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Adherence Patterns Over Time several errors, such as incorrect titles or systematic review. Am J Orthod Dentofacial
Initial post-treatment compliance ranges authors in the references. References were Orthop. 2014 Jun;145(6):720-7. doi: 10.1016/j.
between 60% and 90% of prescribed hours. found to be outdated, incorrect, or we could ajodo.2014.01.019. PMID: 24880842.
However, adherence typically drops to not locate them—inaccurate referencing of 10. Nobre R, Pozza DH. Parental influence in
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less than 40% within a year. Objective articles when generating in-text citations. orthodontic treatment: a systematic review.
Med Pharm Rep. 2023 Jan;96(1):28-34. doi:
monitoring often reveals wear-time 10.15386/mpr-2415. Epub 2023 Jan 25. PMID:
overestimation by ~5 hours/day versus self- When questioned, ChatGPT acknowledged 36818313; PMCID: PMC9924810.
report. Compliance is similarly suboptimal miscellaneous discrepancies, making it 11. Zotti F, Zotti R, Albanese M, Nocini PF,
across appliance types. Some patients apparent that it was imperfect and/or not Paganelli C. Implementing post-orthodontic
demonstrate excellent long-term adherence, forthcoming about information it may have compliance among adolescents wearing
but wide variability exists. 12 struggled to gather/report. removable retainers through Whatsapp: a pilot
study. Patient Prefer Adherence. 2019 Apr
Retention Outcomes and Stability OVERALL CONCLUSIONS: 23;13:609-615. doi: 10.2147/PPA.S200822.
Orthodontic relapse is often linked to poor Can we trust the results? Overall, yes. PMID: 31118585; PMCID: PMC6498955.
compliance. While few studies directly The results extracted from the systematic 12. Kacer KA, Valiathan M, Narendran S,
Hans MG. Retainer wear and compliance
correlate wear time with tooth stability, reviews proved accurate after many in the first 2 years after active orthodontic
evidence suggests better outcomes with revisions. However, caution should be taken treatment. Am J Orthod Dentofacial Orthop.
improved adherence. A WhatsApp support with references and in-text citations, as AI 2010 Nov;138(5):592-8. doi: 10.1016/j.
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intervention demonstrated reduced relapse. creates inaccuracies. ajodo.2008.12.027. PMID: 21055599.
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Fixed retainers provide passive stability 13. Dong J, Reeves L, Ali A, Freeman MK,
but carry the risk of unnoticed failure. AI reduced the time it takes to compile and Adunlin G. A Systematic Review of the
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Removable retainers are effective if worn analyze articles, but it did not replace the Effectiveness of Text Message Reminders
diligently. Patient perception of relapse can authors’ critical review of the accuracy of on Asthma Medication Adherence. Innov
reinforce compliance post-treatment. the results. Pharm. 2018 Oct 16;9(3):1-7. doi: 10.24926/
iip.v9i3.1370. PMID: 34007710; PMCID:
Interventions to Improve Compliance References: PMC6302753.
14. Johnston CD, Littlewood SJ. Retention in
Text message reminders are effective, 1. Zhang G, Jin Q, Jered McInerney D, Chen Y, orthodontics. Br Dent J. 2015 Feb 16;218(3):119-
Wang F, Cole CL, Yang Q, Wang Y, Malin BA,
low-cost tools. App-based interventions Peleg M, Wallace BC, Lu Z, Weng C, Peng Y. 22. doi: 10.1038/sj.bdj.2015.47. PMID:
show mixed results. Electronic sensors Leveraging generative AI for clinical evidence 25686428.
(e.g., TheraMon ) may enhance short- synthesis needs to ensure trustworthiness. J 15. Lyros I, Tsolakis IA, Maroulakos MP, Fora
®
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term adherence via Hawthorne effect. Biomed Inform. 2024 May;153:104640. doi: E, Lykogeorgos T, Dalampira M, Tsolakis
Peer support, such as moderated chat 10.1016/j.jbi.2024.104640. Epub 2024 Apr 10. AI. Orthodontic Retainers: A Critical Review.
groups, improves motivation and outcomes. PMID: 38608915; PMCID: PMC11217921. Children (Basel). 2023 Jan 28;10(2):230. doi:
10.3390/children10020230. PMID: 36832359;
Educational counseling—especially when 2. ChatGPT4o. https://chatgpt.com/?model=gpt-4o. PMCID: PMC9954726.
involving parents—reinforces compliance. 3. Molyneaux C, Sandy JR, Ireland AJ. 16. Martin C, Littlewood SJ, Millett DT,
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Incentive-based strategies and signed Orthodontic retention and the role of the Doubleday B, Bearn D, Worthington HV,
general dental practitioner. Br Dent J. 2021
contracts may aid adherence. Multimodal Jun;230(11):753-757. doi: 10.1038/s41415-021- Limones A. Retention procedures for stabilising
approaches combining reminders, education, 2875-5. Epub 2021 Jun 11. PMID: 34117434; tooth position after treatment with orthodontic
and monitoring offer the greatest promise. PMCID: PMC8193161. braces. Cochrane Database Syst Rev. 2023 May
4. van der Bie RM, Bos A, Bruers JJM, Jonkman 22;5(5):CD002283. doi: 10.1002/14651858.
Conclusion About The Evidence REG. Patient adherence in orthodontics: a CD002283.pub5. PMID: 37219527; PMCID:
Patient compliance with retainers is a linchpin scoping review. BDJ Open. 2024 Jul 16;10(1):58. PMC10202160.
of long-term orthodontic success. While doi: 10.1038/s41405-024-00235-2. PMID:
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patients often understand the importance of 39013856; PMCID: PMC11252357. Barrett Towns is a third-
retention, adherence falls short, particularly 5. Fu, L. M., Ellman, S., Gao, J., Tahir, P., & year dental student at
beyond the first post-treatment year. Oberoi, S. (2023). Patient Compliance with New York University
Removable Orthodontic Retainers During
Factors such as retainer type, education, Retention Phase: A Systematic Review. Journal College of Dentistry
parental support, and regular follow-up of the California Dental Association, 51(1). with a strong interest
shape outcomes. Research supports using https://doi.org/10.1080/19424396.2023.2243016. in orthodontics and
multifaceted interventions—including 6. Nahajowski M, Lis J, Sarul M. Orthodontic patient-centered care.
text reminders, peer support, and clinician Compliance Assessment: A Systematic Review.
reinforcement—to maintain adherence. Int Dent J. 2022 Oct;72(5):597-606. doi: Dr. Analia Veitz-Keenan,
10.1016/j.identj.2022.07.004. Epub 2022 Aug DDS, FAGD, is a Clin-
Conclusions About The Use of AI for This 10. PMID: 35961844; PMCID: PMC9485511. ical Professor at NYU
Review 7. Al-Moghrabi D[3], Salazar F, Pandis N, College of Dentistry,
Fleming PS. Compliance with removable
ChatGPT proved useful in discovering orthodontic appliances and adjuncts: A Department of Oral
some appropriate articles and synthesizing systematic review and meta-analysis. Am J Maxillofacial Pathol-
information into a concise research paper. Orthod Dentofacial Orthop. 2017;152(1):17-32. ogy, Radiology and
However, what was a simple task took time 8. Vig KW. Patient compliance to wear Medicine, and Epidemiology and Health
to verify the generated information. Upon orthodontic retainers during postretention may Promotion. She has a private practice in
review, multiple mistakes were discovered vary by age, gender, and time since braces Brooklyn, NY, and is NYSAGD’s 2024-25
across the paper. References were incorrect were removed. J Evid Based Dent Pract. 2012 president.
or inappropriate, as we requested systematic Sep;12(3 Suppl):202-3. doi: 10.1016/S1532-
reviews. Many of the references were not 3382(12)70037-4. PMID: 23253846.
9. Mai W, He J, Meng H, Jiang Y, Huang
systematic reviews or research articles. The C, Li M, Yuan K, Kang N. Comparison of
four systematic reviews listed contained vacuum-formed and Hawley retainers: a
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