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Compliance with removable orthodontic appliances.
1Department of Oral and Maxillofacial Surgery and Orthodontics, Monklands Hospital, Airdrie, Scotland.
Evidence-Based Dentistry
|December 23, 2017
Summary
Orthodontic appliance wear is significantly less than prescribed, with patients self-reporting higher usage than actual. Awareness of monitoring may improve compliance, but more research is needed.
Area of Science:
- Orthodontics
- Dental Compliance
- Public Health
Background:
- Removable orthodontic appliances are crucial for treatment success.
- Suboptimal patient compliance is a significant challenge in achieving desired treatment outcomes.
Purpose of the Study:
- To systematically review and synthesize evidence on compliance with removable orthodontic appliances.
- To identify barriers to compliance and effective interventions.
Main Methods:
- Comprehensive database search (Medline, PubMed, etc.) for quantitative and qualitative studies until May 2016.
- Quality assessment using Cochrane risk of bias, ROBINS-I, and mixed methods appraisal tool.
- Meta-regression to analyze appliance type effects on compliance.
Main Results:
- Objectively measured wear time was substantially lower than stipulated for all appliances, notably headgear.
- Self-reported wear time consistently exceeded objectively measured time, also highest for headgear.
- Awareness of monitoring and younger age correlated with improved compliance; early treatment stages showed better adherence.
Conclusions:
- Compliance with removable orthodontic appliances is generally suboptimal.
- Interventions like patient awareness of monitoring show potential but require further investigation.
- Identifying specific barriers and effective strategies is essential for improving appliance wear.
