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Alawdi GM, Al Fahad MF, Al Muzher SB, Alfaifi AH, Hazeem AM, Dakheel RS, Jan RH, Al-Qutub LM, Alharbi LH, Khalil A. Does Invisalign Outperform Fixed Appliance in Treating Vertical Discrepancies? Cureus 2024; 16:e65973. [PMID: 39221357 PMCID: PMC11365740 DOI: 10.7759/cureus.65973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2024] [Indexed: 09/04/2024] Open
Abstract
Aligners became popular among adult patients for their superior aesthetics and comfort in comparison to conventional fixed appliances. It has undergone numerous enhancements over time, allowing it to address more complex malocclusions. Many researchers argued that managing vertical discrepancies is more challenging than addressing anteroposterior issues. This complexity arose from the mechanical requirements for treatment and the required mechanics to prevent relapse. Studies assessing the treatment outcome of anterior open bite closure using clear aligners have yielded conflicting results regarding the mechanisms of bite closure. Proposed mechanisms included extrusion of upper or lower incisors, lingual tipping of upper or lower incisors, intrusion of upper or lower molars, counterclockwise rotation of the mandible, or various combinations of these mechanisms. The research highlighted the biomechanical challenges associated with using aligners for the treatment of deep bites as mandibular incisor intrusion and leveling the curve of Spee remain among the least predictable movements. Given the widespread use of aligners, it is imperative to rigorously assess the effectiveness of clear aligners in achieving overbite correction to ensure they deliver the desired outcome. This review aimed to assess the performance of Invisalign in the management of vertical discrepancies. It sought to identify the dentoskeletal effects of clear aligners in addressing deep bite and anterior open bite cases, understand the mechanisms behind overbite correction, and provide a comprehensive overview of the existing research on this topic.
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Baumer C, Schmidtmann I, Ohlendorf D, Ferrari Peron P, Wehrbein H, Erbe C. Orthodontists' instructions for oral hygiene in patients with removable and fixed orthodontic appliances. Int J Dent Hyg 2024; 22:329-336. [PMID: 37845796 DOI: 10.1111/idh.12763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/01/2023] [Accepted: 09/03/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION The aim of this questionnaire-based survey was to evaluate information on frequencies, instructions and products relating to oral hygiene (OH) in orthodontic practices. METHODS Using a computer-generated randomization list, 1000 orthodontists were selected and sent a questionnaire. The size and number of inhabitants of the federal states of Germany were considered. The federal states with the highest return rate (Baden-Wuerttemberg [BW], Bavaria [B], Hesse [H], Lower Saxony [LS], Nordrhein-Westphalia [NRW]) were considered and differences between the 16 federal states were divided into North, South, East and Central Germany. RESULTS The response rate of the questionnaires was 52.4%. The majority (53.8%) worked in one practice alone. Most (59.1%) have been orthodontists for 5-25 years. For vestibular multibracket appliances (MBA) in BW, B, H and LS over 90% recommended interdental brushes (IDB). In NRW 91.4% recommend fluoride gel. In B and H more than 80% chose electric toothbrush (ETB), in BW, LS and NRW more than 80% manual toothbrush (MTB). For lingual MBA (LMBA) in BW, H, LS and NRW with approximately 50% each fluoride gel, IDB and MTB were chosen. In B fluoride gel, IDB and ETB. For removable apparatus (RA), five federal states recommended MTB (>80%) and ETB (BW, B, H > 80%; NRW > 70%; LS > 60%). CONCLUSION Electric toothbrushes are recommended for the use with all appliances, only with removable appliances manual toothbrushes are favoured. For vestibular MBA it is strongly advised to use IDB additionally.
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Affiliation(s)
- Christina Baumer
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Daniela Ohlendorf
- Social Medicine and Environmental Medicine, Institute of Occupational Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Priscila Ferrari Peron
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Heinrich Wehrbein
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Christina Erbe
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
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Nahajowski M, Lis J, Sarul M. Orthodontic Compliance Assessment: A Systematic Review. Int Dent J 2022; 72:597-606. [PMID: 35961844 PMCID: PMC9485511 DOI: 10.1016/j.identj.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The aim of this review was to determine whether the type of removable appliance, as well as the age and sex of the patient, may affect the extension or reduction of wear time by assessing the correlation between the mean actual and orthodontist-recommended wear times. METHODS Randomised case control trials, cohort studies, case series, observational studies, reviews, and retrospective analyses were identified. The quality of the studies was assessed using the Cochrane Collaboration Tool and modified Newcastle-Ottawa Scale. The electronic databases Embase, PubMed, Scopus, and Web of Science were reviewed, and 542 articles were obtained, of which 31 were qualified for qualitative synthesis. The data from 1674 participants were collected and a weighted average was determined for the mean wear time of each appliance. RESULTS Regardless of the type of extra- or intraoral appliances, mean wear time was shorter than recommended, although patients using intraoral appliances cooperated more. The best compliance was noted for Schwarz appliances (73.70%) and plate retainers (85%). There was no evidence of an influence of patients' age and sex on compliance during treatment. CONCLUSIONS The considerable inconsistency and imprecision of articles could affect the reliability of the results. Previous studies analysing the effectiveness of treatment with removable appliances based on an arbitrarily assumed average wear time need to be revised in order to verify the actual wear time with the use of microsensors.
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Affiliation(s)
- Marek Nahajowski
- Department of Integrated Dentistry, Wroclaw Medical University, Wroclaw, Poland.
| | - Joanna Lis
- Department of Orthodontics and Dentofacial Orthopedics, Wroclaw Medical University, Wroclaw, Poland
| | - Michał Sarul
- Department of Integrated Dentistry, Wroclaw Medical University, Wroclaw, Poland
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Frilund E, Sonesson M, Magnusson A. Patient compliance with Twin Block appliance during treatment of Class II malocclusion: a randomized controlled trial on two check-up prescriptions. Eur J Orthod 2022; 45:142-149. [PMID: 35968672 PMCID: PMC10065135 DOI: 10.1093/ejo/cjac046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Compliance is crucial for the treatment outcome with removable appliances. Previous studies on treatment with the Twin Block appliance have focused on effectiveness in relation to other treatment methods or wear-time. Studies on different check-up intervals to improve compliance seem to be lacking. OBJECTIVES To compare the impact of two different check-up prescriptions on patient compliance and treatment outcome during treatment with Twin Block. TRIAL DESIGN Two-arm parallel group, single-centre, randomized controlled trial. MATERIALS AND METHODS Seventy-three patients, 38 boys, and 35 girls, mean age 11.2 years, were included and block-randomized into two groups treated with a Twin Block appliance. Group 1 was called for check-up visit every sixth week and group 2 every fourth week. Compliance was evaluated with a TheraMon® microsensor, moulded into the appliance, measuring wear-time. Overjet, overbite, and molar relationships were assessed on study casts before and after treatment. The treatment outcomes were analysed on an intention-to-treat basis. RESULTS In group 1, the reduction of overjet was 5.2 mm and the mean wear-time was 6.9 hours. In group 2, the reduction was 4.7 mm and the wear-time was 6.1 hours. Seventy-four per cent of the patients presented an overjet of 4 mm or less. Wear-time did not correlate to age, gender, or severity of malocclusion. HARMS No harm was observed in any patient. Lateral open bites were registered during treatment but were normalized at the end of the treatment. LIMITATIONS The trial was a single-centre study and long-term effects were not evaluated. CONCLUSIONS During treatment with the Twin Block appliance, a 4-week check-up interval did not improve treatment outcome or increase wear-time, compared to a 6-week check-up interval. The mean wear-time was 6.5 hours per day, even if the recommendation was 12 hours. CLINICAL TRIAL REGISTRATION NCT05155774.
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Affiliation(s)
- Erik Frilund
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.,Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Mikael Sonesson
- Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Orthodontics, Section 4, University of Malmö, Malmö, Sweden
| | - Anders Magnusson
- Department of Orthodontics, The Institute for Postgraduate Dental Education, Jönköping, Sweden.,Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Factors Influencing Appliance Wearing Time during Orthodontic Treatments: A Literature Review. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157807] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This review aims to analyze the multiple factors affecting patients’ level of compliance (how much they wear removable devices/clear aligners) during orthodontic treatments and to investigate the available methods and devices to monitor the appliance wearing time and to improve it. A literature search was conducted on electronic databases (Pubmed, Scopus, and Google Scholar). The results of the present study suggest that compliance indicators may misestimate the intraoral wearing time. Compliance is affected by patient-related factors (age, personality traits, the importance of personal appearance, self-perception of malocclusion), appliance-related factors (visibility, pain/discomfort), and clinician-related factors (trust, clear and complete communication, motivation). The motivation of pre-pubertal patients is mostly external, while adolescents/young adults have intrinsic motivation for orthodontic treatment. Patients’ self-reports tend to overestimate the appliance wearing time. Even if there is a lack of evidence, teledentistry might improve patients’ awareness of being monitored, thus increasing the time for which orthodontic devices are worn. Compliance is a key factor for clear aligner treatments, but high-quality studies focusing on this aspect are missing. Further studies should focus on how to handle the lack of cooperation and how to increase compliance in order to maximize the treatment’s results.
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A comparative assessment of the dentoskeletal effects of clear aligners vs miniplate-supported posterior intrusion with fixed appliances in adult patients with anterior open bite. A multicenter, retrospective cohort study. Am J Orthod Dentofacial Orthop 2022; 162:214-228.e4. [PMID: 35339320 DOI: 10.1016/j.ajodo.2021.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION This study aimed to retrospectively evaluate the dentoskeletal effects of clear aligners (Invisalign) vs miniplate-supported posterior intrusion (MSPI) and identify factors associated with posttreatment overbite in adults with anterior open bite. METHODS Twenty-nine patients treated with Invisalign and 24 with MSPI combined with full-fixed orthodontic appliances were included from 5 orthodontic practices. Pretreatment and posttreatment lateral cephalometric measurements were included as outcomes. Comparisons across groups and identification of final overbite predictors were assessed with regression modeling and machine learning techniques. RESULTS MSPI induced significantly greater maxillary molar intrusion (1.5 mm; 95% confidence interval [CI], 0.83-2.17; P <0.001), with subsequent reduction of anterior face height (ANS-Me) (-2.77 mm; 95% CI, -3.64 to -1.91; P <0.001), Mp-SN° (-1.95°; 95% CI, -2.77 to -1.12; P <0.001), and ANB° (-1.69°; 95% CI, -2.44 to -0.94; P <0.001) compared with Invisalign. MSPI resulted in a significantly larger increase in SNB° (0.94°; 95% CI, 0.23-1.65; P = 0.01) and point-Pog projection (2.45 mm; 95% CI, 1.12-3.77; P = 0.001). Compared with MSPI, Invisalign had a significantly greater increase in the distance of maxillary (1.05 mm; 95% CI, 0.38-1.72; P = 0.003) and mandibular (0.9 mm; 95% CI, 0.19-1.60; P = 0.01) incisal edges relative to their apical bases, with borderline greater lingual tipping of only the maxillary incisors (2.82°; 95% CI, -0.44 to 6.09; P = 0.09). Appliance type and initial overbite were significant final overbite predictors across all models. However, this difference was only evident in male patients (males [1.65; 95% CI, 0.99-2.32; P <0.001]; female [-0.04; 95% CI, -0.52 to 0.44; P = 0.87]). CONCLUSIONS Both appliances effectively improve overbite. MSPI applied the correction via molar intrusion and counterclockwise mandibular autorotation, whereas Invisalign via maxillary and mandibular incisor extrusion.
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Nahajowski M, Lis J, Sarul M. The Use of Microsensors to Assess the Daily Wear Time of Removable Orthodontic Appliances: A Prospective Cohort Study. SENSORS 2022; 22:s22072435. [PMID: 35408050 PMCID: PMC9003140 DOI: 10.3390/s22072435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/18/2022] [Accepted: 03/19/2022] [Indexed: 11/19/2022]
Abstract
Orthodontic treatment with removable appliances is still common in children and adolescents. However, their effectiveness depends primarily on the patients’ compliance. Currently, it is possible to check the daily wear time (DWT) of the removable appliances using special microsensors. The aim of this prospective cohort study was to assess the degree of patients’ compliance depending on the type of removable appliance used. In total, 167 patients (87 F, 80 M) were enrolled in the study and were treated with block appliances (Klammt, Twin-Block), Schwarz plates, and block appliances in combination with headgear. All patients were followed up for 6 months with the mean daily wear time checked at followup visits using TheraMon® microsensors fitted in the appliances. It has been shown that the type of appliance influences the patients’ compliance. The DWT for the Twin Block was significantly longer compared to the DWT for the other appliances. Girls have been shown to wear removable appliances better than boys. It has been proven that the majority of patients do not follow the orthodontist’s recommendations, wearing removable appliances for just over half of the recommended time. Microsensors can be used for objective verification of patients’ compliance, which allows for a reliable assessment of the effectiveness of treatment with removable appliances.
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Affiliation(s)
- Marek Nahajowski
- Department of Integrated Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
- Clinic of Orthodontics, Academic Policlinic of Stomatology, Krakowska 26, 50-425 Wroclaw, Poland;
- Correspondence:
| | - Joanna Lis
- Clinic of Orthodontics, Academic Policlinic of Stomatology, Krakowska 26, 50-425 Wroclaw, Poland;
- Department of Orthodontics and Dentofacial Orthopedics, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
| | - Michał Sarul
- Department of Integrated Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
- Clinic of Integrated Dentistry, Academic Policlinic of Stomatology, Krakowska 26, 50-425 Wroclaw, Poland
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Arreghini A, Trigila S, Lombardo L, Siciliani G. Objective assessment of compliance with intra- and extraoral removable appliances. Angle Orthod 2016; 87:88-95. [PMID: 27508935 DOI: 10.2319/020616-104.1] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To conduct an objective assessment of the level of compliance in young patients prescribed various types of removable appliances and to determine the influence of device type, treatment duration, and patient age, gender, psychological maturity, and awareness of monitoring on compliance. MATERIALS AND METHODS A total of 30 patients were fitted with either a class 2 (Frankel or bionator) or a class 3 (face mask) removable appliance, each bearing a compliance indicator chip, and they were instructed to wear them for 13 hours per day. Compliance was monitored by means of the sensor for an average of 8 months. Of the patients, 14 were informed that their appliance was fitted with a monitoring sensor, and 16 were not. The psychological maturity of all patients was assessed on the Nowicki-Strickland Locus of Control Scale, and the effect on compliance of this score as well as the patient- and treatment-related variables considered were determined via statistical analysis Results: The mean compliance recorded by the chips was 8.6 ± 2.9 hours, far lower than the 13 hours prescribed, and younger patients showed significantly greater compliance than adolescents (P < .01). However, no significant differences in compliance were found between intra- and extraoral appliances, and neither gender, psychological scores, treatment duration, nor awareness of being monitored had any significant effect. CONCLUSIONS Compliance is generally very poor in young patients, regardless of their gender and psychological maturity. Although awareness of monitoring does not appear to boost compliance, such systems may be a valuable means of providing a dentist with objective information regarding their patients' compliance.
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Schott TC, Meyer-Gutknecht H, Mayer N, Weber J, Weimer K. A comparison between indirect and objective wear-time assessment of removable orthodontic appliances. Eur J Orthod 2016; 39:170-175. [DOI: 10.1093/ejo/cjw026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kushida CA, Nichols DA, Holmes TH, Miller R, Griffin K, Cardell CY, Hyde PR, Cohen E, Manber R, Walsh JK. SMART DOCS: a new patient-centered outcomes and coordinated-care management approach for the future practice of sleep medicine. Sleep 2015; 38:315-26. [PMID: 25409112 PMCID: PMC4288613 DOI: 10.5665/sleep.4422] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 10/10/2014] [Indexed: 11/03/2022] Open
Abstract
ABSTRACT The practice of medicine is currently undergoing a transformation to become more efficient, cost-effective, and patient centered in its delivery of care. The aim of this article is to stimulate discussion within the sleep medicine community in addressing these needs by our approach as well as other approaches to sleep medicine care. The primary goals of the Sustainable Methods, Algorithms, and Research Tools for Delivering Optimal Care Study (SMART DOCS) are: (1) to introduce a new Patient-Centered Outcomes and Coordinated-Care Management (PCCM) approach for the future practice of sleep medicine, and (2) to test the PCCM approach against a Conventional Diagnostic and Treatment Outpatient Medical Care (CONV) approach in a randomized, two-arm, single-center, long-term, comparative effectiveness trial. The PCCM approach is integrated into a novel outpatient care delivery model for patients with sleep disorders that includes the latest technology, allowing providers to obtain more accurate and rapid diagnoses and to make evidence-based treatment recommendations, while simultaneously enabling patients to have access to personalized medical information and reports regarding their diagnosis and treatment so that they can make more informed health care decisions. Additionally, the PCCM approach facilitates better communication between patients, referring primary care physicians, sleep specialists, and allied health professionals so that providers can better assist patients in achieving their preferred outcomes. A total of 1,506 patients 18 y or older will be randomized to either the PCCM or CONV approach and will be followed for at least 1 y with endpoints of improved health care performance, better health, and cost control. CLINICAL TRIALS NUMBER http://www.clinicaltrials.gov, NCT02037438.
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Affiliation(s)
| | | | | | | | - Kara Griffin
- Sleep Medicine and Research Center, Chesterfield, MO
| | | | | | - Elyse Cohen
- Stanford Sleep Medicine Center, Redwood City, CA
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Mantie-Kozlowski A, Pitt K. Treating myofunctional disorders: a multiple-baseline study of a new treatment using electropalatography. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2014; 23:520-529. [PMID: 25178428 DOI: 10.1044/2014_ajslp-14-0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 08/15/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE This study assessed the benefit of using electropalatography (EPG) in treatment aimed at habilitating individuals with nonspeech orofacial myofunctional disorders (NSOMD). METHOD The study used a multiple-baseline design across 3 female participants who were referred for an evaluation and possible treatment of their NSOMD. Treatment sessions were 30 min and provided twice weekly. Participant 1 received 8 treatments, Participant 2 received 6 treatments, and Participant 3 received 4 treatments. The patterns of sensor activation produced when participants' tongues made contact with the electropalate during saliva swallows were compared with the patterns of age-matched peers. Individualized goals were developed on the basis of these comparisons. RESULTS Treatment was generally effective for the established goals. Of the 3 participants, 2 met all their goals, and the 3rd participant made gains across 1 of 2 goals. Participants continued to perform above baseline levels for most targeted goals during testing 5-8 weeks posttreatment. CONCLUSION When used in skilled treatment, EPG has potential as a means of habilitating NSOMD. It may serve as a valuable tool, providing the clinician and client with information that allows for individualized treatment planning.
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Methods to evaluate compliance of patients with removable appliances—survey results. J Orofac Orthop 2014; 75:144-53. [DOI: 10.1007/s00056-013-0202-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 07/09/2013] [Indexed: 10/25/2022]
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Habit breaking appliance for multiple corrections. Case Rep Dent 2013; 2013:647649. [PMID: 24198976 PMCID: PMC3808727 DOI: 10.1155/2013/647649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 08/29/2013] [Indexed: 11/17/2022] Open
Abstract
Tongue thrusting and thumb sucking are the most commonly seen oral habits which act as the major etiological factors in the development of dental malocclusion. This case report describes a fixed habit correcting appliance, Hybrid Habit Correcting Appliance (HHCA), designed to eliminate these habits. This hybrid appliance is effective in less compliant patients and if desired can be used along with the fixed orthodontic appliance. Its components can act as mechanical restrainers and muscle retraining devices. It is also effective in cases with mild posterior crossbites.
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Pauls A, Nienkemper M, Panayotidis A, Wilmes B, Drescher D. Effects of wear time recording on the patient's compliance. Angle Orthod 2013; 83:1002-1008. [PMID: 23611166 PMCID: PMC8722835 DOI: 10.2319/010913-25.1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2013] [Accepted: 03/01/2013] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVE To assess the effect of wear-time recording on subjective and objective wear time. MATERIALS AND METHODS This study retrospectively examined a group of 18 patients and a control group of 14 patients at four appointments over 168 days. The patients were treated with removable appliances with embedded TheraMon-microsensors to be worn for 15 hours per day. The study group was not told about the microsensor until the first appointment after fitting of the appliance. At each appointment patients were asked about their subjective wear time and afterward were told about the objective wear time. The existence of the microsensor was revealed to the control group when the appliance was fitted. Objective wear time was also announced at every appointment. RESULTS Mean wear times did not significantly differ between groups at any appointment or regarding overall wear time. Highly significant differences between subjective and objective wear time were found when patients did not know that their wear time had been monitored. CONCLUSION Mean wear times assessed in this study concur with data of previous studies. Patients tend to overestimate their wear times but become more realistic once they know wear time is being monitored. Objective measurement of wear time allows a more realistic view of compliance by patient and orthodontist. Knowing that wear time is recorded does not necessarily increase the amount of time removable appliances are worn by the patient.
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Affiliation(s)
- Alexander Pauls
- Researcher, Department of Orthodontics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Manuel Nienkemper
- Instructor, Department of Orthodontics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Agamemnon Panayotidis
- Researcher, Department of Orthodontics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Benedict Wilmes
- Associate Professor, Department of Orthodontics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Dieter Drescher
- Professor and Department Chair, Department of Orthodontics, Heinrich-Heine-University, Düsseldorf, Germany
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The Hybrid Aesthetic Functional (HAF) Appliance: A Less Visible Proposal for Functional Orthodontics. Case Rep Dent 2013; 2013:298671. [PMID: 23956884 PMCID: PMC3730209 DOI: 10.1155/2013/298671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 07/02/2013] [Indexed: 12/01/2022] Open
Abstract
In modern orthodontics, aesthetics appear to have a decisive influence on orthodontic appliance preferences and acceptability. This paper reports the early application of a newly emerged functional device with enhanced aesthetics in a Class II treatment. Patient perspectives and technical considerations are discussed along with recommendations for further design development. It can be assumed that the use of thermoplastic material-based appliances may meet both the therapeutic and aesthetic demands of young age groups.
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Gurgel RK, Shelton C. The SoundBite hearing system: patient-assessed safety and benefit study. Laryngoscope 2013; 123:2807-12. [PMID: 23856912 DOI: 10.1002/lary.24091] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 01/29/2013] [Accepted: 02/13/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine the safety and efficacy of the SoundBite for patients over a 6 month period of use. STUDY DESIGN Prospective, multisite, nonrandomized patient enrollment with outcomes based on audiometric profile and self-reported assessment. METHODS Patients with single-sided deafness were eligible for the study. Patients were fit with the standard SoundBite sound transducer and were asked to wear the device regularly for 6 months. At the end of the trial period, patients completed both a self-assessment and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaires. RESULTS Thirty-four subjects completed the study. Mean APHAB scores improved significantly for ease of communication (P < 0.001), background noise (P < 0.001), reverberation (P < 0.001), and global benefit (P < 0.001). Patients reported high rates of auditory benefit in a variety of listening situations and high rates of overall satisfaction with the device. One adverse event with a superficial mouth sore was reported and resolved after appropriate dental care. Twelve patients (35%) reported acoustic feedback. In six of these patients, the feedback resolved after device adjustment. CONCLUSION The SoundBite is a new hearing prosthesis that delivers bone conduction energy. It offers advantages over traditional osseointegrated devices that require surgical placement. Patient satisfaction with the device after 6 months of regular use is high. The SoundBite provided improvement in ease of communication, hearing in background noise, sound reverberation, and an overall global hearing benefit. Acoustic feedback is the most commonly reported problem with the SoundBite, and this is minimized with proper fitting.
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Affiliation(s)
- Richard K Gurgel
- Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, U.S.A
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Borrie FRP, Elouafkaoui P, Bearn DR. A Scottish cost analysis of interceptive orthodontics for thumb sucking habits. J Orthod 2013; 40:145-54. [PMID: 23794695 DOI: 10.1179/1465313312y.0000000028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE There is a potential cost saving to be made within the NHS by providing simple interceptive treatment rather than comprehensive treatment at a later date. The focus of this study is to determine the size of this potential cost by looking at the cost to NHS Tayside for the provision of interceptive treatment for cessation of thumb sucking and where this has been unsuccessful (or not provided) the costs of correction of the associated malocclusion. DESIGN A cost analysis is described, investigating the costs of treatment solely to the NHS, both in the primary and secondary setting. METHODS Three potential treatment pathways are identified with the costs calculated for each pathway. The actual cost of providing this treatment in NHS Tayside, and the potential cost saving in Tayside if there was a change in clinical practice are calculated. Both discounting of costs and a sensitivity analysis are performed. RESULTS The cost to NHS Tayside of current practice was calculated to be between £123,710 and £124,930 per annum. Change in practice to replace use of a removable with a fixed habit breaker for the interceptive treatment of thumb sucking reduced the calculated cost to between £99,581 and £105,017. CONCLUSION A saving could be made to the NHS, both locally and nationally, if the provision of a removable habit breaker was changed to a fixed habit breaker. In addition, increasing the proportion receiving active treatment, in the form of a fixed habit breaker, rather than monitoring, would appear to further reduce the cost to the NHS considerably.
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Questionnaire study of electronic wear-time tracking as experienced by patients and parents during treatment with removable orthodontic appliances. J Orofac Orthop 2013; 74:217-25. [DOI: 10.1007/s00056-013-0143-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 11/27/2012] [Indexed: 10/26/2022]
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Schott TC, Göz G. Color fading of the blue compliance indicator encapsulated in removable clear Invisalign Teen® aligners. Angle Orthod 2011; 81:185-91. [PMID: 21208067 DOI: 10.2319/052610-288.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
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.
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Applicative Characteristics of New Microelectronic Sensors Smart Retainer® and TheraMon® for Mea suring Wear Time. J Orofac Orthop 2010; 71:339-47. [DOI: 10.1007/s00056-010-1019-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Accepted: 08/23/2010] [Indexed: 11/25/2022]
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