Zahid`s Study Notes

IOTN RuIer
Modified IOTN*

IOTN have two components:
$ Aesthetic Component (AC)
% DentaI HeaIth Component (DHC)
A. Aesthetic Component (AC)
Grade 1-7: NO treatment (NT)
Grade 8-10: Definitive need of treatment (DNT)
Method of recording aesthetic component:
1, Ask pt to close teeth on posteriors
2. Retrected lips
3. Grade overall attractiveness of anterior teeth rather then specific morphological similarities to photographs
4. Ìst impression is usually correct
5. Focus is to differentiate those at 8-10 then DEFINITVE NEED OF TREETMENT
B. DentaI HeaIth Component (DHC)
For DHC again IOTN has been simpIified in to two categories:
1. DEFINITVE NEED OF TREETMENT
2. No DNT
The Subject is examined for 5 specific conditions and if one is found a DNT is recorded and no further
condition is sought

Method:
Examine each subject for:
MOCDO

Missing
Over jet
Cross bite
DispIacement of "Contacts Points" (of two most imbricate teeth)
Overbite
Recording the DHC
1. Examine using mocdo ScaIe
2. As soon as DNT reached examination stoped
3. IOTN RuIer is required

It has a white Iine at 4mm and a red Iine at 6mm.
White Iine is for reverse over jet
Crowding
Open Bite
Reverse over jet (ROJ)
Red Iine is at 6mm represent positive over jet
Over jet (if greater then red) = Need for Treatment (DNT)
AppIication of MOCDO SCALE
1 . Missing Teeth(InvisibIe)
A. CongenitaIIy/TraumaticaIIy absent:
If Iess then white line is the space left, if in your opinion treatment is required to open or close the
space then DEFINITVE NEED OF TREETMENT
B. Ectopic Canines
Ìs canine palpable on bucal sulcus if not DEFINITVE NEED OF TREETMENT

C. Impacted
Ìf at or less then white line space available, then DEFINITVE NEED OF TREETMENT
2.Over Jet
Measure oj up to IabiaI aspect of the most prominent incisor
A. Increased (CIass 2)
if >6 more then red Iine DEFINITVE NEED OF TREETMENT
B. Reversed (CIass3)
All four incisors must be in lingual occlusion.
If ROJ faII on white Iine (4mm) DEFINITVE NEED OF TREETMENT
3. Cross Bites
Can b anterior or posterior but mostly posterior
Check for the displacement on closure if yes DEFINITVE NEED OF TREETMENT

4.DispIacement of contact points
Only applies to crowding in permanents
Measured between contact points of two most crowded anterior teeth
Ìf the most crowded tooth is beyond white line DEFINITVE NEED OF TREETMENT
5. Overbite:
C. Deep

Causes trauma to gingival or palatal tissue
D. Open
Ìf beyond white line then DEFINITVE NEED OF TREETMENT
Note : Generalised spacing is not recorded in DHC.
Ref: pcwww.liv.ac.uk written by Donald Burden and Cynthia Pine with assistance from BASCD working party on orthodontics
with thanks.
*****************************************************************************************************************
Reading a ruIer:
Upper Ieft haIf: positive over jet=a
0-2 over jet upto 3.5mm up to normaI grade 1
3-i overjet 3.5-6 mm incompetent Iips grade 3 since positive over jet=a so 3a
2-c - do- compitent Iip grade 2 -do- so 2a
4 6-9mm 4a
5 > 9mm 5a
Lower Ieft haIf:
now reverse overjet =b
and reverse overjet with maticatory/speech defect=m
1 up to 1mm = 2 since reverse overjet =b so 2b
3 >1 but < 3.5mm -do- 3b
4 >1 but < 3.5mm with masticatory and speech defect 4m
4 > 3.5 with no m 4b
5 >3.5 with masticatory or speech defect 5m
Right side is for contact dispIacement
DispIacement of "Contacts Points" (of two most imbricate teeth) =d
1 dispIacement <1 mm minor grade 1
2 >1 to < 2 grade 2 2d
3 >2 to < 4 mm grade3 3d
4 >4 grade4 4d

MiddIe
Open bite e; or deep bite f
4f
4e
3f

3e
2e
2f
aII other are seIf expIanatory
MOCDO
Missing teeth (I= impacted ,h= hypodotia)
5i=

5h=

4h=
Over Jet a/b or m
5 a =
4.a =
3.a=
2.a=
5m=
4m=
4 b=

3.b=

2.b=

(d)
4 d=
3d=

2.d=

(c)
Check for the displacement on closure if yes definitive need for treatment
4c=
3.c=

2c=
(e=open&f=deep)
4.f=
3.f=

2.f=

and
4e=

3.e=

2.e=

CIinicaI Significance:
ExampIe:

% 'HQWDO +HDOWK &RPSRQHQW '+&.

$ $HVWKHWLF &RPSRQHQW $&.

*UDGH  12 WUHDWPHQW 17.

*UDGH  'HILQLWLYH QHHG RI WUHDWPHQW '17.

271 5XOHU 0RGLILHG .271 . Re m em be rm ei ny ou rp ra ye rs .

0HWKRG RI UHFRUGLQJ DHVWKHWLF FRPSRQHQW % 'HQWDO +HDOWK &RPSRQHQW '+&.

1. )RU '+& DJDLQ .271 KDV EHHQ VLPSOLILHG LQ WR WZR FDWHJRULHV  '().W KDV D ZKLWH OLQH DW PP DQG D UHG OLQH DW PP :KLWH OLQH LV IRU UHYHUVH RYHU MHW &URZGLQJ 2SHQ %LWH 5HYHUVH RYHU MHW 52-.79( 1((' 2) 75((70(17  1R '17 5HFRUGLQJ WKH '+&    .

5HG OLQH LV DW PP UHSUHVHQW SRVLWLYH RYHU MHW 2YHU MHW LI JUHDWHU WKHQ UHG.

1HHG IRU 7UHDWPHQW '17.

Re m em be rm ([DPLQH XVLQJ PRFGR 6FDOH $V VRRQ DV '17 UHDFKHG H[DPLQDWLRQ VWRSHG .271 5XOHU LV UHTXLUHG ei 0LVVLQJ 2YHU MHW &URVV ELWH 'LVSODFHPHQW RI ³&RQWDFWV 3RLQWV´ RI WZR PRVW LPEULFDWH WHHWK.

2YHUELWH ny 0HWKRG ([DPLQH HDFK VXEMHFW IRU 02&'2 ou 7KH 6XEMHFW LV H[DPLQHG IRU  VSHFLILF FRQGLWLRQV DQG LI RQH LV IRXQG D '17 LV UHFRUGHG DQG QR IXUWKHU FRQGLWLRQ LV VRXJKW rp ra  $VN SW WR FORVH WHHWK RQ SRVWHULRUV  5HWUHFWHG OLSV  *UDGH RYHUDOO DWWUDFWLYHQHVV RI DQWHULRU WHHWK UDWKHU WKHQ VSHFLILF PRUSKRORJLFDO VLPLODULWLHV WR SKRWRJUDSKV  .79( 1((' 2) 75((70(17 ye rs .VW LPSUHVVLRQ LV XVXDOO\ FRUUHFW  )RFXV LV WR GLIIHUHQWLDWH WKRVH DW  WKHQ '().1.

79( 1((' 2) 75((70(17 & .PSDFWHG .1.QFUHDVHG &ODVV .I DW RU OHVV WKHQ ZKLWH OLQH VSDFH DYDLODEOH WKHQ '().79( 1((' 2) 75((70(17 2YHU -HW 0HDVXUH RM XS WR ODELDO DVSHFW RI WKH PRVW SURPLQHQW LQFLVRU $ .1.$ &RQJHQLWDOO\7UDXPDWLFDOO\ DEVHQW % (FWRSLF &DQLQHV .V FDQLQH SDOSDEOH RQ EXFDO VXOFXV LI QRW '().

% 5HYHUVHG &ODVV.

I 52.IDOO RQ ZKLWH OLQH PP. $OO IRXU LQFLVRUV PXVW EH LQ OLQJXDO RFFOXVLRQ .

79( 1((' 2) 75((70(17 1((' 2) 75((70(17 1((' 2) 75((70(17 ou 2) 75((70(17 rp ra .79( be 2QO\ DSSOLHV WR FURZGLQJ LQ SHUPDQHQWV 0HDVXUHG EHWZHHQ FRQWDFW SRLQWV RI WZR PRVW FURZGHG DQWHULRU WHHWK .79( ei 'LVSODFHPHQW RI FRQWDFW SRLQWV  2YHUELWH em &DXVHV WUDXPD WR JLQJLYDO RU SDODWDO WLVVXH ' 2SHQ .1.79( 1((' 2) 75((70(17 ye   0LVVLQJ 7HHWK .79( 1((' & 'HHS Re m 1((' 2) 75((70(17 1RWH  *HQHUDOLVHG VSDFLQJ LV QRW UHFRUGHG LQ '+& 5HI SFZZZOLYDFXN ZULWWHQ E\ 'RQDOG %XUGHQ DQG &\QWKLD 3LQH ZLWK DVVLVWDQFH IURP %$6&' ZRUNLQJ SDUW\ RQ RUWKRGRQWLFV ZLWK WKDQNV ny LI ! PRUH WKHQ UHG OLQH '().QYLVLEOH. '().1.1.I WKH PRVW FURZGHG WRRWK LV EH\RQG ZKLWH OLQH '().1.I EH\RQG ZKLWH OLQH WKHQ '().79(  &URVV %LWHV rm &DQ E DQWHULRU RU SRVWHULRU EXW PRVWO\ SRVWHULRU &KHFN IRU WKH GLVSODFHPHQW RQ FORVXUH LI \HV '().I OHVV WKHQ ZKLWH OLQH LV WKH VSDFH OHIW LI LQ \RXU RSLQLRQ WUHDWPHQW LV UHTXLUHG WR RSHQ RU FORVH WKH VSDFH WKHQ '().1.1.

rs $SSOLFDWLRQ RI 02&'2 6&$/( .

5HDGLQJ D UXOHU JUDGH  JUDGH  VLQFH SRVLWLYH RYHU MHW D VR D JUDGH  GR VR D D D /RZHU OHIW KDOI rm 5LJKW VLGH LV IRU FRQWDFW GLVSODFHPHQW 'LVSODFHPHQW RI ³&RQWDFWV 3RLQWV´ RI WZR PRVW LPEULFDWH WHHWK.

G  GLVSODFHPHQW  PP PLQRU JUDGH   ! WR   JUDGH   ! WR   PP JUDGH  ! JUDGH ei QRZ UHYHUVH RYHUMHW E DQG UHYHUVH RYHUMHW ZLWK PDWLFDWRU\VSHHFK GHIHFW P  XS WR PP  VLQFH UHYHUVH RYHUMHW E VR  ! EXW  PP GR  ! EXW  PP ZLWK PDVWLFDWRU\ DQG VSHHFK GHIHFW  !  ZLWK QR P  ! ZLWK PDVWLFDWRU\ RU VSHHFK GHIHFW ny ou 8SSHU OHIW KDOI SRVLWLYH RYHU MHW D  RYHU MHW XSWR PP XS WR QRUPDO L RYHUMHW  PP LQFRPSHWHQW OLSV F  GR FRPSLWHQW OLS  PP  ! PP I H I Re m em H H I DOO RWKHU DUH VHOI H[SODQDWRU\ be 0LGGOH 2SHQ ELWH H RU GHHS ELWH I rp E E P E P G G G ra ye rs .

LPSDFWHG K K\SRGRWLD.02&'2 0LVVLQJ WHHWK L K K Re m em 2YHU -HW D DE RU P D D D P be rm .

ei ny ou rp ra ye rs .

P E E E G G G ou &KHFN IRU WKH GLVSODFHPHQW RQ FORVXUH LI \HV F GHILQLWLYH QHHG IRU WUHDWPHQW F F ei ny H RSHQ I GHHS.

I I I DQG H H H Re m em be rm rp F.

ra G.

ye rs .

&OLQLFDO 6LJQLILFDQFH ([DPSOH Re m em be rm ei ny ou rp ra ye rs .

Sign up to vote on this title
UsefulNot useful