Quality and Efficiency of Treatment – our Quality Study since 2011
Quality of Results
At the end of your orthodontic treatment your teeth should be straight and symmetrical and your bite should be unimpaired and in the regular position with no doubt at all. Since many patients are not aware of this, occasionally an orthodontic treatment is only performed for the visible front teeth, neglecting all other findings. This is acceptable in adults after extensive consultation, but should be exceptional in the treatment of children and adolescents. We not only strive for the highest possible quality of results, but have also measured our quality since 2011 with the internationally known PAR Index.
Our treatment outcomes have been continuously evaluated with the PAR Index from 2011 to 2015 by an independent scientist from Cardiff University (Wales, UK). Since 2016, the evaluation has been performed by Dr. Madsen who has been trained and calibrated for the PAR Index, without any apparent impact on the results. In the beginning, difficult cases have up to 50 PAR points, easy-to-treat cases around 10 points. Good quality of orthodontics is assessed when the PAR Index is 5 points or less and the percentage improvement is at least 70% at the end of treatment. We distinguish comprehensive treatments in which all findings are corrected, aesthetic treatments only for the anterior teeth and small early treatments in primary school children. About 90% of our patients receive comprehensive treatment. The evaluation of the year 2017 resulted in the following values:
Practice in Mannheim
- Comprehensive treatments: PAR at the beginning 24.57 points, at the end 4.64 points which makes 19.93 points of absolute improvement, 81.1% percentage improvement.
Practice in Ludwigshafen
- Comprehensive treatments: PAR at the beginning 23.86 points, at the end 5.98 points which makes 17.88 points of absolute improvement, 74.9% percentage improvement.
The slightly better values from our practice in Mannheim can be explained by the fact that in 2017 only about a quarter of the treatments was completed in comparison to our practice in Ludwigshafen. The results are very good in both practices compared to values published in the literature. In the comprehensive treatments, our quality of results is even comparable to the best results published in the scientific literature.
Efficiency of Treatments
Noteworthy is the efficiency of our treatments: as our treatment durations are particularly short, this leads to an extremely good PAR improvement per year. In 2017, for most of our patients, we had an average treatment time of 14.9 months (Mannheim) and 17.4 months (Ludwigshafen) for the comprehensive treatments. Thus, we achieve an improvement of 19.21 points per year (practice Mannheim), 14.17 points per year (practice Ludwigshafen). The extremely good results in Mannheim can once again be explained by the fact that not many treatments were completed there in 2017. This practice had been opened since March 2017. This simply gave more time and attention to each patient.
The results mentioned are very good values, which are otherwise hardly found in literature – especially not in Germany. Our patients benefit from the extraordinary efficiency of the treatment: good results in an unusually short time! By contrast, in German PAR studies an annual improvement of well below 10 PAR points is usually achieved, sometimes even a modest 3 points per year. This indicates a poor ratio of effort and benefits that is specific to German orthodontics.
The comprehensive quality measurement continues indefinitely and still shows very good results with a constant end-PAR between 5 and 6. However, since 2011 we have been able to reduce the average duration of treatment by almost 10%. The average treatment duration for comprehensive treatments has been reduced to less than 18 months in both practices since 2017. This shows how our patients benefit from our high quality standards.