Methods of assessing and grading malocclusion: a review.

Methods of assessing and grading malocclusion are reviewed under the headings: Diagnostic, Epidemiological, Treatment need, Treatment success and Treatment complexity. Historic and current usage, together with an appraisal of some of their advantages and weaknesses, are presented. The multifactorial and multivariate nature of malocclusion makes any single classification not only difficult but also of limited value in dentofacial assessment. Angle's classification, which is widely used, was originally devised as a prescription for orthodontic treatment planning: not as an epidemiological tool. Many of the indices developed to assess treatment need may be criticised for lack of objectivity. Most of the current indices of treatment standards show low intra- and inter-examiner variability when compared with those used for diagnostic or epidemiological purposes. To date, no suitable index has been developed to measure treatment complexity.