Reporting and conducting of the scoping review
The protocol for this scoping review was drafted according to guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P) statement [11, 12] (Additional file 1a) and the PRISMA extension for Scoping Reviews (PRISMA-ScR) [13] (Additional file 1b). For the methods of this review we consulted Arksey and O’Malley’s framework [14] and the Reviewer’s Manual of the Joanna Briggs Institute (JBI) for conducting scoping reviews [15] as well. We registered our protocol a priori in the registries of the Open Science Framework (https://doi.org/10.17605/OSF.IO/EC6QD). Ethical approval for this scoping review protocol was granted by the Ethical Committee of ACTA on 11 February 2022. Our planned and future research projects are reported in a flow diagram (Fig. 1).
Flow diagram of the current and future research projects.
Eligibility criteria
The following selection criteria will be applied:
Sources of evidence: studies of all designs with the primary aim of investigating any form of patient adherence in orthodontics will be included, with the exception of case reports and studies investigating adherence in the following patients: those with an intellectual or physical disability that could affect their ability to coincide with their therapist’s recommendations and advice, those with oral cleft and craniofacial conditions, and those treated solely for obstructive sleep apnoea. Patients with oral cleft and craniofacial conditions are excluded because of the higher orthodontic burden for this group of patients [16]. Patients solely treated for obstructive sleep apnoea are excluded because of the difference in treatment need and used appliances for this group of patients. Research in adherence for these groups of patients should be reported in separate reviews.
Publication type: peer reviewed manuscripts only. No grey literature sources will be included.
Publication date: eligible studies published from 2006 onwards will be included. The ACTA has been exploring patient compliance in orthodontics up to 2006 [10].
Publication language restrictions: only eligible studies published in English will be included.
Information sources and search strategy
The information sources and key terms have been selected in consultation with a medical information specialist working at the Vrije Universiteit (VU) Amsterdam medical university library. The following electronic databases will be searched: Embase, PubMed, and Web of Science Core Collection. The following key terms, including synonyms and subheadings of the MeSH terms, will be used in the search strategies: ‘treatment adherence and compliance’ and ‘orthodontics’. Two reviewers (RB and RJ) pilot tested these strategies. A draft search strategy for PubMed is presented in Additional file 2. The draft search resulted into 3201 results. Since our selection criteria require a publication date from 2006 onwards, we decided to apply this search restriction immediately to make the selection of eligible studies more convenient. The search will be performed by the medical information specialist. Citation tracking and searching of reference lists of included eligible studies will be performed to identify additional eligible relevant research.
Selection of sources of evidence
The results will be screened independently by multiple reviewers (RB and RJ) in two stages. In the first stage, results will be screened based on the studies’ title, abstract and keywords to identify eligible publications using a conducted first stage screening form (Additional file 3). Rayyan, a free web and mobile application will be used for this first stage. In the second stage, after identification of relevant studies, full-text articles will be obtained and a final selection of studies to be included in our scoping review will be made based on our eligibility criteria using a conducted second stage screening form (Additional file 4). EndNote will be used as the reference management software program. Two reviewers (RB and RJ) pilot tested the two screening stages using 50 randomly selected studies from the 3201 results of the draft search strategy and fine-tuned the screening forms. Potential disagreements between the two reviewers during the two-stage screening will be resolved by rereading of the pertinent studies. Persisting disagreements will be resolved by independent validation by a third reviewer (AB or JB) to either reach consensus or to cast a decisive vote for selection. All steps of the screening and selection process will be presented in a PRISMA flow diagram [11].
Data charting process
For data extraction, a data charting form (Additional file 5) was conducted using the data extraction template and guidance for scoping reviews of the Joanna Briggs Institute [15] and the checklists of the Enhancing the Quality and Transparency Of health Research Network (EQUATOR Network). Two reviewers (RB and RJ) pilot tested the data charting form. The data charting process will be performed by the two reviewers who selected the sources of evidence (RB and RJ). Potential disagreements between the two reviewers will be resolved by rereading of the pertinent studies. Persisting disagreements will be resolved by independent validation by a third reviewer (AB or JB) to reach consensus on the data to be extracted.
Quality assessment and risk of bias
Quality appraisals and risk of bias assessments are optional when conducting a scoping review [13, 14] and are typically not performed. Due to the expectation that the eligible studies will include various study designs and will have a lack of reported quantitative outcome measures, we will not perform a quality appraisal or risk of bias assessment or perform any quantitative analyses of the results.
Synthesis of the results
A narrative description will be provided for the analysis of the included studies containing the year of publication, design of the study, objective of the study, methodology of the study, population and sample size of the study, outcome measures of the study (if described), and any key findings that relate to our research questions. Tables will be created to report the characteristics and results of the eligible studies. A draft table to summarize the characteristics and key findings of the included studies is presented in Fig. 2.
Draft table to summarize the characteristics and key findings of the included studies.
The results will be categorized into the following topics, partially based on recommendations by previous research into compliance in orthodontics [2]:
What is known about the definition of patient adherence in orthodontics?
What is known about the effects of patient adherence on orthodontic treatment outcomes?
What is known about the methods of measuring patient adherence in orthodontics?
What is known about the degree of patient adherence during active orthodontic treatment, taking into account different types of appliances and different stages of treatment?
What is known about the degree of patient adherence during the orthodontic retention phase?
What is known about factors to influence patient adherence and methods to promote patient adherence in orthodontics?
Identified knowledge gaps will be reported and recommendations for future research will be suggested.
