Journal of Datta Meghe Institute of Medical Sciences University

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 15  |  Issue : 3  |  Page : 347--352

Evaluation of the awareness of different orthodontic treatment appliances in patients undergoing orthodontic treatment of Maharashtra – A survey


Amol Verulkar1, Ranjit Kamble2, Sunita Srivastav2, Twinkle Bajaj1, Niyati Potode1,  
1 Department of Orthodontics and Dentofacial Orthopedics, V.Y.W.S. Dental College, Amravati, Maharashtra, India
2 Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi(M), Wardha, Maharashtra, India

Correspondence Address:
Dr. Amol Verulkar
404, Prince Homes Apartment, Gandhi Nagar, Amravati, Maharashtra
India

Abstract

Aim: The aim of the study was to evaluate and compare the awareness of different orthodontic treatment appliances in patients undergoing orthodontic treatment, in Maharashtra, India. Materials and Methods: A cross-sectional questionnaire-based study was conducted among patients undergoing orthodontic treatment in different teaching institutes of Maharashtra through an e-survey using Google Forms. A total of 360 patients undergoing orthodontic treatment in different teaching institutes of Maharashtra were randomly selected. The 10-item closed questionnaire in structured format was framed for the patients undergoing orthodontic treatment in Maharashtra. Ten orthodontic treatment appliances' options representing the major therapeutic modalities of choice used in daily practices were listed, namely, space maintainers, arch expanders, external growth modification devices, internal growth modification devices, stainless steel (SS)/ceramic/lingual braces, clear aligners, and combined orthodontic-surgical cases. Details regarding the E-mail were collected, which was followed by questions on awareness and knowledge. Participants were asked to rate their awareness level using a Likert-type scale. Conclusion: (1) The study group showed very low awareness of growth modification devices and moderate-to-high awareness of SS brackets and ceramic brackets. (2) Educational community programs should focus on improving the general knowledge of orthodontic appliances, especially the ones concerning early functional jaw orthopedic treatments.



How to cite this article:
Verulkar A, Kamble R, Srivastav S, Bajaj T, Potode N. Evaluation of the awareness of different orthodontic treatment appliances in patients undergoing orthodontic treatment of Maharashtra – A survey.J Datta Meghe Inst Med Sci Univ 2020;15:347-352


How to cite this URL:
Verulkar A, Kamble R, Srivastav S, Bajaj T, Potode N. Evaluation of the awareness of different orthodontic treatment appliances in patients undergoing orthodontic treatment of Maharashtra – A survey. J Datta Meghe Inst Med Sci Univ [serial online] 2020 [cited 2021 Apr 20 ];15:347-352
Available from: http://www.journaldmims.com/text.asp?2020/15/3/347/308572


Full Text



 Introduction



The malocclusion can be defined as an occlusion with mal-relationship between the arches in any of the planes or anomalies in tooth position beyond the normal limits are considered one of the most common oral diseases.[1] Maloccluded teeth can cause psychosocial problems related to impaired dentofacial esthetics to patients; in addition, it can affect oral health by increasing the prevalence of dental caries and periodontal diseases as well as temporo-mandibular disorders.[1] Orthodontic treatment is an elective one, but it can be useful in cases of psychosocial, developmental, functional, and oral health problems.[2]

Facial appearance is one of the most important physical characteristics in the development of one's self-confidence; therefore, it seems that people who are satisfied with their own appearance have more self-confidence in comparison with others.[3] The most important motivation for orthodontic treatment is improvement in dentofacial esthetics.[4],[5] An increase in the number of orthodontic treatments has been seen in most industrialized countries in recent decades.[6],[7] The demand for orthodontic treatment is influenced not only by the malocclusion prevalence and severity, but also by sex, socioeconomic status, and ethnic origin, as well as the availability of different orthodontic appliances and funding of orthodontic services.[6],[7],[8] For instance, it has been observed that girls, in general, undergo orthodontic treatment more frequently than boys.[9]

Oral health knowledge and awareness are considered to be an essential prerequisite for health-related behavior.[10] Awareness is the state or ability to perceive, to feel, or to be conscious. Awareness forms the basis for planning oral health, which is an inseparable part of general health. On an extensive literature review by the researcher, there are very less reported studies to assess the awareness of orthodontic treatment appliances in the society. Rather than evaluating the awareness of orthodontic treatment appliances in population, in the present study, we evaluated the awareness of different orthodontic appliances in patients undergoing orthodontic treatment only.

Aim

The aim of the study was to evaluate and compare the awareness of different orthodontic treatment appliances in patients undergoing orthodontic treatment in different teaching institutes of Maharashtra.

Objectives

The following were the objectives perceived during this survey:

To evaluate the awareness of different orthodontic treatment appliances in patients undergoing orthodontic treatment in different teaching institutes of MaharashtraTo compare the awareness of different orthodontic treatment appliances in patients undergoing orthodontic treatment in different teaching institutes of Maharashtra.

 Materials and Methods



Study setting

A cross-sectional, questionnaire-based study was conducted among patients undergoing orthodontic treatment in different teaching institutes of Maharashtra through an e-survey using Google Forms between September and December 2019.

Study population and sampling technique

A total of 360 patients undergoing orthodontic treatment in different teaching institutes of Maharashtra constituted the study population. The final sample size was 360, and E-mails were sent to 500 members through Google Form.

Study tools and data collection

The 10-item closed questionnaire in structured format was framed for the patients undergoing orthodontic treatment in different teaching institutes of Maharashtra. The questionnaire was distributed to the patients undergoing orthodontic treatment in different teaching institutes of Maharashtra. Lawshe's method was used for content validity using judgments from a panel of ten subject matter experts.[11] The reliability was also established by test–retest method among twenty volunteers of similar population. The Kappa value was 0.9 which indicated high reliability. This was followed by pilot testing among ten volunteers who were asked to answer the questionnaire and provide feedback on the content, clarity, and brevity of the questionnaire.

Ten orthodontic treatment appliances' options representing the major therapeutic modalities of choice used in daily practices were listed, namely, space maintainers, arch expanders, external growth modification devices, internal growth modification devices, stainless steel (SS)/ceramic/lingual braces, clear aligners, and combined orthodontic-surgical cases. An image was shown next to each one (the images displayed, space maintainer, palatal expander, headgear, twin block, SS brackets, ceramic brackets, lingual brackets, self-ligating brackets, clear aligner partially inserted, and a pre- and posttreatment extraoral profile photograph of a combined orthodontic and surgical case). All images selected were resized and edited to reflect a similar dimension and clear demonstration from the standard view. Details regarding the E-mail were collected, which was followed by questions on awareness and knowledge. The participants were asked to rate their awareness level using a Likert-type scale for awareness.[12] It composed of five categories as follows: (1) not at all aware, (2) slightly aware (3) somewhat aware, (4) moderately aware, and (5) extremely aware. Checkboxes were provided, and the participants had to click on any one option for each question. Care was taken that one person could answer the questionnaire only once and all questions were mandatory. The responses were directly recorded through Google Forms. As this was an e-survey, the informed consent was included in the Google Form.

Ethical clearance

The Institutional Ethics Committee of VYWS Dental College has approved the Research work proposed to be carried out at VYWS Dental College, Amravati Date: 12th Feb 2018 with Reference no VYWS/IC/2018/16.

 Results



The online recorded information was converted into codes and analyzed. The analysis was done using descriptive statistics and expressed in the form of percentages. The focus of this framework of the survey is to find the awareness of different orthodontic treatment appliances in patients undergoing orthodontic treatment in different teaching institutes of Maharashtra.

The framework with ten questionnaires and outcome results is as follows:

Outcome 1: Awareness of space maintainers

Nearly 21.3% of the patients were not aware at all and nearly 71.7% of the patients were slightly to somewhat aware about space maintainers [Graph 1].[INLINE:1]

Outcome 2: Awareness of arch expanders

Almost 37.8% of the patients were not aware at all and nearly 55.5% of the patients were slightly to somewhat aware about arch expanders [Graph 2].[INLINE:2]

Outcome 3: Awareness of external growth modification device (headgear)

Nearly 54.1% of the patients were not aware at all and nearly 37% of the patients were slightly to somewhat aware about external growth modification device [Graph 3].[INLINE:3]

Outcome 4: Awareness of internal growth modification devices (myofunctional appliances)

Overall 49.9% of the patients were not aware at all and nearly 45.4% of the patients were slightly to somewhat aware about internal growth modification devices [Graph 4].[INLINE:4]

Outcome 5: Awareness of stainless steel brackets

Very less patients were not aware at all, nearly 71.1% of the patients were extremely aware, and 25% of the patients were moderately to somewhat aware about SS brackets [Graph 5].[INLINE:5]

Outcome 6: Awareness of ceramic brackets

Very less patients were not aware at all, nearly 44% of the patients were extremely aware, and 55% of the patients were moderately to somewhat aware about ceramic brackets [Graph 6].[INLINE:6]

Outcome 7: Awareness of lingual brackets

Nearly 23.9% of the patients were not aware at all and nearly 75% of the patients were extremely to somewhat aware about lingual brackets [Graph 7].[INLINE:7]

Outcome 8: Awareness of self-ligating brackets

Almost 57.7% of the patients were not aware at all and nearly 42% of the patients were extremely to somewhat aware about self-ligating brackets [Graph 8].[INLINE:8]

Outcome 9: Awareness of clear aligners

Nearly 10.5% of the patients were not aware at all, nearly 30.1% of the patients were slightly aware, and 48% of the patients were extremely to somewhat aware about clear aligners [Graph 9].[INLINE:9]

Outcome 10: Awareness of combined orthodontic-surgical cases

Nearly 32.2% of the patients were not aware at all, nearly 23.8% of the patients were slightly aware, and 44% of the patients were extremely to somewhat aware about combined orthodontic-surgical treatment [Graph 10].[INLINE:10]

 Discussion



Awareness is the state or ability to perceive, to feel, or to be conscious. Awareness forms the basis for planning oral health, which is an inseparable part of general health. On an extensive literature review by the researcher, there are a number of reported studies[13],[14],[15],[16],[17] to assess the awareness of orthodontic treatment in the society, but there are very less studies[18] for evaluating the awareness of orthodontic treatment appliances in the population. In the present study, we evaluated the awareness of different orthodontic appliances in patients undergoing orthodontic treatment only rather than evaluating awareness in the general population.

In the present study, a total of 360 patients undergoing orthodontic treatment in different teaching institutes of Maharashtra were randomly selected. The 10-item closed questionnaire in structured format was framed for the patients undergoing orthodontic treatment for evaluating the awareness on different orthodontic appliances. The questionnaire was distributed to the patients undergoing orthodontic treatment in different teaching institutes of Maharashtra.

Bindayel[18] evaluated the awareness of orthodontic modalities and preference of appliance and payment options in Saudi Arabia population on a sample size of 350 using nine questionnaires.

The highest awareness among orthodontic devices listed was related to SS bracket and ceramic bracket. A group of preadolescents had earlier expressed an approximate moderate level of awareness regarding orthodontic procedures.[19] In connection to this, Adegbite et al. have distributed a self-administered questionnaire to medical students. They found that when participants were asked to identify appliances used in orthodontics (including dentures and other removable appliances), only 57.7% have identified orthodontic brackets as a related treatment device.

On the other hand, external growth modification device, for example, headgear, and internal growth modification device, for example, myofunctional appliances, displayed the lowest level of awareness.

A study of Iranian patients showed that although 94% have identified the orthodontic goal of tooth arrangement using special braces, only 32% were aware that orthodontic treatment can be rendered at any age.[13]

This highlights the lack of specific knowledge about growth modification appliances in the studied population group. Therefore, additional education and knowledge transfer channels should be utilized to improve patients' awareness and recognition of various orthodontic service and treatment options. This is crucial as the information about functional appliances' therapy availability would stimulate seeking consultations regarding early treatment when needed. Information education packages were developed previously and were found to increase awareness.[20] Furthermore, providing orthodontic patients with information about their procedure before their orthodontic therapy initiation using audiovisual information was shown to have a significant improvement in patient knowledge.[21] Similar to the distribution path of the present survey, positive effect of social media platform was earlier documented as worthy of consideration in improving patients' orthodontic information and future compliance.[22],[23],[24],[25],[26],[27],[28],[29]

 Conclusion



The study group showed very low awareness of growth modification devices and moderate-to-high awareness of SS brackets and ceramic bracketsEducational community program should focus on improving the general knowledge of orthodontic appliances, especially the ones concerning early functional jaw orthopedic treatments.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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