Background: The prevalence of malocclusion in Indonesia is still very high, which is about 80% of the population and is one of the major dental and oral health problems. Based on the research result of Health Research and Development Agency of the Ministry of Health of the Republic of Indonesia, the prevalence of the highest malocclusion cases in children aged 12-15 years is 15.6%. Ages 13-15 years there are many disorders in the oral cavity such as dental growth disorder that can cause malocclusion that can affect the function, welfare, and quality of life. Objective: To determine the need for orthodontic treatment based on perceptions of using IKPO in adolescents aged 13-15 years in SMP Muhammadiyah 3 Yogyakarta. Method: This research is an analytical observation research with cross sectional design. The samples are adolescents aged 13-15 years in SMP Muhammadiyah 3 Yogyakarta with 100 randomly selected samples. Each sample completes the IKPO questionnaire and an intraoral photo is taken to see the relationship between orthodontic treatment needs. Results: The results showed 61% of subjects required orthodontic treatment and 63% had Class I malocclusion, 28% had Class II malocclusion and 9% had Class III malocclusions. The analytic result stated that there was a correlation between the questionnaire of orthodontic treatment needs on age with Chi-Square test obtained significant value of 0.037 (p-value <0.05). Conclusion: There is a need for orthodontic treatment based on perceptions of using IKPO in adolescents aged 13-15 years at SMP Muhammadiyah 3 Yogyakarta.