Sciote, James J.2024-09-122024-09-122024-08http://hdl.handle.net/20.500.12613/10700Introduction: In the United States, there is currently no universally accepted clinical assessment tool to ensure high quality orthodontic care through routine audit. In this pilot study, I aim to apply the Peer Assessment Rating (PAR) Index to the Temple graduate orthodontic clinic to provide insight on treatment outcomes and distribution of services. To date, this is the first time an established clinically objective measure of malocclusion has been applied to a graduate orthodontic health clinic for routine audit. This audit aims to further investigate: 1. If there are any differences in treatment outcome for patients who had the entirety of their treatment completed with one resident vs patients who were transferred to another resident during their care. 2. If there are any differences in treatment outcome between patients that are paying for their treatment out of pocket vs patients paying through Medicaid insurance programs.Materials and Methods: A pilot study with a retrospective chart review design that will implement a PAR Index audit to assess treatment outcomes at Temple University Graduate Orthodontic Clinic. 3-dimensional scans before and after treatment were analyzed and measured based upon the PAR index established guidelines. Patient funding and transferal status were extracted from dental EHR software and compared utilizing a difference-in-difference estimation. Results: 159 patient treatments were evaluated. Transferred patients had a mean PAR score decrease of 71.14%, and non-transferred patients had a mean PAR score decrease of 62.98%. Privately funded patients had a mean PAR score decrease of 61.29%, and insurance funded patients had a mean PAR score decrease of 72.02%. There was a significant difference in pre-treatment PAR score based on patient transfer status (P = 0.01) and funding (P = 0.01) via Students T-test. There was not a significant difference in post-treatment PAR score based on patient transfer status (P = 0.84) and funding (P = 0.70) via Students T-test. There was a significantly different reduction of PAR score by funding status (P = 0.04), but not by transferal status (P = 0.12) based upon the difference-in-difference estimation via negative binomial regression analysis. Conclusion: Overall, the PAR index can be applied to university orthodontic clinics for routine clinical audit and can provide insight on treatment outcomes and distribution of services. Transferred patient start on average with a significantly more severe malocclusion compared to patients that are not transferred, but their post-treatment PAR scores on average are not significantly different. There was no statistically significant difference treatment outcome between patients who were transferred and those who were not transferred to another resident during treatment. Insurance funded patients start on average with a significantly more severe malocclusion compared to privately funded, but their post-treatment PAR scores on average are not significantly different. There was a significantly greater decrease in PAR score treatment outcome for the insurance funded patients compared to the privately funded patients. Mean PAR score percentage reduction was similar to that of the British regional orthodontic centres in 1995.  57 pagesengIN COPYRIGHT- This Rights Statement can be used for an Item that is in copyright. Using this statement implies that the organization making this Item available has determined that the Item is in copyright and either is the rights-holder, has obtained permission from the rights-holder(s) to make their Work(s) available, or makes the Item available under an exception or limitation to copyright (including Fair Use) that entitles it to make the Item available.http://rightsstatements.org/vocab/InC/1.0/DentistryText157982024-08-30Moletsky_temple_0225M_15798.pdf