Optimizing Orthodontic Clear Aligner Treatment with Artificial Intelligence Driven Dental Monitoring

Objective: This study analyzes using Dental Monitoring™ (DM), an artificial intelligence based innovative technology for tooth movement monitoring, to individualize clear aligner change intervals in orthodontic treatment. While the in vitro accuracy of DM is established, its effectiveness in patient care remains limited. The primary aim of this study is to evaluate the efficacy of implementing DM in orthodontic clear aligner treatment. The objectives are 1) to evaluate the validity and accuracy of DM AI image analysis notification software in detecting conditions regarding clear aligner issues and 2) other oral hygiene concerns compared to the “gold standard” orthodontist visual exam of uploaded DM Scans; and 3) to conduct a pilot study assessing the first six months of treatment outcomes using the DM GoLive protocol based on standardized ABO indices compared to conventional aligner change intervals. Methods: A three-arm parallel randomized clinical trial with a balanced allocation (1:1:1) was conducted with 37 patients. Group 1, experimental group, was instructed to use DM software to determine aligner change interval, starting at 5 days and then was instructed to progress to subsequent aligner based on the DM GoLive Protocol. Group 2, conventional treatment, changed aligners every 7 days. Group 3, conventional treatment, changed aligners every 14 days. An orthodontist analyzed scans in the DM online dashboard for notifications, and intraoral scans were provided at pretreatment timepoint (T0) and at 6months (T1) for comparing American Board of Orthodontics (ABO) indices. Results: The Dental Monitoring AI image analysis software demonstrated a higher accuracy for generalized detection of clear aligner and oral hygiene parameters, while a lower accuracy was demonstrated for localized detection of stated parameters. Within the first six months of treatment, all groups demonstrated improvement of ABO; however, the experimental group was not the most improved. Conclusions: Dental monitoring is a viable option for use clinical use in guiding aligner treatment. However, the clinician should still use their judgement for case selection and consider patient compliance with clear aligner treatment. Funding: American Association of Orthodontists Foundation (AAOF) IRB and/or ACC Protocol #: 2021-0644