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EVALUATION OF TREATMENT OUTCOMES AND THEIR CORELATION TO VARIOUS PRESCRIPTION …….a clinical audit

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INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com

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Orthodontists define quality by cephalometric measures , the patient by shortness of treatment time , and the parent by the size of the bill. What is a warranty ? ? ? It’s a synonym for quality assurance.

Are warranties and health care related ? www.indiandentalacademy.com


Quality assurance is a necessary component of contemporary health care . In recent years the need for all health care organizations to have clear policies and procedures for maintaining quality through Clinical audit has become pressing … … … …

AUDIT- whither or wither ? Audit, by examining whether clinical practice in a given situation is measured up to agreed standards ,seeks to extend the knowledge of practioner about their own practice . www.indiandentalacademy.com


Practice audit is a wheel spinning exercise Audit is useless unless Followed by planning

Implementation is useless unless evaluated

Planning is useless unless implemented

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The evaluation of final models is essential for orthodontists who are interested in improving their clinical results Every orthodontist , either alone or with a practice consultant , should x-ray their practice to determine its strengths and weaknesses , and to plan any changes , as indicated by the practice audit www.indiandentalacademy.com


S

I M

A

O B J

AND

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E C T I

V E S


To evaluate and analyze the final treatment outcomes To correlate the results obtained with various prescriptions

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M A AN T D E R I A L S

M E T H O D S

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OBJECTIVE GRADING SYSTEM

The American board of orthodontics is constantly striving to make the phase III clinical examination a fair , accurate , meaningful experience for candidates . In an effort to provide the candidates with a tool to assess the adequacy of their finished orthodontic results the board has established an objective grading system www.indiandentalacademy.com


ABO MEASURING GAUGE

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Alignment Marginal ridge Buccolingual inclination Occlusal contacts Occlusal relationships Overjet Interproximal contacts www.indiandentalacademy.com


A L I G N M E N T

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M A R G I N A L

R I D G E

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BUCCO-LINGUAL INCLINATION

O C C CONTACTS L U S A www.indiandentalacademy.com L


T

E

J

R

E

V

O

OCCLUSAL RELATIONSHIP

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C O N T A C T S

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20 finished cases treated for class I bimaxillary protrusion were selected for the study. The sample was divided into two sub groups of 10 cases each:Cases treated with brackets having ROTH prescription (Group A) Cases treated with MBT bracket system (Group B)

The study was single blinded , where the operator did not know the sample division. www.indiandentalacademy.com


The whole sample of 20 cases was evaluated using the ABO grading system to determine the degree of improvement and the quality of results.

The results were compared to the master chart , and the respective groups were co-related to analyze the degree of improvement in each Group.

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R E S U L T S www.indiandentalacademy.com


Full Sample Size 30 25 20 15 10 5 0

patients

Deductions AVERAGE DEDUCTION (All parameters) www.indiandentalacademy.com : 19.5 POINTS


MARGINAL RIDGE

D E D U T I O N S

20 18 16 14 12 10 8 6 4 2 0 PATIENTS

Most of the deductions were limited to the 1st and 2nd molars www.indiandentalacademy.com


BUCCO – LINGUAL INCLINATION

D E D U T I O N S

20 18 16 14 12 10 8 6 4 2 0 PATIENTS

Average deductions : 6.8 www.indiandentalacademy.com


OCCLUSAL CONTACTS

D E D U T I O N S

20 18 16 14 12 10 8 6 4 2 0 PATIENTS

Average deductions : 5.1 www.indiandentalacademy.com


The average deduction for the whole sample was 19.5 points Statistically significant deductions were found for bucco-lingual inclination and occlusal contacts

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PART 2 : Correlation to various prescriptions 30

Deductions

25 20 15 10 5 0

MBT

PATIENT S

ROTH www.indiandentalacademy.com


RESULT COMPARED TO THE MASTER CHART :-

Average deduction for ROTH prescription brackets was 21.5 points Average deductions for MBT bracket system was 16.0 points. Significant differences were found in bucco - lingual inclination and occlusal contacts between the two groups. No significant differences were found for other parameters. www.indiandentalacademy.com


D I S C U S S I O N www.indiandentalacademy.com


To improve the quality of orthodontic care , attention should focus on internal audit This being a procedure where individual health care professionals get a feed back on Performance compared with others or with what should be expected Cases treated with MBT bracket system showed lesser ABO OGS scores i.e., cases were finished better. www.indiandentalacademy.com


Bucco - lingual inclination / occlusal contacts

Operator efficiency

Prescription

In cases treated with ROTH prescription, most of the deductions were limited to bucco - lingual inclination and occlusal contacts . High tip , low torque values Operator efficiency Time and effort required to built in extra bracket features and their expression www.indiandentalacademy.com


C O N L U S I O N www.indiandentalacademy.com


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The importance of clinical audit in upgrading the standard of treatment outcome

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The treatment outcome of cases treated with MBT bracket system were better than those treated with brackets having ROTH prescription.

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CLINICAL AUDIT …….a partnership with quality

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www.indiandentalacademy.com Leader in continuing dental education

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide r...

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