Adult patient expectations and satisfaction: Can they be influenced by viewing the three-dimensional predicted outcome before fixed orthodontic treatment of dental crowding?

Background

Investigating the possible changes in patients’ expectations of and satisfaction with the orthodontic treatment outcomes when they were given the three-dimensional digital prediction of their teeth alignment before the beginning of treatment.

Methods

A prospective non-controlled single-group clinical trial was conducted on 28 (18 females, 10 males, mean age: 20.68 ± 1.91 years) patients with Class I malocclusion and moderate dental crowding who required a nonextraction orthodontic treatment. Patients were given the expectations questionnaire on their first visit (T0). Then, patients were shown a three-dimensional digital setup–created by Orthoanalyzer software (3Shape, Copenhagen, Denmark)–of the proposed treatment results before orthodontic treatment (T1) and received two questionnaires, the second expectations questionnaire and the satisfaction with the proposed changes questionnaire. Treatment was then initiated using the fixed appliances and completed. After debonding, a question about patients’ satisfaction with the achieved changes was completed (T2).

Results

Patients’ expectations level significantly increased after watching the predicted alignment of teeth compared with the initial levels in terms of chewing ($\overline{x}$ = 5.54 and $\overline{x}$= 6.71), speech ($\bar{x}$ =5.93 and $\overline{x}$= 6.93), and oral hygiene improvement ($\bar{x}$= 7.93 and $\overline{x}$=8.61 ± 1.06; at T0 and T1, respectively). The remaining items showed no significant differences between the two assessment times. Patients had a higher level of satisfaction at the end of treatment than after watching the proposed outcome. There were significant statistical differences in the items related to teeth appearance ($\overline{x}$= 9.12 and $\overline{x}$= 9.60 at T1 and T2, respectively), and teeth engagement ($\overline{x}$= 8.92 and $\overline{x}$= 9.40 at T1 and T2, respectively)

Conclusions

Watching the predicted alignment outcome increased patients’ expectations of chewing, speech, and oral hygiene improvement compared with the initially recorded levels. Patients were more satisfied with the final result than what was recorded after viewing the predicted plan. However, these results were not clinically significant.