DOI: https://doi.org/10.53350/pjmhs221621185 ORIGINAL ARTICLE P J M H S Vol. 16, No.02, FEB 2022 1185 The value of the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN) in the Assessment of Subjective Orthodontic Treatment Need HAIDER ZAHID 1 , AIMAN NIAZ 2 , SOFIA SHEHZAD 3 , SUNNIYA SAEED 4 , KAINAT KHAN 5 , PALWASHA KHAN 6 1 Registrar, Department of Orthodontics, Sardar Begum Dental Hospital, Gandhara University, Peshawar, Pakistan. 2 House Officer, Department of Peadodontics, Sardar Begum Dental Hospital, Gandhara University, Peshawar, Pakistan. 3 Professor, Department of Preventive and Community Dentistry, Sardar Begum Dental Hospital, Gandhara University, Peshawar, Pakistan 4 Post-Graduate Trainee, Department of Orthodontics, Islamic International Dental Hospital, Riphah University, Islamabad, Pakistan 5 House officer, Department of Peadodontics, Sardar Begum Dental Hospital, Gandhara University, Peshawar, Pakistan. 6 House officer, Department of Peadodontics, Sardar Begum Dental Hospital, Gandhara University, Peshawar, Pakistan. Correspondence to: Dr. Haider Zahid (BDS, MDS), Email: d.haiderzahid1991@gmail.com, Phone: 0345 5777790 ABSTRACT Background: Malocclusion is the most common dental problem. Its correction needs assessment before planning Orthodontic treatment. The index of orthodontic treatment need (IOTN) is one of the most valuable method of grading and evaluating malocclusion. A number of studies stated; using the IOTN have reported that there is limited use of aesthetic component in school going children. Objectives: To estimate whether dental concern expressed by the grade of the AC chosen by subjects is reliable and whether it may be predictive for potential co-operation. Materials and Methods: This study was carried out in school going children of 12 year of age in kpk Pakistan. This study was based on a questionnaire and clinical examination. The questionnaire consists of various items. On the basis of these item questionnaire was filled. Clinical examination was done at the schools each time by the same orthodontist. Statistical analysis was done. Results: Out of total children, 29 were female and 58 were male. Most of the children were satisfied with dental aesthetics. Most of them wanted to change colour of the teeth. Most of the enrolled students were classified in “ no treatment need’ category” followed by “need borderline treatment” category. Satisfaction with aesthetic were also evaluated (P -value <0.090). Conclusion: It was concluded that large number of people were in need of the orthodontic therapy as per the aesthetic component of IOTN. Key words: Index of Orthodontic Treatment Need, Aesthetic Component, Scan scale INTRODUCTION Malocclusion or “bad bites” is one of the most common oral health problem (1). Patients with malocclusion are in need for orthodontic treatment. If such patients are not treated in time then malocclusion will lead to a number of oral health issue. The lethal effects of malocclusions on the oral health are still blurred. Different methods are used to assess the malocclusion in order to stop further complication. There are a number of indices that have been used to classify the malocclusion into different groups according to malocclusion severity. These indices are the Treatment Priority Index (TPI), Summers’ Occlusal index , the Need for Orthodontic Index, the Handicapping Malocclusion Assessment Record, and the Index of Orthodontic Treatment Need (IOTN) (2, 3) . Out of these the best and reliable tool for assessment of orthodontic treatment need is the Index of Orthodontic Treatment Need (IOTN) (4) . In routine clinical practice, most treatment decisions are based on orthodontic treatment need index. The IOTN is an internationally recognized method for objectively evaluating treatment need (5) . In 1989, the Index of Orthodontic Treatment Need was introduced by Brook & Shaw in UK and later renamed as ‘IOTN’ (2, 6) . It is a modified form of index used by the Swedish Dental Health Board (2, 7) . It is a clinical index which categorizes malocclusion on the basis of treatment needs ultimately to compare populations. The main reasons for orthodontic treatment are usually an improvement in facial or dental aesthetic. The IOTN index consists of two parts: (1) Dental Health Component (DHC) and (2) Aesthetic Component (AC) (8, 9) . Both DHC & AC are recorded separately. In this study the Aesthetic Component of the IOTN is used, which comprises of a 10-grade scale illustrated by different colors in intra-oral photographs. The series of photographs shows 3 categories in regard to treatment: (10) Grades 1-4: need no treatment. Grades 5-7: need borderline treatment. Grades 8-10: need severe treatment. Like other countries, the demand for orthodontic treatment is increasing day by day in Pakistan. In Pakistan a number of dental colleges provide such services. Fig: IOTN AC Scale