Angle’s Classification Versus Dental Aesthetic Index in Evaluation of Malocclusion among Turkish Orthodontic Patients

Objective: To evaluate Angle's classification and dental aesthetic index (DAI) in interpretation of malocclusion among orthodontic patients. Methods: A total of 457 orthodontic patients (284 female, 173 male) between 9 to 17 years old who referred to the orthodontic clinic were included in this study. Malocclusion prevalence, the severity of malocclusion and treatment requisite were evaluated as was the association between DAI and Angle's classification. Pearson Chi-square test was used for the comparison of categorical data. p<0.05 was considered as significant. Results: The percentage of patients with DAI =25 indicating little or no need for treatment was 20.8% and 52.7% (DAI =31) had highly desirable or mandatory need for treatment. Among patients with DAI =25, a significantly high percentage of patients were in Class I (37.0%) (p<0.001). Significantly higher percentage of patients were having DAI score of =35 in Class II/1(42.6%) and Class II/2 (36.5%) than Class I (18.8%) and Class III (31.3%) groups (p<0.001). Only 50.1% of patients with Class III malocclusion were associated with appropriate DAI scores (=31) of severity and treatment need category. Conclusion: Only 52.7% of patients referring to orthodontic clinic revealed DAI score of =31 suggesting severe, very severe or disabling malocclusion with highly desirable or mandatory orthodontic treatment requisite. Although DAI seems sensitive to detect the presence of Angle's classification based malocclusion, it may be improved in terms of severity and treatment requisite criteria. While the complementary use of the two methods seems to be feasible and is suggested in all-inclusive evaluation and care for patients with malocclusion in clinical practice.