title: Effect of intervention using a messaging app on compliance and duration of treatment in orthodontic patients.
abstract: OBJECTIVE
  This study aims to determine the effectiveness of a messaging app (WeChat) in improving patients' compliance and reducing the duration of orthodontic treatment (DOT).
  
  
  METHODS
  A randomized controlled trial was performed in a dental hospital and a clinic from August 2012 to May 2015. Orthodontic patients were included at the beginning of treatment. Patients with multiphase treatment or braceless technique were excluded. Participants were randomized to WeChat group (received regular reminders and educational messages) or control group (received conventional management) and were followed up until the treatment was completed. Primary outcome measure was DOT. Others were late and failed attendance, bracket bond failure, and oral hygiene condition.
  
  
  RESULTS
  One hundred twelve patients in each group participated and completed the trial. DOT in WeChat group were 7.3 weeks shorter (P = 0.007). There were less failed attendance (3.1 vs. 10.9 %, P < 0.001), late attendance (20.1 vs. 29.9 %, P < 0.001), and bracket bond failure (11.8 vs. 16.1 %, P < 0.001) in WeChat group than control. There was no difference in orthodontic plaque index nor modified gingivitis index between the two groups before and after treatment. Number of failed attendances was identified as an independent factor affecting DOT (P = 0.004; HR = 0.89, 95 % CI 0.84 to 0.95).
  
  
  CONCLUSIONS
  The intervention with WeChat is effective in reducing the treatment duration and bracket bond failure, and improving the attendance in orthodontic patients.
  
  
  CONCLUSIONS
  DOT can be reduced by improving patient's compliance. The messaging app is useful for outpatient education and management.
authors.affiliation: State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 17 Section 3 Ren Min Nan Lu, Chengdu, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Orthodontics, Jin Qin Dental Clinic, No.96 Section 1 Er Huan Lu West, Chengdu, 610041, China.
authors.forename: Zhen-Rui
authors.initials: ZR
authors.lastname: Xu
authors.affiliation: Department of Orthodontics, Jin Qin Dental Clinic, No.96 Section 1 Er Huan Lu West, Chengdu, 610041, China.
authors.forename: Na
authors.initials: N
authors.lastname: Tang
authors.affiliation: State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 17 Section 3 Ren Min Nan Lu, Chengdu, China.
authors.forename: Cui
authors.initials: C
authors.lastname: Ye
authors.affiliation: Department of Orthodontics, Jin Qin Dental Clinic, No.96 Section 1 Er Huan Lu West, Chengdu, 610041, China.
authors.forename: Xiao-Ling
authors.initials: XL
authors.lastname: Zhu
authors.affiliation: Department of Orthodontics, Jin Qin Dental Clinic, No.96 Section 1 Er Huan Lu West, Chengdu, 610041, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 17 Section 3 Ren Min Nan Lu, Chengdu, China. hxorthod@gmail.com.
authors.forename: Zhi-He
authors.initials: ZH
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D063731:Mobile Applications; D009971:Orthodontics, Corrective; D010349:Patient Compliance; D013997:Time Factors
keywords: Orthodontics; Patient education; Randomized controlled trial; Telemedicine; Text messaging; WeChat