Outcome and long-term stability of an early orthodontic treatment strategy in public health care.

Our aim was to evaluate the long-term treatment outcome of a systematically applied orthodontic screening and early treatment strategy in a public dental health care system, with special reference to occlusal stability at least 5 years post-retention. The subjects (N = 68) belonged to one age cohort born in a Finnish rural municipality (N = 85), and they were regularly followed from 8 to 20 years. Persons with malocclusions were screened and treated according to pre-planned protocol. Treatment need was assessed according to the Dental Health Component of the Index of Orthodontic Treatment Need, and treatment outcome using the peer assessment rating (PAR) Index and Little's Index of Irregularity. Eighty-two per cent of the treated participants were out of retention (mean 6.9 years post-retention) at age 20. Definite treatment need in the study population decreased from 37% to 3 %. In the treated group, the mean PAR improvement decreased from 65 % to 63% from age 15 to 20 years. The mean irregularity score for the mandibular incisors was 4.0 [standard deviation (SD) 2.4] and for maxillary incisors 3.7 (SD 2.1) with no significant difference between treated and not treated subjects. The results suggest that definite need for orthodontic treatment may be predominantly eliminated from the target population with a systematically implemented treatment strategy focusing on early treatment with simple appliances. Emphasis on early timing of treatments may have contributed to the good long-term stability of treatment results.

Orthodontic treatment need from eight to 12 years of age in an early treatment oriented public health care system: a prospective study.

The aim of this study was to investigate the effects of an early treatment oriented orthodontic program on treatment need at age 12 years in a public health care system. The subjects consisted of one whole age cohort in a municipality in Finland, 87 children in total. All children were examined at ages eight, 10, and 12 years. Treatment need was assessed on casts using a modified Dental Health Component of the Index of Orthodontic Treatment Need and a 10-Grade Scale based on the Treatment Priority Index. Early treatment was started on children having definite treatment need according to both indices. The agreement between indices was good at ages eight and 12 years and moderate at age 10 years. Treatment need changed significantly from eight to 12 years. Of the 29 children with definite treatment need at age eight years, only two had treatment need at age 12 years. Of the 38 children with no treatment need at age eight years, 28 remained in this category and only two children had definite need for treatment at age 12 years. The duration of treatment ranged from one to 61 months, although 59% of the treatments lasted two years or less. We conclude that systematically planned early orthodontic treatment may have contributed to the significant reduction in treatment need from eight to 12 years of age.