Abstract

Aim: Compare the quality of the completion of the cases through dental models attended by the residents of the Orthodontics postgraduate of Universidad Autonoma of Nuevo Leon.

The residents did not know the criteria measured by the American Board of Orthodontics (ABO) in its phase III and the residents who did understand these criteria, in addition to knowing if the residents met a minimum of 4 criteria.

Materials and Methods: Dental models from the Orthodontics postgraduate archive were used; 98 models in total were analyzed and divided into two groups. Group 1 consisted of residents who did not know the criteria that would be measured, of which 49 models were taken. The other, group 2 did know the requirements; another 49 models were taken. They were evaluated by the same examiner using a millimeter caliper authorized by the American Board of Orthodontics, seven of the eight criteria reviewed by the ABO were examined; these were alignment, marginal ridges, buccolingual inclination, occlusal relationship, occlusal contacts, overjet, and contacts interproximal. A comparison between groups was performed using the Mann-Whitney test, and the result was p=0.05.

Results: No significant differences were found between the two groups. However, the criterion with the lowest negative score or the least failed was interproximal contacts, followed by occlusal contact, marginal ridges, occlusal relationship, overjet, alignment, and buccolingual inclination.

Conclusions: It was concluded that the residents completed the cases the same way whether or not they knew the criteria required by the Board.

Keywords

Dental models; ABO; Phase III; Residents; Postgraduate orthodontics

Introduction

The ABO's mission is to establish and maintain high levels of clinical excellence [1,2]. What is achieved through effective evaluations?

These examinations covered the candidate's knowledge base (Phase II) and clinical skills (Phase III) [3]. To evaluate post-treatment cases and panoramic radiographs, the ABO establishes an index called OGS (Objective grading system) [4]. This index covers eight criteria and is used for candidates to evaluate and prepare their cases anytime. It also helps us to see if we are producing the quality results required by the ABO.

The ABO experience is a learning experience. Knowing the criteria and how to evaluate them helps us recognize our problems when completing an orthodontic case [5].

In the present study, this index was used, and cases treated by residents who knew the measured criteria were compared against those who did not know what would be measured. And to observe if this makes any difference in the management of the completion of the cases [1-10].

Materials and Methods

The study population was 98 models from the Orthodontic Postgraduate Archive of the Autonomous University of Nuevo León; it was divided into two groups; group 1 was made up of dental models of cases completed by residents who did not know what was going to be measured. Group 2 was formed by resident models who knew what they were going to measure.

The selection of the cases was random, and the inclusion criterion was that they fell within any category described by the ABO [6]. Early treatment of malocclusions, malocclusion in adults, class I treated with extractions, deep overbite, class II division 1, class II division 1 treated with extractions, anteroposterior skeletal discrepancy, and transverse discrepancy. The excluded cases were those requiring orthognathic surgery, missing teeth, cleft lip, and palate, patients with different syndromes, and patients who underwent surgery that did not accept surgery and were compensated with orthodontics.

In addition, cases that were measured with a negative score were ≥ 35 points and were eliminated. The criteria evaluated (OGS) [7]: Alignment, marginal ridges, buccolingual inclination, occlusal relationship, occlusal contact, overjet, and interproximal contact. Also, root parallelism was left aside since this criterion is measured in panoramic radiographs, and only models were evaluated in this study (dental). The passing value for each model was established by the total average of the 98 cases; the passing average with seven criteria was ≤ 23, and the value per criterion was ≤ 4. The models were measured by the same person, and, The ABO calibration was used and the advice of Dr. Roberto Justus, a member of the ABO Directors staff, was also consulted.

The data were transferred to sheets designed by the ABO, and the statistical test comparison between groups was performed using the Mann-Whitney test, with p=0.05 were carried out with the SPSS program.

Results

The results were that of the 98 cases, 63 cases failed, with a remaining total of 35 cases approved, of which 17 were from group 1 and 18 cases from group 2 (Graph 1). Comparing the values using the Mann-Whitney test, it was found that there is no significant difference between them (Z=0.366 with a p=0.732).

Graph 1: Shows the distribution of approved cases in the two groups.

The assessment was conducted to see if they met a minimum of 4 criteria and took into account 81 cases in total. There were 17 cases excluded for having a global score of ≥ 35 points. The sample was composed of 38 cases for group 1 and 43 cases for group 2. The value per criterion was ≤ 4, and the results were that 10 cases from group 1 met a minimum of 4 criteria. In group 2, 21 cases met the four criteria. The cases that passed with five criteria were from group 1, yielding 17 cases, and from group 2, there were 11 cases. With six criteria, group 1 had 9 cases, and group 2 had 10 cases. With seven criteria, 2 cases passed in group 1 and only 1 case in group 2 (Graph 2 and Table 1).

Graph 2: Shows the number of cases in the two groups that pass with 4, 5, 6, and 7 criteria.

	Group 1	Group 2	Total
Criteria 4 Frequency % of total	10 12.3%	21 25.9%	31 38.3%
5 Frequency % of total	17 21.0%	11 13.6%	28 34.6%
6 Frequency % of total	9 11.1%	10 12.3%	19 23.5%
7 Frequency % of total	2 2.5%	1 1.2%	3 3.75%
Total Frequency % of total	38 46.9%	43 53.1%	81 100%

Table 1: The number of criteria organizes the total cases that each group met.

The distribution of the criteria that were best met from highest to lowest was as follows: interproximal contact with the total number of cases examined 81; marginal ridges with 68 cases; occlusal contact and occlusal relationship with 65 instances, overjet with 60 cases; and finally buccolingual inclination and alignment with 30 cases.

Discussion

The data obtained in this study demonstrate no significant difference between residents who knew what would be measured versus those who did not know the criteria in the study carried out by Knierim, Roberts, and Hartsfield [3,8]. They compared the completion of cases between residents of the University of Indiana where changes were made in the patient management protocol against another group of residents where those changes had yet to be implemented. The results were that there was an improvement in the completion of the cases when making these changes in the care protocol; these changes were as simple as recognizing the main flaws in the OGS, collecting pre-finished models of the cases, reducing the tendency of transfer cases to successive generations of residents. Another investigation with results that agreed was carried out by Cook, Devon, Harris, and Vaden [9]. They compared cases between Orthodontic students and Orthodontic specialists, and the results were that there were no differences between these groups. Nonetheless, there were criteria that obtained better results in one group than in another; for instance, the specialists obtained better values in marginal ridges and occlusal relationships. The students also had better scores in occlusal contact and interproximal contact. In contrast to these results, the study published by Abei, Amberman, and Hans [11,10]. Where they compared specialists against general dentists, the results showed a statistical difference, with better values for the specialists in the alignment criterion.

Let’s evaluate the criteria that were best met in this research. We observe that interproximal contacts are the ones that obtained the lowest values (best results), which agrees with the results of residents versus specialists. This criterion was best met in students, followed by another that were best met by specialists, such as the marginal ridge criterion. The alignment criterion in this research had the highest values (bad results), and if we compare this with previous studies, we will observe that this criterion marked the difference between specialists and general dentists who practice Orthodontics. If we evaluate in depth the reason for this failure, we can realize that the resident's lack of experience is an important reason why he failed in this criterion; this is demonstrated by the study published by YangsPowers, Sadoswsky, Rosenstein, and Be Gole [7,11]. It is explained that the group of specialists versus residents had higher values in the alignment criterion, justifying that the specialists' models had been rigorously selected and chosen to have a good result. In contrast, the population of residents had been taken at random. Another criterion with high values was buccolingual inclination; this could be because this criterion is related to long-term improvement Nett and Huang [12].

If we consider that the measurements of the criteria in this research were carried out in models taken immediately after the removal of the appliance and did not allow any improvement regarding this criterion [13-17].

Conclusions

Statistically, there is no difference between the group that knew the criteria and those that did not know them; both groups completed the cases correctly according to the ABO. Operator experience is a significant factor that significantly affects the completion of cases, as this is a skill that the resident is on the way to forging.

Conflict of Interests

The authors declare no conflict of interest.

Acknowledgement

Our Thanks to Roberto Justus for the advice provided in this work.

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Article Information

Article Type: RESEARCH ARTICLE

Citation: Torre-Martinez HHH, Tijerina DL, Menchaca-Flores PN, Carrillo-González RJ, del Carmen Theriot Giron M, et al. (2024) Evaluation of Finished Models of the Orthodontics Postgraduate Course at the Universidad Autonoma de Nuevo Leon According to Phase III of the American Board of Orthodontics. Int J Dent Oral Health 10(4): dx.doi.org/10.16966/2378-7090.427

Copyright: © 2024 Torre-Martinez HHH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication history: 

Received date: 08 Oct, 2024

Accepted date: 18 Oct, 2024

Published date: 24 Oct, 2024