title: Quantifying patient adherence during active orthodontic treatment with removable appliances using microelectronic wear-time documentation.
abstract: OBJECTIVE
  The aim of this study was to quantify the wear times of removable appliances during active orthodontic treatment.
  
  
  METHODS
  The wear times of 141 orthodontic patients treated with active removable appliances in different locations were documented over a period of 3 months using an incorporated microsensor. Gender, age, treatment location, health insurance status, and type of device were evaluated with respect to wear time. Significant associations between wear times and patient factors were calculated using non-parametric tests.
  
  
  RESULTS
  The median daily wear time was 9.7 hours/day for the entire cohort, far less than the 15 hours/day prescribed. Younger patients wore their appliances for longer than older patients (7-9 years 12.1 hours/day, 10-12 years 9.8 hours/day, and 13-15 years 8.5 hours/day; P < 0.0001). The median wear time for females (10.6 hours/day) was 1.4 hours/day longer than males (9.3 hours/day; P = 0.017). Patients treated at different locations wore their devices with a difference of up to 5.0 hours/day. Privately insured patients had significantly longer median wear times than statutorily insured patients. No significant difference in wear time was noted according to device type.
  
  
  CONCLUSIONS
  The daily wear time of removable appliances during the active phase of orthodontic therapy can be routinely quantified using integrated microelectronic sensors. The relationship between orthodontist and patient seems to play a key role in patient adherence. Wear-time documentation provides the basis for more individualized wear-time recommendations for patients with removable appliances. This could result in a more efficient, shorter, and less painful orthodontic therapy.
authors.affiliation: *Department of Orthodontics and Orofacial Orthopedics, University Hospital of Dentistry, Eberhard Karls University Tübingen.
authors.forename: Katharina
authors.initials: K
authors.lastname: Schäfer
authors.affiliation: **Department of Orthodontics, University of Homburg/Saar, and Private Practice, Traben-Trarbach.
authors.forename: Björn
authors.initials: B
authors.lastname: Ludwig
authors.affiliation: ***Department of Orthodontics, University of Aachen, Germany.
authors.forename: Hannes
authors.initials: H
authors.lastname: Meyer-Gutknecht
authors.affiliation: *Department of Orthodontics and Orofacial Orthopedics, University Hospital of Dentistry, Eberhard Karls University Tübingen, timm.schott@med.uni-tuebingen.de.
authors.forename: Timm Cornelius
authors.initials: TC
authors.lastname: Schott
mesh_terms: D000293:Adolescent; D002648:Child; D004282:Documentation; D004582:Electronics, Medical / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008904:Miniaturization; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods; D009968:Orthodontic Appliances, Removable; D010349:Patient Compliance / Q000706:statistics & numerical data*; D013997:Time Factors