{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T16:02:30Z","timestamp":1780070550701,"version":"3.54.0"},"reference-count":68,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective:<\/jats:title>\n To evaluate the outcome of early treatment in Class I, II, and III malocclusions based on the reduction of weighted Peer Assessment Rating (PAR) scores.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n Two hundred thirty subjects (female = 105; male = 125) selected from 400 cases were divided into three groups based on their malocclusions (Class I, II, and III). The PAR index was evaluated prior to early treatment (T0), at the end of phase I (T1), and after completion of phase II therapy (T2). The reliability of overall PAR scores was assessed by Bland-Altman plot and intraclass correlation coefficient. The starting age, total weighted PAR scores and their changes after phase I and II treatments, treatment time, and the percentage of correction in the three different malocclusions were assessed by repeated-measures analysis of variance with post hoc analysis. The level of significance was set at\n P<\/jats:italic>\n < .05.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n More than 30% reduction of the weighted PAR scores and less than 10 points of the remaining weighted PAR scores were observed in all malocclusion groups at T1. The Class III group had the highest percentage of correction during phase I treatment.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Early treatment effectively reduced the complexity of Class I, II, and III malocclusions and accounted for 57%, 64%, and 76% of the total correction, respectively, after phase I treatment, as indicated by an overall reduction in weighted PAR scores. The Class III group responded most favorably to early treatment followed by the Class II group.<\/jats:p>\n <\/jats:sec>","DOI":"10.2319\/091417-618.1","type":"journal-article","created":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T10:28:01Z","timestamp":1520418481000},"page":"253-258","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of early treatment outcomes rendered in three different types of malocclusions"],"prefix":"10.2319","volume":"88","author":[{"given":"Valmy","family":"Pangrazio-Kulbersh","sequence":"first","affiliation":[{"name":"Adjunct Professor, Department of Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, Mich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He-Kyong","family":"Kang","sequence":"additional","affiliation":[{"name":"Adjunct Associate Professor, Department of Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, Mich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archana","family":"Dhawan","sequence":"additional","affiliation":[{"name":"Private practice, Royal Oak, Mich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riyad","family":"Al-Qawasmi","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, Mich"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael Rocha","family":"Pacheco","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Dental Materials, School of Dentistry, University of Detroit Mercy, Detroit, Mich"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-88-3-253-b01","series-title":"J Dent","first-page":"477","article-title":"Is orthodontics prior to 11 years of age evidence-based? 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Angle Orthod. 2015;85:510\u2013517."},{"key":"i0003-3219-88-3-253-b03","series-title":"Cochrane Database Syst Rev","article-title":"Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children","author":"Thiruvenkatachari \n B,","year":"2013","unstructured":"Thiruvenkatachari \n B, \n \n \n Harrison \n JE, \n \n \n Worthington \n HV, \n \n \n O'Brien \n KD. \n \n \n Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children. Cochrane Database Syst Rev. 2013;(11):CD003452."},{"key":"i0003-3219-88-3-253-b04","series-title":"Cochrane Database Syst Rev","article-title":"Orthodontic treatment for posterior crossbites","author":"Agostino \n P,","year":"2014","unstructured":"Agostino \n P, \n \n \n Ugolini \n A, \n \n \n Signori \n A, \n \n \n Silvestrini-Biavati \n A, \n \n \n Harrison \n JE, \n \n \n Riley \n P. \n \n \n Orthodontic treatment for posterior crossbites. Cochrane Database Syst Rev. 2014;(8):CD000979."},{"key":"i0003-3219-88-3-253-b05","series-title":"Angle Orthod","first-page":"264","article-title":"Longitudinal occlusal changes from primary to permanent dentition in children with normal primary occlusion","volume":"69","author":"Legovic \n M,","year":"1999","unstructured":"Legovic \n M, \n \n \n Mady \n L. \n \n \n Longitudinal occlusal changes from primary to permanent dentition in children with normal primary occlusion. Angle Orthod. 1999;69:264\u2013266."},{"key":"i0003-3219-88-3-253-b06","series-title":"Angle Orthod","first-page":"728","article-title":"Prevalence and change of malocclusions from primary to early permanent dentition: a longitudinal study","volume":"85","author":"Dimberg \n L,","year":"2015","unstructured":"Dimberg \n L, \n \n \n Lennartsson \n B, \n \n \n Arnrup \n K, \n \n \n Bondemark \n L. \n \n \n Prevalence and change of malocclusions from primary to early permanent dentition: a longitudinal study. Angle Orthod. 2015;85:728\u2013734."},{"key":"i0003-3219-88-3-253-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"492","article-title":"Deciduous-dentition malocclusion predicts orthodontic treatment needs later: findings from a population-based birth cohort study","volume":"147","author":"Peres \n KG,","year":"2015","unstructured":"Peres \n KG, \n \n \n Peres \n MA, \n \n \n Thomson \n WM. \n \n \n Deciduous-dentition malocclusion predicts orthodontic treatment needs later: findings from a population-based birth cohort study. Am J Orthod Dentofacial Orthop. 2015;147:492\u2013498."},{"key":"i0003-3219-88-3-253-b08","series-title":"Early-Age Orthodontic Treatment","article-title":"Bahreman Aliakbar","year":"2013","unstructured":"Bahreman Aliakbar. Early-Age Orthodontic Treatment. Hanover Park, IL: Quintessence;2013."},{"key":"i0003-3219-88-3-253-b09","series-title":"Principles in Contemporary Orthodontics","article-title":"Early treatments in orthodontics","author":"Lahcen \n O,","year":"2011","unstructured":"Lahcen \n O, \n \n \n Lazrak \n L. \n \n \n Early treatments in orthodontics. In: Naretto, S, ed.Principles in Contemporary Orthodontics. London, United Kingdom: Intech;2011:251\u2013276."},{"key":"i0003-3219-88-3-253-b10","series-title":"Semin Orthod","first-page":"246","article-title":"Unlocking orthodontic malocclusions: an interplay between form and function","volume":"4","author":"Gugino \n CF,","year":"1998","unstructured":"Gugino \n CF, \n \n \n Dus \n I. \n \n \n Unlocking orthodontic malocclusions: an interplay between form and function. Semin Orthod. 1998;4:246\u2013255."},{"key":"i0003-3219-88-3-253-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"463","article-title":"Evaluation of the peer assessment rating (PAR) index as an index of orthodontic treatment need","volume":"122","author":"Firestone \n AR,","year":"2002","unstructured":"Firestone \n AR, \n \n \n Beck \n FM, \n \n \n Beglin \n FM, \n \n \n Vig \n KW. \n \n \n Evaluation of the peer assessment rating (PAR) index as an index of orthodontic treatment need. Am J Orthod Dentofacial Orthop. 2002;122:463\u2013469."},{"key":"i0003-3219-88-3-253-b12","series-title":"Eur J Orthod","first-page":"180","article-title":"The P.A.R. index (Peer Assessment Rating): methods to determine outcome of orthodontic treatment in terms of improvements and standards","volume":"14","author":"Richmond \n S,","year":"1992","unstructured":"Richmond \n S, \n \n \n Shaw \n WC, \n \n \n Roberts \n CT, \n \n \n Andrews \n M. \n \n \n The P.A.R. index (Peer Assessment Rating): methods to determine outcome of orthodontic treatment in terms of improvements and standards. Eur J Orthod. 1992;14:180\u2013187."},{"key":"i0003-3219-88-3-253-b13","series-title":"Am J Orthod Dentofacial Orthop","first-page":"172","article-title":"The validation of the Peer Assessment Rating index for malocclusion severity and treatment difficulty","volume":"107","author":"De Guzman \n L,","year":"1995","unstructured":"De Guzman \n L, \n \n \n Bahiraei \n D, \n \n \n Vig \n KWL, \n \n \n Vig \n P, \n \n \n Weyant \n RJ, \n \n \n O'Brien \n K. \n \n \n The validation of the Peer Assessment Rating index for malocclusion severity and treatment difficulty. Am J Orthod Dentofacial Orthop. 1995;107:172\u2013176."},{"key":"i0003-3219-88-3-253-b14","series-title":"Angle Orthod","first-page":"164","article-title":"Orthodontic outcomes assessment using the peer assessment rating index","volume":"71","year":"2001","unstructured":"Allen Dyken R, Sadowsky PL, Hurst D. Orthodontic outcomes assessment using the peer assessment rating index. Angle Orthod. 2001;71:164\u2013169."},{"key":"i0003-3219-88-3-253-b15","series-title":"Acta Medica","first-page":"203","article-title":"PAR index in the evaluation of the stability of the orthodontic treatment results: a review","volume":"49","author":"Ramanthan \n C.","year":"2006","unstructured":"Ramanthan \n C. \n \n \n PAR index in the evaluation of the stability of the orthodontic treatment results: a review. Acta Medica2006;49:203\u2013207."},{"key":"i0003-3219-88-3-253-b16","series-title":"Am J Orthod Dentofacial Orthop","first-page":"489","article-title":"Comparison of peer assessment ratings (PAR) from 1-phase and 2-phase treatment protocols for class II malocclusions","volume":"123","author":"King \n GJ,","year":"2003","unstructured":"King \n GJ, \n \n \n McGorray \n SP, \n \n \n Wheeler \n TT, \n \n \n Dolce \n C, \n \n \n Taylor \n M. \n \n \n Comparison of peer assessment ratings (PAR) from 1-phase and 2-phase treatment protocols for class II malocclusions. Am J Orthod Dentofacial Orthop. 2003;123:489\u2013496."},{"key":"i0003-3219-88-3-253-b17","series-title":"Am J Orthod Dentofacial Orthop","first-page":"592","article-title":"The effectiveness of phase I orthodontic treatment in a Medicaid population","volume":"127","author":"Mirabelli \n JT,","year":"2005","unstructured":"Mirabelli \n JT, \n \n \n Huang \n GJ, \n \n \n Siu \n CH, \n \n \n King \n GJ, \n \n \n Omnell \n L. \n \n \n The effectiveness of phase I orthodontic treatment in a Medicaid population. Am J Orthod Dentofacial Orthop. 2005;127:592\u2013598."},{"key":"i0003-3219-88-3-253-b18","series-title":"Am J Orthod Dentofacial Orthop","first-page":"235","article-title":"Effect of early treatment on stability of occlusion in patients with Class II malocclusion","volume":"133","author":"Pavlow \n SS,","year":"2008","unstructured":"Pavlow \n SS, \n \n \n McGorray \n SP, \n \n \n Taylor \n MG, \n \n et al. \n Effect of early treatment on stability of occlusion in patients with Class II malocclusion. Am J Orthod Dentofacial Orthop. 2008;133:235\u2013244."},{"key":"i0003-3219-88-3-253-b19","series-title":"Treatment of Malocclusion of the Teeth: Angle's System","author":"Angle \n EH.","year":"1907","unstructured":"Angle \n EH. \n \n \n Treatment of Malocclusion of the Teeth: Angle's System. Philadelphia, PA: White Dental Manufacturing Company;1907."},{"key":"i0003-3219-88-3-253-b20","series-title":"Semin Orthod","first-page":"188","article-title":"Leeway space and the resolution of crowding in the mixed dentition","volume":"3","author":"Gianelly \n AA.","year":"1995","unstructured":"Gianelly \n AA. \n \n \n Leeway space and the resolution of crowding in the mixed dentition. Semin Orthod. 1995;3:188\u2013194."},{"key":"i0003-3219-88-3-253-b21","series-title":"Orthdodontic and Orthopedic Treatment in the Mixed Dentition","author":"McNamara \n JA\n Jr,","year":"1993","unstructured":"McNamara \n JA\n Jr, \n \n \n Brudow \n WL. \n \n \n Orthdodontic and Orthopedic Treatment in the Mixed Dentition. 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Am J Orthod Dentofacial Orthop. 2000;118:414\u2013420."},{"key":"i0003-3219-88-3-253-b32","series-title":"Am J Orthod Dentofacial Orthop","first-page":"7.e9","article-title":"Long-term stability of Class III treatment: rapid palatal expansion and protraction facemask vs LeFort I maxillary advancement osteotomy","volume":"131","author":"Pangrazio-Kulbersh \n V,","year":"2007","unstructured":"Pangrazio-Kulbersh \n V, \n \n \n Berger \n J, \n \n \n Janisse \n FN, \n \n \n Bayirli \n B. \n \n \n Long-term stability of Class III treatment: rapid palatal expansion and protraction facemask vs LeFort I maxillary advancement osteotomy. Am J Orthod Dentofacial Orthop. 2007;131:7.e9\u2013e19."},{"key":"i0003-3219-88-3-253-b33","series-title":"Nephron Clin Pract","first-page":"214","article-title":"Cohort studies: prospective versus retrospective","volume":"113","author":"Euser \n AM,","year":"2009","unstructured":"Euser \n AM, \n \n \n Zoccali \n C, \n \n \n Jager \n KJ, \n \n \n Dekker \n FW. \n \n \n Cohort studies: prospective versus retrospective. Nephron Clin Pract. 2009;113:214\u2013217."},{"key":"i0003-3219-88-3-253-b34","series-title":"Am J Orthod Dentofacial Orthop","first-page":"544","article-title":"Early treatment outcome assessed by the Peer Assessment Rating index","volume":"115","author":"Pangrazio-Kulbersh \n V,","year":"1999","unstructured":"Pangrazio-Kulbersh \n V, \n \n \n Kaczynski \n R, \n \n \n Shunock \n M. \n \n \n Early treatment outcome assessed by the Peer Assessment Rating index. 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Angle Orthod. 2015;85:510\u2013517."},{"key":"i0003-3219-88-3-253-b03","series-title":"Cochrane Database Syst Rev","article-title":"Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children","author":"Thiruvenkatachari \n B,","year":"2013","unstructured":"Thiruvenkatachari \n B, \n \n \n Harrison \n JE, \n \n \n Worthington \n HV, \n \n \n O'Brien \n KD. \n \n \n Orthodontic treatment for prominent upper front teeth (Class II malocclusion) in children. Cochrane Database Syst Rev. 2013;(11):CD003452."},{"key":"i0003-3219-88-3-253-b04","series-title":"Cochrane Database Syst Rev","article-title":"Orthodontic treatment for posterior crossbites","author":"Agostino \n P,","year":"2014","unstructured":"Agostino \n P, \n \n \n Ugolini \n A, \n \n \n Signori \n A, \n \n \n Silvestrini-Biavati \n A, \n \n \n Harrison \n JE, \n \n \n Riley \n P. \n \n \n Orthodontic treatment for posterior crossbites. 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Angle Orthod. 2015;85:728\u2013734."},{"key":"i0003-3219-88-3-253-b07","series-title":"Am J Orthod Dentofacial Orthop","first-page":"492","article-title":"Deciduous-dentition malocclusion predicts orthodontic treatment needs later: findings from a population-based birth cohort study","volume":"147","author":"Peres \n KG,","year":"2015","unstructured":"Peres \n KG, \n \n \n Peres \n MA, \n \n \n Thomson \n WM. \n \n \n Deciduous-dentition malocclusion predicts orthodontic treatment needs later: findings from a population-based birth cohort study. Am J Orthod Dentofacial Orthop. 2015;147:492\u2013498."},{"key":"i0003-3219-88-3-253-b08","series-title":"Early-Age Orthodontic Treatment","article-title":"Bahreman Aliakbar","year":"2013","unstructured":"Bahreman Aliakbar. Early-Age Orthodontic Treatment. Hanover Park, IL: Quintessence;2013."},{"key":"i0003-3219-88-3-253-b09","series-title":"Principles in Contemporary Orthodontics","article-title":"Early treatments in orthodontics","author":"Lahcen \n O,","year":"2011","unstructured":"Lahcen \n O, \n \n \n Lazrak \n L. \n \n \n Early treatments in orthodontics. In: Naretto, S, ed.Principles in Contemporary Orthodontics. London, United Kingdom: Intech;2011:251\u2013276."},{"key":"i0003-3219-88-3-253-b10","series-title":"Semin Orthod","first-page":"246","article-title":"Unlocking orthodontic malocclusions: an interplay between form and function","volume":"4","author":"Gugino \n CF,","year":"1998","unstructured":"Gugino \n CF, \n \n \n Dus \n I. \n \n \n Unlocking orthodontic malocclusions: an interplay between form and function. Semin Orthod. 1998;4:246\u2013255."},{"key":"i0003-3219-88-3-253-b11","series-title":"Am J Orthod Dentofacial Orthop","first-page":"463","article-title":"Evaluation of the peer assessment rating (PAR) index as an index of orthodontic treatment need","volume":"122","author":"Firestone \n AR,","year":"2002","unstructured":"Firestone \n AR, \n \n \n Beck \n FM, \n \n \n Beglin \n FM, \n \n \n Vig \n KW. \n \n \n Evaluation of the peer assessment rating (PAR) index as an index of orthodontic treatment need. 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