Join me for a summary looking at remote monitoring in orthodontic clinical practice, and if it can improve, quicken and enhance orthodontic clinical practice. This podcast is based on an excellent webinar by Jonathan Sandler and Juan Carlos Varela, as part of the Angle-net webinar series. I discuss how Dental Monitoring works, the proposed advantages and a review of the emerging research on this innovation in orthodontics. 

What is Dental Monitoring?

• AI software which assesses occlusal and dental changes through a series of intra-oral photographs taken by the patient using their smartphone 

  
  

How does it work?

• Upload STL / digital study model

  
  



• Ai segmentation of teeth which maps digital study model to the photos

  
  



• Aligner fit analysis:

  
  





• Discrepancy between tooth surface and aligner fit 

  
  



• Either proceed, continue wear or see clinician

  
  





• Fixed appliances 

  
  





• Assess rate of movement and schedule appointment

  
  





• Other proposed benefits

  
  





• Oral hygiene assessment

  
  



• Breakages

  
  



• Retention changes

  
  

What do patients think of it?

Patients attitudes to remote monitoring

• 81% interested in reducing number of appointments due to telemonitoring – Dalessandri 2021

  
  



• 25% of patients found scans difficult to perform, with duration of scan 2-17 minutes Hansa 2020

  
  

Does it reduce appointments and make treatment quicker? Sangalli 2024

• Decrease the number of in-office visits by 1.68–3.5 visits 

  
  



• No difference in treatment duration 

  
  



• No statistical reduction in emergency appointments

  
  

Are treatment outcome better (aligners)? 

• No difference in tooth movements  Hansa 2021

  
  



• No difference in number of refinements  Hansa 2021

  
  

• PAR changes – no difference in quality of outcomes Jarad Marks 2024

  
  

Is oral health better? 

• DM reduced plaque scores Costi 2019

  
  



• 31% Improved hygiene  Manzo white paper

  
  

Other innovations with remote monitoring?

Remote STL files

• Scan taken without patient attending the practice 

  
  



• Scanbox 

  
  



• Formulate STL file and fit aligner in surgery

  
  

Is Dental Monitoring accurate? Ferlito 2022

• 80% repeatability from 2 scans

  
  



• 44.7% repeatability and reproducibility 

  
  



• Discrepancy between scanbox and intra-oral scan varied between 0.5-1.9mm, angular measurements maximum error 8.9 degrees

  
  

Conclusion

• 2-3 appointments less

  
  



• No difference in overall duration

  
  



• Some people struggle to use

  
  



• Accuracy and repeatability variable

  
  



• No difference in the quality of the outcome

  
  

Areas which are of concern

• Unknown accuracy of occlusal assessments from a reliable retruded contact position

  
  



• Patient motivation maybe better delivered in person

  
  



• Ai environment cost 2-3% of energy used by data centres

  
  

Other ways to reduce time?

• Diagnostic and treatment planning acumen

  
  



• Identify main aspect of malocclusion and address through efficient mechanics