Objectively measured compliance during early orthodontic treatment: Do treatment needs have an impact?

Abstract

Objective assessment of daily wear time of removable appliances is possible, so the next step is to ascertain whether the severity of malocclusion influences patients' compliance. This could help resolve the controversy over the question of whether removable appliance therapy truly works. The aim of the study was to investigate whether the patient's orthodontic treatment needs affect the cooperation between the patient and the doctor, and to find a correlation that could affect recommendations for orthodontic treatment. The study involved 58 patients (29 boys, 29 girls) aged 9-12 years, who qualified for treatment with removable appliances equipped with a sensor system. The patients were divided into four groups according to their Index of Orthodontic Treatment Need dental health component scores. Over a 9-month period, data stored in the sensors were compared with the recommended daily wear time (DWT) of the appliances, and a statistical analysis was conducted. DWT differed considerably in all the groups. Statistically significant differences in the mean DWT values occurred only when extreme values of the IOTN DHC were compared. The degree of patient compliance depends to a small extent on the severity of malocclusion. Patients with mild malocclusion will probably be less likely to cooperate. Among patients with severe malocclusion, compliance may be unpredictable. Patient compliance is an important background factor that can explain a lot of the controversy over the effectiveness of treatment with removable appliances.