverse Overjets
• If the reverse overjet falls
exactly on the 4mm (white line)
record in the Definite Need for
Treatment category
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First line (white) – 4mm
Crowding
Reverse overjets
Open bites
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‘MOCDO’
•
•
•
•
•
Missing teeth
Overjets
Crossbites
Displacement of contact points
Overbites
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Crossbites
• Can be anterior or posterior, but
mostly posterior.
• Check for displacement on closure.
• If displacement on closure = Need for
Treatment
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‘MOCDO’
•
•
•
•
Missing teeth
Overjets
Crossbites
Displacement of contact points
(crowding)
• Overbites
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Crowding
• Only applies to crowding
between permanent teeth
• Measure between the contact
points of the two most
crowded teeth
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First line (white) – 4mm
Crowding
Reverse overjets
Open bites
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‘MOCDO’
•
•
•
•
•
Missing teeth
Overjets
Crossbites
Displacement of contact points
Overbites
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Overbite
• Deep overbite
• Open bite
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Deep Overbite
• Deep overbite causing
gingival or palatal traumatic
injury
= Definite Need for Treatment
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Other Points of the Modified IOTN
• Generalised spacing is not
recorded in the Dental Health
Component
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