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DOI: 10.1055/s-0043-111785
Messungen der Compliance und Bestimmungsfaktoren für einen Therapieerfolg mit herausnehmbaren funktionskieferorthopädischen Apparaturen
Compliance Measurements and Determinants of Successful Therapy Outcomes with Removable Functional AppliancesPublication History
Publication Date:
20 July 2017 (online)
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Zusammenfassung
Zielsetzung Ziel dieser Studie war es, die Patientencompliance beim Tragen herausnehmbarer funktionskieferorthopädischer Apparaturen zu bestimmen und Faktoren zu definieren, die den Erfolg einer Behandlung beeinflussen könnten.
Methoden Bei 88 Klasse-II-Patienten, die konsekutiv mit herausnehmbaren funktionskieferorthopädischen Apparaturen behandelt worden waren, wurden die Tragezeiten quantifiziert und mithilfe des TheraMon®-Mikrosensors in Verbindung mit anderen behandlungsbezogenen Faktoren analysiert.
Ergebnisse Die mittlere Tragezeit (±SD) betrug 10,2 (±2,86) Stunden/Tag, die mittlere Overjet-Reduktion 4,7 mm (±2,50) und die mittlere Gesamtbehandlungsdauer 6,9 (±3,0) Monate. Die objektiven und geschätzten Tragezeiten waren signifikant unterschiedlich (p<0,001), und die objektive Tragezeit war positiv mit der Gesamtreduktion des Overjets korreliert (r=0,29, p=0,007). Die mittlere Overjet-Reduktion während der Beobachtungsphase war am niedrigsten bei Patienten mit einer Tragezeit von<8 Stunden/Tag. Der Grad der Schmerzen/Beschwerden und die objektive Tragezeit waren umgekehrt korreliert (r=–0,41, p<0,001). Die Motivation war umgekehrt mit Schmerzen/Beschwerden korreliert (r=–0,23, p=0,03) und positiv mit der Tragezeit assoziiert (r=0,37, p=0,001). Das Ausmaß der Schmerzen/Beschwerden und die Motivation trugen unabhängig voneinander zur täglichen Tragezeit der funktionskieferorthopädischen Apparatur bei.
Schlussfolgerungen Die empfohlene Tragezeit wird nahezu nie erreicht, und die Reduktion des Overjets und die Tragezeit zeigen eine moderate Korrelation. Die Compliance ist unabhängig mit Schmerzen/Beschwerden und Motivation assoziiert, korreliert jedoch nicht mit dem Alter, dem Geschlecht, Mobbing oder der Mundhygiene. Die direkte Quantifizierung der Tragezeit und die klinischen Ergebnisse während der Behandlung ermöglichen es dem Zahnarzt, personalisierte Empfehlungen zur Tragezeit zu geben.
Abstract
Objectives The purpose of this study was to determine patient compliance with wearing removable functional orthodontic appliances and define factors that might influence successful treatment outcome.
Methods The wear times of 88 consecutive Class II patients undergoing treatment with removable functional appliances were quantified and analyzed using the TheraMon® microsensor in conjunction with other treatment-related factors.
Results The mean (SD) wear time was 10.2 (2.86) hours a day, the mean overjet reduction was 4.7 (2.50) mm, and the mean total treatment duration was 6.9 (3.0) months. Objective and estimated wear times differed significantly (p<0.001), and objective wear time was positively associated (r=0.29, p=0.007) with total overjet reduction. The mean overjet reduction during the observation period was lowest in patients with a wear time <8 hours/day. The degree of pain/discomfort and objective wear time were inversely correlated (r=−0.41, p<0.001). Motivation was inversely associated with pain/discomfort (r=−0.23, p=0.03) and positively associated with wear time (r=0.37, p=0.001). Pain/discomfort and motivation independently contributed to the daily wear time of the appliance.
Conclusions Recommended wear time is almost never achieved, and overjet reduction and wear time show moderate correlation. Compliance is independently associated with pain/discomfort and motivation but does not correlate with age, gender, bullying, or oral hygiene. Direct quantification of wear time and clinical results during treatment enable the clinician to give personalized wear time recommendations.
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