Understanding factors influencing compliance with removable functional appliances: A qualitative study

El-Huni, Anas; Salazar, Fiorella B. Colonio; Sharma, Pratik; Fleming, Padhraig S.

doi:10.1016/j.ajodo.2018.06.011

Cited by 43 publications

(37 citation statements)

References 12 publications

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“…The bulk of the TB's acrylic blocks generating an interincisal gap, the retentive wire work on the anterior teeth, and the addition of color to the acrylic all contributed to the increased conspicuousness of the TB as compared with the ITMA. 6 Despite a reporting in this study that the TB was more conspicuous and noticeable to friends and family than the ITMA, the largest proportion of both groups advised they were neutral about having a discrete appliance and that visibility was not important to them. This similarity could have been related to the age range of the groups, which, for the TB group, was from 8-14 years and for the ITMA group was 10-17 years.…”

Section: Discussioncontrasting

confidence: 55%

“…This difference in embarrassment was most likely attributable to the TB's bulk, size, and even the color of the acrylic, because all of these elements contributed to the appliance's conspicuousness. Patients in the study completed by El-Huni et al 6 reported that size and color of the TB were considered barriers to their compliance because patients desired a more discrete and unnoticeable device. Even after a period of acclimatization and increased patient acceptance, a highly visible appliance may still be seen to cause social concerns, especially when encountering new people and situations.…”

Section: Discussionmentioning

confidence: 99%

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Investigation and comparison of patient experiences with removable functional appliances:

Zybutz¹,

Drummond²,

Lekic³

et al. 2021

The Angle Orthodontist

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Objectives To compare patients' experiences with the Invisalign Teen with Mandibular Advancement® (ITMA) and Twin Block (TB) appliances, both initially and after several months of wear. Materials and Methods Sixty-eight patients completed an anonymous survey after at least 2 months of wearing ITMA or TB. Forty-five patients treated with ITMA (18 boys, 27 girls, mean age 13.6 years, SD ± 1.54) and 23 patients treated with TB (13 boys, 10 girls, mean age 10.60 years, SD ± 1.92) were included. Results More patients using the TB found their appliance to be visually intimidating as compared with patients using the ITMA (21.7% vs 8.9%). TB was more noticeable than the ITMA (69.6% vs 25%). Appliance insertion was more difficult for TB patients (21.8% vs 4.44% for ITMA). After several months, there were more reports of tooth soreness and lip/cheek soreness in the ITMA group. TB patients were more embarrassed even after several months (14.3% vs 0% for ITMA). More TB patients required extra appointments for breakage (50% vs 22.2% for ITMA). Speech, drooling, and jaw and lip/cheek soreness worsened initially for both groups but improved over time. There were no differences between the groups regarding visible facial changes, satisfaction with treatment experience, or time to acclimatize to the appliance. Conclusions TB and ITMA patients shared similar experiences for most of the parameters measured, but there were significant differences between the groups regarding appliance wear and management, discomfort, and function.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Investigation and comparison of patient experiences with removable functional appliances:

Zybutz¹,

Drummond²,

Lekic³

et al. 2021

The Angle Orthodontist

View full text Add to dashboard Cite

show abstract

“…Another limitation is related to the effectiveness and predictability of conservative treatment with functional appliances, which is dependent on patients’ compliance, self-motivation, peer and authority influence, quality of life impairment and adaptability, perceived treatment progress, as well as pragmatic and recall issues, which may reduce or decrease the wearing time of the oral appliances [ 43 , 44 ]. Patient recommendations to improve compliance included effective communication, tailoring of prescribed wear duration, physical alteration of the appliance, and use of reminding tools [ 45 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Radiographic Assessment of Pediatric Condylar Fractures after Conservative Treatment with Functional Appliances—A Systematic Review

Staderini

Patini

Tepedino

et al. 2020

IJERPH

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Background: To evaluate the effectiveness of conservative treatment with functional appliances for condylar fractures in pediatric age. Methods: Four electronic databases (PubMed, EBSCO, Scopus, and Web of Science) were consulted with no restriction of publication status or year, up to 31 August 2020. Selection criteria: based on the PICOS criteria, the selection criteria were set for observational human studies, with at least 10 patients and six months of follow-up. The study population included pediatric patients (aged 5–16 years), with unilateral or bilateral condylar fracture, treated with functional appliances. Condylar remodeling and mandibular growth were analyzed through sequential radiographic examinations. Data collection and analysis: Two independent reviewers carried out title-abstract screening, and a senior investigator was involved to solve any disagreement. The quality of the evidence was assessed through the Canada Institute of Health Economics (IHE) quality appraisal checklist, and the National Institutes of Health (NIH) quality assessment tool. Results: A total of 971 articles were retrieved from the electronic search; among them, three studies met the eligibility criteria. A moderate risk of bias was detected in all the studies, due to common limitations (absence of multicenter studies, prospective design, blindness of the investigators, patients’ drop-out). At follow-up examinations (between 6 months and 4.9 years), the difference of condylar neck length between the “injured” and “healthy” side was approximately 2 mm, while the anteroposterior condylar width discrepancy was recorded up to 1 mm. Conclusions: Short- and long-term data revealed that conservative treatment with functional appliances led to partial or full radiological recovery of the joint morphology, along with good to excellent functional results. Patients’ age has a crucial role on the treatment choice, and the type of fracture (presence of condylar displacement, or dislocation) is also a major prognostic indicator of the radiologic outcome. Limitation: To confirm the effectiveness of functional appliances, more prospective clinical long-term follow-up studies with homogeneous samples of condylar fractures are deemed necessary. Registration: The study protocol was registered on PROSPERO (CRD42020205650).

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“…However, only one-third of participants reported satisfactory wear levels of vacuum-formed retainers after two years despite being uniformly (100%) adherent at six-month follow-up (Al-Moghrabi et al, 2018). Motives for wearing removable functional appliances include the development of positive dental changes, allied to parental involvement and professional encouragement at follow-up appointments (Čirgić et al, 2015; El-Huni et al, 2019). However, it would be intuitive to expect facilitators of retainer wear to be different as these perform a relatively passive function in maintaining treatment outcomes with participants also having less frequent follow-ups.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing adherence to vacuum-formed retainer wear: A qualitative study

2019

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Objective: To explore factors influencing adherence to vacuum-formed retainer wear over a minimum period of four years. Design: A qualitative study based on a randomised controlled trial assessing the effectiveness of orthodontic retainers. Setting: Institute of Dentistry, Queen Mary University of London. Participants: Fifteen participants wearing vacuum-formed retainers for at least four years. Methods: One-to-one semi-structured interviews were undertaken on a criterion-based purposive sample of participants wearing vacuum-formed retainers. The interviews were audio-recorded, transcribed verbatim and analysed using Framework Methodology. Results: High self-reported levels of adherence in the early stages of retention were linked to a desire to maintain orthodontic outcomes and the negative perception of potential post-treatment changes. However, adherence typically reduced over time due to a combination of factors including the negative impact of retainers on quality of life and pragmatic issues related to retainer wear. Network support was found to be important in the short and long term, with instances of self-directed wear and negative beliefs concerning the importance of retainer wear and predisposition to post-treatment changes. Lack of follow-up appointments and immaturity of participants prompted independent decisions to cease retainer wear. Conclusions: Six key influencers of prolonged adherence with vacuum-formed retainer wear were identified. Future strategies to improve adherence should account for these while also being responsive to time elapsed since debond and patient age.

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Understanding factors influencing compliance with removable functional appliances: A qualitative study

Cited by 43 publications

References 12 publications

Investigation and comparison of patient experiences with removable functional appliances:

Investigation and comparison of patient experiences with removable functional appliances:

Radiographic Assessment of Pediatric Condylar Fractures after Conservative Treatment with Functional Appliances—A Systematic Review

Factors influencing adherence to vacuum-formed retainer wear: A qualitative study

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