Title: Validation of the Risk Of Malocclusion Assessment (ROMA) index
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. Materials and 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.