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Personal esthetic perceptions of the dentofacial complex INDEX OF ORTHODONTIC TREATMENT
and the associated psychosocial need are directly reflected NEED–AESTHETIC COMPONENT [26]
in perceived need for orthodontic care. Treatment is,
therefore, often influenced more by demand rather than Each subject was shown 10 colored photographs depicted
by need. In the past, orthodontic treatment need was in the AC of IOTN [Figure 1] and was asked to choose the
[18]
evaluated from a strictly professional viewpoint (normative one with the closest resemblance to their actual smile.
need), but several studies have stated that self‑perceived This was done on memory recall basis, and the subjects
dental appearance is also important in the decision to were not allowed to check their smile in the mirror. The
seek orthodontic treatment. [19‑21] score of the chosen photograph was used to determine
Although dissatisfaction with dental appearance is broadly the perceived need for orthodontic treatment. A definite
related to the severity of the occlusal irregularities, there need of treatment was represented by photos 8–10,
are differences in the recognition and evaluation of the while borderline and no need for orthodontic treatment
dental features. [14,22] For this reason, professional opinions were represented by photos by photos 5–7 and 1–4,
regarding evaluation of facial esthetics may not coincide respectively.
with the perceptions and expectations of patients. [23,24]
Statistical analysis
The aims of present study were to: The data was analyzed using the SPSS software (version 11.5)
• Assess self‑perceived dental appearance among rural (SPSS Inc., Chicago, IL, USA). Bivariate analyses using the
Indian population using aesthetic component (AC) of the Chi‑square test (χ ) at 5% significance level were performed
2
index of orthodontic treatment need (IOTN) index to test the influence of age and gender on perceived
• Determine if gender and age influence patient orthodontic treatment needs.
self‑perception.
RESULTS
METHODS
Table 1 shows the age‑wise and gender‑wise distribution
of study population. A total of 528 males (53.33%)
Ethical considerations and 462 females (46.67%) were selected. Of these,
The study protocol was approved by Institutional Ethical
review committee of Sudha Rustagi College of Dental 210 males (49.65%) and 213 females (50.45%) were in the
Sciences and Research, Faridabad. Voluntary consent was age group of 16–18 years, whereas 318 males (56.08%)
obtained from each participant before the study. and 249 females (43.92%) were in the age group of
18 years old and above.
Study population Table 2 represents the distribution of the individual
A cross‑sectional study was carried out to assess scores according to the IOTN‑AC index. Maximum number
the perceived aesthetic impact of malocclusion in
16–24 year‑old subjects selected from the rural
population of Faridabad, Haryana, India. A pilot study was
conducted to assess the methodology and to estimate the
sample size. A sample size of 990 was calculated to be
satisfactory. Older adolescents and younger adults were
selected since they are at an age when facial aesthetics
including those of teeth are of importance. A stratified
two‑stage cluster sampling technique with villages as the
primary sampling unit was utilized. All subjects between
16 and 24 years old, willing to participate and to give
their consent, were selected. Subjects with presence of
mixed dentition, any structural abnormality in the teeth
concerned and those undergoing or with a history of
any orthodontic treatment were excluded. The study was
conducted from July to November 2013.
The perceived orthodontic treatment need was assessed
using the AC of IOTN. [25]
All readings were recorded on a specially prepared form.
Calibration of examiner
A single calibrated examiner performed all measurements.
The intra‑examiner test was performed in the
measurement of the IOTN‑AC. Reliable results were seen Figure 1: Photographs depicted in the esthetic component of the index
with κ = 0.82. of orthodontic treatment need (IOTN)

Plast Aesthet Res || Vol 1 || Issue 2 || Sep 2014 59