The Efficacy of Early Orthodontic Treatment Using the ICON

Orthodontists today question the benefits of phase-one orthodontic treatment. Objective: This study used the Index of Complexity, Outcome, and Need (ICON) as an objective measure of the need for phase two treatment after a phase-one was completed. Methods: The sample consisted of 172 phase 1 subjects treated by one orthodontist (TXgroup). Birthdate, gender, Angle classification, appliances used, and initial(T0) and final(T1) treatment dates were abstracted from patient records. This sample was compared to 172 untreated control subjects from the Bolton Study (CTgroup). Between group differences were evaluated with paired t-tests and a p-value < 0.05 was used to assign statistical significance. According to ICON protocol, treatment is "optional" when ICON scores are below 43. Results: At T0 the mean ICON score for TXgroup was 78.66 ± 12.91 versus 76.56 ± 10.52 for the CTgroup.This difference was not signficant(NS). At T1 the mean ICON for TXgroup was 64.80 ± 17.86 versus 76.94 ± 10.55 for CTgroup (P<0.05). Twenty of the 172 (11%) treated subjects had post treatment ICON scores less than 43. The mean score (T0) for the "optional" group (TXopt)was 68.75 ± 10.87 and for the other 152 subjects (TXneeded)was 79.96 ± 12.62 (p=NS). The final score (T1) for the TXopt group was 33.85 ± 6.37 versus 68.67 ± 14.74 for the TXneeded group (P<0.05). Conclusion: Using ICON, 11% of the TXgroup moved from the "treatment needed" to the "treatment optional" category. No subjects in the CTgroup changed categories.