Treatment outcomes after extraction and nonextraction treatment evaluated with the American Board of Orthodontics objective grading systemby Chrysi Anthopoulou, Dimitrios Konstantonis, Margarita Makou

American Journal of Orthodontics and Dentofacial Orthopedics




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Treatment outcomes after nonextraction treatment e

American Board of Orthod grading system arga eatm is stu com treatment choice was a significant predictor of success inant analysis was applied to a sample of 542 patients, t to at the onset of treatment. When conducting a retrospective project aiming at posttreatment comparisons of different treatment groups and are therefore ideal for 10,11 0889-5406/$36.00

Copyright  2014 by the American Association of Orthodontists.

ORIGINAL ARTICLEvarious techniques or treatment modalities, the discriminant analysis is the ideal statistical analysis; it ensures that all variables that might influence a clinician's treatment decision are considered.5 When used in orthodontics, discriminant analysis can assign group membership, identify a borderline spectrum of patients who could belong to either group, and provide variables with unique discriminating power.6-9 Borderline subjects have the same probability of being included in

From the Department of Orthodontics, Dental School, University of Athens,

Athens, Greece. aResident. bResearch associate. cProfessor and head.

All authors have completed and submitted the ICMJE Form for Disclosure of

Potential Conflicts of Interest, and none were reported.

Address correspondence to: Dimitrios Konstantonis, Department of Orthodontics, University of Athens, 2 Thivon St, 11526 Athens, Greece; e-mail, dikons@

Submitted, February 2014; revised and accepted, July 2014.IIn clear-cut cases, the decision is easy to make; however, when the pendulum starts to swing between the 2 different treatments, the orthodontist must decide which one to implement.1-4 Then it would be of paramount

Comparing outcomes of inadequately matched extraction and nonextraction subjects would introduce bias to a research study, since the differences at the outcome would simply reflect preexisting differenceshttp:/the ABO-OGS. Results: The total scores ranged from 11 to 41 (mean, 27.04; SD, 6.3) for the extraction group and from 16 to 44 (mean, 29.07; SD, 7.1) for the nonextraction group. The variable of buccolingual inclination had the highest scores in both groups (8.44 [SD, 3.3] for the extraction group; 8.90 [SD, 3.8] for the nonextraction group; mean difference, 0.46; 95% CI, 1.44, 2.37; P 5 0.63). However, no statistically significant intergroup differences were found, either between the scores of the 8 ABO-OGS variables or between the total ABOOGS scores. Regarding the success rates of the ABO examination, no significant difference was found between the 2 treatment groups (odds ratio, 2.55; 95% CI, 0.74, 0.85; P 5 0.14). Conclusions: For a patient with a borderline Class I malocclusion, extraction and nonextraction treatment can achieve the same quality of results as assessed by the ABO-OGS. Additionally, in these Class I patients, the treatment modality (extraction or nonextraction) is not a significant predictor of passing the ABO examination. (Am J Orthod

Dentofacial Orthop 2014;146:717-23) n addressing a Class I malocclusion, there are 2 main reatment modalities: extraction and nonextraction. importance to know which modality is more likely achieve better treatment results.and a borderline sample of 55 patients was obtained. Of these patients, 25 were treated with extractions and 30 without extraction of the 4 first premolars. Treatment results were then assessed using the 8 variables ofChrysi Anthopoulou,a Dimitrios Konstantonis,b and M

Athens, Greece

Introduction: A controversy exists regarding better tr and without extractions are evaluated. The aims of th objective grading system (ABO-OGS) to evaluate and tion Class I patients and to determine whether the according to the ABO examination. Methods: Discrim/ and valuated with the ontics objective rita Makouc ent outcomes when patients treated with extractions dy were to use the American Board of Orthodontics pare treatment outcomes in extraction vs nonextrac-various posttreatment comparisons. 717 treatment need, complexity, improvement, and final 718 Anthopoulou, Konstantonis, and Makououtcome was appraised by the index of complexity, outcome, and need, which was introduced by Daniels and Richmond13 in 2000. Themain advantages of this index were its ability to provide more objective information and its simplicity, since no special equipment was required. The main drawback of this index was that esthetics constituted the most important part of the evaluation. The American Board of Orthodontics (ABO) recommended a more integral way of evaluating treatment outcomes: the ABO objective grading system (ABO-OGS).14 The ABO-OGS index can evaluate completed orthodontic treatment using dental casts and radiographs. Furthermore, a high percentage of accordance canbe achieved in both interexaminer and intraexaminer assessments. The ABO-OGS index is an evaluation method of the final occlusion with 8 criteria that contribute to ideal intercuspation and function. To make the measuring process more reliable, a measuring instrumentwas recommended. Ideal occlusion and alignment achieve a score of 0 points. For each parameter that deviates from ideal, 1 or 2 points are added. Cases are classified as successful or failed according to their ABOOGS scores. A score of 20 points or fewer will usually pass the ABO examination, and a score of more than 30 points will usually fail. Cases scoring between 20 and 30 are subject to individual reassessment.14-20 These advantages have led to the widespread use of the ABOOGS in assessing treatment outcomes.15-21 Our aims in this study were to identify, through discriminant analysis, a bias-free sample of borderline extraction and nonextraction Class I patients and to compare their treatment outcomes with the ABO-OGS. The investigated parameters were the occlusion and the root angulation criteria established by the ABO. Additionally, we investigatedwhether the treatment choicewas a significant predictor of the success of the ABO examination.