Background: The accurate assessment of malocclusion is challenging Establishing a correct diagnosis is of the utmost importance in serving the patient’s and the profession’s need
Objective: the aim of this study was to assess the level of agreement of a panel of orthodontists, considered the “gold standard” in assessing malocclusion. Particularly, this investigation attempted to determine the specific occlusal traits that led to their decision and the level of agreement between orthodontists in prioritizing such traits.
Material and Methods: Thirteen orthodontists from the San Francisco Bay area examined 153 models from the UCSF Orthodontic clinic and recorded the need for treatment of each as a score of 1 – 12 on an adjectival scale.
Results: Twelve occlusal traits were identified as contributory to the orthodontist’s cast score. The presence of impacted teeth and crossbite were the two variables that most influenced the total score. Orthodontists agreed the most on adequacy of midline, function, spacing, and impacted teeth as determinants (or not) of the given score. They agreed the least on alignment, esthetics, overbite or open bite, and the sagittal relationship.
Conclusions: This study presents a new perspective by evaluating agreement in the inclusion of a specific occlusal trait when determining the cast score. We conclude that the assessment of certain occlusal traits of any malocclusion may vary greatly among different orthodontists.