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Objective: To compare the time efficiency of aligner therapy (ALT) and conventional edgewise braces (CEB) based on large samples of patients treated by the same highly experienced orthodontist, with the same treatment goals for both groups of patients. Materials and Methods: The retrospective portion of the study evaluated 150 CEB patients who were matched, based on mandibular crowding and number of rotated teeth, to 150 ALT patients. All records were obtained at one orthodontist's office. All of the patients had mild-to-moderate Class I malocclusions (≤5 mm incisor crowding) and were treated nonextraction. Age, gender, total treatment time, total number of appointments, types of appointments, materials used, mandibular crowding, and number of rotated teeth were recorded from the patients' records. The prospective portion of the study timed the various types of appointments for both treatments with a stopwatch. Results: Compared to ALT, CEB required significantly (P < .01) more visits (approximately 4.0), a longer treatment duration (5.5 months), more emergency visits (1.0), greater emergency chair time (7.0 minutes), and greater total chair time (93.4 minutes). However, ALT showed significantly (P < .01) greater total material costs and required significantly more total doctor time than CEB (P < .01). Conclusions: Whether the greater time efficiency of ALT offsets the greater material costs and doctor time required depends on the experience of the orthodontist and the number of ALT case starts.

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This chapter presents a new paradigm for sustainable data-driven language learning systems design in higher education that draws on qualitative reflections spanning a decade (2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020)(2021)(2022) with stakeholders from an ongoing global research study with the FLAX (Flexible Language Acquisition) and F-Lingo projects at the University of Waikato in Aotearoa New Zealand (Fitzgerald (2019) A new paradigm for open data-driven language learning systems design in higher education; König et al. (2022) Smart CALL). Design considerations are presented for remixing domain-specific open access content into Open Educational Resources (OER) for academic English language provision across formal and non-formal higher education contexts. Primary stakeholders in the research collaboration include the following three groups: (1) Knowledge organisations that provide open access to academic content-libraries and archives, including the British Library and the Oxford Text Archive, universities in collaboration with MOOC providers and the CORE (COnnecting REpositories) open access aggregation service at the UK Open University; (2) Researchers who mine and remix academic content into corpora and open data-driven language learning systems-converging from the fields of open education, computer science and applied corpus linguistics; (3) Knowledge users who re-use and remix academic content into OER-English for Academic Purposes (EAP) practitioners from university language centres. Automated content analysis was carried out on a corpus of interview and focus discussion data with the three stakeholder groups in this research. We discuss themes arising from the research data that reflect the different stakeholders' experiences of remixing open access research content that has been produced within the academy for reuse as open educational content for teaching and learning features of academic language within open datadriven language learning systems. These open learning systems have been specifically designed to scale with OER expansion and traction in mind for their sustainable uptake both within and beyond the brick and mortar of the traditional university. The new paradigm presented in this chapter challenges, as the OER movement must, established business models and deeply embedded cultural or institutional norms that present obstacles to OER expansion and traction and the sustainability of the movement. One persistent challenge concerns the lack of open education policy across the higher education sector for full open access (for use, modification, adaptation) via Creative Commons licensing to content produced within the academy. Thus, while this research has theoretical and practical implications in applied linguistics, computer science, language teaching and learning and open education, more generally, it also has significant cultural, business model and policy implications for higher education.

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