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Comparing Salzmann Index Inter-arch deviation among Medicaid Patients seeking orthodontic treatment in Pennsylvania

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Thesis/Dissertation
Date
2024-06
Advisor
Godel, Jeffrey H.
Committee member
Sciote, James J.
Doumit, Carmen
Group
Department
Oral Biology
Subject
Dentistry
 Malocclusion
 Medicaid
 Orthodontics
 Salzmann
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http://hdl.handle.net/20.500.12613/10716
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Seebold_temple_0225M_15795.pdf
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DOI
http://dx.doi.org/10.34944/dspace/10678
Abstract
Introduction: The Salzmann Evaluation Index (SEI) was chosen by the state of Pennsylvania to evaluate the treatment needs of prospective orthodontic patients and to help determine the allocation of funding for orthodontic treatment, with a score of 25 being the threshold for funding allocation. This study will compare the summed scores of the columns under the inter-arch deviation (IAD) rows, which represent eight types of malocclusion (overjet, overbite, anterior crossbite, anterior openbite, Class II, Class III, posterior crossbite, and posterior openbite) to determine whether there is a difference in the scores of those approved and denied orthodontic insurance coverage. Materials and Methods: 560 Patients with SEI >25, submitted for Medicaid orthodontic insurance approval from Temple University were stratified into “approved” (n=289) and “unapproved” (n=271) for treatment. Their mean IAD column scores (representing the malocclusions listed above) were compared and tested with Wilcoxon test for significance. Results: Anterior crossbite, anterior openbite, posterior crossbite, and posterior openbite were identified as significantly higher scores in the “approved” group compared to the “unapproved” group. Overjet, overbite, Class II, and Class III had no significant differences between approved and unapproved groups. Conclusions: Patients with anterior crossbite, anterior openbite, posterior crossbite, and posterior openbite may be more likely to receive coverage for orthodontic treatment by Medicaid insurance companies in Pennsylvania. Scores denoting presence of overjet, overbite, Class II, and Class III malocclusions were not different in patients approved and denied coverage for orthodontic treatment.
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