Quantification of wear-time adherence of removable appliances in young orthodontic patients in relation to their BMI: a preliminary study

Abstract

PurposeThe relationship between unhealthy body mass index (BMI) and adherence to orthodontic treatment with removable appliances has not previously been evaluated.ObjectiveThe aim of this study was to quantify the association between BMI and wear time of removable orthodontic appliances and to evaluate BMI changes during orthodontic treatment.Patients and methodsFifty-three normal-weight and 39 overweight/obese children and adolescents (7–15 years old) undergoing orthodontic treatment with removable appliances were enrolled into the study. BMI categories were determined using standardized age-specific and sex-specific BMI criteria, using data measured at the beginning of therapy and once during orthodontic treatment. Wear times of removable appliances were measured at 15-minute intervals over a period of 5 months using implanted microelectronic sensors. Median wear-time values were used in the analysis with the Mann–Whitney U-test used to test statistical differences between groups.ResultsThe median wear time of removable orthodontic appliances was 9.3 hours for normal-weight patients and 9.2 hours for overweight/obese patients. No statistically significant (P>0.05) or clinically relevant differences in usage or adherence were detected between normal-weight and overweight/obese patients. BMI did not influence wear time or behavior of removable orthodontic appliances by young patients. The majority of patients showed qualitative decreases in BMI during therapy.ConclusionThe orthodontic treatment of young patients with removable devices does not require BMI-dependent changes in the treatment strategy. However, the use of removable appliances during meal times raises the possibility of reducing food intake, and in this way the orthodontist may have an active role to play in weight reduction.

Evaluation of body weight, body mass index, and body fat percentage changes in early stages of fixed orthodontic therapy

“…Although no clear consensus exists, the best-accepted definition for clinically important weight loss is approximately 5% over 6–12 months. [ 15 16 ] Schott and Ludwig[ 17 ] found that the orthodontic treatment of young patients with removable appliances showed qualitative decrease in BMI over a period of 6 to 36 months.…”

A feasible method to improve adherence of Hawley retainer in adolescent orthodontic patients: a randomized controlled trial

“…Many studies have investigated suitable methods for measuring a patient’s removable appliance wear time, 14 , 15 so quantifying patient compliance over the whole therapy period can routinely be performed in an orthodontic office. 16 – 18 However, few studies have researched the factors that predict compliance with retainer use or interventions that improve compliance with removable appliances or retainers. 13 Patient compliance was found to be influenced by psychological and sociodemographic traits.…”

Influence of increased body mass index on orthodontic tooth movement and related parameters in children and adolescents: A systematic review of longitudinal controlled clinical studies

“…The risk of bias in individual studies (Jayachandran et al, 2017; Saloom et al, 2017, 2018; Schott and Ludwig, 2014; von Bremen et al, 2013, 2016, 2018) was assessed by two authors (ZA and FJ) using the Risk of Bias In Non-randomised Studies (ROBINS-I) assessment tool. This tool assesses the bias in five domains including potential confounding, selection, classification, attrition and reporting bias (Sterne et al, 2016).…”