Join me for a summary looking at remote monitoring in orthodontic clinical practice, and if it can improve, quicken and enhance orthodontic clinical practice. This podcast is based on an excellent webinar by Jonathan Sandler and Juan Carlos Varela, as part of the Angle-net webinar series. I discuss how Dental Monitoring works, the proposed advantages and a review of the emerging research on this innovation in orthodontics.
What is Dental Monitoring?
AI software which assesses occlusal and dental changes through a series of intra-oral photographs taken by the patient using their smartphone
How does it work?
Upload STL / digital study model
Ai segmentation of teeth which maps digital study model to the photos
Aligner fit analysis:
Discrepancy between tooth surface and aligner fit
Either proceed, continue wear or see clinician
Fixed appliances
Assess rate of movement and schedule appointment
Other proposed benefits
Oral hygiene assessment
Breakages
Retention changes
What do patients think of it?
Patients attitudes to remote monitoring
81% interested in reducing number of appointments due to telemonitoring – Dalessandri 2021
25% of patients found scans difficult to perform, with duration of scan 2-17 minutes Hansa 2020
Does it reduce appointments and make treatment quicker? Sangalli 2024
Decrease the number of in-office visits by 1.68–3.5 visits
No difference in treatment duration
No statistical reduction in emergency appointments
Are treatment outcome better (aligners)?
No difference in tooth movements Hansa 2021
No difference in number of refinements Hansa 2021
PAR changes – no difference in quality of outcomes Jarad Marks 2024
Is oral health better?
DM reduced plaque scores Costi 2019
31% Improved hygiene Manzo white paper
Other innovations with remote monitoring?
Remote STL files
Scan taken without patient attending the practice
Scanbox
Formulate STL file and fit aligner in surgery
Is Dental Monitoring accurate? Ferlito 2022
80% repeatability from 2 scans
44.7% repeatability and reproducibility
Discrepancy between scanbox and intra-oral scan varied between 0.5-1.9mm, angular measurements maximum error 8.9 degrees
Conclusion
2-3 appointments less
No difference in overall duration
Some people struggle to use
Accuracy and repeatability variable
No difference in the quality of the outcome
Areas which are of concern
Unknown accuracy of occlusal assessments from a reliable retruded contact position
Patient motivation maybe better delivered in person
Ai environment cost 2-3% of energy used by data centres
Other ways to reduce time?
Diagnostic and treatment planning acumen
Identify main aspect of malocclusion and address through efficient mechanics
