This new index incorporates features of both the Index of Orthodontic Need (IOTN) and the Peer Assessment Rating (PAR). The aesthetic component of IOTN is included along with scores for upper arch crowding/spacing; presence of cross-bite; overbite/open bite, and buccal segment relationship. As in the PAR, weightings are added to reflect current orthodontic opinion. The sum of the scores and their weightings gives a pretreatment score, which is said to reflect the need for, and likely complexity of, the treatment required. Following treatment the index is scored again to give an improvement grade (pretreatment score minus 4 × post-treatment score) and thus the outcome of treatment. This ambitious index is currently undergoing evaluation

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