Determining the Need for Orthodontic Treatment Based on Index of Complexity, Outcome and Treatment Need in the 12-15 Year Old Students in Ahvaz in 2014

Document Type : Original Article


1 Department of Orthodontics, Faculty of Dentisty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Department of Vital Statistics, Faculty of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Faculty of Dentisty International Arvand, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

4 Department of Orthodontics, Faculty of Dentisty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran


Background and Objectives: Protruding and irregular teeth with malocclusion has long been regarded as a problem for many people, but in modern orthodontics, the number of people who interested in improving the problems associated with orthodontict reatment on facial  appearance, has been more than in the past. In addition, various tools are available for screening and treatment planning, one of which is index of complexity, outcome and need (ICON).This study aims to assess the need for orthodontic treatment based on ICON in 12-15 yrs. old students in Ahvaz.
Subjects and Methods: This cross sectional and descriptive- analytical study was performed on the 240 students 15-12 yrs. old in Ahvaz city schools. Data were collected using a questionnaire including demographic characteristics and different indexes of ICON. The data were analyzed using SPSS-19. The threshold for need intervention was allocated as 43 on the scale.
Results: Based on the allocated threshold of 43, 19.17% of students needed orthodontic treatment with ICON values of 22.2% for girls and 16.8% for boys. In addition, the average of ICON score of the students in this study was 32.61 and there were no relationship between sex and age of students and their need for orthodontic treatment (P> 0.05).
Conclusion: Average ICON scores in the study population for both sexes was lower than the threshold need for treatment. Further studies based on this index and comparison with other indices is recommended in order to gain more understanding on the usefulness of this tool in screening and treatment of malocclusion teeth.


1-Corrucini RS, Paciani E. Orthodontistry and dental occlusion in Etruscans. Angel Orthod 1989 Mar; 59(1): 61-4.
2-Shaw WC, Rees G, Dawe M, Charles CR. The influence of dent facial appearance on the social attractiveness of young adults. Am J Orthod 1985 Jan; 87(1):  21-6.
3-Bresnahan B, Kiyak A, Masters SH, McGorray SP, Lincoln A, King G. Quality of life and economic burdens of malocclusion in US patients enrolled in Medicaid. J Am Dent Assn 2010 Oct; 141(10): 1202-12.
4-Meyer-Marcotty P, Gerdes AB, Reuther T. Persons with cleft lip and palate are looked at differently. J Dent Res 2010 Apr; 89(4): 400-4.
5-Jolley C, Huang GJ, Greenlee G, SpieKerman C, Kiyak HA, King GJ. Dental effects of interceptive orthodontic treatment in Medicaid population: interim results from a randomized clinical trial. Am J Orthod Dentofac Orthod 2010 Mar; 137(3):  324-33.
6-Macgregor FC. Social and psychological implications of dentofacial disfigurement. Angle Orthod 1979 Jul; 40(3): 231-3.
7-Brunrlle JA, Bhat M, Lipton JA. Prevalence and distribution of selected occlusal characteristics in the US population, 1988-91. J Dent Res 1996;  75:  706-13.
8-HassanZade H, Khanehmasjedi M. Prevalence of maxillofacial malocclusion in the 11-14 year old students of Ahvaz school in 2002. Master’s of  Dental Thesis, Ahvaz dentistry Faculty, 2002.[In persian]. 
9-Brook PH, Shaw WC. The development of an index of Orthodontic treatment priority. Eur Orthod 1989 Aug; 11: 309-20.
10-Cons NC, Jenny J, Kohout FJ, Jakobsen J, Shi Y, Ying WH, "et al". Comparing ethic group-specific, DAI equations with the standard DAI. Int Dent J 1994 Apr; 44(2): 153-8.
11-Onyeaso C, Begole EA. Relationship between index of complexity outcome and need, dental aesthetic index, peer assessment rating index, and American Board of orthodontics objective grading system. Am J Orthod Dentofacial  Orthop 2007 Feb; 131(2): 248-52.
12-Daniels C, Richmond S. The development of the index of complexity, outcome and need (ICON). Br J Orthod 2000 Jun; 27(2): 149-62.
13-Borzabadi-Farahani A, Borzabadi-farahani A. Agreement  between   the  index  of  complexity ,outcome and  need and the dental  and aesthetetic  components  of  the  Index  of  Orthodontic Treatment  Need . Am J Orthod Dentofacial Orthop  2011Aug; 140(2): 233-8.
14-Fireston AR, Beck FM, Beglin FM, Vig KWL. Validity of Index of Complexity, Out come and Need (ICON) in determining orthodontic treatment need. Angle orthod 2002 Feb; 72(1): 5-20.
15-Norremose CRN, De Abreu MHNG, De Magalhaes CS, Moreira NA. Validity of two occlusal indices for determining orthodontic treatment needs for patients treated in a public   university in Belo Horizonte, Minas Gerais State, Brazil. Cad Saude   Publica 2011Mar; 27 (3): 581-90.
16-Liao ZY, Jian F, Long H, Lu Y, Wang Y, He YW, "et al". Validity  assessment and determination of the cut off value for the index of  complexity, outcome  and  need  among  12-13 years-old  in  southern  chinese.  Int J Oral Sci 2012 Jun; 4(2): 88-93.
17-Baubiniene D, Sidlauskas A, Miseviciene I. The need for orthodontic treatment among 10–11- and 14–15-years-old Lithuanian school children.  Medicina (Kaunas) 2009; 45(10): 814-21.
 18-Chestnutt IG, Burden DJ, Steele JG, Pitts NB, Nuttall NM, Morris AJ. The orthodontic condition of children in the United Kingdom, 2003. Br Dent J. 2006 Jun 10; 200(11):609-12;quiz 638.
19-Liepa A, Urtane I, Richmond S, Dunstan F. Orthodontic treatment need in Latvia. Eur J Orthod 2003Jun; 25(3): 279–84.
20-Eslamipour F, Asgari I, Farzaneh khoo AR. Frequency of dental anomalies and the need for orthodontic treatment in 12-19 year-old adolescents in Isfahan. J Isfahan Den Sch 2011; 6(5): 543-52. [In Persian] 
21-Feizbakhsh M, Omrani A, Teimori F, Mirlohi F. Orthodontic treatment needs of 14-18 year-old female students of Isfahan in 2009-2010 using IOTN index. J Isfahan Dent Sch 2011; 7(1): 47-52. [In Persian] 
22-Safavi SM, Sefidroodi A, Nouri M, Eslamian L, Kheirieh S, Bagheban AA. Orthodontic treatment need in 14-16 years-old Tehran high school students. Aust Orthod J 2009; 25(1): 8-11.
23-Gabris K, Marton S, Madlena M. Prevalence of malocclusion in Hungarian adolescents. Eur J Orthod 2006 Oct; 28(5):467-70.
24-Khanehmasjedi M, Bassir L, Haghighizadeh M. Evaluation of relationship between orthodontic treatment need according Dental Aesthetic Index (DAI) and student’s perception in 11-14 year old students in the city of Ahvaz in 2005. J Mashhad Dent Sch, Mashhad Uni of Med Sci 2007; 31: 37-46.
25-Urtane I, Pugaca J, Liepa A, Rogovska I. The severity of malocclusion and need for orthodontic treatment in correspondence with the age. Stomatologija 2006; 8(2): 35-8.