Does daily wear time of Twin Block reliably predict its efficiency of class II treatment?

Abstract

Purpose The objective of this study was to investigate how daily wear time (DWT) influences class II malocclusion treatment efficiency. Materials and methods The study group consisted of 55 patients (mean age 10.4 years) diagnosed with a class II/1 malocclusion. Twin block appliances, with built-in Theramon® microsensors (MC Technology, Hargelsberg, Austria) to monitor patients’ cooperation (daily wear time assessment), were used for treatment. Cephalograms were taken and the following initial and final measurements were compared: Co-Gn, Co-Go, Co-Olp, Pg-Olp, WITS, SNA, SNB, ANB, Co-Go-Me, overjet, molar and canine relationships. The Shapiro–Wilk test, Wilcoxon signed-rank test, Student’s t-test, Levene’s test, Mann–Whitney U test, Kruskal–Wallis test, χ2 test, and Spearman’s rank correlation coefficient with p < 0.05 set as the statistical significance level were used to determine the correlation of the outcomes with DWT; a ROC (receiver operating characteristic) curve was calculated to illustrate diagnostic ability of the binary classifier system. Results DWT was very highly positively correlated with change of the Pg-Olp parameter and highly with an improvement in the ANB, SNA, and SNB angles, an increase in the WITS parameter and an increase in Co-Gn distance. DWTs < 7.5 h correlated with significantly less improvement of the investigated variables. However, DWT > 7.5 h did not significantly correlate with the improvement of the overjet and most of the linear parameters in the mandible. The ROC curve and its AUC (area under curve) allowed the determination of a DWT of 7 h and 48 min to be capable of establishing a class I relationship with 83% probability. Conclusions Class II treatment efficiency was influenced by DWT; an 8 h threshold value had an 83% probability of establishing a class I relationship.

Orthodontic Compliance Assessment: A Systematic Review

“…Retainers, 7 , 12 , 25 , 34 , 35 , 36 functional appliances, 7 , 8 , 9 , 13 , 16 , 17 , 19 , 24 , 26 , 31 , 37 , 38 , 39 , 40 active removable appliances, 8 , 9 , 16 , 22 , 24 , 32 , 41 and extraoral appliances 17 , 18 , 20 , 21 , 23 , 27 , 28 , 29 , 30 , 31 , 33 were used in the study. Objective measurement of DWT was carried out primarily using TheraMon® microsensors.…”

“…The quality of case control and cohort studies as assessed by NOS was high. As many as 17 eligible studies 7 , 8 , 30 , 31 , 32 , 33 , 38 , 39 , 41 , 9 , 13 , 18 , 19 , 26 , 27 , 28 , 29 scored 8 out of total 9 points, whilst the remaining studies 6 , 16 , 17 , 20 , 21 , 22 , 23 , 24 , 40 scored 7 out of 9 points. The results of those analyses are presented in Appendix Tables 3 and 4 .…”

“…With the use of such sensors, it has already been proven that patients do not comply with the recommended DWT and usually shorten it arbitrarily. 13 Nevertheless, the question of which specific factors are significantly correlated with better or worse patient compliance remains open. Therefore, the aim of our systematic review was to determine whether the type of removable appliance, as well as age and sex of the patient, might result in extending or shortening of DWT.…”

3D Printed Customized Facemask for Maxillary Protraction in the Early Treatment of a Class III Malocclusion: Proof-of-Concept Clinical Case

“…A clinical trial on the use of sensorized custom-made facemasks in the early treatment of Class III malocclusions is currently ongoing at the Orthodontic Clinic of the Careggi University Hospital in Florence. Wear time monitoring allows for objectively assessing to what extent a patient’s compliance influences the outcome of facemask therapy and whether there is a threshold value of wear time for the treatment to be clinically effective [ 26 , 27 ].…”

The Use of Microsensors to Assess the Daily Wear Time of Removable Orthodontic Appliances: A Prospective Cohort Study

“…He stresses that in view of the impossibility of objective evaluation of the degree of patients’ compliance, all existing studies concerning the effectiveness of functional therapy, which reveal the full potential of therapeutic options of functional appliances, are not fully dependable. Our recently published studies prove that very satisfactory results of functional treatment can be obtained in compliant patients [ 36 ].…”