## Materials, Methods, and Concept
### Methods
#### 2.2.2 Practical Aspects of Dental Monitoring(r) (DM) (Dental Monitoring Co., Paris, France)  
Patients who do not use Dental Monitoring have to go for regular check-ups, which means that they always get a certain number of aligners, which they wear until the time of the check-up. Usually, this is a month, maximum two. During this time, we have minimal interaction with the patient; we do not see if there is a problem or if the treatment is going as planned. If a problem does arise, the doctor usually does not discover it promptly enough, so the treatment must be adjusted or redone. The patient also had to check for the presence of attachments and report if they were dropping off. Many times, the patient himself does not notice the loss of the attachment. In the monitored orthodontic practice, 98% of patients are users of the DM app. The advantage of DM is the reduced frequency of visits to the outpatient clinic. The use of DM eliminates frequent check-ups, where many times no problem is found or, on the contrary, the doctor states that treatment has failed. Patients without DM were given aligners for a while until the next check-up. During this time, everything could have become complicated. Either the attachment fell off or the aligner was not fitting properly [30]. However, with the use of DM, these problems are outdated. The main purpose of the app is to make the work of the doctor and the dental assistants/nurses easier [31]. DM looks at thousands of scans/photos of patients' teeth every day. It sees them from different angles and can compare each photo with another. In orthodontic treatment with invisible aligners, this sophisticated software is used frequently. It detects an incipient problem early. This type of treatment is used to monitor attachments, buttons, and non-tracking aligners. It will also detect poor hygiene, which will show up as inflamed gums, plaque, and dental calculus. A big plus is that it can also highlight aphthae, gingival recession, and, in certain cases, dental caries [32]. The patient data provided to DM is processed by Artificial Intelligence (AI) and a report is returned to the patient after each scan about their current condition. Depending on the report, patients can get the option of changing their aligners for another set. The standard \(10+2\) protocol can be accommodated by an orthodontist depending on the patient's compliance, hygiene, increment per aligner, biomechanical difficulty of the particular phase of the treatment, and many other aspects. With the \(10+2\) protocol, the patient can change aligners every \(10\) days as long as they wear them for more than \(22\) h a day [33]. If there is a problem, the software will halt the patient on the current aligner for another \(2\) days before another opportunity for intraoral video-scanning with another evaluation. In such a situation, the reason for the halt is reported to the nurses and doctors at the patient's office. The most common problem is attachment debonding or non-tracking. In cases of attachment debonding, a new template is ordered by nurses upon the decision of the orthodontist about the importance of that particular attachment in the context of the current phase of the treatment as well as the aspect of the estimated date of the new attachment template's delivery in the context of the current wear of the aligner. In some cases, the template is ordered for the next aligner stage, where an appointment is booked in advance without stopping the flow of the treatment. In other cases, a patient is halted on the current aligners until a template arrives and the attachment is rebonded. In those cases, patient's with poor tracking typically improve their compliance, and non-tracking is resolved naturally. In cases of significant non-tracking, it makes no sense to bypass the decision of the DM to manually halt, as such an override would lead to even more tracking.