Innovative customized CAD/CAM nickel-titanium lingual retainer versus standard stainless-steel lingual retainer: A randomized controlled trial

Abstract

Objective To compare computer-aided design and computer-aided manufacturing (CAD/CAM) customized nitinol retainers with standard stainless-steel fixed retainers over a 12-month study period. Methods This randomized controlled trial (RCT) was conducted on 62 patients randomly allocated to a control group that received stainless-steel retainers or a test group that received customized CAD/CAM nickel-titanium retainers. Four time points were defined retainer placement (T0) and 1-month (T1), 6-month (T2), and 12-month (T3) follow-up appointments. At each time point, Little’s irregularity index (LII) (primary endpoint) and dental stability measurements such as intercanine width were recorded in addition to assessment of periodontal parameters. Radiological measurements such as the incisor mandibular plane angle (IMPA) were recorded at T0 and T3. Failure events (wire integrity or debonding) were assessed at each time point. Results From T0 to T3, LII and other dental measurements showed no significant differences between the two groups. The data for periodontal parameters remained stable over the study period, except for the gingival index, which was slightly, but significantly, higher in the test group at T3 ( p = 0.039). The IMPA angle showed no intergroup difference. The two groups showed no significant difference in debonding events. Conclusions This RCT conducted over a 12-month period demonstrated no significant difference between customized CAD/CAM nickel-titanium lingual retainers and standard stainless-steel lingual retainers in terms of dental anterior stability and retainer survival. Both retainers eventually appeared to be equally effective in maintaining periodontal health.

What causes failure of fixed orthodontic retention? – systematic review and meta-analysis of clinical studies

“…Among those 10 retainers, only one became loose within the study period; the remaining ones were still in place at 24 months. Gelin et al 2020 [ 34 ] RCT Comparison of effectiveness of CAD/CAM customized nitinol retainers with standard stainless-steel fixed retainers 61 patients (43 W 18 M) Groups were designed as equal – one patient dropped out Rectangular 0.014 × 0.014 in memory shape customized CAD/CAM nitinol retainer (Memotain™; CA Digital GmbH, Mettmann, Germany)Vs.Round 0.0175′ 6-strand twisted stainless-steel wire retainer (Supra-FlexTM; RMO Europe, Illkirch-Graffenstaden, France) Failure rate, changes in intercanine width, interpremolar width, anterior arch length, total arch length, Gingival index, Plaque Index with other periodontal measurements within 12 months period. (checked monthly)VAS Scale was used to measure patients satisfaction.Little Index measured at the beginning, after 6 and 12 months and IMP angle were measured at the begging and in the end of treatment The average number of debonding per patientshowed no significant difference from during the study between the two groups.…”

“… In case if detachment of retainer was noticed during the visit, the subject was allowed to approach immediately for repair and bond failure was recorded in the upcoming visit. NONE Risk of bias judgement LOW SOME CONCERNS HIGH HIGH SOME CONCERNS LOW Salehi et al 2013 [ 30 ] Arash et al 2020 [ 31 ] Scribante et al 2011 [ 32 ] Rose et al 2002 [ 33 ] Gelin et al 2020 [ 34 ] Kartal et al 2020 [ 35 ] Random sequence generation LOW HIGH SOME CONCERNS SOME CONCERNS LOW LOW Allocation concealment LOW SOME CONCERNS SOME CONCERNS SOME CONCERNS LOW LOW Blinding of participants and personnel HIGH HIGH HIGH HIGH HIGH HIGH Blinding of outcome assessment SOME CONCERNS SOME CONCERNS HIGH SOME CONCERNS SOME CONCERNS HIGH Incomplete outcome data LOW SOME CONCERNS LOW LOW LOW LOW Selective reporting LOW SOME CONCERNS SOME CONCERNS SOME CONCERNS LOW LOW Other bias (why) The study included patients during growth period. The study included patients during growth period.…”

“…The novelty - customized CAD/CAM (computer-aided design/computer-aided manufacture) nitinol retainer provides neither superior stability nor lesser gingival influence compared to classical twisted stainless-steel wire retainer [ 34 , 35 ]. Referring to the bonding procedure: direct vs. indirect the only difference is shorter chairtime [ 24 , 40 ].…”

“…In the included studies, no clear effect of the wire used (SS wire, NiTi) on the patient’s periodontal condition was found [ 27 , 34 , 35 ]. Either, in the literature, no detrimental effect of the presence of a retention wire on the health of periodontal tissues was found, indicating a greater risk of periodontitis in the fixed retention obtained with FRC [ 50 – 52 ].…”

Three-dimensional evaluation of the transfer accuracy of a bracket jig fabricated using computer-aided design and manufacturing to the anterior dentition: An in vitro study

“…[9][10][11][12] These devices can be fabricated manually in the laboratory, or the entire process can be digitalized using computer-aided design and manufacturing (CAD/CAM). [13][14][15][16] To our knowledge, no previous studies have verified the accuracy of a transfer device fabricated using CAD/CAM, taking into account various possible variables that may affect its accuracy.…”