## Materials, Methods, and Concept
### Methods
#### 2.2.2 Practical Aspects of Dental Monitoring(r) (DM) (Dental Monitoring Co., Paris, France)
In these cases, an extra aligner of that particular stage can be ordered or even at the \(-1\) stage, and the patient is given a chance to \"catch up\" with tracking; otherwise, a revision is performed. This means a new scan and photos are made in the office and submitted for a new set of aligners to be manufactured according to the original plan. Some functions can change these system settings. For example, if the patient has had a splint not fitting on one tooth for a long time and the doctor evaluates this problem as satisfactory, there is a Force GO button. This means that the Artificial Intelligence (AI) will move the patient to the next aligner even if it evaluates the problem. However, from our point of view, the Force STOP function is missing. It would slow down the treatment of patients who are not \(100\%\) compliant with the conditions and rules of treatment. Figure 3 shows an example of the visual communication of dental assistants/dental nurses, respectively, with the patient, with a message visualizing the problem exported directly from the DM scan. This represents the practical first layer of problem identification, where, depending on the type and severity of the problem, pre-processed with AI telemonitoring recognition, a dental nurse is alerted with treatment issues and fixes them according to the office protocols, alerting doctors only when necessary otherwise handling  
communication with or education of the patient [34]. The post-identification problem has three main levels of management:  
1. Semi-automatic AI communication with the patient (e.g., non-ideal dental hygiene with automatic recommendations for improvement);
2. Digital or face-to-face problem management with the dental assistant (e.g., inadequate dental hygiene or the need to improve the wearing of aligners);
3. Need for direct decision-making by the dentist, revision of treatment, or direct doctor-patient communication, depending on the severity and nature of the problem detected by the DM app. Or when a clinical alert, setup by the doctor, has been achieved. Patients receive scan reports, messages from nurses, and scan reminders in the chat section within the DM app. In the past, patients had to keep track of when they changed aligners, how many days they had been wearing the aligner, etc. With this system, they do not have to worry at all about the date they change their aligners. The DM app will remind the patient on the day of the scan to let them know it is scan time. Within a few hours, the patient will be told if they can change their aligner or if they need to stay on that aligner. Every patient who starts DM is fully trained in the use of the app. It is explained to patients why they need to do ongoing scans. The procedure to use DM is to download the app, create a profile, and perform basic setup on the phone. If everything is done, it goes straight to scanning. The phone is set up in a special dental scan box, which ensures the stability of our photos [35]. Figure 4 shows crucial patient education by nurses directly affecting the effectiveness of telemedicine-enhanced workflow. Individual scans consist of four photos:  
1. A scan of bitten teeth without aligners;
2. A scan of the teeth apart, without aligners;
3. A scan where the patient has his mouth open and the inside of the teeth is scanned, without aligners;
4. A scan of teeth apart with aligners. Figure 3: Dental assistants/nurses visually communicate problems with the patient represented in the black circle using DM scan exports. AI pre-processing identifies the severity of the problem, and nurses fix the issue(s) by managing patient communication/education; otherwise, doctors are alerted as needed. Each video sequence is processed by Artificial Intelligence (AI) [36] to produce photographs of the teeth taken from multiple angles. The video sequences are examined, and DM generates a conclusion from each one to inform not only the patient but also the clinic staff. DM facilitates the work of the medical staff. It makes us aware of the problems that trouble the patients.