Evaluation of treatment outcomes /certified fixed orthodontic courses by Indian dental academy

EVALUATION OF TREATMENT
OUTCOMES AND THEIR
CORELATION TO VARIOUS
PRESCRIPTION
…….a
clinical audit

www.indiandentalacademy.com

INDIAN DENTAL ACADEMY
Leader in continuing dental education


Orthodontists define quality by cephalometric
measures , the patient by shortness of treatment
time , and the parent by the size of the bill.
What is a warranty ? ? ?
It’s a synonym for quality
assurance.

Are warranties and health care
related ?

Quality assurance is a necessary component of
contemporary health care . In recent years
the need for all health care organizations
to have clear policies and procedures for
maintaining quality through Clinical audit has
become pressing … … … …

AUDIT- whither or wither ?
Audit, by examining whether clinical practice in a
given situation is measured up to agreed standards
,seeks to extend the knowledge of practioner about
their own practice . www.indiandentalacademy.com

Practice audit is a wheel spinning
exercise
Audit is useless
unless
Followed by planning

Implementation is useless
unless
evaluated

Planning is useless
unless
implemented


The evaluation of final models is
essential for orthodontists who are
interested in improving their clinical
results
Every orthodontist , either alone or with
a practice consultant , should x-ray
their practice to determine its strengths
and weaknesses , and to plan any
changes , as indicated by the practice
audit

S

I
M

A

O
B
J

AND


E
C
T
I

V
E
S

To evaluate and analyze the final treatment
outcomes
To correlate the results obtained with various
prescriptions


M
A
AN
T
D
E
R
I
A
L
S

M
E
T
H
O
D
S


OBJECTIVE GRADING SYSTEM

The American board of orthodontics is constantly striving to
make the phase III clinical examination a fair , accurate ,
meaningful experience for candidates .
In an effort to provide the candidates with a tool to assess
the adequacy of their finished orthodontic results the board
has established an objective grading system

ABO MEASURING GAUGE


Alignment
Marginal ridge
Buccolingual
inclination
Occlusal contacts
Occlusal
relationships
Overjet
Interproximal
contacts

A
L
I
G
N
M
E
N
T


M
A
R
G
I
N
A
L

R
I
D
G
E


BUCCO-LINGUAL INCLINATION

O
C
C CONTACTS
L
U
S
A
L

T

E

J

R

E

V

O

OCCLUSAL RELATIONSHIP


C
O
N
T
A
C
T
S


20 finished cases treated for class I bimaxillary protrusion were
selected for the study. The sample was divided into two sub groups
of 10 cases each:Cases treated with brackets having ROTH prescription (Group A)
Cases treated with MBT bracket system (Group B)

The study was single blinded , where the
operator did not know the sample
division.

The whole sample of 20 cases was evaluated using
the ABO grading system to determine the degree
of improvement and the quality of results.

The results were compared to the master chart , and
the respective groups were co-related to analyze the
degree of improvement in each Group.


R
E
S
U
L
T
S

Full Sample Size
30
25
20
15
10
5
0

patients

Deductions
AVERAGE DEDUCTION (All parameters)
: 19.5 POINTS

MARGINAL RIDGE

D
E
D
U
T
I
O
N
S

20
18
16
14
12
10
8
6
4
2
0
PATIENTS

Most of the deductions were limited to the 1st and 2nd molars

BUCCO – LINGUAL INCLINATION

D
E
D
U
T
I
O
N
S

20
18
16
14
12
10
8
6
4
2
0
PATIENTS

Average deductions : 6.8

OCCLUSAL CONTACTS

D
E
D
U
T
I
O
N
S

20
18
16
14
12
10
8
6
4
2
0
PATIENTS

Average deductions : 5.1

The average deduction for the whole sample was 19.5
points
Statistically significant deductions were found for
bucco-lingual inclination and occlusal contacts


PART 2 : Correlation to various prescriptions
30

Deductions

25
20
15
10
5
0

MBT

PATIENT
S

ROTH

RESULT COMPARED TO THE MASTER CHART :-

Average deduction for ROTH prescription brackets
was 21.5 points
Average deductions for MBT bracket system was
16.0 points.
Significant differences were found in bucco - lingual inclination
and occlusal contacts between the two groups.
No significant differences were found for other
parameters.

D
I
S
C
U
S
S
I
O
N

To improve the quality of orthodontic care , attention should focus
on internal audit
This being a procedure where individual health care professionals
get a feed back on Performance compared with others or with
what should be expected
Cases treated with MBT bracket system showed lesser ABO OGS
scores i.e., cases were finished better.

Bucco - lingual inclination / occlusal contacts

Operator efficiency

Prescription

In cases treated with ROTH prescription, most of the deductions were limited
to bucco - lingual inclination and occlusal contacts .
High tip , low torque values
Operator efficiency
Time and effort required to built in extra bracket features and their expression

C
O
N
L
U
S
I
O
N



The importance of clinical audit in upgrading the standard
of treatment outcome



The treatment outcome of cases treated with MBT bracket
system were better than those treated with brackets having
ROTH prescription.


CLINICAL AUDIT
…….a partnership with quality


Leader in continuing dental education


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