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Index of orthodontic treatment need (IOTN) IOTN - Grade 3 The aesthetic component The aesthetic component has 10 grades. The observer is meant to score the severity of the malocclusion in comparison with the image scale below. Trying to match malocclusion to the images is incorrect, these are for guidance only. ©Copyright European Orthodontic Society (Ruth Evans and William Shaw, Preliminary evaluation of an illustrated scale for rating dental attractiveness, European Journal of Orthodontics 9:314-318)