Evaluation of the effectiveness of a tailored mobile application in increasing the duration of wear of thermoplastic retainers: a randomized controlled trial.


Journal

European journal of orthodontics
ISSN: 1460-2210
Titre abrégé: Eur J Orthod
Pays: England
ID NLM: 7909010

Informations de publication

Date de publication:
03 11 2020
Historique:
pubmed: 5 12 2019
medline: 26 1 2021
entrez: 5 12 2019
Statut: ppublish

Résumé

The 'My Retainers' mobile application is a patient-informed intervention designed to enhance removable retainer wear and associated patient experiences during the retention phase. To evaluate the effect of receiving the 'My Retainers' application on objectively assessed thermoplastic retainer (TPR) wear time, stability, periodontal outcomes, patient experiences, and knowledge related to retainers. Eighty-four participants planned for removable retention with TPRs were assigned either to receive the 'My Retainers' application or to control not receiving electronic reminders during the 3-month period. Randomization was based on computer-generated random numbers and allocation was concealed using opaque, sealed envelopes. The primary outcome was objectively assessed retainer wear recorded using an embedded TheraMon® micro-electronic sensor. Secondary outcomes, including irregularity of the maxillary and mandibular incisors, plaque levels, bleeding on probing and probing depth, were assessed at baseline and 3-month follow-up; and analysed using a series of mixed models. Experiences and knowledge related to orthodontic retainers were recorded using questionnaires. The outcome assessor was blinded when possible. Receipt of the mobile application resulted in slightly higher median wear time (0.91 hours/day); however, this difference was not statistically significant (P = 0.56; 95% confidence interval [CI]: -2.19, 4.01). No significant differences were found between the treatment groups in terms of stability (P = 0.92; 95% CI: -0.03, 0.04), plaque levels (P = 0.44; 95% CI: -0.07, 0.03), bleeding on probing (P = 0.61; 95% CI: -0.05, 0.03) and probing depth (P = 0.79; 95% CI: -0.09, 0.07). Furthermore, similar levels of patient experiences (P = 0.94) and knowledge related to retainers (P = 0.26) were found. However, marginally better levels of knowledge were identified in the intervention group. No harms were observed. A relatively short follow-up period with the study confined to a single-center in a university-based hospital. Provision of the bespoke 'My Retainers' application did not lead to an improvement in adherence with TPR wear over a 3-month follow-up period. Further refinement and research are required to develop and investigate means of enhancing adherence levels. NCT03224481.

Sections du résumé

BACKGROUND
The 'My Retainers' mobile application is a patient-informed intervention designed to enhance removable retainer wear and associated patient experiences during the retention phase.
OBJECTIVES
To evaluate the effect of receiving the 'My Retainers' application on objectively assessed thermoplastic retainer (TPR) wear time, stability, periodontal outcomes, patient experiences, and knowledge related to retainers.
MATERIALS AND METHODS
Eighty-four participants planned for removable retention with TPRs were assigned either to receive the 'My Retainers' application or to control not receiving electronic reminders during the 3-month period. Randomization was based on computer-generated random numbers and allocation was concealed using opaque, sealed envelopes. The primary outcome was objectively assessed retainer wear recorded using an embedded TheraMon® micro-electronic sensor. Secondary outcomes, including irregularity of the maxillary and mandibular incisors, plaque levels, bleeding on probing and probing depth, were assessed at baseline and 3-month follow-up; and analysed using a series of mixed models. Experiences and knowledge related to orthodontic retainers were recorded using questionnaires. The outcome assessor was blinded when possible.
RESULTS
Receipt of the mobile application resulted in slightly higher median wear time (0.91 hours/day); however, this difference was not statistically significant (P = 0.56; 95% confidence interval [CI]: -2.19, 4.01). No significant differences were found between the treatment groups in terms of stability (P = 0.92; 95% CI: -0.03, 0.04), plaque levels (P = 0.44; 95% CI: -0.07, 0.03), bleeding on probing (P = 0.61; 95% CI: -0.05, 0.03) and probing depth (P = 0.79; 95% CI: -0.09, 0.07). Furthermore, similar levels of patient experiences (P = 0.94) and knowledge related to retainers (P = 0.26) were found. However, marginally better levels of knowledge were identified in the intervention group. No harms were observed.
LIMITATIONS
A relatively short follow-up period with the study confined to a single-center in a university-based hospital.
CONCLUSIONS
Provision of the bespoke 'My Retainers' application did not lead to an improvement in adherence with TPR wear over a 3-month follow-up period. Further refinement and research are required to develop and investigate means of enhancing adherence levels.
CLINICAL REGISTRATION
NCT03224481.

Identifiants

pubmed: 31799628
pii: 5651357
doi: 10.1093/ejo/cjz088
doi:

Banques de données

ClinicalTrials.gov
['NCT03224481']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

571-579

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

Dalya Al-Moghrabi (D)

Centre for Oral Bioengineering, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.
Department of Preventive Dental Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.

Nikolaos Pandis (N)

Department of Orthodontics, Dental School, Medical Faculty, University of Bern, Switzerland; Private practice, Corfu, Greece.

Kieran McLaughlin (K)

Centre for Oral Bioengineering, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.

Ama Johal (A)

Centre for Oral Bioengineering, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.

Nikolaos Donos (N)

Centre for Oral Immunobiology and Regenerative Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.

Padhraig S Fleming (PS)

Centre for Oral Bioengineering, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.

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