[Orthodontic treatment from the patients' and parents' viewpoint--the results of a practical and clinical questionnaire study (II)]

Color fading of the blue compliance indicator encapsulated in removable clear Invisalign Teen® aligners

OBJECTIVE

To evaluate the color fading in aqueous solutions of the blue dot wear-compliance indicators of the Invisalign Teen® System outside the oral cavity.

MATERIALS AND METHODS

The compliance indicators in the Invisalign Teen aligners were tested for color resistance in various aqueous models with no saliva involved.

RESULTS

Color fading was observed as a function of time, pH, and temperature while compliance indicators were stored in drinking water or sour soft drinks and in conjunction with the use of cleaning tablets and a dishwasher. The findings of color fading were consistent with the color changes observed when the aligners were being worn by patients. Color fading, notably as observed in connection with acidic soft drinks and cleaning techniques, introduces uncertainty into the assessment of actual patient compliance, as reflected by the fading colors of compliance indicators.

CONCLUSION

Compliance indicators are not immune to simple intentional or unintentional manipulations. Therefore, they can best show an estimate of wear time but cannot be recommended as objective wear-time indicators.

[The influence of information and communication in the orthodontic consultation and treatment visit. II. The communication style and compliance]

The establishment of a good rapport between dentist and patient is together with providing information a basic prerequisite for successfully motivating the patient to comply with the guidance the dentist provides. Both the style adopted in verbally communicating with the patient and also nonverbal communication play a decisive role in the establishment and maintenance of such a relationship. In the pilot study presented here, which draws on psychological interaction analysis of video recordings taken of the initial consultation with 27 patients and of 28 routine treatment sessions with different patients, the typical interaction patterns between the orthodontist and the patient are objectively assessed and compared. The most important findings of the study were: (1) The mean duration of the chairside sessions was lowest during routine encounters with cooperative patients. (2) During consultations approximately 2/3 of the time was taken up talking to each other. On the other hand, in treatment sessions with uncooperative patients only 1/4 of the time was devoted to verbal communication. (3) The orthodontist dominated the conversation in all groups and especially in conversing with the uncooperative patients. (4) In the consultation sessions the dentist and the patient related relatively strongly to each other. (5) Providing mere information significantly predominated over any discussion of the professional aspects of the treatment. (6) During the consultations eye contact was maintained over almost all of the sessions.(ABSTRACT TRUNCATED AT 250 WORDS)

[A retrospective examination of the acceptance of removable appliances]

In order to study the subjective attitudes of patients and their parents to orthodontic treatment questionnaires were handed out to both groups. One hundred and forty five patient questionnaires and those answered by 114 parents formed the base of the study. The majority of the patients were only able to provide partial answers to precise questions about their treatment. Speech impairment, pressure, and salivation were given as being the most vexatious aspects of the treatment. The majority of the patients and the majority of parents favored removable appliances over fixed appliances. The patients' social environment did not negatively influence their attitude to orthodontic treatment.

[The determinants of wear behavior in treatment with removable orthodontic appliances]

The interplay of significant determinants of patient appliance wear is discussed in terms of a conceptual model reflecting the current state of research in orthodontic compliance. Appliance wear is determined by treatment-related factors such as regimen and perceived comfort, as well as by external factors such as patient personality and parental attitudes. Patient attitudes are the critical link between these influences. In the focus of this article are the patient's experiences and perceptions of treatment and the way they are affected by appliance and prescribed wear. Furthermore, possible measures to enhance compliance are highlighted.

[Recommended times for wearing removable appliances--the results of a survey]

Since prescribed wear times of removable appliances are, in combination with comfort, relevant to compliance, a questionnaire on the prevalence, the nature and the differentiation of such prescriptions in active orthodontic treatment was sent to 300 orthodontists selected at random among the members of the German Orthodontic Society. On the basis of 172 responses (response rate 57.5%), the following results were obtained: In eight to 16-years olds "active" treatment is administered with Schwartz plates in an average of 43.7%, and with functional orthopaedic appliances in an average of 37.6% of the cases, the classical activator (61.1%) and the bionator (58.7%) being used most frequently. Particular times of day or night are prescribed as wear times by some 60% of responders, while others prescribe merely a certain number of hours of daily wear. Identical prescriptions are given to the majority of patients by 86.6%, and are unchanged throughout the course of active treatment by 73.8%. Wear times actually prescribed average 15 (functional appliances) and 16 hours (plates) daily, while the minimum wear time considered necessary for successful treatment averages 12.8 for functional appliances and 13.9 for plates.

[The wear-timing measuring device in orthodontics--cui bono? Reflections on the state-of-the-art in wear-timing measurement and compliance research in orthodontics]

The recent development of fully functioning timing devices has yielded a new impulse to scientific research on orthodontic compliance. In contrast, promises and risks of the practical application of timing devices have thus far largely gone unheeded. In this survey, possible benefits of this new device are considered along with a critical discussion of technical and sociopsychological issues of its practical application. Following a review of the current state of orthodontic timing technology, basic implications of the collection and utilization of this new type of data are outlined. Short- and long-term perspectives of objective measurement of compliance are presented in terms of optimized treatment devices, enhanced patient compliance and improved orthodontist-patient relations. An evaluation project on benefits and risks of orthodontic timing devices is being called for.