Abstract
Objectives:
To explore the prevalence of discrepancies between estimated and actual orthodontic treatment duration and identify predictors of treatment delays.
Material and Methods:
A total of 96 patients (62.5% female; age = 15.6 ± 6.8 years) who completed an orthodontic treatment with pre-adjusted edgewise fixed appliances between 2015 and 2023 were retrospectively included. Differences between actual and estimated treatment duration >3 months were classified as discrepancies and categorized as “overestimation” or “underestimation.” Such discrepancies were compared on demographics, COVID period, and orthodontic parameters using Student’s t-tests and chi-square tests, as appropriate. Predictors of underestimated treatment duration were assessed with logistic regression analysis.
Results:
Actual treatment duration significantly differed from the estimated duration (26.5 ± 9.6 vs. 21.6 ± 3.6 months; P <0.001), with 65.6% cases exhibiting treatment discrepancy (P = 0.003) and 61.5% of them being underestimated (P = 0.032). Cases with underestimated durations more commonly displayed posterior crossbite (30.9% vs. 5.4%; P = 0.004), larger SNA angle (83.7 ± 3.7 vs. 78.8 ± 3.8; P = 0.005), bracket debonding (53.4% vs. 31.4%; P = 0.039; odds ratio [OR] = 2.51, 95% confidence interval [CI] = 1.04–6.04), and were most likely conducted during COVID period (33.9% vs. 10.8%; P = 0.011; OR = 4.23, 95% CI = 1.31–13.62) compared to overestimated ones. Posterior crossbite (P = 0.006) and COVID period (P = 0.007) were significant predictors of treatment underestimation.
Conclusions:
Approximately two-thirds of orthodontic treatments showed discrepancies between estimated and actual duration, with 61.5% being underestimated especially in presence of posterior crossbite and during COVID period.
Plain language summary
Why was this study done? People who start orthodontic treatment with braces often want to know how long their treatment will last. Knowing the expected treatment time is important because it affects motivation, comfort, and overall satisfaction. However, orthodontic treatment does not always go as planned, and treatment may take longer than expected. When this happens, patients and families may feel frustrated or disappointed. This study aimed to understand how often orthodontic treatment lasts longer than expected and why this happens. What did the researchers want to find out? The researchers wanted to find out which factors are linked to longer-than-expected orthodontic treatment time. They expected that certain bite problems or unexpected events could increase treatment length. What did the researchers do? The research team looked at 96 patients who received orthodontic treatment at a university dental clinic. For each patient, they compared the estimated treatment time given at the start with the actual time it took to complete treatment. They also looked at common features among patients whose treatment lasted longer than expected. What did the researchers find? In approximately two out of three patients, the estimated treatment time was not accurate. In most cases, treatment lasted longer than expected by about 4 months. These patients most likely had a posterior crossbite (a problem with how the back teeth fit together) or their treatments were carried out during the COVID-19 pandemic. What do the findings mean? Estimating orthodontic treatment time in advance is challenging, even for experienced clinicians. Some factors that affect treatment length cannot be predicted at the start of care. Clear communication with patients and families about the possibility of delays is needed. Setting realistic expectations will improve patient satisfaction.
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