The first 100 cases: a personal audit of orthodontic treatment assessed by the PAR (peer assessment rating) index

Abstract

The first 100 consecutively started cases treated by a specialist registrar in orthodontics were examined and pre- and post-study models were scored using the peer assessment rating (PAR) index. The PAR index proved both simple and reproducible to use: 92 cases had post-treatment records available, 91 patients registered a drop in PAR score, and one patient registered an increase. Of these 92 patients, 38 (41%) were greatly improved, 43 (47%) were improved, and 11 (12%) were made worse or no different (ie they failed to achieve a 30% drop in PAR score). Of the factors examined, only the appliance type used was significantly related to PAR score change. Of the 11 cases apparently made worse, individual examination revealed that four of these represented beneficial occlusal changes but due to limited treatment goals they did not register as improved using the PAR index according to previously agreed criteria. The PAR index measures 'good tooth position' which, although very important, is not the only factor in orthodontic treatment. The use of the PAR index to detect 'good' and 'bad' orthodontic treatment is not without problems. Its use in mixed dentition and adjunctive orthodontic treatments may not always be appropriate.

Development of a treatment outcome standard as a result of a clinical audit of the outcome of fixed appliance therapy undertaken by hospital-based consultant orthodontists in the UK.

“…[5][6][7][8][9][10][11][12][13] The paper of greatest relevance to the current audit is that by O'Brien et al in 1993, 5 in which the authors looked at 17 hospital departments and investigated some 1,392 cases treated with fixed appliances. They examined all cases, including those in which the appliances were removed early, and included all grades of operator.…”

A comparison of the Index of Complexity Outcome and Need (ICON) with the Peer Assessment Rating (PAR) and the Index of Orthodontic Treatment Need (IOTN)

“…2,3 Experience with IOTN has shown that the need for treatment does not necessarily equate to the complexity of the treatment. It is important to make an assessment of complexity for the following clinical reasons (Richmond et al 4 …”

PAR Index in the Evaluation of the Stability of the Orthodontic Treatment Results. A Review

“…The index is considered as a simple, objective and a reliable manner (19) for evaluating the stability after orthodontic treatment. Several studies have been conducted which demonstrate the method for assessing the stability after orthodontic treatment using the PAR index (1,2,9,12,17,21,22). According to the rules of the PAR index, each of the components of the dentition i.e.…”

“…There are basically three methods of assessing improvement using the PAR index (9,20 Centerline Score 0 -Coincident and upto one quarter lower incisor width 1 -One quarter to one half lower incisor width 2 -Greater than one half lower incisor width Tab. 5: Scores for recording the midline that are needed to assess the midline discrepancies.…”