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Meade MJ, Dreyer CW. An assessment of the treatment information contained within the websites of direct-to-consumer orthodontic aligner providers. Aust Dent J 2020; 66:77-84. [PMID: 33237579 DOI: 10.1111/adj.12810] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND The use of direct-to-consumer (DTC) orthodontic aligners is growing. The purpose of this study was to evaluate the quality of information contained within the websites of DTC orthodontic aligner providers. METHODS Websites that satisfied inclusion criteria were assessed for the presence of specific treatment-related features. Four validated quality of information instruments and readability tools were used to evaluate the content of the websites. Descriptive statistical analyses and intra-examiner reliability tests were performed. RESULTS Twenty-one websites were evaluated. Few websites referred to the need for pre-treatment dental health (38.1%) and indefinite post-treatment retention (23.8%). Most websites (95.2%) were categorized as either 'poor' or 'very poor' according to their DISCERN scores. DISCERN items regarding information bias and treatment risks scored particularly poorly. Cohen's kappa intra-examiner reliability testing for DISCERN scores was 0.81-0.89. Three websites honoured two out of the four Journal of the American Medical Association benchmarks and 18 honoured one benchmark only. The readability scores indicated 'difficult to read' content. CONCLUSIONS The quality of information contained within the websites of DTC orthodontic aligner providers is poor. Patient consent for DTC aligner treatment based solely on the information contained within the websites is likely to be invalid.
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Affiliation(s)
- M J Meade
- Orthodontic Unit, School of Dentistry, The University of Adelaide, Adelaide, South Australia, Australia
| | - C W Dreyer
- Orthodontic Unit, School of Dentistry, The University of Adelaide, Adelaide, South Australia, Australia
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Long H, Wu Z, Yan X, Wang Q, Liu L, Wang Y, Jian F, Liao L, Li X, Lai W. An objective system for appraising clear aligner treatment difficulty: clear aligner treatment complexity assessment tool (CAT-CAT). BMC Oral Health 2020; 20:312. [PMID: 33167950 PMCID: PMC7654177 DOI: 10.1186/s12903-020-01300-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 10/28/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Recent years have witnessed a remarkable evolution of clear aligner technology and clear aligners are becoming more and more versatile in treating orthodontic patients. The aim of this study was to develop an objective evaluation system for assessing clear aligner treatment difficulty. METHODS A total of 120 eligible patients (100 patients for developing and testing the evaluation system and 20 patients for validating this system) were recruited in this retrospective cross-sectional study. Based on clinical data (dental models, radiographs and photographs), complexity levels of cases were evaluated by two experts and regarded as the gold standard. Difficulty scores were determined through an evaluation system encompassing three domains (dental model analysis, radiographic examinations and clinical examinations). The reliability of the evaluation system was examined through analyzing the agreement between complexity levels and difficulty scores. Moreover, multivariable linear regression test was used to examine the independent association of each variable (e.g. overbite and crowding) with the complexity level. RESULTS The results revealed that the assessment of treatment difficulty by this objective evaluation system substantially matched the gold standard (R2 = 0.80). The multivariable regression test revealed that complexity level was significantly associated with difficulty score (p < 0.001), age (p = 0.015), tooth extraction (p < 0.001), treatment stage (p < 0.01) and the number of difficult tooth movement (p = 0.005). This objective evaluation system elaborated in this study was viable and reliable in appraising clear-aligner treatment difficulty in clinical practice. CONCLUSIONS We suggest orthodontists and general practitioners use this objective evaluation system (CAT-CAT) to appraise clear aligner treatment difficulty and to select appropriate clear aligner patients.
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Affiliation(s)
- Hu Long
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhouqiang Wu
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xinyu Yan
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qingxuan Wang
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lu Liu
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Wang
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Jian
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lina Liao
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaolong Li
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenli Lai
- Department of Orthodontics, State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Bustati N, Rajeh N. The impact of COVID-19 pandemic on patients receiving orthodontic treatment: An online questionnaire cross-sectional study. J World Fed Orthod 2020; 9:159-163. [PMID: 33221177 PMCID: PMC7584421 DOI: 10.1016/j.ejwf.2020.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/14/2020] [Accepted: 10/16/2020] [Indexed: 12/14/2022]
Abstract
Background The spread of Coronavirus Disease 2019 (COVID-19) has led to a major public health issue; most dental clinics were closed and millions of orthodontic patients were unable to complete their treatment. This study aimed to assess the challenges faced by patients receiving orthodontic treatment and their preferred solutions to overcoming these challenges during this pandemic. Methods An online questionnaire was developed and sent to patients receiving orthodontic treatment at a public or private clinic. Results A total of 388 responses were analyzed: mean age 20.4 ± 4 years, 75% (291) female, and 58% (226) received their treatment at a public clinic. Of all participants, 27.3% (106) were still unable to attend their appointments and 69% (244) stated that closing of the clinic was the main reason for missing their appointments. Depending on their type of appliance, the patients faced different problems and chose multiple ways to deal with them. Most participants had fixed appliances, 84% (327), and only 21% (64) of them stated that they had no problem compared with 39% (11) and 36% (8) for removable appliance and clear aligner groups, respectively. Conclusion The COVID-19 pandemic has had a significant impact on orthodontic treatments. Almost every orthodontic patient had to stop attending their appointments, which put them in complicated situations and in fear of delayed treatment. Patients from a public clinic and patients with fixed appliances reported more problems than others. More attention should be giving to teleorthodontics; also orthodontists should prepare their patients to deal with some of the problems related to their appliances when possible.
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Affiliation(s)
- Nour Bustati
- Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria.
| | - Nada Rajeh
- Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
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