Accuracy of digital American Board of Orthodontics Discrepancy Index measurements.

INTRODUCTION: A digital analysis that is shown to be accurate will ease the demonstration of initial case complexity. To date, no literature exists on the accuracy of the digital American Board of Orthodontics Discrepancy Index (DI) calculations when applied to pretreatment digital models. METHODS: Plaster models were obtained from 45 previous patients with varying degrees of malocclusion. Total DI scores and the target disorders were computed manually with a periodontal probe on the original plaster casts (gold standard) and digitally using Ortho Insight 3D (Motion View Software, Hixson, Tenn) and OrthoCAD (Cadent, Carlstadt, NJ). Intrarater and interrater reliabilities were assessed for 15 subjects using the Spearman rho correlation test. Accuracies of the DI scores and target disorders were assessed for all 45 subjects using Wilcoxon signed ranks tests. RESULTS: Intrarater and interrater reliabilities were high for total DI scores and most target disorders (r > 0.8). No significant difference was found between total DI score when measured with OrthoCAD compared with manual calculations. The total DI scores calculated by Ortho Insight 3D were found to be significantly greater than those by manual calculation by 2.71 points. CONCLUSIONS: The findings indicate that a DI calculated by Ortho Insight 3D may lead the clinician to overestimate case complexity. OrthoCAD's DI module was demonstrated to be a clinically acceptable alternative to manual calculation of the total scores.

A report of the ABO Resident Clinical Outcome Study (the pilot study).

INTRODUCTION: A 4-year collaborative project between the American Board of Orthodontics (ABO) and 15 American orthodontic graduate programs concluded at the ABO Clinical Examination in February 2006. METHODS: Fifty recent graduates (the pilot study group) presented cases that were treated in their graduate programs as partial fulfillment of the requirements for ABO certification. The examinees were tested by calibrated ABO examiners and required to satisfy traditional ABO standards. They presented appropriate case reports that contained the ABO's 3 measurement instruments. Thirty-nine practicing orthodontists (the control group) presented cases according to the traditional ABO Clinical Examination process. RESULTS: Ninety percent of the pilot study group and 85% of the control group successfully accomplished ABO certification. There was a difference of 2.38 points between the 2 groups for the mean total scores of the cases that passed. The pilot study group presented cases that met the historic averages for case complexity (discrepancy index). CONCLUSIONS: Residents in orthodontic programs are able to treat cases to ABO standards of quality.

The American Board of Orthodontics: Diplomate recertification.

Although some specialty certifying boards began recommending or requiring recertification of their "boarded" specialists as early as 1986, recertification is a relatively new concept for the specialty of orthodontics. In the mid 1990s, the American Board of Orthodontics (ABO) recognized that many other medical and dental specialty boards had already established voluntary or mandatory recertification policies and decided to establish its own time-limited certifying policy. After a series of field tests involving former directors, council members of the College of Diplomates of the ABO, and volunteer diplomates, the ABO instituted a recertification policy for candidates who applied for initial certification after January 1, 1998. Since then, the total number of diplomates who have been recertified has steadily increased. Surveys of successfully recertified diplomates reflect a positive feeling about the process. When medical and dental specialists are expected to be more accountable, recertification has been shown to be a valid method to help ensure continued competency. The ABO believes that the formulation of educational and certifying processes to document a diplomate's clinical competency throughout his or her career will help to serve the public welfare. The ABO is attempting to make initial certification and periodic recertification attainable for more orthodontists and, in so doing, to provide a standard by which we exist as a specialty.

The ABO discrepancy index: a measure of case complexity.

A criterion for determining the acceptability of a case presented for the American Board of Orthodontics (ABO) Phase III clinical examination is case difficulty. Case difficulty can often be subjective; however, it is related to case complexity, which can be quantifiable. Over the past 5 years, the ABO has developed and field-tested a discrepancy index, made up of various clinical entities that are measurable and have generally accepted norms. These entities summarize the clinical features of a patient's condition with a quantifiable, objective list of target disorders that represent the common elements of an orthodontic diagnosis: overjet, overbite, anterior open bite, lateral open bite, crowding, occlusion, lingual posterior crossbite, buccal posterior crossbite, ANB angle, IMPA, and SN-GoGn angle. The greater the number of these conditions in a patient, the greater the complexity and the greater the challenge to the orthodontist. The ABO is considering several options for applying the discrepancy index to the Phase III clinical examination.