Orthodontist and General Practitioner Perceptions of Invisalign Treatment Outcomes

Abstract

Objectives: Little is known about the treatment standards and expectations of Invisalign treatment outcomes between orthodontists and general practitioners (GP). The objective of this qualitative research project was to explore how orthodontists and GPs perceive Invisalign treatment outcomes, and to determine which criteria they use to judge successful treatment. Methods: Open-ended interviews were conducted with three orthodontists and two GPs. These interviews were recorded, transcribed, coded and analyzed by the conventional phenomenological qualitative research protocol. Each clinician selected four Invisalign cases that they treated and perceived as successful outcomes. To augment qualitative methods, quantitative data were generated to determine pre-treatment Discrepancy Index (DI) and post-treatment Objective Grading System (OGS) scores as calculated by OrthoCAD software. Results: Independent sample T-tests showed no significant difference in total DI score (p=0.287) and total OGS score (p=0.840) between the orthodontist (n=12) and GP (n=7) cases. Orthodontists perceive incisor torque and smile esthetics as important criteria for successful Invisalign outcomes. In contrast, GPs do not. Orthodontists and GPs unanimously perceive that Class I occlusion is an important criterion for successful treatment. GPs perceive extraction cases as a challenge to obtain successful outcome with Invisalign whereas, orthodontists do not. Conclusions: Differences exist between orthodontist and GP perceptions of what constitutes successful Invisalign treatment. Currently employed standards of excellence can be found in a wide spectrum of finishes; however, they are incapable of defining the excellence of finish. Selective standards differentiate the GPs from orthodontists, but agreement exists for ambition to finish in Class I occlusion. Esthetics and torque are valued higher by the orthodontists than are by the GPs. The utility of current standards- of-care need to be questioned and redefined.