Outcomes of orthodontic treatment performed by individual orthodontists vs 2 orthodontists collaborating on treatment

Agreement of the Discrepancy Index Obtained Using Digital and Manual Techniques—A Comparative Study

The discrepancy index evaluates the complexity of the initial orthodontic diagnosis. The objective is to compare whether there is a difference in the final discrepancy index score of the American Board of Orthodontics (ABO) when obtained using digital and manual techniques. Fifty-six initial orthodontic records in a digital and physical format were included (28 each) in 2022 at the Center for Research and Advanced Studies in Dentistry. For the digital measurements, iTero and TRIOS 3 intraoral scanners were used, along with Insignia software and cephalometric tracing with Dolphin Imaging software. Manual measurements were obtained in dental casts using the ruler indicated for the previously mentioned discrepancy index, in addition to conventional cephalometric tracing. Student’s t-test did not show statistically significant differences between the digital and manual techniques, with final discrepancy index scores of 24.61 (13.34) and 24.86 (14.14), respectively (p = 0.769). Cohen’s kappa index showed very good agreement between both categorical measurements (kappa value = 1.00, p = 0.001). The Bland–Altman method demonstrated a good agreement between continuous measurements obtained by both techniques with a bias of 0.2500 (superior limit of agreement =9.0092988, inferior limit of agreement = −8.5092988). Excellent agreement was observed in obtaining the discrepancy index through digital technique (Intraoral scanning and digital records) and manual technique (conventional records).

Did Covid-19 Pandemic Effect Orthodontic Treatment Outcome? A Clinical Evaluation Using the Objective Grading System (OGS) And Peer Assessment Rating (PAR) Index

Introduction

This study aimed to compare the treatment outcome of patients whose orthodontic treatment was completed before or during the coronavirus disease 2019 pandemic.

Methods

Pretreatment and posttreatment models of 100 patients treated with fixed orthodontic appliances were evaluated using the peer assessment rating (PAR) index. Posttreatment models and panoramic radiographs were measured and scored with the objective grading system (OGS). All patients had their treatment plans before the coronavirus disease 2019 pandemic, but the orthodontic treatment finishing date was before (prepandemic: group 1, n = 50) or during (pandemic: group 2, n = 50) the pandemic. Intergroup comparisons were tested with an independent samples t test or Mann-Whitney U test. Chi-square test statistics and Fisher exact test were used to compare categorical variables.

Results

Significant higher posttreatment weighted maxillary alignment score was found in group 2. However, no significant difference was found between the groups concerning the mean total weighted PAR reduction (29.8 ± 9.9 vs 25.6 ± 8.7) and posttreatment total weighted PAR scores (1 vs 2). The PAR index score improvement (%) was similar between the groups (93.7 ± 7.1 vs 89.9 ± 13.0). No statistically significant difference was found between the groups for the total OGS score (32 vs 33). A lower score for marginal ridge height (4 vs 3) and a higher score for buccolingual inclination (7 vs 11), and a lower score for occlusal relationship (3 vs 1) were found in group 2. Canceled appointments (1.1 ± 0.7 vs 4.8 ± 1.6) and the number of missed appointments (0.6 ± 0.5 vs 1.1 ± 0.8) were statistically higher in group 2, whereas the total number of appointments (27.3 ± 8.8 vs 21.8 ± 5.4) were statistically less. The treatment duration was comparable in both groups.

Conclusions

Reduced and irregular appointments during the pandemic resulted in significantly higher posttreatment weighted maxillary alignment and worsening of the buccolingual inclination. However, the PAR score improvement, total OGS score, and treatment duration were not affected.