Lower Fixed Retainers: Bonded On All Teeth Or Only On Canines?<i>A Systematic review</i>

Lb, Moda; Barros, Ana Luiza Correa da Silva; Fagundes, Nathália Carolina Fernandes; Normando, David; Maia, Lucianne Cople; Mendes, Sissy Maria Dos Anjos

doi:10.2319/013019-63.1

Cited by 14 publications

(27 citation statements)

References 31 publications

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“…However, bonding only on canines is likely to come at the cost of lower stability of the anterior alignment of the mandibular. 10,19 FRs in the mandible are maintained for prolonged periods, even for life. 14 Growing popularity and extended use can be associated with unwanted sequelae such as the development of decalcification or caries or the presence of gingival or periodontal inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…7 A comparison of the effectiveness among various combinations of vacuum-formed retainer, stripping, positioner, and retainers bonded to canines only, 3,4,8,9 despite some variability, on average revealed no significant differences in maintaining alignment. 9 Fixed retainers (FR) bonded to all 6 anterior teeth seem to be more effective than FR bonded to 3's only 10 and are a sensible alternative when even small increases in incisor irregularity are unacceptable. Such FRs are more effective at maintaining mandibular labial segment alignment but have a higher failure rate in comparison with vacuum-formed retainers.…”

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confidence: 99%

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A comparative assessment of failures and periodontal health between 2 mandibular lingual retainers in orthodontic patients. A 2-year follow-up, single practice-based randomized trial

Wegrodzka¹,

Kornatowska²,

Pandis

et al. 2021

American Journal of Orthodontics and Dentofacial Orthopedics

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Introduction:The objective of this study was to compare the survival rates and periodontal health in patients with 3-strand round twisted (RT) vs 8-strand rectangular braided (RB) fixed retainers bonded to all 6 anterior teeth in the mandible. Methods: A total of 133 patients completing orthodontic treatment (median age, 24.6 years; 25th percentile, 17.2 years; 75th percentile, 32.4 years; minimum, 15.1 years; maximum, 49.8 years) were randomly allocated in a 1:1 ratio to receive either an RT or RB wire retainer. Inclusion criteria were all mandibular permanent incisors and canines present, no active caries, no restorations, no fractures on the mandibular incisors and canines, no periodontal disease. Patients with poor oral hygiene before debonding were excluded from the trial. The primary outcome was any first-time retainer failure. Secondary outcomes were periodontal index, bleeding on probing, plaque index, gingival index, and probing depth. Randomization was accomplished with random permuted blocks of size 4, 6, or 8 with allocation concealed in sequentially numbered, opaque, sealed envelopes. Blinding was not possible in this trial. Patients were evaluated at baseline, 3, 6, 12, 18, and 24 months after placement of the retainer. Retainer survival was assessed using Cox regression. Periodontal parameters were reported at each time point and generalised estimating equations were used to assess the effect of treatment, time, tooth and treatment X time interaction on the indices. Results: Baseline characteristics were similar between groups; in 1 patient, the intervention was discontinued. During 2-year follow-up 37 of 66 (56.1%, RT group) and 32 of 66 (48.5%, RB group) retainers failed at least once (log-rank test, P 5 0.55). The adjusted hazard ratio was 0.69 (95% confidence interval, 0.42-1.12; P 5 0.13). Neither age nor gender was a predictor of failure. All periodontal parameters (periodontal index, bleeding on probing, plaque index, gingival index, and pocket depth) were comparable between groups and remained relatively stable during follow-up. Conclusions: The overall risk for first-time failure was high and amounted to 52.3% (56.1% in the RT group and 48.5% in the RB group). There was no difference in terms of survival or periodontal health between the examined retainers.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

A comparative assessment of failures and periodontal health between 2 mandibular lingual retainers in orthodontic patients. A 2-year follow-up, single practice-based randomized trial

Wegrodzka¹,

Kornatowska²,

Pandis

et al. 2021

American Journal of Orthodontics and Dentofacial Orthopedics

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“…Fixed or removable retention appliances can reduce the risk of relapse [1], but to date there is still limited evidence on treatment protocols, wearing time and duration [2]. However, long-term retention with fixed lingual retainers is commonly recommended and often considered the gold standard (method of first choice) in orthodontic retention [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Post-treatment Stability in Orthodontic Retention with Twistflex Retainers—Do Patients Benefit from Additional Removable Retainers?

et al. 2022

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Objectives To evaluate post-treatment movements of lower anterior teeth during orthodontic retention in patients with fixed twistflex retainers versus those with combined fixed and removable retainers. Materials and Methods This study was based on a retrospective data analysis of 57 adult patients during orthodontic retention. They were assigned to two groups: In group 1 (n = 30) the lower jaw was provided with twistflex retainers only and in group 2 (n = 27) with a twistflex combined with a removable retainer for night-time use. Orthodontic study models of the lower jaw were digitalized and superimposed. Tooth movements were analyzed at the retainer bonding (t0) and follow-up appointment ≥ six months later (t1). Rotational tooth movements (°) were measured around the x-axis (mesial/distal direction), the y-axis (buccal/lingual direction) and the z-axis (longitudinal direction, tooth axis). Translational tooth movements (mm) were registered along the x-axis (buccal/lingual direction), the y-axis (mesial/distal direction) and the z-axis (apical/coronal direction). Results Canine and incisor position changes during orthodontic retention were more pronounced in group 1 compared to group 2 except for canine rotations around the z-axis. In both groups in most of the cases stable lower incisor alignment could be found, but the proportion was significant higher in group 2 (group 1: 56.7% vs. group 2: 81.5%). Severe misalignment was present in 13.3% of the participants of group 1 and only in 7.4% of group 2. The extent of canine tipping and movements along the x- and y-axis in severe misalignment cases was significantly lower in group 2 compared to 1. Conclusions Lower incisor alignment was more stable in patients with combined fixed and removable retainers compared to fixed retainers only. Clinical Relevance Based on the present findings, the routinely application of supplementary removable retainers can be recommended to enhance anterior tooth alignment in patients with fixed twistflex retainers.

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“…The choice of retention device may depend on the initial malocclusion, expected growth, occlusal development, and the expected adherence. Bonded retainers seem to be popular as they effectively prevent tipping and rotation of the teeth (102,103). They are rather independent of cooperation and can be used for long periods (65,87,104,105), although there are few studies on real long-term use.…”

Section: Common Retention Devices In the Maxillary Archmentioning

confidence: 99%

Stability of aligned maxillary anterior teeth after orthodontic treatment: amount of changes with different retention methods and without retention

Naraghi¹

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Well-aligned anterior teeth are the major reason for the patients seeking orthodontic treatment, and keeping teeth aligned and stable afterwards is a goal for the orthodontist and the patient. Relapse after treatment is a common problem, and it is defined as when teeth go back to their previous positions. Removable or fixed retainers have been used to avoid relapse after treatment. It has been common practice to use removable retention to retain anterior teeth in the maxilla. However, in recent decades, it has become increasingly common to retain with bonded retainers. Almost all previous studies on retention devices in the maxilla were based on removable retainers. Consequently, there existed knowledge gaps and lack of short-term and long-term studies on the capability to maintain the stability of the maxillary anterior teeth with bonded retainers. Hence, the reason for the papers in this study. In addition, it is not known if retentionis needed in all orthodontic patients or if there are patients, based on their initial malocclusion and individual variations, who may not need retention after treatment. The research questions addressed in this thesis thus originate from knowledgegaps and clinical needs concerning retention strategies after orthodontic treatments. To provide strong clinical evidence, randomised controlled trials (RCT) as well as intention to treat (ITT) methodology has been assessed. The results are expected to be beneficial for the patients who will be offered the most effective retention strategy for maxillary anterior teeth based on patients’ preferences. In Paper I and II, 45 and 27 adolescents’ patients were collected from the Orthodontic Clinic in Mariestad, Sweden. At the time when Paper Iand II were conducted, there were no studies that had evaluated the longterm effect of bonded retainers in the maxilla. In two RCTs, Paper III and IV, 90 and 63 adolescents’ patients were collected from the Orthodontic Clinic in Växjö, Region Kronoberg, Sweden. Paper I: The aim was to investigate the amount and pattern of relapse of maxillary anterior teeth previously retained with a bonded retainer. Paper II: The aim was to investigate the amount and pattern of changes of maxillary anterior teeth seven years post-retention, which previously were retained with a bonded retainer. Paper III: The aim was to evaluate post-treatment changes in the irregularity of the maxillary six anterior teeth and single tooth Contact Point Discrepancy (CPD) of three different retention methods. Paper IV: The aim was to evaluate whether retention is needed after orthodontic treatment for impacted maxillary canines and with moderate pre-treatment irregularity in the maxilla. Key findings in Paper I • The contact relationship between the laterals and the centrals is the most unstable contact. Canines are the most stable teeth. • There was no difference in the relapse pattern between rotational displacements and labiolingual displacement. Key findings in Paper II • There was a strong correlation between irregularity at one- and seven-years post-retention. Stable cases one-year post-retention were stable and unstable cases deteriorated with time. Key findings in Paper III • All three retention methods showed equally effective retention capacity and all the changes found in the three groups were small and considered clinically insignificant. Thus, the null hypothesis was confirmed. All three methods can be recommended. Key findings in Paper IV • Changes between the retention and the non-retention group were statistically but not clinically significant. Since satisfactory clinical results one-year post-treatment were found in the non-retention group, retention does not appear always to be needed. • Most of the changes occur within the first 10-week period after treatment with no retention. Key conclusions and clinical implications Both removable and bonded retainers are effective for holding teeth inposition and can be used for preventing the relapse. It can be enough toretain with bonded retainer 12-22 instead of 13-23. It might be possibleto avoid retention in selected cases in the short-term, but a longer evaluationperiod is needed.

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Lower Fixed Retainers: Bonded On All Teeth Or Only On Canines?A Systematic review

Cited by 14 publications

References 31 publications

A comparative assessment of failures and periodontal health between 2 mandibular lingual retainers in orthodontic patients. A 2-year follow-up, single practice-based randomized trial

A comparative assessment of failures and periodontal health between 2 mandibular lingual retainers in orthodontic patients. A 2-year follow-up, single practice-based randomized trial

Post-treatment Stability in Orthodontic Retention with Twistflex Retainers—Do Patients Benefit from Additional Removable Retainers?

Stability of aligned maxillary anterior teeth after orthodontic treatment: amount of changes with different retention methods and without retention

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