Title Remote Dental Monitoring Can Reduce In-office Appointments in Patients Treated with Clear Aligner Therapy
Clinical Question In patients receiving comprehensive orthodontic treatment with clear aligners, does remote Dental Monitoring reduce in-office appointments and treatment duration compared to patients treated without remote Dental Monitoring?
Clinical Bottom Line Remote Dental Monitoring (DM) has been shown to decrease the amount of necessary clinical appointments for those treated by clear aligners without compromising the quality of treatment or the patient experience. However, the available evidence regarding improvements in treatment efficiency is either contested or inconclusive.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
37278017Sangalli / 202311 studies including 542 healthy patients Systematic review of non-randomized trials
Key resultsReview included 11 studies including 542 healthy patients of any age (315 w/DM in active or passive phase of treatment). The integration of Dental Monitoring with standard clear aligner therapy showed a statistically significant reduction of 1.68-3.5 in-office appointments, however a decrease in overall treatment time was not demonstrated.
36990528Lam / 202356 patients with full permanent dentition Randomized Controlled Trial
Key resultsStudy included 56 patients with full permanent dentition seeking comprehensive clear aligner therapy w/o missing or previously extracted permanent teeth and not requiring extractions (28 w/DM). Dental Monitoring significantly decreased the number of required clinical appointments by 1.5 visits over an average of 11.6 months while also revealing a significantly longer treatment duration by 1.9 months. The investigators found no significant difference in patient satisfaction between groups.
Evidence Search (orthodontics "dental monitoring")
Comments on
The Evidence
Sangalli systematically reviewed publications through Nov. 2022 with broad search criteria. Eligibility was limited to healthy patients of any age and the use of Dental Monitoring at any phase of orthodontic treatment, either active or passive. Due to the novelty of the recently developed technology, the availability of quality studies were few and limited by shorter observation periods and follow-up. Additionally, the baseline characteristics of the study group were heterogenous in terms of both age and sex. The included study designs were case reports and retrospective and prospective cohort studies determined to be of good or fair quality. Lam randomly divided 56 patients into equal groups, both being treated with clear aligners. Each group had clear progression protocols and regular intervention intervals. The treating investigator was not blinded during the trial and subjects were not blind to their treatment group. This study is the only known controlled trial on this topic at the time of writing.
Applicability The Sangalli review included patients of any age seeking clear aligner therapy, while the Lam trial limited its study group to those undergoing comprehensive treatment with clear aligners and had full permanent dentitions without previous history or need of extractions – generally describing cases of mild to moderate complexity. The results can be generalized to most orthodontists using clear aligners. However, the clinical significance of reduced in-office visits and its potential benefit for both patients and practitioners can only be determined by the clinician.
Specialty (Orthodontics)
Keywords Dental Monitoring, Invisalign, clear aligner therapy, remote monitoring
ID# 3547
Date of submission 10/25/2023
E-mail shaferr@livemail.uthscsa.edu
Author Lane Shafer, DMD
Co-author(s) Chase Hardy, DMD
Co-author(s) e-mail hardyc1@livemail.uthscsa.edu
Faculty mentor Maria Karakousoglou, BDS, MS
Faculty mentor e-mail karakousoglo@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available