Applicability of the IOTN-AC index in a bimaxillary protrusion population

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Responses to questionnaire administered to participants_

Question	1(Not a reason)	2	3	4 (very much a reason)
1. To make my smile nicer	5 (4.5)	17 (15.5)	22 (20.0)	61 (55.5)
2. To help me chew food better	41 (37.3)	27 (24.5)	19 (17.3)	18 (16.4)
3. To make my family happy	70 (63.6)	11 (10.0)	15 (13.6)	9 (8.2)
4. To help me with my schoolwork	88 (80.0)	7 (6.4)	6 (5.5)	4 (3.6)
5. To make my teeth look nicer	7 (6.4)	6 (5.5)	21 (19.1)	71 (64.5)
6. To help my breathing	84 (76.4)	9 (8.2)	8 (7.3)	3 (2.7)
7. To feel more confident	21 (19.1)	14 (12.7)	23 (20.9)	46 (41.8)
8. To help my top and bottom teeth fit together	8 (7.3)	15 (13.6)	24 (21.8)	57 (51.8)
9. To help me speak more clearly	47 (42.7)	21 (19.1)	13 (11.8)	24 (21.8)
10. To make my face look better	31 (28.2)	23 (20.9)	28 (25.5)	23 (20.9)
11. To make me feel better about myself	32 (29.1)	14 (12.7)	23 (20.9)	36 (32.7)
12. To keep my gums healthy	16 (14.5)	19 (17.3)	32 (29.1)	37 (33.6)
13. To make me feel healthier	30 (27.3)	16 (14.5)	17 (15.5)	41 (37.3)
14. To keep me from losing teeth in future	23 (20.9)	15 (13.6)	14 (12.7)	52 (47.3)
15. To help me make friends	84 (76.4)	10 (9.1)	6 (5.5)	5 (4.5)
16. To keep my jaw joints healthy	23 (20.9)	23 (20.9)	25 (22.7)	33 (30.0)
17. To help my front teeth fit together	9 (8.2)	14 (12.7)	31 (28.2)	51 (46.4)
18. To make me look better	25 (22.7)	16 (14.5)	25 (22.7)	39 (35.5)
19. To make me feel better about going out	42 (38.2)	23 (20.9)	19 (17.3)	20 (18.2)
20. To help keep my jaw joint from clicking	47 (42.7)	20 (18.2)	18 (16.4)	19 (17.3)
21. To help my back teeth fit together	26 (23.6)	19 (17.3)	19 (17.3)	40 (36.4)
22. To make it easier to get on with people	79 (71.8)	8 (7.3)	9 (8.2)	8 (7.3)
23. To make it easier to bite into food	40 (36.4)	17 (15.5)	14 (12.7)	34 (30.9)

Inter and intra examiner reliability for orthodontist IOTN scores_

Test	Intra-examiner reliability (IOTN-AC)		Intra-examiner reliability (IOTN-DHC)		Inter-examiner reliability (IOTN-AC)		Inter-examiner reliability (IOTN-DHC)
Spearman’s correlation	0.821	<0.001	0.604	0.002	0.914	<0.001	0.713	<0.001
Cohen’s Kappa	0.681	<0.001	0.477	<0.001	0.872	<0.001	0.599	<0.001

Correlation between patient IOTN AC and Questionnaire items Q1 and Q5_

	IOTN-AC patient vs Q1		Patient IOTN-AC vs. Q5		Q1 vs Q5
Test	p value		p value		p value
Pearson correlation	0.110	0.226	0.143	0.147	0.437	<0.001

Frequency of IOTN scores by severity and gender_

GENDER
	Male (%)	Female (%)	Total (%)
Patient -Ac
Mild	40 (49.4)	41 (50.6)	81 (73.6)
Moderate	7 (63.6)	4 (36.4)	11 (10)
Severe	4 (23.5)	13 (76.5)	17 (15.5)
Total	51 (46.8)	58 (53.2)	109 (99.1)
Missing			1 (0.9)
Orthodontist -Ac
Mild	38 (45.2)	46 (54.8)	84 (76.4)
Moderate	0 (0)	0 (0)	0 (0)
Severe	14 (58.3)	10 (41.7)	24 (21.8)
Total	52 (48.1)	56 (51.9)	108 (98.2)
Missing			2 (1.8)
Orthodontist -DHC
Moderate	5 (50)	5 (50)	10 (9.1)
Severe	47 (47)	53 (53)	100 (90.9)
Total	52 (47.3)	58 (52.7)	110 (100)

Agreement and correlation between patient and orthodontist IOTN AC scores and normative need_

	IOTN-AC patient vs. Orthodontist		Patient IOTN-AC vs. IOTN-DHC		Orthodontist IOTN-AC vs. IOTN-DHC
Test	p value		p value		p value
Spearman’s correlation	0.435	<0.001	0.124	0.198	0.094	0.334
Cohen’s Kappa	0.395	<0.001	0.017	0.307	0.014	0.329