1
|
Nordblom N, Büttner M, Schwendicke F. Artificial Intelligence in Orthodontics: Critical Review. J Dent Res 2024; 103:577-584. [PMID: 38682436 PMCID: PMC11118788 DOI: 10.1177/00220345241235606] [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] [Indexed: 05/01/2024] Open
Abstract
With increasing digitalization in orthodontics, certain orthodontic manufacturing processes such as the fabrication of indirect bonding trays, aligner production, or wire bending can be automated. However, orthodontic treatment planning and evaluation remains a specialist's task and responsibility. As the prediction of growth in orthodontic patients and response to orthodontic treatment is inherently complex and individual, orthodontists make use of features gathered from longitudinal, multimodal, and standardized orthodontic data sets. Currently, these data sets are used by the orthodontist to make informed, rule-based treatment decisions. In research, artificial intelligence (AI) has been successfully applied to assist orthodontists with the extraction of relevant data from such data sets. Here, AI has been applied for the analysis of clinical imagery, such as automated landmark detection in lateral cephalograms but also for evaluation of intraoral scans or photographic data. Furthermore, AI is applied to help orthodontists with decision support for treatment decisions such as the need for orthognathic surgery or for orthodontic tooth extractions. One major challenge in current AI research in orthodontics is the limited generalizability, as most studies use unicentric data with high risks of bias. Moreover, comparing AI across different studies and tasks is virtually impossible as both outcomes and outcome metrics vary widely, and underlying data sets are not standardized. Notably, only few AI applications in orthodontics have reached full clinical maturity and regulatory approval, and researchers in the field are tasked with tackling real-world evaluation and implementation of AI into the orthodontic workflow.
Collapse
Affiliation(s)
- N.F. Nordblom
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - M. Büttner
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - F. Schwendicke
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University of Munich, Munich, Germany
| |
Collapse
|
2
|
Snider V, Homsi K, Kusnoto B, Atsawasuwan P, Viana G, Allareddy V, Gajendrareddy P, Elnagar MH. Clinical evaluation of Artificial Intelligence Driven Remote Monitoring technology for assessment of patient oral hygiene during orthodontic treatment. Am J Orthod Dentofacial Orthop 2024; 165:586-592. [PMID: 38363256 DOI: 10.1016/j.ajodo.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 02/17/2024]
Abstract
INTRODUCTION This study aimed to clinically evaluate the accuracy of Dental Monitoring's (DM) artificial intelligence (AI) image analysis and oral hygiene notification algorithm in identifying oral hygiene and mucogingival conditions. METHODS Twenty-four patients seeking orthodontic therapy were monitored by DM oral hygiene protocol during their orthodontic treatment. During the bonding appointment and at each of 10 subsequent adjustment visits, a total of 232 clinical oral examinations were performed to assess the presence of the 3 oral hygiene parameters that DM monitors. In each clinical timepoint, the subjects took an oral DM scan and received a notification regarding their current oral status at that moment in time. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to evaluate AI and clinical assessment of plaque, gingivitis, and recession. RESULTS A total of 232 clinical time points have been evaluated clinically and by the DM AI algorithm. For DM's AI detection of plaque and calculus, gingivitis, and recession, the sensitivity was 0.53, 0.35, and 0.22; the specificity was 0.94, 0.96, and 0.99; and the accuracy was 0.60, 0.49, and 0.72, respectively. CONCLUSIONS DM's oral hygiene notification algorithm has low sensitivity, high specificity, and moderate accuracy. This indicates a tendency of DM to underreport the presence of plaque, gingivitis, and recession.
Collapse
Affiliation(s)
- Vivian Snider
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Ill
| | - Karen Homsi
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Ill
| | - Budi Kusnoto
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Ill
| | - Phimon Atsawasuwan
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Ill
| | - Grace Viana
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Ill
| | | | - Praveen Gajendrareddy
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, Ill
| | - Mohammed H Elnagar
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Ill.
| |
Collapse
|
3
|
Sangalli L, Alessandri-Bonetti A, Dalessandri D. Effectiveness of dental monitoring system in orthodontics: A systematic review. J Orthod 2024; 51:28-40. [PMID: 37278017 DOI: 10.1177/14653125231178040] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Dental monitoring (DM) constitutes a recent technological advance for the remote monitoring of patients undergoing an orthodontic therapy. Especially in times of health emergency crisis, the possibility of relying on remote monitoring could be particularly useful. OBJECTIVES To assess the effectiveness of DM in orthodontic care. ELIGIBILITY Studies conducted on healthy patients undergoing orthodontic care where DM was applied, assessing a change in treatment duration, emergency appointments, in-office visits, orthodontic relapse, early detection of orthodontic emergencies and improvement of oral health status. INFORMATION SOURCES PubMed, Web of Science and Scopus were searched for publications until November 2022. RISK OF BIAS Quality assessment was performed with the STROBE Checklist. DATA EXTRACTION Data were extracted independently by two reviewers, and discrepancies were resolved with a third reviewer. INCLUDED STUDIES Out of 6887 records screened, 11 studies were included. SYNTHESIS OF RESULTS DM implemented to the standard orthodontic care was found to significantly decrease the number of in-office visits by 1.68-3.5 visits and showed a possible trend towards improvement of aligner fit. Conversely, evidence does not support a reduction of treatment duration and emergency appointments. The assessment of the remaining variables did not allow any qualitative synthesis. CONCLUSIONS This review highlighted that DM implemented to standard orthodontic care can significantly decrease the number of in-office visits and may potentially result in an improved aligner fit. Due to the low quality of most of the included studies and the heterogeneity of the orthodontic system where DM was applied, studies with different investigation team and rigorous methodology are advocated.
Collapse
Affiliation(s)
- Linda Sangalli
- College of Dental Medicine, Midwestern University, Downers Grove, IL, USA
| | - Anna Alessandri-Bonetti
- Department of Oral Health Science, Division of Orofacial Pain, College of Dentistry, University of Kentucky, Lexington, KY, USA
- Institute of Dental Clinic, A. Gemelli University Policlinic IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Domenico Dalessandri
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| |
Collapse
|
4
|
Allareddy V, Rampa S, Venugopalan SR, Elnagar MH, Lee MK, Oubaidin M, Yadav S. Blockchain technology and federated machine learning for collaborative initiatives in orthodontics and craniofacial health. Orthod Craniofac Res 2023; 26 Suppl 1:118-123. [PMID: 37036565 DOI: 10.1111/ocr.12662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/25/2023] [Accepted: 03/29/2023] [Indexed: 04/11/2023]
Abstract
There is a paucity of largescale collaborative initiatives in orthodontics and craniofacial health. Such nationally representative projects would yield findings that are generalizable. The lack of large-scale collaborative initiatives in the field of orthodontics creates a deficiency in study outcomes that can be applied to the population at large. The objective of this study is to provide a narrative review of potential applications of blockchain technology and federated machine learning to improve collaborative care. We conducted a narrative review of articles published from 2018 to 2023 to provide a high level overview of blockchain technology, federated machine learning, remote monitoring, and genomics and how they can be leveraged together to establish a patient centered model of care. To strengthen the empirical framework for clinical decision making in healthcare, we suggest use of blockchain technology and integrating it with federated machine learning. There are several challenges to adoption of these technologies in the current healthcare ecosystem. Nevertheless, this may be an ideal time to explore how best we can integrate these technologies to deliver high quality personalized care. This article provides an overview of blockchain technology and federated machine learning and how they can be leveraged to initiate collaborative projects that will have the patient at the center of care.
Collapse
Affiliation(s)
- Veerasathpurush Allareddy
- Department of Orthodontics, University of Illinois Chicago College of Dentistry, Chicago, Illinois, USA
| | | | | | - Mohammed H Elnagar
- University of Illinois Chicago College of Dentistry, Chicago, Illinois, USA
| | - Min Kyeong Lee
- University of Illinois Chicago College of Dentistry, Chicago, Illinois, USA
| | - Maysaa Oubaidin
- University of Illinois Chicago College of Dentistry, Chicago, Illinois, USA
| | - Sumit Yadav
- UNMC College of Dentistry, Lincoln, Nebraska, USA
| |
Collapse
|
5
|
Snider V, Homsi K, Kusnoto B, Atsawasuwan P, Viana G, Allareddy V, Gajendrareddy P, Elnagar MH. Effectiveness of AI-driven remote monitoring technology in improving oral hygiene during orthodontic treatment. Orthod Craniofac Res 2023; 26 Suppl 1:102-110. [PMID: 37113065 DOI: 10.1111/ocr.12666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/30/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of Dental Monitoring™ (DM™) Artificial Intelligence Driven Remote Monitoring Technology (AIDRM) technology in improving the patient's oral hygiene during orthodontic treatment through AI-based personalized active notifications. METHODS A prospective clinical study was conducted on two groups of orthodontic patients. DM Group: (n = 24) monitored by DM weekly scans and received personalized notifications on the DM smartphone application regarding their oral hygiene status. Control Group (n = 25) not monitored by DM. Both groups were clinically assessed using Plaque Index (OPI) and the Modified Gingival Index (MGI). DM Group was followed for 13 months and the Control Group was followed for 5 months. Student-independent t test and paired t tests were used to investigate the mean differences between study groups and between time points for each group respectively. RESULTS At all time points, the mean differences indicated that the DM group had lower OPI and MGI values than the control group. The mean value for OPI and MGI were statistically significantly lower in the DM group (OPI = 1.96, MGI = 1.56) than in the control group (OPI = 2.41, MGI = 2.17) after 5 months. A rapid increase in mean OPI and MGI values was found between T0 and T1 for both study groups. A plateau effect for OPI scores appeared to occur from T1 to T5 for both study groups, but the plateau effect seemed to be more pronounced for the DM group than the study group. The MGI values for both study groups also increased dramatically from baseline to T5, however, a plateau effect was not observed. CONCLUSIONS The oral hygiene of orthodontic patients rapidly worsens over the first 3 months and plateaus after about 5 months of treatment. AIDRM by weekly DM scans and personalized active notifications may improve oral hygiene over time in orthodontic patients.
Collapse
Affiliation(s)
- Vivian Snider
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Karen Homsi
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Budi Kusnoto
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Phimon Atsawasuwan
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Grace Viana
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Veerasathpurush Allareddy
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Praveen Gajendrareddy
- Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Mohammed H Elnagar
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| |
Collapse
|
6
|
Liu J, Zhang C, Shan Z. Application of Artificial Intelligence in Orthodontics: Current State and Future Perspectives. Healthcare (Basel) 2023; 11:2760. [PMID: 37893833 PMCID: PMC10606213 DOI: 10.3390/healthcare11202760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
In recent years, there has been the notable emergency of artificial intelligence (AI) as a transformative force in multiple domains, including orthodontics. This review aims to provide a comprehensive overview of the present state of AI applications in orthodontics, which can be categorized into the following domains: (1) diagnosis, including cephalometric analysis, dental analysis, facial analysis, skeletal-maturation-stage determination and upper-airway obstruction assessment; (2) treatment planning, including decision making for extractions and orthognathic surgery, and treatment outcome prediction; and (3) clinical practice, including practice guidance, remote care, and clinical documentation. We have witnessed a broadening of the application of AI in orthodontics, accompanied by advancements in its performance. Additionally, this review outlines the existing limitations within the field and offers future perspectives.
Collapse
Affiliation(s)
- Junqi Liu
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
| | - Chengfei Zhang
- Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
| | - Zhiyi Shan
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China;
| |
Collapse
|
7
|
Homsi K, Ramachandran V, Del Campo DM, Del Campo LM, Kusnoto B, Atsawasuwan P, Viana G, Oubaidin M, Allareddy V, Elnagar MH. The use of teleorthodontics during the COVID-19 pandemic and beyond - perspectives of patients and providers. BMC Oral Health 2023; 23:490. [PMID: 37454048 PMCID: PMC10349415 DOI: 10.1186/s12903-023-03215-4] [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: 02/22/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic significantly impacted dental services, resulting in reduced staff availability, limited appointments, and some dental clinics even being forced to close their doors. Despite these challenges, the need for dental consultants remained present, particularly in emergency situations. One area of orthodontics that had seen a surge in demand during the pandemic is Teleorthodontics. With the help of Teleorthodontics, orthodontic consultations, assessments, and even treatment monitoring could be conducted remotely, making it a safe and convenient option for patients during those challenging times. AIM This survey aimed to evaluate the acceptance of patients and their orthodontists on the use of different modes of communication through Teleorthodontics during the COVID-19 pandemic and their willingness to continue using this in the future. METHODS An online survey instrument in Qualtrics was distributed to orthodontic patients at the University of Illinois, Chicago. The survey was available on a rolling basis for up to 6 months. A total number of 364 partients voluntarily participated in the survey. The Faculty and Residents were also asked to participate in a survey through recruitment via their UIC email addresses. RESULTS According to our survey, both patients and providers showed acceptance of Teleorthodontics and have used it in different forms during orthodontic treatment. The application is easy-to-use, convenient, and not at all time-consuming. Overall satisfaction with using this application was recorded at 92%, with 66% of patients stating that it saved them time by eliminating the need to travel to the orthodontic clinic. 30% of providers found that the interaction with patients using Teleorthodontics was a positive experience and would recommend it in future. CONCLUSION Teleorthodontics has shown great potential, particularly in follow-up cases, and holds promise as a valuable tool for online remote dental consultations in the future.
Collapse
Affiliation(s)
- Karen Homsi
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Vinitha Ramachandran
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA.
| | | | - Laura Martin Del Campo
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Budi Kusnoto
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Phimon Atsawasuwan
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Grace Viana
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Maysaa Oubaidin
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | | | - Mohammed H Elnagar
- Department of Orthodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| |
Collapse
|
8
|
El Tantawi M, Lam WYH, Giraudeau N, Virtanen JI, Matanhire C, Chifamba T, Sabbah W, Gomaa N, Al-Maweri SA, Uribe SE, Mohebbi SZ, Hasmun N, Guan G, Polonowita A, Khan SB, Pisano M, Ellakany P, Baraka MM, Ali AA, Orellana Centeno JE, Pavlic V, Folayan MO. Teledentistry from research to practice: a tale of nineteen countries. FRONTIERS IN ORAL HEALTH 2023; 4:1188557. [PMID: 37397348 PMCID: PMC10311964 DOI: 10.3389/froh.2023.1188557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/26/2023] [Indexed: 07/04/2023] Open
Abstract
Aim The COVID-19 pandemic has accelerated teledentistry research with great interest reflected in the increasing number of publications. In many countries, teledentistry programs were established although not much is known about the extent of incorporating teledentistry into practice and healthcare systems. This study aimed to report on policies and strategies related to teledentistry practice as well as barriers and facilitators for this implementation in 19 countries. Methods Data were presented per country about information and communication technology (ICT) infrastructure, income level, policies for health information system (HIS), eHealth and telemedicine. Researchers were selected based on their previous publications in teledentistry and were invited to report on the situation in their respective countries including Bosnia and Herzegovina, Canada, Chile, China, Egypt, Finland, France, Hong Kong SAR, Iran, Italy, Libya, Mexico, New Zealand, Nigeria, Qatar, Saudi Arabia, South Africa, United Kingdom, Zimbabwe. Results Ten (52.6%) countries were high income, 11 (57.9%) had eHealth policies, 7 (36.8%) had HIS policies and 5 (26.3%) had telehealth policies. Six (31.6%) countries had policies or strategies for teledentistry and no teledentistry programs were reported in two countries. Teledentistry programs were incorporated into the healthcare systems at national (n = 5), intermediate (provincial) (n = 4) and local (n = 8) levels. These programs were established in three countries, piloted in 5 countries and informal in 9 countries. Conclusion Despite the growth in teledentistry research during the COVID-19 pandemic, the use of teledentistry in daily clinical practice is still limited in most countries. Few countries have instituted teledentistry programs at national level. Laws, funding schemes and training are needed to support the incorporation of teledentistry into healthcare systems to institutionalize the practice of teledentistry. Mapping teledentistry practices in other countries and extending services to under-covered populations increases the benefit of teledentistry.
Collapse
Affiliation(s)
- Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Walter Yu Hang Lam
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | | | - Jorma I. Virtanen
- Institute of Dentistry, Faculty of Medicine, University of Turku, Turku, Finland
| | - Cleopatra Matanhire
- Department of Oral Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Timothy Chifamba
- Department of Oral Health, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Wael Sabbah
- Centre for Host Microbiome Interactions, King’s College London, London, United Kingdom
| | - Noha Gomaa
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Sadeq Ali Al-Maweri
- Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Sergio E. Uribe
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
- School of Dentistry, Universidad Austral de Chile, Valdivia, Chile
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, Latvia
| | - Simin Z. Mohebbi
- Research Center for Caries Prevention, Dentistry Research Institute, and Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Noren Hasmun
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Guangzhao Guan
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Ajith Polonowita
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Sadika Begum Khan
- Department of Prosthetic Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Massimo Pisano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Baronissi, Italy
| | - Passent Ellakany
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Marwa Mohamed Baraka
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | | | - Verica Pavlic
- Department of Periodontology and Oral Medicine, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | | |
Collapse
|
9
|
Strunga M, Urban R, Surovková J, Thurzo A. Artificial Intelligence Systems Assisting in the Assessment of the Course and Retention of Orthodontic Treatment. Healthcare (Basel) 2023; 11:healthcare11050683. [PMID: 36900687 PMCID: PMC10000479 DOI: 10.3390/healthcare11050683] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
This scoping review examines the contemporary applications of advanced artificial intelligence (AI) software in orthodontics, focusing on its potential to improve daily working protocols, but also highlighting its limitations. The aim of the review was to evaluate the accuracy and efficiency of current AI-based systems compared to conventional methods in diagnosing, assessing the progress of patients' treatment and follow-up stability. The researchers used various online databases and identified diagnostic software and dental monitoring software as the most studied software in contemporary orthodontics. The former can accurately identify anatomical landmarks used for cephalometric analysis, while the latter enables orthodontists to thoroughly monitor each patient, determine specific desired outcomes, track progress, and warn of potential changes in pre-existing pathology. However, there is limited evidence to assess the stability of treatment outcomes and relapse detection. The study concludes that AI is an effective tool for managing orthodontic treatment from diagnosis to retention, benefiting both patients and clinicians. Patients find the software easy to use and feel better cared for, while clinicians can make diagnoses more easily and assess compliance and damage to braces or aligners more quickly and frequently.
Collapse
|
10
|
Jallal M, Berrada K, Bouaddi O, El Badisy I, Charaka H, Serhier Z, Bennani Othmani M, Nejjari C, Khalis M. How Physicians in a Moroccan Tertiary Care Center Perceive Teleconsultation During COVID-19 Pandemic? Telemed J E Health 2023; 29:284-292. [PMID: 36126680 DOI: 10.1089/tmj.2022.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Recent technological advances have paved the way for a new modality of medical practice known as teleconsultation. Positive perceptions about the benefits of teleconsultation and its acceptance by clinicians are key predictors of its uptake. The aim of this study was to assess knowledge, perceptions, and acceptability of teleconsultation among Moroccan physicians. Methods: This is a descriptive cross-sectional study conducted at the Cheikh Khalifa International University Hospital (HCK) of Casablanca, Morocco. Study participants answered an anonymous self-administered questionnaire designed based on similar studies. The questionnaire contained four sections related to demographic characteristics, knowledge about telemedicine and teleconsultation, perceptions about teleconsultation, and its acceptability by the study participants. Results: Of 486 eligible participants, a total of 212 completed the questionnaire. Approximately 96.7% had prior knowledge of teleconsultation. Most participants identified internet access (95.3%), data security (93.4%), and confidentiality (92.9%) as the main facilitators to the use of teleconsultation. The main barriers to the use of teleconsultation were internet access issues (98.6%), poor audio quality (96.2%), poor video quality (94.3%), and difficulty encountered by patients in expressing themselves and communicating with their physician (79.7%). The majority of participants (91.5%) believed that teleconsultation will be an integral part of future medical practice and about 70.8% thought that they would be able to allot time to teleconsultation in their current schedules. Conclusions: The findings of this study should be used by policy makers to remove barriers and promote enablers of teleconsultation use by physicians to bring health care closer to the Moroccan population.
Collapse
Affiliation(s)
- Manar Jallal
- Medical Informatics Laboratory, Faculty of Medicine and Pharmacy, University Hassan II, Casablanca, Morocco
| | - Kenza Berrada
- Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Oumnia Bouaddi
- International School of Public Health, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Imad El Badisy
- International School of Public Health, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Hafida Charaka
- Department of Research and Development, Ibn Sina University Hospital Center, Rabat, Morocco
| | - Zineb Serhier
- Medical Informatics Laboratory, Faculty of Medicine and Pharmacy, University Hassan II, Casablanca, Morocco
| | - Mohammed Bennani Othmani
- Medical Informatics Laboratory, Faculty of Medicine and Pharmacy, University Hassan II, Casablanca, Morocco
| | - Chakib Nejjari
- International School of Public Health, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Mohamed Khalis
- International School of Public Health, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| |
Collapse
|
11
|
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.
Collapse
|
12
|
Teledentistry in the Management of Patients with Dental and Temporomandibular Disorders. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7091153. [PMID: 35437507 PMCID: PMC9013296 DOI: 10.1155/2022/7091153] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/16/2022] [Indexed: 01/08/2023]
Abstract
Telemedicine is a subunit of telehealth, and it uses telecommunication technology, video, digital images, and electronic medical records to allow the exchange of clinical information and images over remote distances for dental consultation, diagnosis, and treatment planning. Dental clinical practice requires face-to-face interaction with the patients, and therefore, during the COVID-19 pandemic, it has mostly been suspended. In this view, teledentistry offers the opportunity to continue dental practice, avoiding the face-to-face examination that put patients and healthcare professionals at infection risk. Teledentistry encompasses several subunits such as teleconsultation, telediagnosis, telemonitoring, and teletriage. To date, there are several experiences described in literature that suggest that teledentistry could be applied to support traditional care of different oral diseases. However, there are some issues that need to be addressed. Reimbursement concerns, costs, license regulations, limits in physical examinations, and expert equipment are principal issues that should be overcome in telemedicine and in teledentistry. In this narrative review, we provide an overview of the different teledentistry approaches in the care of patients with dental and temporomandibular disorders, as well as discussing the issues that need to be addressed to implement this approach in clinical practice.
Collapse
|
13
|
Sangalli L, Savoldi F, Dalessandri D, Visconti L, Massetti F, Bonetti S. Remote digital monitoring during the retention phase of orthodontic treatment: A prospective feasibility study. Korean J Orthod 2022; 52:123-130. [PMID: 35321951 PMCID: PMC8964474 DOI: 10.4041/kjod.2022.52.2.123] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/27/2021] [Accepted: 11/03/2021] [Indexed: 01/24/2023] Open
Abstract
Objective To evaluate if a remote digital monitoring system added at the end of orthodontic treatment could positively influence the retention phase by reducing the occurrence of misfit of removable appliances, number of emergency appointments (EA), and orthodontic relapse. Methods Twenty-seven patients who completed active orthodontic treatment were divided into the study and control groups. In addition to the standard chairside follow-up appointments at month 1 (T1), month 3 (T2), month 6 (T3), the study group patients were monitored using Dental Monitoring® with monthly intra-oral scans. Occurrence of misfit of removable retainers, number of EAs, and intercanine width change were recorded for both groups. Differences in EAs and retainer fit were assessed using the chi-square test. Intra-group and inter-group differences in the intercanine width were assessed with Friedman test and Mann–Whitney U test, respectively (α = 0.05). Results The study group showed a significantly lower occurrence of misfit of removable retainers (p = 0.027) compared to the control group. No significant inter- and intra-group difference was found in the EAs and intercanine width change at each time-point. Conclusions Integrating remote monitoring systems, such as Dental Monitoring®, to the retention phase of the orthodontic treatment may lower the occurrence of misfit of removable retainers. However, a small sample size and a short observation period limit the strength of this evidence. These preliminary results tentatively suggest that remote monitoring technologies may be beneficial, especially during the COVID-19 pandemic, when the regularity of in-office visits might be disrupted.
Collapse
Affiliation(s)
- Linda Sangalli
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.,Department of Oral Health Science, Division of Orofacial Pain, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Domenico Dalessandri
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Luca Visconti
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Francesca Massetti
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Bonetti
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| |
Collapse
|
14
|
Utilization of a 3D Printed Orthodontic Distalizer for Tooth-Borne Hybrid Treatment in Class II Unilateral Malocclusions. MATERIALS 2022; 15:ma15051740. [PMID: 35268969 PMCID: PMC8911017 DOI: 10.3390/ma15051740] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 12/10/2022]
Abstract
This paper introduces a novel method of 3D designing and 3D printing of a hybrid orthodontic tooth-borne personalized distalizer for treatment of unilateral Class II malocclusion. Research objectives were to clinically utilize 3D printed distalizers, appraise feasibility of this technique and compare two different biocompatible photopolymers (white and transparent). Frequency of distalizers’ debonding and patients’ aesthetical perception was evaluated on the set of 12 complete orthodontic treatments. The mean duration of treatment period with a bonded distalizer was 6.4 months. All cases were adults with unilateral Class II malocclusion managed with a hybrid approach as a part of Invisalign® comprehensive treatment. Results showed that such perspective practice is feasible for 3D design and in-office 3D printing of a personalized distalizer. Results also showed no clinically significant differences between both studied biopolymers. The paper discusses an evaluation of such personalized distalizer functionality with regard to the current state of the art and compares to conventional prefabricated alternatives like a Carriere® Distalizer™ appliance. Research showed a preference of patients towards transparent biocompatible photopolymer instead of the white A2 shade. The paper concludes that additive manufacturing from dental resins is a viable method in personalization and in-office 3D printing of orthodontic auxiliaries, particularly distalizers. New materials for orthodontic 3D printing endow enhanced individualization, thus more efficient treatment.
Collapse
|
15
|
Technique for Orthodontic Clinical Photographs Using a Smartphone. Int J Dent 2022; 2022:2811684. [PMID: 35103062 PMCID: PMC8800594 DOI: 10.1155/2022/2811684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 01/08/2022] [Indexed: 11/17/2022] Open
Abstract
Smartphone cameras have advanced at a rapid rate. With this advancement, it is possible to take high quality orthodontic clinical photographs using a smartphone. The aim of this article is to describe the technique to take orthodontic clinical photographs using a smartphone.
Collapse
|
16
|
Alassiry AM, Hakami Z. The Attitude, Perception, and Mental Health of Patients Receiving Orthodontic Treatment During the COVID-19 Pandemic in Saudi Arabia. Patient Prefer Adherence 2022; 16:363-372. [PMID: 35189625 PMCID: PMC8848244 DOI: 10.2147/ppa.s348933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/27/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The COVID-19 pandemic has forced dental clinics to shut down indefinitely, leaving thousands of orthodontic patients in unending fear and dismay. The study aimed to assess the attitude, perceptions and mental health status of patients undergoing orthodontic treatment in Saudi Arabia during the lockdown. PATIENTS AND METHODS A cross-sectional study was conducted among orthodontic patients of different clinics across Saudi Arabia and selected using two-stage clustered sampling. A validated Arabic questionnaire comprising four sections including demographic data, patients' interactions, attitude and perception, and Kessler Psychological Distress Scale was sent via digital means. Descriptive and inferential statistics were applied with the level of significance set to p<0.05. RESULTS A total of 512 orthodontic patients voluntarily participated in the study. Eighty-four percent of the patients contacted their orthodontist once or twice during this period, 22% percent did not receive any communication from their orthodontist, 18% were very worried about not being able to continue their treatment, 72% were concerned about the treatment duration increasing post lockdown, 18% suffered cuts or lacerations due to their appliance, and 32% had poking wires. Seventy-six percent of patients were willing to visit a clinic post lockdown only with proper preventive measures in place. A mild level of mental distress (22.76 ± 8.69) was reported using the Kessler Psychological Distress Scale. Female orthodontic patients >25 years of age with >1 year of ongoing treatment were associated with higher levels of mental distress. CONCLUSION The current pandemic has impacted the mental health status of orthodontic patients in some form or another. Older females with longer treatment times were more affected by the lockdown. The lack of effective communication from the orthodontist led to some negative perceptions about their treatment.
Collapse
Affiliation(s)
- Ahmed Mohammed Alassiry
- Preventive Dental Sciences Department, Faculty of Dentistry, Najran University, Najran, Saudi Arabia
| | - Zaki Hakami
- Division of Orthodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
- Correspondence: Zaki Hakami, Division of Orthodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia, Tel +966-544702011, Email
| |
Collapse
|
17
|
Thurzo A, Kurilová V, Varga I. Artificial Intelligence in Orthodontic Smart Application for Treatment Coaching and Its Impact on Clinical Performance of Patients Monitored with AI-TeleHealth System. Healthcare (Basel) 2021; 9:healthcare9121695. [PMID: 34946421 PMCID: PMC8701246 DOI: 10.3390/healthcare9121695] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 11/27/2021] [Accepted: 12/04/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Treatment of malocclusion with clear removable appliances like Invisalign® or Spark™, require considerable higher level of patient compliance when compared to conventional fixed braces. The clinical outcomes and treatment efficiency strongly depend on the patient's discipline. Smart treatment coaching applications, like strojCHECK® are efficient for improving patient compliance. PURPOSE To evaluate the impact of computerized personalized decision algorithms responding to observed and anticipated patient behavior implemented as an update of an existing clinical orthodontic application (app). MATERIALS AND METHODS Variables such as (1) patient app interaction, (2) patient app discipline and (3) clinical aligner tracking evaluated by artificial intelligence system (AI) system-Dental monitoring® were observed on the set of 86 patients. Two 60-day periods were evaluated; before and after the app was updated with decision tree processes. RESULTS All variables showed significant improvement after the update except for the manifestation of clinical non-tracking in men, evaluated by artificial intelligence from video scans. CONCLUSIONS Implementation of application update including computerized decision processes can significantly enhance clinical performance of existing health care applications and improve patients' compliance. Using the algorithm with decision tree architecture could create a baseline for further machine learning optimization.
Collapse
Affiliation(s)
- Andrej Thurzo
- Department of Stomatology and Maxillofacial Surgery, Faculty of Medicine, Comenius University in Bratislava, 81250 Bratislava, Slovakia
- Correspondence: ; Tel.: +421-903-110-107
| | - Veronika Kurilová
- Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, 81219 Bratislava, Slovakia;
| | - Ivan Varga
- Institute of Histology and Embryology, Faculty of Medicine, Comenius University in Bratislava, 81372 Bratislava, Slovakia;
| |
Collapse
|
18
|
Sangalli L, Fernandez-Vial D, Moreno-Hay I, Boggero I. Telehealth Increases Access to Brief Behavioral Interventions in Orofacial Pain Clinic during COVID-19 Pandemic: A Retrospective Study. PAIN MEDICINE 2021; 23:799-806. [PMID: 34623433 PMCID: PMC8524454 DOI: 10.1093/pm/pnab295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/09/2021] [Accepted: 10/04/2021] [Indexed: 01/25/2023]
Abstract
Objective Aim of the study was to test if orofacial pain patients were more likely to start and complete a brief psychological intervention for managing certain chronic orofacial pain conditions (physical self-regulation, PSR) via telehealth (during the COVID-19 pandemic) vs. in-person (prior to the COVID-19 pandemic). Exploratory aim was to describe demographic factors that may influence the patients to start and complete PSR. Methods Retrospective medical charts of all patients seen at a university-affiliated tertiary orofacial pain clinic between July–December 2019 (in person, pre-pandemic) and July–December 2020 (telehealth, during pandemic) were reviewed. Charts were examined for demographic information and to compare the number of patients who started and completed PSR during each study period (chi-squared test). Results Of 248 new patients seen in the clinic during 2019 period, 25 started PSR in-person (10.08%). Of 252 new patients seen during 2020 period, 53 started PSR via telehealth (21.03%). Patients were more likely to start PSR (OR = 6.21, p<.001, CI = 2.499 to 15.435) and more likely to complete all three sessions of PSR (OR = 5.69, p<.001, CI = 2.352 to 13.794) when it was offered via telehealth than in-person. Among those who started PSR via telehealth, patients from metropolitan areas were more likely to start the intervention than those from non-metropolitan areas (p=.045). Conclusions Offering brief psychological pain interventions via telehealth in tertiary orofacial pain clinics has demonstrated feasibility and may improve willingness to participate in psychological treatments. Results need to be replicated with prospective data as modality was confounded with pandemic in the current study.
Collapse
Affiliation(s)
- Linda Sangalli
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Diego Fernandez-Vial
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Isabel Moreno-Hay
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Ian Boggero
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| |
Collapse
|
19
|
Sangalli L, Savoldi F, Dalessandri D, Bonetti S, Gu M, Signoroni A, Paganelli C. Effects of remote digital monitoring on oral hygiene of orthodontic patients: a prospective study. BMC Oral Health 2021; 21:435. [PMID: 34493255 PMCID: PMC8422366 DOI: 10.1186/s12903-021-01793-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/27/2021] [Indexed: 02/08/2023] Open
Abstract
Background Remote digital monitoring during orthodontic treatment can help patients in improving their oral hygiene performance and reducing the number of appointments due to emergency reasons, especially in time of COVID-19 pandemic where non-urgent appointments might be discouraged. Methods Thirty patients scheduled to start an orthodontic treatment were divided into two groups of fifteen. Compared to controls, study group patients were provided with scan box and cheek retractor (Dental Monitoring®) and were instructed to take monthly intra-oral scans. Plaque Index (PI), Gingival Index (GI), and White Spot Lesions (WSL) were recorded for both groups at baseline (t0), every month for the first 3 months (t1, t2, t3), and at 6 months (t4). Carious Lesions Onset (CLO) and Emergency Appointments (EA) were also recorded during the observation period. Inter-group differences were assessed with Student's t test and Chi-square test, intra-group differences were assessed with Cochran’s Q-test (significance α = 0.05). Results Study group patients showed a significant improvement in plaque control at t3 (p = 0.010) and t4 (p = 0.039), compared to control group. No significant difference was observed in the number of WSL between the two groups. No cavities were detected in the study group, while five CLO were diagnosed in the control group (p = 0.049). A decreased number of EA was observed in the study group, but the difference was not significant. Conclusions Integration of a remote monitoring system during orthodontic treatment was effective in improving plaque control and reducing carious lesions onset. The present findings encourage orthodontists to consider this technology to help maintaining optimal oral health of patients, especially in times of health emergency crisis.
Collapse
Affiliation(s)
- Linda Sangalli
- Department of Information Engineering, Faculty of Engineering, University of Brescia, Via Branze 38, 25123, Brescia, Italy.,Division of Orofacial Pain, College of Dentistry, University of Kentucky, 740 S. Limestone, Lexington, KY, 40536, USA
| | - Fabio Savoldi
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, 2/F, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR
| | - Domenico Dalessandri
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Stefano Bonetti
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| | - Min Gu
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, 2/F, Prince Philip Dental Hospital, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, Hong Kong SAR.
| | - Alberto Signoroni
- Department of Information Engineering, Faculty of Engineering, University of Brescia, Via Branze 38, 25123, Brescia, Italy
| | - Corrado Paganelli
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy
| |
Collapse
|
20
|
Timm LH, Farrag G, Baxmann M, Schwendicke F. Factors Influencing Patient Compliance during Clear Aligner Therapy: A Retrospective Cohort Study. J Clin Med 2021; 10:jcm10143103. [PMID: 34300269 PMCID: PMC8303492 DOI: 10.3390/jcm10143103] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 11/27/2022] Open
Abstract
Compliance is highly relevant during clear aligner therapy (CAT). In this retrospective cohort study, we assessed compliance and associated covariates in a large cohort of CAT patients. A comprehensive sample of 2644 patients (75.0% females, 25.0% males, age range 18–64 years, median 27 years), all receiving CAT with PlusDental (Berlin, Germany) finished in 2019, was analyzed. Covariates included demographic ones (age, gender) as well as self-reported questionnaire-obtained ones (satisfaction with ones’ smile prior treatment, the experience of previous orthodontic therapy). The primary outcome was compliance: Based on patients’ consistent use of the mobile application for self-report and aligner wear time of ≥22 h, patients were classified as fully compliant, fairly compliant, or poorly compliant. Chi-square test was used to compare compliance in different subgroups. A total of 953/2644 (36.0%) of patients showed full compliance, 1012/2644 (38.3%) fair compliance, and 679/2644 (25.7%) poor compliance. Males were significantly more compliant than females (p = 0.000014), as were patients without previous orthodontic treatment (p = 0.023). Age and self-perceived satisfaction with ones’ smile prior to treatment were not sufficiently associated with compliance (p > 0.05). Our findings could be used to guide practitioners towards limitedly compliant individuals, allowing early intervention.
Collapse
Affiliation(s)
- Lan Huong Timm
- Sunshine Smile, Windscheidstraße 18, 10627 Berlin, Germany;
- Correspondence:
| | - Gasser Farrag
- Sunshine Smile, Windscheidstraße 18, 10627 Berlin, Germany;
| | | | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité—Universitätsmedizin Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany;
| |
Collapse
|
21
|
Effectiveness of a Selective Etching Technique in Reducing White Spots Formation around Lingual Brackets: A Prospective Cohort Clinical Study. COATINGS 2021. [DOI: 10.3390/coatings11050572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The risk of developing white spot lesions (WSLs) after orthodontic treatment with lingual brackets is generally considered lower than with labial ones, even if plaque accumulation is frequently higher due to the increased difficulty level in oral hygiene maintenance. In this prospective clinical study, selective enamel etching technique effectiveness in reducing plaque accumulation and WSLs was tested. Thirty patients were bonded with a split-mouth approach: two randomly selected opposite quadrants were used as the test sides, using customized plastic etching guides, and the other two as control sides, applying traditional direct etching methods. The plaque presence around the braces was recorded after 1, 3, 6, and 12 months according to a lingual plaque accumulation index (LPAI), as was the presence of WSLs. PAI measured values were significantly higher in the control sides during the observation period. Test and control sides differed significantly for new WSL onset only after 12 months of treatment. Therefore, the present research demonstrated that this guided enamel etching technique allowed for significant reduction in plaque accumulation around the lingual brackets and reduced onset of white spots after one year of treatment.
Collapse
|