Factors related to orthodontic treatment time in adult patients

Abstract

Introduction:The length of time that it takes an orthodontist to treat adult patients varies widely. Objective: The aim of this study was to investigate how different variables influence treatment time. Methods: Seventy clinical case reports of successfully treated adult patients were examined. The patients were selected from 4,723 records held by three experienced orthodontists. The influence exerted by the following variables on treatment time was assessed: age, sex, facial pattern, severity of malocclusion (measured by the PAR index), sagittal relationship of canines, type of brackets (ceramic or metal), tooth extractions, missed appointments and orthodontic appliance issues/breakages, the latter being the dependent variable. Assessment was performed by multiple linear regression analysis, followed by the stepwise method with P < 0.05. Results: The number of times a patient missed their appointment (no-show) (R 2 = 14.4%, p < 0.0001) and the number of appliance issues/breakages (R 2 = 29.71%, p = 0.0037) significantly affected variability in treatment time, and these two variables together can predict 43.75% (R 2 total) of the overall variability in treatment time. Other factors, such as canine relationship at the beginning of treatment, bracket type (metal or ceramic), tooth extractions, age at start of treatment, severity of the initial malocclusion, sex and facial pattern had no significant bearing on treatment time. Conclusions:The duration of orthodontic treatment in adults, when performed by experienced orthodontists, is mainly influenced by factors related to patient compliance. However, several factors which were not included in this study may contribute to variability in orthodontic treatment time.Keywords: Adult. Time factors. Orthodontics.Introdução: o tratamento ortodôntico de pacientes adultos apresenta grande variabilidade no tempo necessário para sua realização. Objetivo: o objetivo desse trabalho foi investigar a influência de diversas variáveis sobre o tempo de tratamento. Métodos: foram examinados 70 casos clínicos, de pacientes adultos, com bom resultado final, coletados em clínicas de três ortodontistas experientes, cujo acervo total inicial era de 4.723 prontuários. A influência das variáveis idade, sexo, padrão facial, severidade inicial da má oclusão (medida por meio do índice PAR), relação sagital de caninos, tipo de braquetes (estético ou metálico), exodontias, faltas às consultas e "quebras" de aparelho, sobre o tempo de tratamento (variável dependente), foram avaliadas por meio da análise de regressão linear múltipla, seguida do método Stepwise, com p < 0,05. Resultados: a quantidade de faltas (R 2 = 14,04%, p < 0,0001) e o número de "quebras" do aparelho (R 2 = 29,71%, p = 0,0037) tiveram influência significativa na variação do tempo de tratamento, sendo essas duas variáveis juntas capazes de prever 43,75% (R 2 total) da variação no tempo de tratamento. Outros fatores, como a relação de caninos ao início do tratamento, o tipo de braquete usado (metálico ou cerâmico), exodontias, a ...

Factors influencing orthodontic treatment time for non-surgical Class III malocclusion

“…Appliance breakages were weak, but statistically associated with treatment time in this study (R 2 =0.0596), as previously described 6,16,20 . Increments in treatment duration might be due to the necessity of returning to a lighter arch wire or the impossibility of treatment evolution in that month.…”

“…Previous reports evaluating adult patients 16 showed that the amount of missed appointments is the factor that affects treatment duration (43.75%) of Class I and Class II patients the most. These findings are supported by our findings (43.49%).…”

“…Factors that could interfere on treatment duration include sex 11 , pretreatment ANB value 11,27 overbite 27 , crowding 2,27 , extractions 2,11,27 , time between appointments 2 , treatment phases 29 , age 10,20 , overjet 6,20 , technique 26 , patient compliance (including missed appointments and debonds) 16,20,27 public or private practice 30 , oral hygiene 12,27 , scholar grades 12 , caries 12 , restorations 12 , arch coordination 12 , parent's occupation 12 .…”

Early vertical correction of the deep curve of Spee

“…The best scientific evidence now available indicates that the type of malocclusion, clinical decisions and patient compliance 3 - 5 have more importance than the technique or bracket used 4 6 , 7 Therefore, altering "technique-sensitive" features can hardly improve efficiency or reduce treatment time, unless these features are common to all techniques.…”

Effects of piezosurgery in accelerating the movement of orthodontic alveolar bone tooth of rats and the expression mechanism of BMP-2

“…However, patients under exodontia require a longer period of time (4). The longer the treatment course is, the greater the risks of gingivitis, enamel demineralization, decayed tooth, and even root resorption (5–6).…”