Comparative assessment of treatment efficiency and patient experience between Dental Monitoring and conventional monitoring of clear aligner therapy: A single-center randomized controlled trial

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Introduction: The aim of this 2-arm randomized controlled clinical trial (RCT) was to assess the effect of Dental Monitoring (DM) on the efficiency of clear aligner therapy (CAT) as well as the patient experience, compared to the conventional monitoring (CM) protocol of regularly scheduled clinical appointments. Methods: 56 patients with a full permanent dentition and treated with CAT participated in this RCT. They were recruited from a single private practice and treated by 1 experienced orthodontist. Randomization was performed with permutated blocks of 8 patients assigned to either a (CM) or DM group with allocations concealed in opaque, sealed envelopes. It was not feasible to blind the subjects or investigators. The primary treatment efficiency outcome assessed was the number of appointments. Secondary outcomes included time to reach first refinement, number of refinements, total number of aligners, and treatment duration. The patient experience was assessed using a visual analogue scale (VAS) questionnaire administered at the end of CAT. Results: No patients were lost to follow-up. There was no significant difference in the number of refinements (mean 0.1; 95% CI, -0.2, 0.5; p = 0.43) and number of total aligners (median 5; 95% CI, -1, 13; p = 0.09). There was a significant difference in the number of appointments, with the DM group requiring 1.5 fewer visits (95% CI, -3.3, -0.7; p = 0.02) as well as overall treatment duration, with the DM group taking 1.9 months longer (95% CI, 0.0, 3.6; p = 0.04). There was a difference between study groups regarding the importance of face-to-face appointments, with the DM group not perceiving face-to-face appointments as important (p = 0.030). Conclusions: The use of DM with CAT resulted in 1.5 fewer clinical appointments and a longer treatment duration by 1.9 months. There were no significant intergroup differences with the number of refinements or total aligners. Both CM & DM groups had similarly high levels of satisfaction with CAT. This research project aims to evaluate these claims by conducting a randomised controlled trial comparing a control group of patients undergoing Invisalign treatment only to an intervention group of patients undergoing Invisalign treatment with Dental Monitoring GoLive over 140 days. Participants will be from Newwave Orthodontics, a private orthodonitc practice in Caloundra. We expect DM will reduce the number of appointments by 1 over this time frame.