The Use of Remote Monitoring for Orthodontic Retention Review
- Conditions
- Orthodontic Relapse
- Interventions
- Other: Clinic ReviewDevice: Dental Monitoring
- Registration Number
- NCT05006339
- Lead Sponsor
- Sydney Local Health District
- Brief Summary
To assess whether using retainers and an artificial intelligence supported remote monitoring system maintains a more stable orthodontic treatment result than using retainers with in-office review appointments.
- Detailed Description
The amount and nature of relapse are unpredictable and natural changes in the dentition are life-long. Although some patients were shown to remain stable despite not wearing retainers, research is unable to provide predictors for identifying those patients and therefore we have to treat all patients as if they have the potential to relapse long term.
Following the results of long-term retrospective studies, there has been a gradual change of practice from prescribing retainers for 1-2 years to long-term retention. This is a significant burden on patients, clinicians and the health system as long term review and maintenance of retainers are required from both parties.
Although some studies showed compliance with the use of orthodontic retainers correlated with factors such as gender, age and type of retainer, one of the main reasons for non-compliance with removable retainers was shown to be just forgetting to wear them. Patient compliance is also needed in attending follow-up appointments for review of fit and intactness of retainers as well as calculus build-up that may be present around fixed lingual wires.
Long term review is also needed to protect patients from any side effects from broken or distorted fixed retainers. This is not common, yet when it happens its side effects can be deleterious. Since patients do not always realise these side effects on time, damage may range from simple malalignment of teeth to having roots of teeth come out of bone creating periodontal and aesthetic consequences.
Attending review appointments could be inconvenient for both patients and parents as they need to take time off of school and work.
There are currently no studies on the efficacy of DM as a tool to monitor orthodontic retention patients. Therefore, this project can shed light on whether the use of DM is an acceptable or more effective way of monitoring patients wearing retainers than traditional in-office orthodontic visits. The results of this study could also help guide clinicians regarding the most effective retention regime using remote monitoring systems. The study will also compare the costs of in-office retainer checks and remote monitoring of retainers, If the results of this study show DM is better, or comparable to, clinical review appointments and it less costly and more convenient, DM may be utilised for patients in the public system freeing chair-time for patients waiting for treatment on the public orthodontic waiting list.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 82
- Consent to participate in the trial and comply with the retention regime and able to follow instructions
- Permanent dentition
- Good general health
- Good oral hygiene and good periodontal health
- Owning or having access to a mobile/smart phone compatible with Dental monitoring application (DM app is available for use on all iOS and Android devices)
-
Patients with
- Congenital anomalies or craniofacial syndromes
- Poor oral hygiene and poor periodontal health
- Missing teeth & teeth with poor enamel quality
-
Patients that were treated with orthognathic surgery
-
Patients that are unwilling or unable to follow the instructions provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Clinic Review Clinic Review Orthodontic retention review via in-office visits as per routine care Dental Monitoring Dental Monitoring Orthodontic retention review via dental monitoring only
- Primary Outcome Measures
Name Time Method Orthodontic treatment stability - Inter-molar width 4 years Distance between the mesiobuccal cusp tips of the right and left first permanent molars
Orthodontic treatment stability - Little's Irregularity Index 4 years The sum of the linear displacements of five labial segment contact point in a labiolingual direction
Orthodontic treatment stability - Inter-canine width 4 years Distance between the cusp tips of right and left canines
Orthodontic treatment stability - Spacing if present 4 years The sum of the linear distances between contact points of teeth that have space between them
Orthodontic treatment stability - Overjet 4 years The maximum distance between the upper incisors edge and the lower incisal labial surface
Orthodontic treatment stability - Overbite 4 years The maximum vertical overlap between the upper and lower incisors with the models in maximal intercuspation
- Secondary Outcome Measures
Name Time Method Oral Health Assessment - Cavity presence if any 4 years Identification of cavities
Cost effectiveness 4 years Total cost of both systems
Retainer problems - compliance 4 years Retainer compliance measured with fit of retainer - space in mm between retainer and teeth
Oral health assessment - Gingivitis if any 4 years Identification of gingivitis
Retainer failure identification time 4 years Retainer failure identification duration, in number of days
Retainer failure 4 years Retainer failure identification, yes or no
Patient satisfaction 4 years Satisfaction with the 2 protocols of retention review using Likert scale questionnaires that have 5 answer options ranging from "strongly agree" to "strongly disagree". Different questions have positive/negative outcomes with either end of the scale.
Trial Locations
- Locations (1)
Sydney Dental Hospital
🇦🇺Surry Hills, New South Wales, Australia