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Retrospective evaluation of the outcome of orthodontic treatment in adults

Retrospektive Bewertung des Therapieerfolgs bei kieferorthopädischer Behandlung von Erwachsenen

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Abstract

The aim of this study was the retrospective evaluation of the outcome of orthodontic treatment in consecutively treated adult patients.

Of 147 adult patients, it was possible to evaluate the records of 88 patients (57 female, 31 male) before (T1) and after treatment (T2), and of 20 of these patients 3.3 years on average after completion of the retention phase (T3). During treatment planning, a nearly “ideal” result was considered attainable (ideal group) for 46 patients, and a “compromise” result (compromise group) was seen as realistic for 42. The assessment was made using the PAR (Peer Assessment Rating) index and the Aesthetic Component (AC) and Dental Health Components (DHC) of the IOTN (Index of Orthodontic Treatment Need). Average length of treatment in the ideal group was 2.4 years, i. e. nearly twice as long as in the compromise group.

The PAR score was reduced by an average of 56% (T2); the reduction in the ideal group was 73%, and in the compromise group 37%. Among the 20 patients for whom at least 6 months had elapsed since completion of the retention phase, a statistically significant relapse between T2 and T3 was observed. The evaluation of overjet and overbite and, in the ideal group, of the midline and maxillary front teeth were primarily responsible for the worsening of the PAR scores between T2 and T3. According to the AC, 53 patients (60%) had moderate to definite treatment needs at the beginning of treatment. Following completion of active treatment, 69 patients (78%) no longer demonstrated treatment indications for aesthetic or psychosocial reasons. Based on the DHC, 88% of the patients were in definite or moderate need of treatment (T1); in contrast, treatment was no longer indicated in 84% at T2. In general, a marked improvement of the examined morphological parameters was observed.

Zusammenfassung

Ziel der Arbeit war die retrospektive Bewertung des kieferorthopädischen Therapieerfolgs bei fortlaufend behandelten erwachsenen Patienten.

Von 147 erwachsenen Patienten konnten die Unterlagen von 88 Patienten (57 weibliche, 31 männliche) vor (T1) und nach der Behandlung (T2) sowie bei 20 Patienten im Durchschnitt 3,3 Jahre nach Abschluß der Retention (T3) ausgewertet werden. Bei 46 Patienten wurde bereits bei der Behandlungsplanung ein annähernd “ideales” Ergebnis als Ziel angestrebt (Idealgruppe) und bei 42 ein “Kompromiß”-Ergebnis (Kompromißgruppe). Die Beurteilung erfolgte mit Hilfe des PAR-Indexes (Peer Assessment Rating) und der Aesthetic Component (AC) und der Dental Health Components (DHC) des IOTN (Index of Orthodontic Treatment Need). Die durchschnittliche Behandlungsdauer in der Idealgruppe war mit 2,4 Jahren nahezu doppelt so lang wie die in der Kompromißgruppe.

Der PAR-Wert konnte im Durchschnitt um 56% reduziet werden (T2); für die Idealgruppe betrug die Reduktion 73% und für die Kompromißgruppe 37%. Bei den 20 Patienten, die mindestens sechs Monate außerhalb der Retention waren, konnte ein statistisch signifikantes Rezidiv zwischen T2 und T3 beobachtet werden. Für die Verschlechterung der PAR-Werte zwischen T2 und T3 waren vor allem die Bewertung von Overjet und Overbite sowie in der Idealgruppe die Bewertung der Mittellinie und der Oberkieferfront verantwortlich. Zu Beginn der Behandlung bestand gemäß des AC bei 53 Patienten (60%) moderater bzw. eindeutiger Behandlungsbedarf. Nach Abschluß der aktiven Behandlung wiesen 69 Patienten (78%) keine Behandlungsindikation aus ästhetischen bzw. psychosozialen Gründen mehr auf. Anhand der DHC bestand bei 88% der Patienten eindeutiger oder moderater Behandlungsbedarf (T1), hingegen zum Zeitpunkt T2 bei 84% keine Behandlungsindikation mehr. Generell konnte eine markante Besserung der untersuchten morphologischen Parameter festgestellt werden.

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Authors and Affiliations

  1. Department of Orthodontics, University of Saarland, Oscar-Orth- Straße 1, D-66421, Homburg/Saar, Germany

    Thomas Riedman & Rolf Berg

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  1. Thomas Riedman
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  2. Rolf Berg
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Correspondence to Thomas Riedman.

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Dedicated to Prof. Dr. Emil Witt on the Occasion of his 65th Birthday.

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Riedman, T., Berg, R. Retrospective evaluation of the outcome of orthodontic treatment in adults. J Orofac Orthop/Fortschr Kieferorthop 60, 108–123 (1999). https://doi.org/10.1007/BF01298961

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