{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T01:53:05Z","timestamp":1780365185135,"version":"3.54.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T00:00:00Z","timestamp":1749945600000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Adolescents undergoing orthodontic fixed appliance treatment face an increased risk of dental caries and developing white spot lesions (WSLs) due to challenges in maintaining effective oral hygiene. Preventive measures, including adherence to clinical guidelines, are important to reduce these risks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To analyse adherence to clinical practice guidelines (CPGs) amongst patients undergoing orthodontic treatment with buccal fixed appliances in the northeast of the Netherlands.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A survey was presented to 539 adolescents aged 12\u201317 undergoing buccal fixed appliance treatment. Participants were recruited from ten orthodontic practices. The survey assessed adherence to the six recommendations of the Dutch CPGs. An adherence sum score (range 0 to 6) was calculated. Descriptive statistics and linear regression analyses (1000 bootstrap samples) were performed to analyse the relationships between participants\u2019 characteristics and adherence sum scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 485 adolescents started the survey, of whom 393 (72.9%) could be included (57% female; 48.9% aged 13 or 14). The median adherence sum score was 5 (IQR 4, 5), and 22.6% (n\u2005=\u200589) had an adherence sum score of 6. Males had a lower adherence sum score than females (\u22120.442, 95% CI: \u22120.979, \u22120.234). Older participants had a lower adherence sum score than younger participants (\u22120.066, 95%CI: \u22120.136, 0.002) per year of age. Higher educated participants had a lower adherence sum score than participants with lower education (\u22120.534, 95%CI: \u22120.953, \u22120.096).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Limitations<\/jats:title>\n                  <jats:p>Self-reported data may introduce information bias as participants may give socially desirable answers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Adherence to the CPGs amongst adolescents with buccal fixed orthodontic appliances is suboptimal, particularly in boys and older adolescents. Tailored educational interventions may address these gaps.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejo\/cjaf041","type":"journal-article","created":{"date-parts":[[2025,6,15]],"date-time":"2025-06-15T05:03:08Z","timestamp":1749963788000},"source":"Crossref","is-referenced-by-count":4,"title":["Adherence to clinical practice guidelines amongst adolescents with buccal fixed orthodontic appliances in northeast Netherlands: a cross-sectional study"],"prefix":"10.1093","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1144-3571","authenticated-orcid":false,"given":"Sebastiaan P","family":"van Doornik","sequence":"first","affiliation":[{"name":"Department of Orthodontics, University Medical Center Groningen , Hanzeplein 1, 9713 GZ, Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0223-7540","authenticated-orcid":false,"given":"Scott","family":"Lietmeijer","sequence":"additional","affiliation":[{"name":"Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen , Antonius Deusinglaan 1, FB 21, 9713 AV Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2374-1771","authenticated-orcid":false,"given":"Yijin","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, University Medical Center Groningen , Hanzeplein 1, 9713 GZ, Groningen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4570-0620","authenticated-orcid":false,"given":"David J","family":"Manton","sequence":"additional","affiliation":[{"name":"Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen , Antonius Deusinglaan 1, FB 21, 9713 AV Groningen ,","place":["The Netherlands"]},{"name":"Academic Center for Dentistry (ACTA) , Gustav Mahlerlaan, 3004 Amsterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5487-1907","authenticated-orcid":false,"given":"Pieter U","family":"Dijkstra","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, University Medical Center Groningen, University of Groningen , Hanzeplein 1, 9713 GZ Groningen ,","place":["The Netherlands"]},{"name":"Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen , Hanzeplein 1, 9713 GZ Groningen ,","place":["The Netherlands"]},{"name":"Sirindhorn School of Prosthetics and Orthotics, Faculty of Medicine Siriraj Hospital, Mahidol University , 14 Arun Amarin Rd, Bangkok 10700 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