title: Quantification of wear-time adherence of removable appliances in young orthodontic patients in relation to their BMI: a preliminary study.
abstract: OBJECTIVE
  The relationship between unhealthy body mass index (BMI) and adherence to orthodontic treatment with removable appliances has not previously been evaluated.
  
  
  OBJECTIVE
  The aim of this study was to quantify the association between BMI and wear time of removable orthodontic appliances and to evaluate BMI changes during orthodontic treatment.
  
  
  METHODS
  Fifty-three normal-weight and 39 overweight/obese children and adolescents (7-15 years old) undergoing orthodontic treatment with removable appliances were enrolled into the study. BMI categories were determined using standardized age-specific and sex-specific BMI criteria, using data measured at the beginning of therapy and once during orthodontic treatment. Wear times of removable appliances were measured at 15-minute intervals over a period of 5 months using implanted microelectronic sensors. Median wear-time values were used in the analysis with the Mann-Whitney U-test used to test statistical differences between groups.
  
  
  RESULTS
  The median wear time of removable orthodontic appliances was 9.3 hours for normal-weight patients and 9.2 hours for overweight/obese patients. No statistically significant (P>0.05) or clinically relevant differences in usage or adherence were detected between normal-weight and overweight/obese patients. BMI did not influence wear time or behavior of removable orthodontic appliances by young patients. The majority of patients showed qualitative decreases in BMI during therapy.
  
  
  CONCLUSIONS
  The orthodontic treatment of young patients with removable devices does not require BMI-dependent changes in the treatment strategy. However, the use of removable appliances during meal times raises the possibility of reducing food intake, and in this way the orthodontist may have an active role to play in weight reduction.
authors.affiliation: Department of Orthodontics, Eberhard Karls University, Tübingen, Germany.
authors.forename: Timm Cornelius
authors.initials: TC
authors.lastname: Schott
authors.affiliation: Private practice, Traben-Trarbach, Germany ; Department of Orthodontics University of Homburg/Saar, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Ludwig
keywords: BMI; adherence; obesity; orthodontics; pediatrics