title: Objective assessment of patient compliance with removable orthodontic appliances: a cross-sectional cohort study.
abstract: OBJECTIVE
  To assess objectively patient compliance with removable orthodontic appliances and the effect of possible influential factors.
  
  
  METHODS
  Wearing times of 45 White patients were recorded with the aid of the TheraMon microsensor. Patient compliance was assessed relative to wear prescription and other parameters, such as age and sex.
  
  
  RESULTS
  There was high individual variation in most measured variables and in all groups/subgroups. During a median observation period of 186 days (range, 55-318 days) the actual wear time was 9.0 h/d (range, 0.0-16.0 h/d) and did not differ between distinct prescriptions (P = .49). Eight patients wore their appliances less than 2 h/d, and six of them did not wear their appliances at all. Overall, the median wear per day relative to prescription was 62.5% (range, 0.0-89.3%) for the 14 h/d and 112.5% (range, 0.0-200.0%) for the 8 h/d prescription wear (P = .01) groups. There was a strong negative correlation of age (median: 12.5 years) with the daily percentage of actual wear time per day relative to wear prescription (14 h/d prescription: n = 21, rho = -0.61, P = .00; 8 h/d prescription: n = 24, rho = -0.73, P = .00), while sex did not exert a significant influence on compliance (P = .58).
  
  
  CONCLUSIONS
  Despite the fact that patients and parents were informed about wear time recording, compliance was insufficient with regard to functional treatment (14 h/d prescription), while it was sufficient for retention purposes (8 h/d prescription). Objective measures are necessary to assess compliance with removable orthodontic appliances since patient compliance is a highly variable issue.
authors.affiliation: a  Doctoral Candidate, Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland.
authors.forename: George
authors.initials: G
authors.lastname: Tsomos
authors.forename: Björn
authors.initials: B
authors.lastname: Ludwig
authors.forename: Johannes
authors.initials: J
authors.lastname: Grossen
authors.forename: Pawel
authors.initials: P
authors.lastname: Pazera
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Gkantidis
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001294:Attitude to Health; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D055617:Micro-Electrical-Mechanical Systems; D016382:Orthodontic Appliance Design; D017289:Orthodontic Appliances, Functional; D009968:Orthodontic Appliances, Removable; D018704:Orthodontic Retainers; D010349:Patient Compliance; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult