Effects of remote digital monitoring on oral hygiene of orthodontic patients: a prospective study

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.

The Attitude, Perception, and Mental Health of Patients Receiving Orthodontic Treatment During the COVID-19 Pandemic in Saudi Arabia

“…15,16 The use of smartphones and digital technology can be useful in evaluating the progression of the treatment and improving the patient's cooperation. 17 Due to the current pandemic, 63% of the patients could not visit their orthodontist for the last 3-6 months. Despite this long period, a good number (63%) of patients regularly followed the instructions given by their orthodontist.…”

Remote digital monitoring during the retention phase of orthodontic treatment: A prospective feasibility study

“… 19 , 20 In the past few years, the market has assisted an increased availability of orthodontic apps to enhance long-distance monitoring and compliance, 21 and a recent study confirmed the positive attitude of patients towards this new digital technology. 22 In orthodontics, it can be applied for monitoring of several treatment aspects, 23 including patients’ oral hygiene during the therapy, 16 , 24 , 25 treatment with clear aligners, 26 , 27 rapid palatal expansion, 15 , 28 , 29 adherence to the use of removable retainers, 8 active working time of self-ligating straight-wire appliances, 30 and clinical follow-up of corticotomy-accelerated orthodontic therapies. 31 …”

“…This problem was not reported in studies in which this technology was applied on a weekly basis. 16 This may suggest that the monthly frequency of scanning leads the patient to forget the method of capturing accurate pictures compared to more frequent monitoring.…”

“…During their first appointment at the beginning of the retention phase (T0), the study group patients were also delivered a ScanBox © (DM, Dental Monitoring) and a dedicated cheek retractor by DM as described elsewhere 16 ( Figure 1 ), and they were asked to download the DM app on their smartphone to perform monthly intraoral scans. The first scan was taken together with the orthodontist to ensure proper use of the device.…”

The Impact of the COVID-19 Pandemic on Israeli Orthodontic Practice: A Clinic’s Activity and Patients’ Attitudes

“…Those who reported declined cooperation expected that the lockdown would have a detrimental impact on the treatment quality and duration. Sangalli et al [ 31 ] showed that remote monitoring during orthodontic treatment improves patients’ plaque control and reduces the onset of carious lesions. Thus, continuous follow ups and remote support may play an important role in improving patients’ cooperation and subsequently, may influence their attitudes regarding treatment success.…”