Is there a need for orthodontic plaque indices?--diagnostic accuracy of four plaque indices.
OBJECTIVE
The aim of this study was to assess the diagnostic performance and accuracy of four plaque indices for orthodontic patients.


METHODS
The plaque accumulation of 140 maxillary incisors with bonded brackets was recorded using intra-oral photographs and assessed using four different plaque indices: the orthodontic plaque (OP) index, the modified orthodontic plaque (MOP) index, the Quigley and Hein (QHP) index and the modified Navy plaque (MNP) index. The assessment was performed twice within a time interval of 4 weeks by four different examiner groups: orthodontists, dentists, students and orthodontic assistants.


RESULTS
No significant differences were detected for the OP and MOP indices among the examiner groups. A significant difference was found for the QHP and MNP indices. The inter- and intra-examiner reliability of the OP and MOP indices was good. In contrast, the reliability for the QHP and MNP indices was moderate to poor with few exceptions. The discrimination performance of the OP and MOP indices was excellent. The sum of the sensitivity and specificity was generally lower for the QHP and MNP indices compared with the OP and MOP indices.


CONCLUSIONS
OP and MOP indices showed good performance. The QHP and MNP indices are not appropriate for orthodontic purposes.


CONCLUSIONS
Traditional plaque indices reflect the typical pattern of plaque accumulation for patients without multi-bracket appliances. The performance of these indices for orthodontic patients has never been investigated. Orthodontic plaque indices that focus on the surface along the gingival margin and areas around the bracket exhibit higher diagnostic performance and accuracy compared with traditional indices.
Department of Orthodontics, Ludwig-Maximilians-University, Munich, Germany. epaschos@med.uni-muenchen.de.
Ekaterini
E
Paschos
Department of Restorative Dentistry, Periodontology and Pediatric Dentistry, Ludwig-Maximilians-University, Munich, Germany.
Katharina
K
Bücher
Department of Restorative Dentistry, Periodontology and Pediatric Dentistry, Ludwig-Maximilians-University, Munich, Germany.
Karin C
KC
Huth
Department of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany.
Alexander
A
Crispin
Department of Orthodontics, Ludwig-Maximilians-University, Munich, Germany.
Andrea
A
Wichelhaus
Dental School, Ludwig-Maximilians-University, Munich, Germany.
Tamina
T
Dietel
D003774:Dental Plaque Index; D006801:Humans; D009970:Orthodontics