Indics / Orthodontic Courses by Indian Dental Academy

INDICES
INDIAN DENTAL ACADEMY

Leader in continuing dental education
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Index
According to Russell, an index is defined as
A numerical value describing the relative
status of the population on a graduated scale with
definite upper and lower limits which is designed to
permit and facilitate comparison with other
population classified with the same criteria and
method.
In the orthodontic context index is described as
A rating or categorizing system that assigns a
numeric score or alpha numeric label to a persons
occlusion. www.indiandentalacademy.com
Requirements of ideal orthodontic index are
(Jamison H.D. and Mc Millan R.S )
1. Simple, reliable and reproducible.
2. Objective and yield quantitative data.
3. Differentiate b/w handicappin and non
handicappin malocclu!ion!.
". #ea!ure deree of handicap.
$. %uic& e'amination.
(. )menable to modification!.
*. +!able either on patient or on !tudy
model.
,ype! of -ndice! . accordin to
/0O1
cclusal !lassification
)nle2! cla!!ification by )nle in 1344
-nci!or cla!!ification by 5allard and

/ayman, 14("
"#eletal classification by 0ou!ton et al, 1443
$alocclusion
Occlu!al inde' by Summer! 14((
0andicappin #alocclu!ion )!!e!!ment

6ecord .0#)61 by Sal7mann, 14(3
-nde' of ,reatment 8eed by 9van! and Shaw

143*
%reatment assessment
:ittle2! irreularity inde' by :ittle 14*$
;eer )!!e!!ment ratin by 6ichmond et al,

143*
!left utcome
<o!lon =ard!tic& by #ar! et al, 143*
$=ear old!2 -nde' by )tac& et al ,144*
&eriodontal
;laque -nde' by Stilne!! > :oe , 14("
<inival -nde'. by :oe > Stilne!!, 14(3

,ype! of -ndice! . accordin to
6ichmond et al1
'iagnostic !lassification
)nle2! cla!!ification
-nci!or cla!!ification
()idemiologic indices
Study prevalence of malocclu!ion in

population.
9 1.Summer2! occlu!al inde'.

2. 6ei!tration of malocclu!ion
de!cribed by 5jor&, ?reb! and Solow
%reatment need ( %reatment )riority) indices.
!ategori*e malocclusion according to le+els of treatment

needs.
(g ,. Index f %reatment -eed (I%-)

.. 'ra#er/s 0andica))ing 1abio 1ingual 'e+iation
index (01')
2. 3rainger/s %reatment &riority Index.(%&I)
4. "al*mann/s 0andica))ing $alocclusion Index
%reatment outcome indices.
Assesssment of changes resulting from treatment
(g ,. &eer Assessment Rating index

.. "ummer/s index
%reatment com)lexity index
Index of !om)lexity utcome and -eed (I!-)

@ariou! indice! of Occlu!ion
Master and Frankel !"#!$
Aount the number of teeth di!placed

or rotated
%ualitative a!!e!!ment
Malalignment %ndex by&ankrik and 'ennel

!"#"$
,ooth di!placement and rotation!

were mea!ured.
Angles classi - Molar reln-
Class I
Class II
Class III
Incisor classi- Incisor reln
Class I
Class II
Class III
Skeletal classi-
Class I
Class II
Class III
Handicapping Labio Lingual deviation
indexD!a"e!#$%&'(
0andicappin malocc and dentofacial

anomalie!.
permanent dentition
)dmini!trative need!
/eihtin factor! by trial and error.
4 component!
!onditions obser+ed 01' score
1. Aleft palate Score 1$
2. Severe ,raumatic deviation! Score 1$
3. Overjet in mm
". Overbite in mm
$. #andibular protru!ion in mm ' $
(. Open bite in mm ' "
*. 9ctopic eruption ,)nterior! only ' 3
3. )nterior crowdin B #a'illa
4. )nterior crowdin B #andible
,O,):

Handicapping Labio Lingual deviation
index b) D!a"e! $%&'(
#odification
aim
* component!.
5oley aue !caled in mm.
!core 13 and over phy!ical handicap

5 conditions of 01' index are 6
1. Aleft palate
2. ,raumatic deviation!
3. Overjet
". Overbite
$. #andibular protru!ion
(. Open bite
*. :abio :inual !pread
code! C
DO2 E condition pre!ent
DF2 E condition ab!ent
D#2E mi'ed dentition
D)2E Alinical approval
DD2EAlinical di!approval
*cclusal index# Summe!s $%&&(
)!!e!! !everity
7 weighted and defined measurements C

1. #olar relation
2. Over jet
3. Overbite
". ;o!terior cro!! bite
$. ;o!terior open bite
(. ,ooth di!placement
*. #idline relation
3. #a'illary median dia!tema
4. Aonenitally mi!!in ma'illary inci!or!.
* malocc !yndrome!
1. OG,O5
2. Di!tal molar relation,OG,O5, po!t cro!!bite,
midline dia!tema, mid line deviation.
3. Aonen mi!!in ma' inci!or!.
". ,ooth di!placement.
$. ;o!t O5
(. #e!ial molar reln,OG,O5, po!t cro!!bite,
midline dia!tema, mid line deviation.
*. #e!ial molar reln, mi'ed dentition analy!i!
.potential tooth di!p1, tooth di!p
Diff !corin !cheme! and form! .

+!eatment p!io!it) index# ,!ainge!
$%&-(
#alocclu!ion Severity 9!timate .#S91 H<rainer

14(IH(1
#S9 !coreH lare!t value
potential tooth di!placement .mi'edHdentition

!pace analy!i!1, ratin di!toclu!ion,
me!ioclu!ion equally.
;ublic health !inificance
11 weihted and defined mea!urement! C

1. +pper ant OG.
2. :ower ant O5.
3. O5
". )nt openbite.
$. Aonenital ab!ence of inci!or!.
(. Di!tal molar relation
*. #e!ial molar relation
3. ;o!terior cro!! bite .ma'. teeth buccal to normal1.
4. ;o!terior cro!! bite .ma'. teeth linual to normal1.
1I. ,ooth di!placement
11. <ro!! anomalie!.
* malocc !yndrome! defined H
1. ;ronathi!m
2. 6etronathi!m
3. Overbite
". Openbite
$. #a'illary e'pan!ion !yndrome
(. #a'illary collap!e !yndrome
*. Aonenitally mi!!in inci!or!
%&I is based on a scale of

1. I .near ideal occlu!ion1
2. 1 H 3 . mild malocclu!ion1
3. " C ( . #oderate malocclu!ion1
". Over ( . !evere malocclu!ion1
,;- !core! only occlu!al characteri!tic!,

e'cludin !&eletal and facial component!.
,;- i! u!ed in national !tudie! of orthodontic

need! for children. 9. +S;0S !tudy in +S) of
childeren aed b/w (H11 yr! in year 14(*
Handicapping malocclusion
assessment !eco!ds b) Sal.mann
$%&/(
;urpo!e C e!tabli!h priority for treatment
accordin to !everity !hown by !core.
/eihted mea!urement! 3 part! C

1. -ntra arch deviation!
$issing teeth
!rowding
Rotation
")acing
2. -nterarch deviation!
+er8et
+erbite
!rossbite
)enbite
$esiodistal de+iations
3. Si' handicappin dentoHfacial deformitie!
1. Jacial and oral cleft!
2. :ower lip palatal to ma'illary inci!or!.
3. Occlu!al interference!
". Junctional jaw limitation!
$. Jacial a!ymmetry
(. Speech impairment.
add 3 point! K (.
-n!truction for Scorin
Irregularity index - Robert Little(1975
Measuring linear dis!lace"ent
Su" o# 5 dis!- degree o# ant irregularity
$ial cali!ers used
Measure"ets #ro" casts
7 ort%odontists & 5' casts
(%ase one-
' (er#ect allign"ent
1-) Min irregularity
*-+ Moderate irregularity
7-9 Se,ere irregularity
1' -ery se,ere irregularity
(%ase .-
/
5 ort%odontists & .5 casts
/
. se!arate occasions
/
1' se,erity esti"ates #or eac% cast
Scattergram-
0ee! 1ssessment Rating
Index 01R(
by Richmond et al.( !")*
1I 5riti!h orthodonti!t!.
9ffectivene!! Orth tmnt.
)!!in! !core! to different occlu!al trait!.
Study model! u!ed.
) !corin !y!tem and a ruler.

$ component!H /eihtin
1. +pper > lower anterior !ement H 1
2. :eft and riht buccal !ement! H 1
3. Over jet H (
". Overbite H 2
$. Aenterline! H "
!ummed final !core..
chane in total !coreH !ucce!! of treatment.

Ahane e'pre!!ed a!B

1. 22 point reduction C <reatly improved
2. L 3IM reduction C wor!e/ no better
K 3IM reduction C -mproved.
-ndicator of clinical performance.
:imitation! of ;)6
1. <eneric weihtin! of OG and O5.
2. Sen!itive to malocclu!ion with hih OG.
3. O5 low weihtin..
". Jacial profile! not con!idered 9.
5ima'illary protru!ion
+2e3alidation o4 01R 4o! Malocclusion
seve!it) and +!eatment Di44icult)
De ,u.man5ba2i!aei5 3ig5 6e)ant and *78!ien 1J*#D*
$%%9
11 )merican Orthodonti!t! H2II ca!t!
6e!ult! ;)6 inde' weihtin! Hmalocc !everity

and treatment difficulty
Index o4 +!eatment Need
I*+N(
b) S2a:
-nde' ha! two component!H

!. +ental ,ealth component C derived from
occlu!ion and alinment.
-. Aesthetic component C Derived from
compari!on of dental appearance to !tandard
photoraph!.
)e!thetic component i! calculated by direct

e'amination, but dental health component
can be !tudied by dental ca!t!.
) !pecial ruler
)!!e!!ed in order B
1. #i!!in teeth
2. Overjet
3. Aro!!bite!
". Di!placement! .Aontact point1
$. Overbite
(sthetic
Index
3rades 9 ,: ;
definite need for
treatment.
< 5 ;
moderate=
borderline need
, 4 ; -o=
slight need
1imitations
1. -n ae!thetic component ,Ala!! --- not
con!idered.
2. Jacial profile not con!idered.
3. Ala!! - bima'illary protru!ion not
con!idered.
Index o4 Complexit) *utcome and
Need IC*N(
4* orthodonti!t! variou! countrie!.
patient! and Dental ca!t!.
) !inle a!!e!!ment method to record

comple'ity, outcome and need.
$ component! H1 min to mea!ure.

1. )e!thetic component
,: )ictures
2. +pper arch Arowdin/ Spacin
"core according to amount of crowding or s)acing
Im)acted teeth in either arch immediately scored <
")acing in one )art can cancel out crowding

elsewhere.
3. Aro!!bite
". -nci!or open bite/ overbite
)en bite measured at mid incisal edges
'ee) bite is measured at dee)est )art of o+erbite.

$. 5uccal !ement )ntero po!terior
>uality of buccal segment interdigitation is measured

(not Angles !lassification)
,. Aesthetic com)onent
1imitations
1. Overjet not con!idered.
2. :ower anterior crowdin not con!idered.
3. #idline !hift not ta&en in account.
,oslon )a!dstic" BA new system of
assessing dental arch relationshi)s in children with
?!1& . Michael Mars( +ennis A. 'lint / !")* A cleft
'alate 0ournal
,he <o!lon =ard!tic&H clinical tool, $ di!crete

cateorie!.
1b0ective /
1. cateori7e malocclu!ion! in +A:; C

!everity,difficulty
2. compare re!ult! of different approache! to
the early treatment of children with +A:;.
'e+elo)ment of ;a!dstic" -mp clinical feat

1. )H ; arch relation!hip CAla!! --- inci!or
relation!hipK cla!! -- div -
2. @ertical labial !ement relation!hip C Open
biteK 6educed overbite K deep overbite.
3. ,ran!ver!e relation!hip C Aanine cro!!bite! K
molar cro!!bite!.
3I ca!e! ta&en.
ran&ed by " orthodonti!t!, !eparated in $

roup!
Group 1 excellent
Group 2 good
<roup 1 or 2 H !imple orthodontic

treatment/ no treatment
Group 3 fair
complex ortho tnmt,
good result
antisipated
limited ortho tmnt

without orthognathic
surgery,if growth fav
Group 4 poor
Group very poor
!rthognathic surgery
5yr old0s Index(Atack-
Sub1ects 2 "ot%od-
-3orn 4CL5
-Re!air o# 4LC(
-6o ort% t"nt
-6o bone gra#ting
-Casts
Intra-exa"iner
Inter-exa"iner
Reln o# 7olson ranking
7rou! 1-8xcelent
7rou! .- 7ood
7rou! )-5air
7rou! *- (oor
7rou! 5- -ery !oor
(la9ue index-Stilness2 loe
7ingi,al index &
Loe 2 Stilness
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INDICES

INDIAN DENTAL ACADEMY

)nle2! cla!!ification by )nle in 1344

-nci!or cla!!ification by 5allard and

"#eletal classification by 0ou!ton et al, 1443

Occlu!al inde' by Summer! 14((

0andicappin #alocclu!ion )!!e!!ment

-nde' of ,reatment 8eed by 9van! and Shaw

:ittle2! irreularity inde' by :ittle 14*$

;eer )!!e!!ment ratin by 6ichmond et al,

<o!lon =ard!tic& by #ar! et al, 143*

$=ear old!2 -nde' by )tac& et al ,144*

;laque -nde' by Stilne!! > :oe , 14("

<inival -nde'. by :oe > Stilne!!, 14(3

Study prevalence of malocclu!ion in

9 1.Summer2! occlu!al inde'.

%reatment need ( %reatment )riority) indices.

!ategori*e malocclusion according to le+els of treatment

(g ,. Index f %reatment -eed (I%-)

%reatment outcome indices.

Assesssment of changes resulting from treatment

(g ,. &eer Assessment Rating index

%reatment com)lexity index

Index of !om)lexity utcome and -eed (I!-)

Master and Frankel !"#!$

Aount the number of teeth di!placed

Malalignment %ndex by&ankrik and 'ennel

,ooth di!placement and rotation!

0andicappin malocc and dentofacial

/eihtin factor! by trial and error.

5oley aue !caled in mm.

!core 13 and over phy!ical handicap

DO2 E condition pre!ent

DF2 E condition ab!ent

D#2E mi'ed dentition

D)2E Alinical approval

7 weighted and defined measurements C

Diff !corin !cheme! and form! .

#alocclu!ion Severity 9!timate .#S91 H<rainer

#S9 !coreH lare!t value

potential tooth di!placement .mi'edHdentition

11 weihted and defined mea!urement! C

%&I is based on a scale of

,;- !core! only occlu!al characteri!tic!,

,;- i! u!ed in national !tudie! of orthodontic

/eihted mea!urement! 3 part! C

9ffectivene!! Orth tmnt.

)!!in! !core! to different occlu!al trait!.

Study model! u!ed.

) !corin !y!tem and a ruler.

!ummed final !core..

chane in total !coreH !ucce!! of treatment.

Ahane e'pre!!ed a!B

-ndicator of clinical performance.

11 )merican Orthodonti!t! H2II ca!t!

6e!ult! ;)6 inde' weihtin! Hmalocc !everity

-nde' ha! two component!H

)e!thetic component i! calculated by direct

4* orthodonti!t! variou! countrie!.

patient! and Dental ca!t!.

) !inle a!!e!!ment method to record

$ component! H1 min to mea!ure.

"core according to amount of crowding or s)acing