Validation of the Risk Of Malocclusion Assessment (ROMA) index

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ABSTRACT

Aim

The aim of this study was to validate the ROMA (Risk Of Malocclusion Assessment) Index, verifying both its
reproducibility and its ability to determine treatment priority.

Methods

The levels of treatment priority assessed for
75 children examined at the Gemelli General Hospital Orthodontic Service (Rome) ranged from grade 3 to grade 5 of the index.
Multivariate analysis was conducted to verify the influence of covariates on the dependent variable. Moreover, the DHC of the IOTN was
assessed for all patients, and a bivariate analysis was carried out to investigate its relationship with the ROMA Index. Intra- and inter-
examiner reliability was calculated on a sample of 20 children, and the reproducibility of the index was evaluated using the Kappa
statistic as a measure of concordance.

Results

It arose that there is an inverse relation between risk grades and the time interval
from the first examination and start of treatment. According to the index, patients at extreme risk require immediate treatment, whereas
priority is lower in case of great or moderate risk. In statistical terms, the study revealed a significant correlation between the ROMA
Index and the DHC of the IOTN. With regard to intra- and inter-examiner reliability, the data collected by the two examiners showed a
high level of agreement.

Conclusion

The ROMA index appears quick to apply, reproducible, reliable and sensitive as a mean for
carefully identifying different dento-skeletal problems. Furthermore, it is able to determine the priority of every risk grade and the
corresponding timing of treatment.

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