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Open Access Research article

Orthodontic treatment of children/adolescents with special health care needs: an analysis of treatment length and clinical outcome

Moritz Blanck-Lubarsch1*, Ariane Hohoff1, Dirk Wiechmann2 and Thomas Stamm1

Author Affiliations

1 Department of Orthodontics, University Hospital Muenster, Westphalian Wilhelms-University, Muenster, Germany

2 Department of Orthodontics, Hannover Medical School, Hannover, Germany

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BMC Oral Health 2014, 14:67  doi:10.1186/1472-6831-14-67

Published: 11 June 2014



The aim of this retrospective study was to analyse the treatment time and differences between the pre- and post-treatment peer assessment rating (PAR) index and aesthetic component (AC) of the index of orthodontic treatment need (IOTN) scores in children/adolescents with special health care needs (SHCNs), compared to non-special health care needs (NSHCNs) controls.


Based on certain inclusion and exclusion criteria, medical records of SHCNs and randomly selected NSHCNs controls at the Department of Orthodontics, University Hospital Muenster were analysed retrospectively for the treatment time, number of appointments, chair time (“moderate” or “considerable”), PAR scores, and AC scores. Sample size calculation, descriptive statistics, and explorative analyses were performed using the Mann–Whitney U Test.


Twenty-nine children with SHCNs (21 boys, 9 girls; median age: 11 years, pre-treatment) and 29 children with NSHCNs (12 boys, 17 girls; median age: 12 years, pre-treatment) were enrolled in this study.

The overall treatment time did not differ between the patient groups. However, more “considerable chair time” was needed for the SHCNs group compared to the control group (p < 0.05), whereas “moderate chair time” was more often needed in patients with NSHCNs (p = 0.001).

The age of the patients at the first and last appointments showed significant statistical differences: children in the SHCNs group commenced orthodontic treatment earlier, by a median of 1 year, compared to children in the NSHCNs group.

The SHCNs group had significantly higher pre- and post-treatment PAR scores (median 21/median 6) and AC scores (median 9/median 3) compared to NSHCNs patients (PAR: median 17/median 0; AC: median 5/median 1).

However, the overall treatment time and the overall PAR and AC score reduction did not differ significantly between the SHCNs and NSHCNs groups.


While the overall treatment time and number of appointments did not differ, the overall chair time was higher in the SHCNs group. The pre- and post-treatment PAR and AC scores were significantly higher in the SHCNs group.

Orthodontic treatment; Children/adolescents with special health care needs (SHCNs); Treatment time; Success; Peer assessment rating (PAR) index; Index of orthodontic treatment need (IOTN); Aesthetic component (AC)