Impact of the SARS-Cov2 Pandemic on Orthodontic Therapies: An Italian Experience of Teleorthodontics

Abstract

To assess the possibility of controlling patients at a distance according to principles of teleorthodontics to understand its possible usefulness in the future routine activity and the impact pandemic may have had on different types of orthodontic treatments. Material and Methods: One hundred orthodontic patients (57 F, 43 M, age 7-46) during quarantine were checked through videocalls and photos sent by patients following proper instructions. Three groups have been distinguished based on the type of therapy: A-fixed appliances; B-removable appliances; C-clear aligners. Relevant events about dental and gingival health, integrity of appliances, orthodontic therapies related symptoms and overall progress of treatments were recorded. Results: A and B groups reported higher percentages of gingival inflammation (27 and 22%), dental plaque (16 and 13%), deciduous tooth loss (8 and 16%). Bracket and attachment detachment were the most frequent events in A and C groups (22 and 23%). Pain and discomfort were reported in A and B groups (35 and 32%). Therapies continued to progress better in C (51% improved dental alignment) and B (31% improved malocclusions) groups. Conclusion: Orthodontics is safe and allows during emergencies to postpone checks. Everyday mobile-technology is useful in managing orthodontic patients unable to carry out in-person control. When their effectiveness equals other systems, treatments with clear aligners without attachments should be preferred in patients unavailable for regular checks.

Clear Aligners: Between Evolution and Efficiency—A Scoping Review

“…A clinical study has been published on the efficiency of the use of this clear aligners’ system with elastics in class II malocclusions [ 15 ]. A recent study evaluates the progress of the therapies with this clear aligner and other brands during the last pandemic [ 35 ]. Another two studies show how to plan hybrid therapies with clear aligners and fixed appliances to manage class II and III malocclusions [ 36 , 37 ].…”

“…and Sorridi (Tecnologia Dentale, Latina, Italy) is documented in the study describing the advantage of using clear aligners when regular orthodontic checks cannot be performed in person. The Sorridi system includes divots (and no attachments), and this is probably the reason why patients wearing these clear aligners reached better results and had no discomfort during the SARS-Cov2 pandemic [ 35 ]. Clear aligners are made of thermoplastic materials.…”

Utility of Teleorthodontics in Orthodontic Emergencies during the COVID-19 Pandemic: A Systematic Review

“…Teledentistry is, in fact, a specialized extension of telemedicine that was first developed at the military level and subsequently found application mainly in the management of patients living in remote rural areas whose movements need to be limited to those necessary for reasons of greater fragility—for example, in the case of cancer patients. In the context of teledentistry, its application to orthodontics, called teleorthodontics, can be considered a very useful tool to assess patients remotely when they need to report a problem related to a fixed or removable device before a periodic check-up in person, or when they have queries about their usage ( Figure 1 ) [ 4 ].…”

Factors Influencing Patient Compliance during Clear Aligner Therapy: A Retrospective Cohort Study

“…Technological advancements in computers, mobile phones, internet security, telecommunications, and software allow increased options for networking, information sharing, and consultation in medicine, facilitating remote and cost-effective (tele-)healthcare [ 1 , 2 , 3 , 4 , 5 , 6 ]. In dentistry, non-contact communication between patients and dentists has been used for various steps along the clinical workflow including initial diagnosis, joint treatment planning, follow-up, and intermediate consultations [ 1 , 2 , 3 , 4 , 5 , 6 ].…”