Dalya Al-Moghrabi1,2, Nikolaos Pandis3, Kieran McLaughlin1, Ama Johal1, Nikolaos Donos4, Padhraig S Fleming1. 1. Centre for Oral Bioengineering, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK. 2. Department of Preventive Dental Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia. 3. Department of Orthodontics, Dental School, Medical Faculty, University of Bern, Switzerland; Private practice, Corfu, Greece. 4. Centre for Oral Immunobiology and Regenerative Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.
Abstract
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.
RCT Entities:
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.