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Improvements respondents would like to see with CAT (N = 51)
| Theme | % | N |
|---|---|---|
| Actual outcomes closer to planned/ predicted by software | 31.4 | 16 |
| Tooth movement | 27.5 | 14 |
| Costs | 17.6 | 9 |
| Aligner material | 11.8 | 6 |
| Software | 11.8 | 6 |
| Environmental | 9.8 | 5 |
| CAT and GDPs | 7.8 | 4 |
| Need for further research | 5.9 | 3 |
| Acceptance of shortcomings | 5.9 | 3 |
Patient-reported CAT issues by respondent
| Always | Mostly | Sometimes | Rarely | Never | Total | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Issue | % | N | % | N | % | N | % | N | % | N | N | |
| Discomfort | 1.54 | 1 | 10.8 | 7 | 53.9 | 35 | 29.2 | 19 | 4.6 | 3 | 65 | |
| Speech/lisping | 0.0 | 0 | 9.2 | 6 | 38.5 | 25 | 46.2 | 30 | 6.2 | 4 | 65 | |
| Smell of aligner | 0.0 | 0 | 7.8 | 5 | 23.4 | 15 | 51.6 | 33 | 17.2 | 11 | 64 | |
| Difficulty in compliance with wear protocol | 0.0 | 0 | 4.6 | 3 | 69.2 | 45 | 24.6 | 16 | 1.5 | 1 | 65 | |
| Wear/breakage of aligner | 0.0 | 0 | 3.1 | 2 | 58.5 | 38 | 33.9 | 22 | 4.6 | 3 | 65 | |
| Loss of aligner(s) | 0.0 | 0 | 3.1 | 2 | 55.4 | 36 | 36.9 | 24 | 4.6 | 3 | 65 | |
| Poor fit of aligner(s) | 0.0 | 0 | 4.6 | 3 | 52.3 | 34 | 41.5 | 27 | 1.5 | 1 | 65 | |
| Appearance of aligner(s) | 0.0 | 0 | 1.5 | 1 | 7.7 | 5 | 63.1 | 41 | 27.7 | 18 | 65 | |
| Appearance/ discomfort of attachments | 0.0 | 0 | 3.1 | 2 | 55.4 | 36 | 33.9 | 22 | 7.7 | 5 | 65 | |
| Staining of teeth around attachments | 0.0 | 0 | 3.1 | 2 | 60.0 | 39 | 32.3 | 21 | 4.6 | 3 | 65 | |
| Dissatisfaction with treatment length | 3.1 | 2 | 6.2 | 4 | 44.6 | 29 | 38.5 | 25 | 7.7 | 5 | 65 | |
| Dissatisfaction with treatment outcome | 0.0 | 0 | 0.0 | 0 | 12.3 | 8 | 76.9 | 50 | 10.8 | 7 | 65 | |
| Dissatisfaction with need for refinement | 0.0 | 0 | 3.1 | 2 | 38.5 | 25 | 40.0 | 26 | 18.5 | 12 | 65 | |
Most significant problems with CAT by respondent (N = 62)
| Theme | % | N |
|---|---|---|
| Concerns over patient compliance with CAT wear protocols | 43.5 | 22 |
| Tooth movements | 16.1 | 10 |
| Detailing/finishing | 16.1 | 10 |
| Overbite | 16.1 | 10 |
| Torque | 14.5 | 9 |
| Lateral incisors | 12.9 | 8 |
| Tracking | 9.7 | 6 |
| Commercialisation: | 6.5 | 4 |
| Case selection | 6.5 | 4 |
| Costs | 4.8 | 3 |
Factors that influence the decision not to provide CAT (N = 8)
| No Influence | Minor Influence | Moderate Influence | Major Influence | Total | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| % | N | % | N | % | N | % | N | N | ||
| Insufficient post-graduate education | 37.5 | 3 | 25.0 | 2 | 37.5 | 3 | 0.0 | 0 | 8 | |
| Concerns over ongoing aligner treatment education | 50.0 | 4 | 50.0 | 4 | 0.0 | 0 | 0.0 | 0 | 8 | |
| My practice (e.g.- University or public orthodontic service) does not provide it | 75.0 | 6 | 0.0 | 0 | 0.0 | 0 | 25.0 | 2 | 8 | |
| Other clinicians in my practice provide aligner treatment | 37.5 | 3 | 12.5 | 1 | 25.0 | 2 | 25.0 | 2 | 8 | |
| Initial costs to the practice | 75.0 | 6 | 25.0 | 2 | 0.0 | 0 | 0.0 | 0 | 8 | |
| Ongoing costs to the practice | 62.5 | 5 | 25.0 | 2 | 0.0 | 0 | 12.5 | 1 | 8 | |
| Costs to the patient | 37.5 | 3 | 50.0 | 4 | 12.5 | 1 | 0.0 | 0 | 8 | |
| Disruption to practice with the introduction of new technology | 37.5 | 3 | 50.0 | 4 | 0.0 | 0 | 12.5 | 1 | 8 | |
| Dependency on a ‘third party’ for treatment provision | 25.0 | 2 | 12.5 | 1 | 37.5 | 3 | 25.0 | 2 | 8 | |
| ‘Fixed appliances provide better treatment outcomes’ | 0.0 | 0 | 0.0 | 0 | 62.5 | 5 | 37.5 | 3 | 8 | |
| Patient expectations | 0.0 | 0 | 62.5 | 5 | 12.5 | 1 | 25.0 | 2 | 8 | |
| Concerns over patient compliance with treatment protocols | 25.0 | 2 | 12.5 | 1 | 37.5 | 3 | 25.0 | 2 | 8 | |
| Other | 1 | |||||||||
Respondent ‘comfort ‘with treating different case types (+/- extractions)
| Comfortable | Uncomfortable | |||
|---|---|---|---|---|
| N = 66 | N = 64 | |||
| Case type | % | N | % | N |
| Spaced dentition | 89.4 | 59 | 0 | 0 |
| 0 to 4mm crowding (mild) | 100 | 66 | 0 | 0 |
| 4.1-8mm crowding (moderate) | 68.2 | 45 | 23.4 | 15 |
| >8mm crowding (severe) | 24.2 | 16 | 70.3 | 45 |
| ↓ OB | 90.9 | 60 | 1.6 | 1 |
| ↑ OB | 1ó.7 | 11 | 78.1 | 50 |
| ↓ OJ | 45.5 | 30 | 10.9 | 7 |
| ↑ OJ | 56.1 | 37 | 21.9 | 14 |
| Unilateral posterior x-bite | 39.4 | 26 | 35.9 | 23 |
| Bilateral posterior x-bite | 15.2 | 10 | 79.7 | 51 |
| Other | 7.6 | 5 | 23.4 | 15 |
Frequency of CAT progress checks by respondents (N = 66)
| Responses | ||
|---|---|---|
| Answer Choices | % | N |
| Every 12 weeks | 15.2 | 10 |
| Every 8 weeks | 40.9 | 27 |
| Every 6 weeks | 15.2 | 10 |
| Every 4 weeks | 1.5 | 1 |
| Only if the patient has a problem - otherwise provide the aligners and check at completion of treatment | 0.0 | 0 |
| When remote monitoring system indicates | 7.6 | 5 |
| ‘Other’ | 19.7 | 13 |
Frequency of prescription of a clear plastic retainer provided by aligner company at the end of CAT (N = 66)
| Responses | ||
|---|---|---|
| Answer Choices | % | N |
| Always | 21.2 | 14 |
| Mostly | ó.1 | 4 |
| Sometimes | 30.3 | 20 |
| Rarely | 19.7 | 13 |
| Never | 21.2 | 14 |
| Other | 1.5 | 1 |
Factors that influence decisions in choosing to use a specific aligner provider
| No | Minor | Moderate | Major | Total | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Factor level of influence | % | N | % | N | % | N | % | N | N | |
| Cost | 22.7 | 15 | 40.9 | 27 | 28.8 | 19 | 7.6 | 5 | 66 | |
| Ease of digital treatment planning | 3.1 | 2 | 6.2 | 4 | 47.7 | 31 | 43.1 | 28 | 65 | |
| Quality of digital treatment plan | 3.0 | 2 | 16.7 | 11 | 42.4 | 28 | 37.9 | 25 | 66 | |
| Sophistication of appliance features | 9.2 | 6 | 40.0 | 26 | 33.9 | 22 | 16.9 | 11 | 65 | |
| Aesthetics of appliances | 21.2 | 14 | 47.0 | 31 | 22.7 | 15 | 9.1 | 6 | 66 | |
| Patient satisfaction | 16.7 | 11 | 33.3 | 22 | 31.8 | 21 | 18.2 | 12 | 66 | |
| Brand awareness (among patients) | 30.3 | 20 | 39.4 | 26 | 21.2 | 14 | 9.1 | 6 | 66 | |
| Ongoing education by provider | 31.8 | 21 | 30.3 | 20 | 28.8 | 19 | 9.1 | 6 | 66 | |
| Assistance in ‘troubleshooting’ | 10.8 | 7 | 29.2 | 19 | 43.1 | 28 | 16.9 | 11 | 65 | |
| Corporate support - advertising | 54.6 | 36 | 36.4 | 24 | 7.6 | 5 | 1.5 | 1 | 66 | |