![]() These indices purport to measure severity of malocclusion objectively, either as a deviation from normal/ideal occlusion or in terms of perceived treatment need. However, in response to an external need for information on the prevalence of malocclusions and for a method to objectively quantify the severity of the various features of malocclusion, several indices have been proposed. Historically, orthodontic diagnosis has been taught and practiced as a descriptive, qualitative subject. These results support the use of the ICON as a validated index of orthodontic treatment need. There was agreement between the expert panel and the index in 155 of the 170 cases. The panel found that 64% of the casts required orthodontic treatment the ICON scores indicated that 65% of the cases needed treatment. The sensitivity (94%), specificity (85%), positive predictive value (92%), negative predictive value (90%), and overall accuracy of the ICON (91%) also confirmed good agreement with the orthodontic specialists. The simple kappa statistic (0.81) indicated very high agreement of the index with the decisions of the expert panel. The results were compared with the decisions of an expert panel of 15 orthodontic specialists from the central Ohio area. One hundred seventy study casts, representing a full spectrum of malocclusion types and severity, were scored for orthodontic treatment need by an examiner calibrated in the ICON. The aim of this study was to investigate the validity of the ICON as an index of orthodontic treatment need compared with the perception of need as determined by a panel of US orthodontists. The Index of Complexity, Outcome, and Need (ICON), based on the perception of 97 orthodontists from 9 countries, has been proposed as a multipurpose occlusal index. Occlusal indices are used to determine eligibility for orthodontic treatment in several publicly funded programs.
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