Abstract

BackgroundRemote 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.MethodsThirty 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).ResultsStudy 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.ConclusionsIntegration 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.

Highlights

  • 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

  • Intra‐group differences The intra-group differences at different time-points for study group patients were significant for Plaque Index (PI), Gingival Index (GI) and White Spot Lesions (WSL) (Table 2)

  • As for Carious Lesions Onset (CLO), no cavities were detected in the study group, while five CLO were diagnosed in the control group (p = 0.049)

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Summary

Introduction

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. Oral hygiene should be routinely controlled in patients undergoing orthodontic treatment. Previous studies proposed a system of active reminders for adolescents undergoing orthodontic treatment by weekly text messaging their parents [8, 10,11,12], using WhatsApp chat room for sharing “selfies” of their smile [13], and using computer-based training to teach Fones brushing technique or modified Bass technique [14]. Frequently used social media among young subjects, such as Instagram [15], or other digital platforms, such as YouTube [16], have shown to improve oral health knowledge among orthodontic patients. Some studies found no positive effect of instructions about oral hygiene during orthodontic treatment by using social media-based and messaging apps, respectively [17, 18]

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