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Alzoubi EE, Camilleri S, Al Muzian M, Attard N. The effect of tooth borne versus skeletally anchored Alt-RAMEC protocol in early treatment of Class III malocclusion: a single-centre randomized clinical trial. Eur J Orthod 2023; 45:517-527. [PMID: 37167546 DOI: 10.1093/ejo/cjad018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
TRIAL DESIGN This was a randomized, controlled trial designed to compare outcomes between the use of dental and skeletal anchorage, using the Face mask/Alternate Rapid Maxillary Expansion and Contraction (FM/Alt-RAMEC) protocol. METHODS AND PARTICIPANTS The study was carried out at Mater Dei Hospital, Malta and included prepubertal skeletal Class III malocclusion patients where the aetiology was primarily maxillary hypoplasia. INTERVENTIONS Two groups were assigned. Group I was treated with FM/Alt-RAMEC and group II was treated with skeletally anchored FM/Alt-RAMEC. Wear-time (WT) of the FM was monitored using TheraMon microsensors. Patients were instructed to wear the FM for 12-14 hours/day for 9 months. Changes were evaluated with lateral cephalograms and analysed with Wilcoxon and Mann-Whitney U tests. ANOVA was used to analyse the effect of gender on compliance parameters. Spearman's correlation coefficient was used to assess the correlation between compliance and skeletal changes. OBJECTIVE To compare the skeletal and dentoalveolar changes in patients treated with these two protocols. OUTCOMES The primary outcome was to assess skeletal and dentoalveolar outcomes in patients treated with skeletally anchored FM/RME and tooth-borne FM/RME; utilizing Alt-RAMEC protocol. The secondary outcome was compliance rate and adherence to FM wear among patients. RANDOMIZATION Randomizer software and the sealed envelope technique were used to randomly allocate patients 1:1 into either group I (tooth-borne FM/Alt-RAMEC) or group II (skeletally anchored FM/Alt-RAMEC). BLINDING It was not possible to blind to treatment allocation, but blinding was used when assessing the outcomes. RESULTS Numbers randomized and analysed. Thirty-five patients were allocated. Group I consisted of 18 subjects and group II consisted of 17 subjects. One patient in group I dropped out due to illness, so 17 subjects in each group completed the study. OUTCOMES Post-treatment changes in group I showed significant increases in SNA (2.10°), ANB (3.90°), Wits (4.70 mm), and overjet (5.40 mm). Group II showed significant increases in ANB (3.10°), Wits (3.20 mm), and overjet (4.50 mm). Wearing time for group I patients was 7.87 ± 2.88 hours/day and for group II was 6.98 ± 2.68 hours/day, with no significant difference between the groups. LIMITATIONS Lack of long-term follow-up post-treatment, making the conclusion applicable only in the short term. HARMS No harm was observed in both groups. CONCLUSION Despite the large difference between the measured and the patient-reported daily WT, both tooth-borne and skeletally anchored FM/Alt-RAMEC showed positive, similar, skeletal and dental effects. CLINICAL TRIAL REGISTRATION ISRCTN12197405.
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Affiliation(s)
- Emad Eddin Alzoubi
- Department of Child Dental Health and Orthodontics, University of Malta, Msida, Malta
| | - Simon Camilleri
- Department of Child Dental Health and Orthodontics, University of Malta, Msida, Malta
| | - Mohammed Al Muzian
- Department of Orthodontics, Faculty of Dentistry, University of Edinburgh, Edinburgh, UK
| | - Nikolai Attard
- Department of Restorative Dentistry, University of Malta, Msida, Malta
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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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Moreno-Fernández A, Iranzo-Cortés JE, Paredes-Gallardo V, García-Sanz V, Tarazona-Álvarez B, Almerich-Silla JM, Bellot-Arcís C, Montiel-Company JM. Effectiveness of removable appliances with temperature sensors in orthodontic patients: a systematic review and meta-analysis. Eur J Orthod 2021; 44:134-145. [PMID: 34100070 DOI: 10.1093/ejo/cjab033] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND/OBJECTIVE Patient compliance during orthodontic treatment is one of the factors that most affects success in the final result. The use of removable appliances is frequent at an early age and the monitoring of its use is essential to assess the collaboration of the patient. The aim of this study was to establish the effectiveness of microsensors included in removable appliances during orthodontic treatment or in the retention phase to enable a reliable and individualized follow-up of the patient. SEARCH METHODS The article search was carried out in various electronic databases and journals without any language restrictions. SELECTION CRITERIA Studies using microsensors into removable appliances were selected with the key selection criterion of a minimum follow-up of 4 weeks. DATA COLLECTION AND ANALYSIS The quality of the studies included was evaluated using the Cochrane scale for the randomized controlled trials and the Newcastle Ottawa Scale for control-case, cohort, and transversal studies. The mean of the differences with a 95% confidence interval was expressed for the continuous data. RESULTS Twenty-nine full-text articles were analysed and included in the qualitative synthesis. In general, the mean daily wear time of removable appliances measured objectively was less than the time that the professional had predetermined. CONCLUSIONS The use of microsensors as an objective measurement method enhances communication and boosts confidence in the orthodontist-patient relationship. More random clinical studies with temperature sensors are needed to establish to what extent they influence the orthodontic outcome. REGISTRATION PROSPERO (CRD42019120525).
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The establishment of a telemedicine center during the COVID-19 pandemic at a tertiary care hospital in Pakistan. CLINICAL EHEALTH 2021. [PMCID: PMC8591851 DOI: 10.1016/j.ceh.2021.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background Telemedicine involves the innovative application of technology to provide remote patient healthcare services especially those relating to emergency care and contagious disease spread. Telemedicine is less developed in low-and-middle-income countries like Pakistan and there is little published literature on its function and efficiency. Our institution was established to triage patients with COVID-19 symptoms to ease the load on emergency departments. Objective To conduct an analysis of the first month of function of a telemedicine/tele-triage center in Pakistan. To determine in which ways it was beneficial to hospital management during the COVID-19 pandemic. Methods This study was carried out at the newly established telemedicine/tele-triage center at the Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU) in Islamabad Pakistan between the 26th March and the 25th April 2020. Data were collected over telephone interview using a proforma to provide each caller with a C-Score (a C-score of >3 indicated observe at home 3–5-indicated home isolation with confirmatory testing and >5 indicated testing and transfer to hospital) representing their COVID-19 risk and informing the nature of the advice given to them. Data were presented using descriptive statistics. Results The center received total of 857 calls. Fever cough dyspnea and flu were present in 327(38.2%) 268(31.3%) 107(12.5%) and 124(14.5%) callers respectively. Based on the completion of the proforma 774(90.3%) callers had a C-Score of > 75(8.8%) callers had a C-Score of 3–5 and 8 (0.9%) callers had a C-Score of >5. We recommended COVID-19 testing in 83 patients (9.68%) based on C-score. Out of these 83 patients 64 underwent testing and only 1 tested positive for COVID-19. Conclusion In a one-month period the center was able to support patients by providing a triage service thereby preventing numerous unnecessary hospital visits and helping to protect healthcare professionals during a global pandemic. Telemedicine has great potential to help patient populations in low-and-middle-income countries.
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Ashfaq A, Memon SF, Zehra A, Barry S, Jawed H, Akhtar M, Kirmani W, Malik F, Khawaja AW, Barry H, Saiyid H, Farooqui N, Khalid S, Abbasi K, Siddiqi R. Knowledge and Attitude Regarding Telemedicine Among Doctors in Karachi. Cureus 2020; 12:e6927. [PMID: 32190480 PMCID: PMC7065727 DOI: 10.7759/cureus.6927] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/09/2020] [Indexed: 12/17/2022] Open
Abstract
Background Telemedicine is an affordable use of information and communication technology (ICT) to enable long-distance patient care and health care services. While the developed world continues to take advantage of this technology, its concept remains new to Pakistan. This study aims to assess the knowledge and perceptions regarding telemedicine among health care professionals in Karachi, Pakistan. Methods This cross-sectional study was carried out among doctors employed in the public health sector in Karachi from June 2018 to August 2018. Data were collected using a self-designed well-structured questionnaire using a five-point Likert scale, built after an extensive literature review. Statistical analysis was carried out using SPSS version 22. Categorical data were reported as frequencies and percentages. Results A total of 224 doctors, working in the Department of Internal Medicine (27.6%), Pediatrics (9.8%), Cardiology (6.6%), Gynecology (5.35%), Neurology (5.8%), and other specialties (44.6%), participated in the study. A total of 80.7 % of the doctors were aware of the definition of telemedicine. A total of 28.1% of them believed telemedicine to be effective in providing faster medical care while 23.2% thought of it as a means of reducing the white coat syndrome. A total of 42.9% believed that telemedicine disrupts the doctor-patient relationship and causes a breach of patient privacy. A total of 34.8% of the doctors favored the idea of introducing national standards for practicing telemedicine while 33.5% of doctors also agreed that providing a legal explanation of telemedicine to patients was of paramount importance. Poverty and lack of education (90.6%) was thought to be the biggest barrier to the practice of telemedicine in the developing world. Conclusions The knowledge regarding telemedicine among doctors in Karachi was found to be average. However, the perceptions about and attitude towards the introduction and implementation of this new technology were welcomed by the majority of participants with an emphasis on increasing awareness. Conferences and workshops are needed to increase knowledge about telemedicine in Pakistan.
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Affiliation(s)
- Ahsan Ashfaq
- Internal Medicine, Jinnah Sindh Medical University (SMC), Karachi, PAK
| | - Shehzeen F Memon
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Ayesha Zehra
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Samrana Barry
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Huzema Jawed
- Internal Medicine, Jinnah Sindh Medical University (SMC), Karachi, PAK
| | - Maryam Akhtar
- General Surgery, Jinnah Sindh Medical University (SMC), Karachi, PAK
| | - Wajeeha Kirmani
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Faaiz Malik
- Internal Medicine, Jinnah Sindh Medical University (SMC), Karachi, PAK
| | - Adina W Khawaja
- General Surgery, Jinnah Sindh Medical University (SMC), Karachi, PAK
| | - Hamama Barry
- Internal Medicine, Dow Medical College, Civil Hospital Karachi, Karachi, PAK
| | - Hadi Saiyid
- Internal Medicine, Jinnah Sindh Medical University (SMC), Karachi, PAK
| | - Nimra Farooqui
- Internal Medicine, Jinnah Sindh Medical University (SMC), Karachi, PAK
| | - Shazra Khalid
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Komal Abbasi
- General Surgery, Jinnah Sindh Medical University (SMC), Karachi, PAK
| | - Rabbia Siddiqi
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
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Grassl N, Nees J, Schramm K, Spratte J, Sohn C, Schott TC, Schott S. A Web-Based Survey Assessing the Attitudes of Health Care Professionals in Germany Toward the Use of Telemedicine in Pregnancy Monitoring: Cross-Sectional Study. JMIR Mhealth Uhealth 2018; 6:e10063. [PMID: 30089606 PMCID: PMC6105866 DOI: 10.2196/10063] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 05/12/2018] [Accepted: 06/18/2018] [Indexed: 01/03/2023] Open
Abstract
Background The demand for fetal monitoring and constant reassurance is high in pregnant women. Consequently, pregnant women use various health apps and are more likely to visit emergency departments due to subjective but nonurgent complaints. However, electronic health (eHealth) and mobile health (mHealth) solutions are rarely used to prevent nonurgent emergency consultations. To implement modern care solutions, a better understanding of the attitudes, fears, and hopes of health care professionals toward eHealth and mHealth is needed. Objective The aim of this study was to investigate the attitudes of health care professionals in obstetrics toward telemedicine. Methods A quantitative Web-based survey on health care professionals in obstetrics in Germany was conducted. The participants included nurses, midwives, and physicians of all age groups and job positions working in hospitals that provide various levels of health care. The questionnaire comprised 24 questions about the characteristics of the study population, views about emergency consultations in obstetrics, attitude toward telemedicine, job satisfaction, and sleeping behavior. Results In total, 244 health care professionals participated in the Web-based survey. In general, health care professionals were skeptical (170/233, 72.9%) about the use of telemedicine in obstetrics; however, 55.8% (130/233) recognized its potential. Moreover, 72% (62/86) of physicians were optimistic in using apps for pregnancy monitoring, whereas 36.1% (47/130) of nonphysicians (P<.001) were not. Significantly, more nonphysicians rejected such developments (75/130, 57.7% rejected) compared with physicians (24/86, 28%; P<.001). We also found that obstetricians with more than 10 years of work-experience are more skeptical; however, approximately 49% (18/37) of them believed that telemedicine could reduce nonurgent emergency consultations, whereas 73.2% (106/145) of obstetricians with less than 5 years of experience (P=.01) thought otherwise. Our survey revealed a high job satisfaction and a prevalence of regular sleeping problems of 45.9% (91/198) among health care professionals in obstetrics. Surprisingly, both job satisfaction and sleeping problems were independent from the number of night shifts per month (P=.77 and P=.99, respectively). Yet, 56.6% (112/198) of the survey participants thought they would be happier with their job if they had to work fewer night shifts per month. Conclusions Our study reveals an ambivalent attitude toward the use of telemedicine among health care professionals in obstetrics in Germany at the moment. Efforts to promote the use of telemedicine should focus on nurses and midwives because these groups are the most skeptical. By contrast, particularly young physicians recognize the potential of apps in patient care and would like to use such technology in pregnancy monitoring.
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Affiliation(s)
- Niklas Grassl
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
| | - Juliane Nees
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
| | - Katharina Schramm
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
| | - Julia Spratte
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
| | - Christof Sohn
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
| | - Timm C Schott
- Centre of Dentistry, Department of Orthodontics and Orofacial Orthopedics, University of Tuebingen, Tuebingen, Germany
| | - Sarah Schott
- Department of Gynecology and Obstetrics, University Women's Clinic Heidelberg, Heidelberg, Germany
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Charavet C, Le Gall M, Albert A, Bruwier A, Leroy S. Patient compliance and orthodontic treatment efficacy of Planas functional appliances with TheraMon microsensors. Angle Orthod 2018; 89:117-122. [PMID: 30080129 DOI: 10.2319/122917-888.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To assess patient compliance and treatment efficacy of preventive expansion treatment with removable Planas functional appliances using an integrated microsensor. MATERIALS AND METHODS Wear time (WT) and behavior of 69 patients undergoing treatment with Planas functional appliances were assessed and analysed using TheraMon microsensors (Gschladt, Hargelsberg, Austria). Patients were followed up for a period of 9 months, and visits were made every 3 months to download WT data from the microsensor and to assess wearing behavior. From individual WT graphs,10 parameters were derived to characterize compliance for each patient. Treatment efficacy was measured by eight parameters determining the level of expansion after 9 months of treatment. RESULTS Patients wore their device on average 15.8 ± 5.2 h/d. WT was unrelated to age and gender, but it was positively influenced by patient habits when keeping appliances during eating, sports, care and handling. Treatment efficacy in terms of intercanine and intermolar expansion was 4.4 ± 1.9 mm and 4.6 ± 2.0 mm for the maxilla, and 5.3 ± 2.0 mm and 4.7 ± 2.3 mm for the mandible, respectively. Efficacy was negatively affected by poor compliance (WT < 9 h/d) and by high variability of within-subject WT recordings. CONCLUSIONS Perfect compliance is not necessary to achieve treatment success, but patients should exhibit sufficient wear time to allow maxillary expansion to occur. The TheraMon microsensor offers a new perspective and aid to individualize treatment prescriptions.
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Brierley CA, Benson PE, Sandler J. How accurate are TheraMon® microsensors at measuring intraoral wear-time? Recorded vs. actual wear times in five volunteers. J Orthod 2017; 44:241-248. [DOI: 10.1080/14653125.2017.1365220] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Catherine A Brierley
- Academic Unit of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
- Orthodontic Department, Chesterfield Royal Hospital, Chesterfield, Derbyshire, UK
| | - Philip E Benson
- Academic Unit of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Jonathan Sandler
- Orthodontic Department, Chesterfield Royal Hospital, Chesterfield, Derbyshire, UK
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Stocker B, Willmann JH, Wilmes B, Vasudavan S, Drescher D. Wear-time recording during early Class III facemask treatment using TheraMon chip technology. Am J Orthod Dentofacial Orthop 2016; 150:533-40. [DOI: 10.1016/j.ajodo.2016.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 10/21/2022]
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Schott TC, Ludwig B. Microelectronic wear-time documentation of removable orthodontic devices detects heterogeneous wear behavior and individualizes treatment planning. Am J Orthod Dentofacial Orthop 2014; 146:155-60. [DOI: 10.1016/j.ajodo.2014.04.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 04/01/2014] [Accepted: 04/01/2014] [Indexed: 11/17/2022]
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Schäfer K, Ludwig B, Meyer-Gutknecht H, Schott TC. Quantifying patient adherence during active orthodontic treatment with removable appliances using microelectronic wear-time documentation. Eur J Orthod 2014; 37:73-80. [PMID: 24993614 DOI: 10.1093/ejo/cju012] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES The aim of this study was to quantify the wear times of removable appliances during active orthodontic treatment. MATERIALS AND METHODS The wear times of 141 orthodontic patients treated with active removable appliances in different locations were documented over a period of 3 months using an incorporated microsensor. Gender, age, treatment location, health insurance status, and type of device were evaluated with respect to wear time. Significant associations between wear times and patient factors were calculated using non-parametric tests. RESULTS The median daily wear time was 9.7 hours/day for the entire cohort, far less than the 15 hours/day prescribed. Younger patients wore their appliances for longer than older patients (7-9 years 12.1 hours/day, 10-12 years 9.8 hours/day, and 13-15 years 8.5 hours/day; P < 0.0001). The median wear time for females (10.6 hours/day) was 1.4 hours/day longer than males (9.3 hours/day; P = 0.017). Patients treated at different locations wore their devices with a difference of up to 5.0 hours/day. Privately insured patients had significantly longer median wear times than statutorily insured patients. No significant difference in wear time was noted according to device type. CONCLUSIONS The daily wear time of removable appliances during the active phase of orthodontic therapy can be routinely quantified using integrated microelectronic sensors. The relationship between orthodontist and patient seems to play a key role in patient adherence. Wear-time documentation provides the basis for more individualized wear-time recommendations for patients with removable appliances. This could result in a more efficient, shorter, and less painful orthodontic therapy.
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Affiliation(s)
- Katharina Schäfer
- *Department of Orthodontics and Orofacial Orthopedics, University Hospital of Dentistry, Eberhard Karls University Tübingen
| | - Björn Ludwig
- **Department of Orthodontics, University of Homburg/Saar, and Private Practice, Traben-Trarbach
| | | | - Timm Cornelius Schott
- *Department of Orthodontics and Orofacial Orthopedics, University Hospital of Dentistry, Eberhard Karls University Tübingen,
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Hyun P, Preston CB, Al-Jewair TS, Park-Hyun E, Tabbaa S. Patient compliance with Hawley retainers fitted with the SMART(®) sensor: a prospective clinical pilot study. Angle Orthod 2014; 85:263-9. [PMID: 24869901 DOI: 10.2319/030814-163.1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the compliance of patients while wearing maxillary Hawley retainers embedded with SMART microsensors. METHODS The sample population consisted of 22 patients who were divided into an experimental (group A) and a control group (group B). Group A was informed that they would be monitored through the use of SMART microsensors, while group B was not informed that they would be monitored. After the delivery of the retainers (T0), the patients were evaluated at T1 and T2, represented by 6- and 12-week follow-up visits, respectively. At T1, group B was informed of our ability to monitor their compliance. Both groups continued wearing their retainers during T1 to T2. RESULTS During T0-T1, Group A wore their retainers for an average of 16.3 hours (SD 4.39), while group B wore their appliances for an average of 10.6 hours (SD 5.36, t = 2.426, P = .027). Although group B increased their retainer wear by 0.5 hours/day from T1 to T2, this increase was not statistically significant. CONCLUSIONS Despite significant differences being noted between the two groups at T1, group B did not show significant mean changes in their wear time before and after becoming aware of the use of the SMART microsensor.
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Affiliation(s)
- Paul Hyun
- a Postgraduate Orthodontic Resident, State University of New York at Buffalo, Buffalo, NY
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