Adolescents’ adherence to intraoral removable appliances: a scoping review
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Notice bibliographique
Résumé
BACKGROUND: Adolescents' lack of adherence to intra-oral removable appliances (IORAs) can lead to poor treatment outcomes. Available literature on this topic hasn't been comprehensively summarized. Existing reviews often combine data from various age groups, lack a standardized conceptual definition of adherence to IORAs, and offer limited evaluation of interventions aimed at improving adherence among adolescents. This scoping review aims to map the breadth and depth of the literature on adolescents' adherence to IORAs and identify research gaps for developing tailored interventions. METHODS: In accordance with Arksey and O'Malley's framework and PRISMA-ScR guidelines, a comprehensive search strategy was implemented across MEDLINE, CINAHL, Web of Science, and ProQuest Theses and Dissertations. Two researchers independently screened titles, abstracts, and full texts. A pilot-tested form facilitated data extraction. Risk of bias was evaluated using RoB 2, ROBINS-I, and JBI tools. Extracted data then underwent both descriptive and content analysis. RESULTS: The 14 included studies focused on adherence to wear-time recommendations (n = 13), with only one examining appointment adherence. Only seven studies (50%) were deemed high-quality. Adherence rates varied across IORAs: vacuum-formed retainers showed wear-time of less than 24 h/day, Hawley retainers averaged 12-15 h/day, Twin Blocks averaged 21 h/day, and Activators averaged 11.5 h/day. Studies pursued various aims: four explored patient perspectives and experiences; one assessed designed interventions; two evaluated treatment adherence and assessed adherence to both recommendations and appointments; and five identified associated factors. Several studies pursued multiple aims. Patient perspectives highlighted challenges like discomfort and social pressures, and enablers such as parental support. Limited intervention studies indicated potential benefits of digital and image-based monitoring. Adherence consistently fell short of recommended daily wear time (DWT), often influenced by motivation, parental involvement, and psychosocial factors. CONCLUSION: Adherence among adolescents to the DWT for intraoral removable appliances is frequently suboptimal, displaying considerable variability depending on appliance type. Both individual and social determinants influence adherence. Robust study designs and a standardized conceptualization of adherence are imperative to generate high-quality, comparable evidence. Evidence-based interventions must be developed and tested to enhance adherence and ultimately optimize treatment outcomes within this patient population.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,000 |
| Bibliométrie | 0,000 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle