{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T12:57:44Z","timestamp":1761397064667,"version":"build-2065373602"},"reference-count":15,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,8,9]],"date-time":"2025-08-09T00:00:00Z","timestamp":1754697600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthod"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To test the validity and reliability of The Spacing Index (TSI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A single-centre diagnostic study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Orthodontic Department, Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester, UK<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>TSI was outlined based on the principle of mild spacing (0\u20134 mm), moderate spacing (5\u20138 mm) and severe spacing (&gt;8 mm). A total of 53 anonymised study models were selected as a convenience sample of patients attending hypodontia multidisciplinary clinics. A range of cases with different amounts of spacing in each arch was chosen. Each model was measured by ML-C in millimetres using calibrated Vernier callipers and then subdivided to give the gold standard spacing TSI categorisation of mild, moderate or severe. Two test raters (CB and NM) then visually assessed the same study models and rated the spacing as mild, moderate or severe. Comparison of the gold standard rating and the test rating was made to assess the validity of TSI. The reliability of the index was assessed by both the gold standard and test raters 2 weeks later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The weighted kappa score was 0.79 (substantial agreement) between the gold standard rater and the test raters for the mild, moderate and severe TSI categories. The weighted kappa scores were greater than 0.80, demonstrating almost perfect intra-observer reliability over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The proposed TSI has been shown to be valid and reliable and could be used to categorise spacing during routine orthodontic assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14653125251358833","type":"journal-article","created":{"date-parts":[[2025,8,9]],"date-time":"2025-08-09T11:23:06Z","timestamp":1754738586000},"page":"270-274","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["The Spacing Index (TSI): A diagnostic classification for spaced dentitions"],"prefix":"10.1177","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3219-6277","authenticated-orcid":false,"given":"Minnie","family":"Lyons-Coleman","sequence":"first","affiliation":[{"name":"Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Bates","sequence":"additional","affiliation":[{"name":"Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4888-0804","authenticated-orcid":false,"given":"Nicky","family":"Mandall","sequence":"additional","affiliation":[{"name":"Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Bassett","sequence":"additional","affiliation":[{"name":"Statsconsultancy Ltd, Amersham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,9]]},"reference":[{"key":"e_1_3_2_2_1","first-page":"45","article-title":"Assessment of mandibular arch length discrepancy utilizing an individualized arch form","volume":"41","author":"Beazley WW","year":"1971","unstructured":"Beazley WW (1971) Assessment of mandibular arch length discrepancy utilizing an individualized arch form. Angle Orthodontist 41: 45\u201354.","journal-title":"Angle Orthodontist"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016356408993963"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.ejo.a035999"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2004.01.005"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ortho.27.1.47"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ortho.27.2.149"},{"key":"e_1_3_2_8_1","first-page":"75","article-title":"Teeth spacing: Etiology and treatment","volume":"10","author":"Gkantidis N","year":"2007","unstructured":"Gkantidis N, Psomiadis S, Topouzelis N (2007) Teeth spacing: Etiology and treatment. Hellenic Orthodontic Review 10: 75\u201392.","journal-title":"Hellenic Orthodontic Review"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.21164\/pomjlifesci.54"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1067\/mod.2000.109031"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_3_2_12_1","volume-title":"Contemporary Orthodontics","author":"Proffit WR","year":"2000","unstructured":"Proffit WR (2000) Contemporary Orthodontics. 3rd edn. St Louis, MO: Mosby.","edition":"3"},{"key":"e_1_3_2_13_1","article-title":"Revisiting the Delphi technique in orthodontics: A systematic review sorting review articles","volume":"15","author":"Rao G","year":"2021","unstructured":"Rao G, Iskandar YH, Mokhtar N (2021) Revisiting the Delphi technique in orthodontics: A systematic review sorting review articles. Journal of Clinical and Diagnostic Research 15: ZE01\u2013ZE05.","journal-title":"Journal of Clinical and Diagnostic Research"},{"key":"e_1_3_2_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejo\/14.2.125"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-5406(95)70151-6"},{"key":"e_1_3_2_16_1","volume-title":"Oral Health Surveys: Basic Methods","author":"World Health Organization","year":"1977","unstructured":"World Health Organization (1977) Oral Health Surveys: Basic Methods. 2nd edn. 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