Comparative assessment of treatment efficiency and patient experience between Dental Monitoring and conventional monitoring of clear aligner therapy: A single-center randomized controlled trial

Abstract

This 2-arm randomized controlled clinical trial (RCT) aimed to assess the effect of Dental Monitoring (DM) on the efficiency of clear aligner therapy (CAT) and patient experience compared with conventional monitoring (CM) used for regularly scheduled clinical appointments. Fifty-six patients with full permanent dentition treated with CAT participated in this RCT. Patients were recruited from a single private practice and treated by 1 experienced orthodontist. Randomization was performed with permutated blocks of 8 patients assigned to either a CM or DM group with allocations concealed in opaque, sealed envelopes. It was not feasible to blind subjects or investigators. The primary treatment efficiency outcome assessed was the number of appointments. Secondary outcomes included the time to reach the first refinement, the number of refinements, the total number of aligners, and treatment duration. The patient experience was assessed using a visual analog scale questionnaire administered at the end of CAT. No patients were lost to follow-up. There was no significant difference in the number of refinements (mean= 0.1; 95% confidence interval [CI], -0.2 to 0.5; P= 0.43) and the number of total aligners (median= 5; 95% CI, -1 to 13; P= 0.09). There was a significant difference in the number of appointments, with the DM group requiring 1.5 fewer visits (95% CI, -3.3, -0.7; p= 0.02) as well as overall treatment duration, with the DM group taking 1.9 months longer (95% CI, 0.0-3.6; P= 0.04). There was a difference between study groups regarding the importance of face-to-face appointments, with the DM group not perceiving face-to-face appointments as important (P= 0.03). DM with CAT resulted in 1.5 fewer clinical appointments and a longer treatment duration of 1.9 months. There were no significant intergroup differences in the number of refinements or total aligners. CM and DM groups had similarly high levels of satisfaction with CAT. The trial was registered at Australian New Zealand Clinical Trials Registry (ACTRN12620000475943). The protocol was published before trial commencement. This research did not receive any grant from funding agencies.