Maxillary expansion therapy with plates featuring a transverse screw: implications of patient compliance with wear-time and screw activation requirements.

OBJECTIVE: The goal of the present work was to determine the influence of screw activation rates and electronically tracked wear times on transverse maxillary expansion with removable orthodontic appliances. METHODS: In all, 28 patients were included in an open prospective observational study covering approximately 6 months of maxillary transverse expansion. In each of these patients, the maxillary plate appliance used for treatment was fitted with a wear-time sensor to document wear time for the duration of the study. Patients were instructed to activate the transverse expansion screw in their plate appliance by 0.2 mm/week. The resultant gap-width increases were monitored with a caliper over three follow-up appointments scheduled at 2-month intervals. RESULTS: Largely linear increases in gap width due to screw activation were only noted within the first 4 months of treatment. The mean increases in gap width fell short of the values that were anticipated after calculations. Longer daily wear times were, on average, associated with larger gap widths. CONCLUSION: Treatment can be objectively monitored by referring to wear-time tracking and by measuring increases in gap width, thus, ensuring that the appliance fits well. In this way, the process can be customized to serve individual needs and to better utilize the full potential of therapy.

Methods to evaluate compliance of patients with removable appliances-survey results.

OBJECTIVES: Are removable appliances still being routinely used in orthodontic offices? Which methods do clinicians use to assess compliance with wear requirements, and how effective are these methods considered to be? SUBJECTS AND METHODS: A questionnaire inquiring about types of treatment, methods of assessing patient compliance with removable appliances, and the perceived effectiveness of these methods was mailed to a sample of 375 members of the German Orthodontic Society ("Deutschen Gesellschaft für Kieferorthopädie", DGKFO). RESULTS: The rate of returned questionnaires was 29%. Almost all respondents (99%) indicated that they used removable appliances and reported having a "relatively high" proportion of patients currently undergoing such treatment. The most widely used methods of compliance assessment were questioning patients and parents (96%) and examining clinical parameters associated with the dentition and the appliance's fit (95-100%). While these parameters were considered "highly effective", questioning the patients and parents was regarded as "less effective" despite its frequent application. CONCLUSION: Removable appliances continue to be a standard method of orthodontic treatment. While patient compliance with wear requirements is mainly assessed via indirect clinical methods, the effectiveness of these parameters remains unclear.