1
|
Roser CJ, Hilgenfeld T, Saleem MA, Rückschloß T, Heiland S, Bendszus M, Lux CJ, Juerchott A. In vivo assessment of artefacts in MRI images caused by conventional twistflex and various fixed orthodontic CAD/CAM retainers. J Orofac Orthop 2024; 85:279-288. [PMID: 36700953 PMCID: PMC11186891 DOI: 10.1007/s00056-022-00445-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/12/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE To assess magnetic resonance imaging (MRI) artefacts caused by different computer-aided design/computer-aided manufacturing (CAD/CAM) retainers in comparison with conventional hand bent stainless steel twistflex retainers in vivo. MATERIALS AND METHODS MRI scans (3 Tesla) were performed on a male volunteer with different CAD/CAM retainers (cobalt-chromium, CoCr; nickel-titanium, NiTi; grade 5 titanium, Ti5) and twistflex retainers inserted. A total of 126 landmarks inside and outside the retainer area (RA; from canine to canine) were evaluated by two blinded radiologists using an established five-point visibility scoring (1: excellent, 2: good, 3: moderate, 4: poor, 5: not visible). Friedman and two-tailed Wilcoxon tests were used for statistical analysis (significance level: p < 0.05). RESULTS Twistflex retainers had the strongest impact on the visibility of all landmarks inside (4.0 ± 1.5) and outside the RA (1.7 ± 1.2). In contrast, artefacts caused by CAD/CAM retainers were limited to the dental area inside the RA (CoCr: 2.2 ± 1.2) or did not impair MRI-based diagnostics in a clinically relevant way (NiTi: 1.0 ± 0.1; Ti5: 1.4 ± 0.6). CONCLUSION The present study on a single test person demonstrates that conventional stainless steel twistflex retainers can severely impair the diagnostic value in head/neck and dental MRI. By contrast, CoCr CAD/CAM retainers can cause artefacts which only slightly impair dental MRI but not head/neck MRI, whereas NiTi and Ti5 CAD/CAM might be fully compatible with both head/neck and dental MRI.
Collapse
Affiliation(s)
- Christoph J Roser
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Tim Hilgenfeld
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Muhammad Abdullah Saleem
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Thomas Rückschloß
- Department of Oral and Maxillofacial Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sabine Heiland
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Alexander Juerchott
- Department of Neuroradiology, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| |
Collapse
|
2
|
Murugaiyan S, Pottipalli Sathyanarayana H, Thakkar D, Padmanabhan S. Post-treatment stability, survival time and periodontal health associated with vacuum-formed, bonded and rapid prototype retainers: A prospective clinical study. J Orthod 2024:14653125241255702. [PMID: 38859624 DOI: 10.1177/14653125241255702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
BACKGROUND New technologies have paved the way for newer fabrication techniques, such as rapid prototyping, which has gained popularity in the fabrication of several orthodontic appliances including retainers. AIM To evaluate the stability, survival time and periodontal health associated with vacuum-formed retainers (VFRs), bonded retainers (BRs) and rapid prototype retainers (RPRs) over a period of 12 months in retention. STUDY DESIGN Prospective clinical study. METHODS A total of 72 participants completing fixed orthodontic treatment were allocated to the following three groups by the investigators based upon their initial malocclusion, compliant and preferences: VFR; BR; and RPR. The primary outcome was Little's Irregularity Index (LII). Other stability parameters, including arch length (AL), inter-canine width (ICW) and inter-molar width (IMW), were also assessed immediately after debonding (T0) and 12 months (T2) after debonding. In addition, survival time, and calculus index and gingival index (GI) were assessed. RESULTS LII showed a significant difference (P = 0.00) between the groups and was increased in the VFR group (0.18 ± 0.22 mm) compared to the BR (0.03 ± 0.05 mm) and RPR (0.01 ± 0.03 mm) groups but was not clinically significant. The mean survival time of maxillary retainers was longest for the RPR group (220.63 days; 95% confidence interval [CI] = 194.1-247.16) but there was no significant difference between the three groups (P = 0.43). The mean survival time of mandibular retainers was higher and the same for the VFR and RPR groups (240 days; 95% CI = 240-240) and there was no significant difference between the three groups (P = 0.38). The calculus index score (P = 0.00) was statistically significant between the groups, with an increased score for the BR group (0.33 ± 0.27) compared to the VFR (0.07 ± 0.16) and RPR (0.13 ± 0.22) groups. Similarly, the GI score (P = 0.02) was statistically significant between the groups and was increased in the BR group (0.01 ± 0.19) compared to the VFR (-0.15 ± 0.18) and RPR (-0.06 ± 0.15) groups. The increase in calculus index and GI scores for the BR group were not clinically significant. CONCLUSION There were no clinically significant differences between the three retainer groups in terms of stability, periodontal health and time to failure.
Collapse
Affiliation(s)
- Sureka Murugaiyan
- Department of Orthodontics and Dentofacial Orthopaedics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Haritha Pottipalli Sathyanarayana
- Department of Orthodontics and Dentofacial Orthopaedics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Digant Thakkar
- Private Practice Silver Smile Dental Specialists, Product Specialist Digant's 3D Orthodontics, Rajkot, Gujarat, India
| | - Sridevi Padmanabhan
- Department of Orthodontics and Dentofacial Orthopaedics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| |
Collapse
|
3
|
Namura Y, Pullisaar H, Holm HV, Syverud M, Mulic A, Vandevska-Radunovic V. Elemental composition, corrosion resistance and mechanical properties of computer-aided design and computer-aided manufacturing fixed retainers versus conventional fixed retainers. J Oral Sci 2024; 66:107-110. [PMID: 38403676 DOI: 10.2334/josnusd.23-0303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
PURPOSE To investigate the elemental composition, corrosion resistance, and mechanical properties of computer-aided design and computer-aided manufacturing (CAD-CAM) retainers versus conventional fixed retainers (FRs). METHODS Eight different retainer wires were investigated. Energy dispersive X-ray spectroscopy was used to determine the elemental composition. Leakage was analysed according to ISO 10271:2020 guidelines. Hardness was tested using the Vickers method with a load of 0.3 kg. The tensile force and tensile strength were evaluated. Multiple comparisons among wires of hardness, tensile force, and strength were conducted using the Welch t-test, with Bonferroni correction. RESULTS Nickel was present in all wires. The CAD-CAM-FR wire, which contained more nickel than the other wires, had no measurable leakage. The gold-plated wires had the highest total leakage, but did not exceed the ISO standard limit. The hardness of the stainless-steel twisted wires was the highest and that of the CAD-CAM-FR wire was the lowest. The tensile strength of the CAD-CAM-FR wire was significantly lower than that of the other wires and similar to the other twisted-wire retainers. CONCLUSION The CAD-CAM-FR wire is likely to have high corrosion resistance and flexibility due to its low hardness.
Collapse
Affiliation(s)
- Yasuhiro Namura
- Department of Orthodontics, Nihon University School of Dentistry
| | - Helen Pullisaar
- Section of Orthodontics, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo
| | | | | | | | | |
Collapse
|
4
|
Çokakoğlu S, Adanur-Atmaca R, Çakır M, Öztürk F. Stability and failure rate during 3 years of fixed retention: A follow-up of an randomized clinical trial on adolescents with four different lingual retainers. Orthod Craniofac Res 2024; 27:251-258. [PMID: 37786933 DOI: 10.1111/ocr.12714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/11/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVE To evaluate stability outcomes and failure rates associated with four types of lingual retainers: (1) dead-soft wire, (2) multistrand stainless steel (SS) wire, (3) CAD/CAM nitinol, and (4) connected bonding pads (CBPs) after 3 years of retention. METHODS This study enrolled 96 patients (66 females, 30 males) with a median age of 19 years with four types of lingual retainers: (1) 0.016 × 0.022-inch dead-soft wire, (2) 0.0215-inch five-strand SS wire, (3) 0.014 × 0.014-inch CAD/CAM nitinol wire, and (4) CBPs. The irregularity index, intercanine distances, and arch lengths were obtained and used to evaluate mandibular stability. Failure rates were also assessed during this study. Data were statistically analysed. RESULTS Irregularity increased, whereas intercanine width and arch length decreased after 3 years of retention. The greatest irregularity was associated with the CBPs and the least with the CAD/CAM retainers. Changes in stability measurements were significantly higher in the dead-soft wire and CBPs than those in the CAD/CAM nitinol and multistrand SS wires. Parallel to these changes, the frequency of failure yielded similar results with the same significance between the groups. The failure rate of CBPs, in contrast to the CAD/CAM nitinol and multistrand SS wires, was significantly higher in the right quadrant (P < .05). CONCLUSION After taking the 3-year results into consideration, CAD/CAM nitinol and multistrand SS wires were found to be more successful than the others in maintaining mandibular stability. The most failures were observed with CBPs after 3 years of retention.
Collapse
Affiliation(s)
- Serpil Çokakoğlu
- Department of Orthodontics, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | | | - Merve Çakır
- Department of Orthodontics, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | | |
Collapse
|
5
|
Koller S, Niederau C, Azraq I, Craveiro RB, Knaup I, Wolf M. Low translational and rotational movements with 2-point stainless-steel retainers over a period of 1 and 3 years. J Orofac Orthop 2023:10.1007/s00056-023-00505-y. [PMID: 38153533 DOI: 10.1007/s00056-023-00505-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 10/25/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES Long-term stabilization of orthodontic treatment outcomes is an everyday challenge in orthodontics. The use of permanently attached lingual retainers has become gold standard. However, in some cases, patients with fixed lingual retainers show retainer-associated side effects. Aiming to reduce these side effects, clinical knowledge about how tooth and arch form stability adaption takes place over time is important to improve long-term retention protocols. Therefore, the present study aimed to investigate occlusion stability and risks for a newly developing malocclusion in a time-dependent manner in patients being treated with permanent 2‑point steel retainers. MATERIALS AND METHODS In this retrospective cohort study, a total of 66 consecutive patients with round stainless-steel retainers were analyzed for postorthodontic occlusion changes after 1 year (group 1, n = 33) and 3 years (group 2, n = 33). Digital Standard Tessellation Language (STL) datasets of the lower jaw were obtained before retainer insertion (T0), and after a 1- (T1) or 3‑year (T2) retention period. Using superimposition software, T1 and T2 situations were compared to T0 regarding rotational and translational changes in tooth positions in all three dimensions. RESULTS Occlusion changes were low in both groups. The investigated lower canines were nearly stable in the 1‑ and 3‑year group, although a retention-time-dependent increase in tooth position change of the central and lateral incisors could be observed. CONCLUSION The present data provide evidence for time-dependent development of posttherapeutic occlusal adaption limited to central and lateral incisors in patients treated with a 2-point retainer. The observed occlusal changes should be interpreted as an occlusal adaption process rather than severe posttreatment changes associated with the orthodontic retainer.
Collapse
Affiliation(s)
- Sarah Koller
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
- Orthodontic Specialist Practice Dr. Inge Kiegel-Koller, Bergheim, Germany
| | - Christian Niederau
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Irma Azraq
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Rogerio Bastos Craveiro
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Isabel Knaup
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Michael Wolf
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| |
Collapse
|
6
|
Koller S, Craveiro RB, Niederau C, Pollak TL, Knaup I, Wolf M. Evaluation of digital construction, production and intraoral position accuracy of novel 3D CAD/CAM titanium retainers. J Orofac Orthop 2023; 84:384-391. [PMID: 35357509 PMCID: PMC10587025 DOI: 10.1007/s00056-022-00393-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/22/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES New opportunities have arisen to manufacture three-dimensional computer-aided design/computer-aided manufacturing (3D CAD/CAM) retainers from titanium blocks by digital cutting technology. These novel technologies need to fulfill requirements regarding digital planning and position accuracy. The aim of the present study was to investigate the digital construction, the CAD/CAM production and the intraoral positioning accuracy of custom-manufactured novel 3D CAD/CAM titanium retainers. MATERIALS AND METHODS A total of 37 prime4me® RETAIN3R (Dentaurum, Ispringen, Germany) retainers were inserted to stabilize the upper anterior front teeth. Following insertion, an intraoral scan was used to record the position. The intraoral position was compared to the virtual setup using 3D superimposition software. Measurement points were evaluated in all three dimensions (horizontal, sagittal and vertical planes). Data were analyzed using Kruskal-Wallis test followed by Dunn's multiple comparison test. RESULTS A total of 185 measurements were performed. The horizontal plane and the sagittal plane demonstrated a high level of positioning accuracy between the planned and the intraoral position. Statistically significant deviations between the preceding virtual setup and the intraoral situation were observed in the vertical dimension. Within the retainer, the intraoral positioning accuracy decreased for the measurement points in the direction of the distal retainer segment. CONCLUSION Based on the results, the present study shows a high level of congruence between the 3D virtually planning and the final intraoral position of the fabricated novel 3D CAD/CAM titanium retainers.
Collapse
Affiliation(s)
- S Koller
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - R B Craveiro
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - C Niederau
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - T L Pollak
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - I Knaup
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - M Wolf
- Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| |
Collapse
|
7
|
Bardideh E, Ghorbani M, Shafaee H, Saeedi P, Younessian F. A comparison of CAD/CAM-based fixed retainers versus conventional fixed retainers in orthodontic patients: a systematic review and network meta-analysis. Eur J Orthod 2023; 45:545-557. [PMID: 37471113 DOI: 10.1093/ejo/cjad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
OBJECTIVE Comparing computer-aided design and computer-aided manufacturing (CAD/CAM) fixed retainers and conventional fixed retainers for their effectiveness in orthodontic patients using systematic review and meta-analysis of literature. SEARCH METHODS A comprehensive search was conducted in MEDLINE, Web of Science, EMBASE, Scopus, Cochrane's CENTRAL, Google Scholar, Ovid, and LILACS up to May 2023, with no language or date restrictions. SELECTION CRITERIA Only randomized clinical trials (RCTs) that complied with PICO questions were included, and the Cochrane Risk of Bias 2.0 (RoB 2) tool was used to assess the risk of bias in the included studies. DATA COLLECTION AND ANALYSIS Using custom-piloted forms, relevant data were retrieved from the included studies. Then a random-effects inverse variance meta-analysis was used to pool the results. Primary outcomes were stability of treatment results measured through dental cast measurements and periodontal status, while secondary outcomes were failure rates and patient-reported outcomes. RESULTS Seven RCTs with 601 participants were included in the review. In the short term (≤6 months), the meta-analysis showed no significant differences in inter-canine distance or arch length between CAD/CAM and conventional fixed retainers in mandibular retainers. However, for Little's irregularity index, single-stranded stainless-steel retainers were notably worse than Ni-Ti CAD/CAM retainers at 3 and 6 months, while multi-stranded stainless-steel retainers only diverged from CAD/CAM at the 6-month milestone, despite the overall clinical inconsequence of these changes. CAD/CAM retainers were associated with a lower plaque index than traditional retainers but no significant difference in gingival index. Failure rates did not differ significantly between CAD/CAM and other types of retainers in mandibular retainers. Nonetheless, one study had a high amount of CAD/CAM retainer failures leading to the study being stopped. CONCLUSIONS In the short term, CAD/CAM fixed retainers show promise as an alternative to traditional retainers. They may enhance periodontal health, as indicated by lower plaque index scores than conventional retainers. However, extensive research is needed to determine the long-term durability and effectiveness of CAD/CAM retainers in orthodontic treatment, particularly regarding their failure rate. Until comprehensive evidence is available, the use of CAD/CAM retainers should be tailored for each case. REGISTRATION The protocol for this systematic review was registered at PROSPERO with the ID CRD42023412741.
Collapse
Affiliation(s)
- Erfan Bardideh
- Dental Research Center, Orthodontics Department, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahsa Ghorbani
- Undergraduate Student of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hooman Shafaee
- Dental Research Center, Orthodontics Department, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pooya Saeedi
- Undergraduate Student of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farnaz Younessian
- Orthodontics and Pediatric Dentistry Department, School of Dentistry, University of Maryland, Baltimore, MD, United States
| |
Collapse
|
8
|
Roser CJ, Bauer C, Hodecker L, Zenthöfer A, Lux CJ, Rues S. Comparison of six different CAD/CAM retainers vs. the stainless steel twistflex retainer: an in vitro investigation of survival rate and stability. J Orofac Orthop 2023:10.1007/s00056-023-00486-y. [PMID: 37378840 DOI: 10.1007/s00056-023-00486-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE To compare failure rates and maximum load capacity (Fmax) of six different computer-aided design/computer-aided manufacturing (CAD/CAM) retainers with those of the hand-bent five-stranded stainless steel twistflex retainer. MATERIALS AND METHODS Six groups (n = 8 per group) of commercially available CAD/CAM retainers (cobalt-chromium [CoCr], titanium grade 5 [Ti5], nickel-titanium [NiTi], zirconia [ZrO2], polyetheretherketone [PEEK], and gold) and twistflex retainers were tested for long-term sufficiency and for Fmax using a self-developed in vitro model. All retainer models underwent a simulated ageing process of about 15 years (1,200,000 chewing cycles with a force magnitude of 65 N at 45° followed by storage in water at 37 °C for 30 days). If retainers did not debond or break during ageing, their Fmax was determined in a universal testing machine. Data were statistically analysed using Kruskal-Wallis and Mann-Whitney U‑tests. RESULTS Twistflex retainers did not fail (0/8) during ageing and had the highest Fmax (445 N ± 51 N). Ti5 retainers were the only CAD/CAM retainers that also did not fail (0/8) and had similar Fmax values (374 N ± 62 N). All other CAD/CAM retainers had higher failure rates during ageing and significantly lower Fmax values (p < 0.01; ZrO2: 1/8, 168 N ± 52 N; gold: 3/8, 130 N ± 52 N; NiTi: 5/8, 162 N ± 132 N; CoCr: 6/8, 122 N ± 100 N; PEEK: 8/8, 65 ± 0 N). Failure was due to breakage in the NiTi retainers and debonding in all other retainers. CONCLUSION Twistflex retainers remain the gold standard regarding biomechanical properties and long-term sufficiency. Of the CAD/CAM retainers tested, Ti5 retainers seem to be the most suitable alternative. In contrast, all other CAD/CAM retainers investigated in this study showed high failure rates and had significantly lower Fmax values.
Collapse
Affiliation(s)
- Christoph J Roser
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Carolien Bauer
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Lutz Hodecker
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Andreas Zenthöfer
- Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Im Neuenheimer Feld 400, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopedics, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Stefan Rues
- Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Im Neuenheimer Feld 400, Heidelberg, Germany
| |
Collapse
|
9
|
Martin C, Littlewood SJ, Millett DT, Doubleday B, Bearn D, Worthington HV, Limones A. Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database Syst Rev 2023; 5:CD002283. [PMID: 37219527 PMCID: PMC10202160 DOI: 10.1002/14651858.cd002283.pub5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Without a phase of retention after successful orthodontic treatment, teeth tend to 'relapse', that is, to return to their initial position. Retention is achieved by fitting fixed or removable retainers to provide stability to the teeth while avoiding damage to teeth and gums. Removable retainers can be worn full- or part-time. Retainers vary in shape, material, and the way they are made. Adjunctive procedures are sometimes used to try to improve retention, for example, reshaping teeth where they contact ('interproximal reduction'), or cutting fibres around teeth ('percision'). This review is an update of one originally published in 2004 and last updated in 2016. OBJECTIVES To evaluate the effects of different retainers and retention strategies used to stabilise tooth position after orthodontic braces. SEARCH METHODS An information specialist searched Cochrane Oral Health Trials Register, CENTRAL, MEDLINE, Embase and OpenGrey up to 27 April 2022 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) involving children and adults who had retainers fitted or adjunctive procedures undertaken to prevent relapse following orthodontic treatment with braces. We excluded studies with aligners. DATA COLLECTION AND ANALYSIS Two review authors independently screened eligible studies, assessed risk of bias and extracted data. Outcomes were stability or relapse of tooth position, retainer failure (i.e. broken, detached, worn out, ill-fitting or lost), adverse effects on teeth and gums (i.e. plaque, gingival and bleeding indices), and participant satisfaction. We calculated mean differences (MD) for continuous data, risk ratios (RR) or risk differences (RD) for dichotomous data, and hazard ratios (HR) for survival data, all with 95% confidence intervals (CI). We conducted meta-analyses when similar studies reported outcomes at the same time point; otherwise results were reported as mean ranges. We prioritised reporting of Little's Irregularity Index (crookedness of anterior teeth) to measure relapse, judging the minimum important difference to be 1 mm. MAIN RESULTS We included 47 studies, with 4377 participants. The studies evaluated: removable versus fixed retainers (8 studies); different types of fixed retainers (22 studies) or bonding materials (3 studies); and different types of removable retainers (16 studies). Four studies evaluated more than one comparison. We judged 28 studies to have high risk of bias, 11 to have low risk, and eight studies as unclear. We focused on 12-month follow-up. The evidence is low or very low certainty. Most comparisons and outcomes were evaluated in only one study at high risk of bias, and most studies measured outcomes after less than a year. Removable versus fixed retainers Removable (part-time) versus fixed One study reported that participants wearing clear plastic retainers part-time in the lower arch had more relapse than participants with multistrand fixed retainers, but the amount was not clinically significant (Little's Irregularity Index (LII) MD 0.92 mm, 95% CI 0.23 to 1.61; 56 participants). Removable retainers were more likely to cause discomfort (RR 12.22; 95% CI 1.69 to 88.52; 57 participants), but were associated with less retainer failure (RR 0.44, 95% CI 0.20 to 0.98; 57 participants) and better periodontal health (Gingival Index (GI) MD -0.34, 95% CI -0.66 to -0.02; 59 participants). Removable (full-time) versus fixed One study reported that removable clear plastic retainers worn full-time in the lower arch did not provide any clinically significant benefit for tooth stability over fixed retainers (LII MD 0.60 mm, 95% CI 0.17 to 1.03; 84 participants). Participants with clear plastic retainers had better periodontal health (gingival bleeding RR 0.53, 95% CI 0.31 to 0.88; 84 participants), but higher risk of retainer failure (RR 3.42, 95% CI 1.38 to 8.47; 77 participants). The study found no difference between retainers for caries. Different types of fixed retainers Computer-aided design/computer-aided manufacturing (CAD/CAM) nitinol versus conventional/analogue multistrand One study reported that CAD/CAM nitinol fixed retainers were better for tooth stability, but the difference was not clinically significant (LII MD -0.46 mm, 95% CI -0.72 to -0.21; 66 participants). There was no evidence of a difference between retainers for periodontal health (GI MD 0.00, 95% CI -0.16 to 0.16; 2 studies, 107 participants), or retainer survival (RR 1.29, 95% CI 0.67 to 2.49; 1 study, 41 participants). Fibre-reinforced composite versus conventional multistrand/spiral wire One study reported that fibre-reinforced composite fixed retainers provided better stability than multistrand retainers, but this was not of a clinically significant amount (LII MD -0.70 mm, 95% CI -1.17 to -0.23; 52 participants). The fibre-reinforced retainers had better patient satisfaction with aesthetics (MD 1.49 cm on a visual analogue scale, 95% CI 0.76 to 2.22; 1 study, 32 participants), and similar retainer survival rates (RR 1.01, 95% CI 0.84 to 1.21; 7 studies; 1337 participants) at 12 months. However, failures occurred earlier (MD -1.48 months, 95% CI -1.88 to -1.08; 2 studies, 103 participants; 24-month follow-up) and more gingival inflammation at six months, though bleeding on probing (BoP) was similar (GI MD 0.59, 95% CI 0.13 to 1.05; BoP MD 0.33, 95% CI -0.13 to 0.79; 1 study, 40 participants). Different types of removable retainers Clear plastic versus Hawley When worn in the lower arch for six months full-time and six months part-time, clear plastic provided similar stability to Hawley retainers (LII MD 0.01 mm, 95% CI -0.65 to 0.67; 1 study, 30 participants). Hawley retainers had lower risk of failure (RR 0.60, 95% CI 0.43 to 0.83; 1 study, 111 participants), but were less comfortable at six months (VAS MD -1.86 cm, 95% CI -2.19 to -1.53; 1 study, 86 participants). Part-time versus full-time wear of Hawley There was no evidence of a difference in stability between part-time and full-time use of Hawley retainers (MD 0.20 mm, 95% CI -0.28 to 0.68; 1 study, 52 participants). AUTHORS' CONCLUSIONS The evidence is low to very low certainty, so we cannot draw firm conclusions about any one approach to retention over another. More high-quality studies are needed that measure tooth stability over at least two years, and measure how long retainers last, patient satisfaction and negative side effects from wearing retainers, such as tooth decay and gum disease.
Collapse
Affiliation(s)
- Conchita Martin
- Orthodontic Department, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | | | - Declan T Millett
- Oral Health and Development, Cork University Dental School and Hospital, Cork, Ireland
| | | | - David Bearn
- School of Dentistry, University of Dundee, Dundee, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Alvaro Limones
- Faculty of Dentistry, Complutense Univesity of Madrid, Madrid, Spain
| |
Collapse
|
10
|
Kang SH, Kwon JS, Chung CJ, Cha JY, Lee KJ. Accuracy and stability of computer-aided customized lingual fixed retainer: a pilot study. Prog Orthod 2022; 23:39. [PMID: 36404385 PMCID: PMC9676156 DOI: 10.1186/s40510-022-00436-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/18/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND With advances in digital technology, new types of lingual fixed retainers are being developed. However, there are few studies that quantitatively evaluate the accuracy and stability of lingual fixed retainers. The aim of this study was to assess the accuracy and stability of two types of computer-aided customized lingual fixed retainers and a conventional lingual fixed retainer. METHODS A total of 10 maxillary and 10 mandibular duplicated dental models were selected, and then, three types of retainers were fabricated on the canine-to-canine area for each model. To evaluate accuracy, wire clearance at interproximal area (WCI) was measured using superimposition analysis. Initial flatness deformation was also measured for vertical distortion of retainers. Lateral width, anteroposterior length, and flatness deformation were measured at three-time points for stability assessment. Thermocycling was used to induce 6 months of time flow. RESULTS The custom-bent group showed significantly higher WCI than the custom-cut and manual groups in the maxillary arch (P = 0.002). The custom-cut group showed significantly less flatness deformation, which was followed by the custom-bent and manual groups in both the maxillary and mandibular arch (P < 0.001). There was no significant difference in stability between the three retainer groups during 5100 cycles of thermocycling (corresponding to 6-month period). CONCLUSIONS Since there was no difference in stability between the three groups, it is recommended to use custom-cut type retainers in light of accuracy. However, accuracy and stability are not the only factors to consider when selecting type of retainers. Because each retainer has advantages and disadvantages, the type of retainers should be decided in consideration of the clinical environment.
Collapse
Affiliation(s)
- Seung-Hyun Kang
- grid.15444.300000 0004 0470 5454Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea
| | - Jae-Sung Kwon
- grid.15444.300000 0004 0470 5454Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul, 03722 Korea
| | - Chooryung Judi Chung
- grid.459553.b0000 0004 0647 8021Department of Orthodontics, Gangnam Severance Hospital, 211, Eonju-ro, Gangnam-gu, Seoul, Korea
| | - Jung-Yul Cha
- grid.15444.300000 0004 0470 5454Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea
| | - Kee-Joon Lee
- grid.15444.300000 0004 0470 5454Department of Orthodontics, The Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea
| |
Collapse
|
11
|
Knaup I, Kobbe C, Ehrlich EE, Esteves-Oliveira M, Abou-Ayash B, Meyer-Lueckel H, Wolf M, Wierichs RJ. Correlation of quantitative light-induced fluorescence and qualitative visual rating in infiltrated post-orthodontic white spot lesions. Eur J Orthod 2022; 45:133-141. [PMID: 36179095 DOI: 10.1093/ejo/cjac051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The aim of this prospective, clinical single-centre study was to evaluate the masking efficacy of post-orthodontic resin infiltration after 12-month follow-up and correlate quantitative and qualitative outcome measures. METHODS Patients with completed fixed orthodontic treatment and the presence of one or more vestibular active non-cavitated white spot lesion/s (WSL) [ICDAS 1 or 2 (International Caries Detection and Assessment System)] were provided with resin infiltration 3-12 months after bracket removal. All patients (n = 31) participating before (t0) intervention were invited again and examined after 12 months (t2). Enamel demineralization was scored using quantitative light-induced fluorescence [QLF (DeltaF[flourescence], DeltaQ[lesion volume], White Spot Area)] and qualitative visual rating [11-point Likert-scale from 0 (no lesions visible on any tooth) to 10 (all teeth affected on the entire vestibular surface)]. RESULTS In 17 patients (7 female and 10 male) 112 WSL (ICDAS 1: n = 1; ICDAS 2: n = 111) in 112 teeth were (re)examined. Before treatment (t0) a significant, weak (DeltaF), and moderate (DeltaQ, White Spot Area) correlation was observed between the quantitative and the qualitative rating (P < 0.002) [median DeltaF: -7.31 (-10.4/-6.58)%; DeltaQ:-2.25 (-10.8/-0.41)% mm2; White Spot Area: 0.34 (0.05/1.16) mm2; visual rating:3.7 ± 1.2]. Resin infiltration led to significantly increased fluorescence and decreased visual scores (P < 0.001) 7 days (t1) and 12 months (t2) after treatment. No significant changes based on DeltaF [-6.55 (-7.29/-6.08)%] and on visual ratings [1.0 ± 1.0] were observed between t1 and t2 (P = 1.000). After 7 days (t1) the correlation between the quantitative and the qualitative ratings remained significant, weak to moderate (P < 0.002). After 12 months (t2) the correlation was (non-)significant and weak for DeltaF, DeltaQ, and White Spot Area (P ≤ 0.097). LIMITATIONS Since the overall masking efficacy of resin infiltration has been shown previously, an untreated control group was omitted. CONCLUSIONS When assessing the masking efficacy of infiltrated post-orthodontic WSL only a weak to moderate correlation was found between QLF values and visual ratings. Furthermore, over time this correlation decreased. Thus, it remains unclear if QLF is a viable method to assess and quantify infiltrated post-orthodontic WSL over time. TRIAL REGISTRATION German Clinical Trials Register (DRKS-ID:DRKS00005067).
Collapse
Affiliation(s)
- Isabel Knaup
- Department of Orthodontics, RWTH Aachen University Hospital, Germany
| | - Celine Kobbe
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Switzerland
| | - Eva-Elaine Ehrlich
- Department of Orthodontics, RWTH Aachen University Hospital, Germany.,Private Orthodontic Office, Goch, Germany
| | | | - Bedram Abou-Ayash
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Switzerland
| | - Hendrik Meyer-Lueckel
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Switzerland
| | - Michael Wolf
- Department of Orthodontics, RWTH Aachen University Hospital, Germany
| | - Richard J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Switzerland
| |
Collapse
|
12
|
Clinical Study on Efficiency of Using Traditional Direct Bonding or OrthGuide Computer-Aided Indirect Bonding in Orthodontic Patients. DISEASE MARKERS 2022; 2022:9965190. [PMID: 36212179 PMCID: PMC9537019 DOI: 10.1155/2022/9965190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 11/18/2022]
Abstract
Objective This study aims to clinically investigate and compare the therapeutic effects and treatment cycle between traditional direct bonding and OrthGuide computer-aided indirect bonding in orthodontic treatment. Methods Forty patients treated at the Department of Orthodontics, Beijing Rytime Dental Hospital between July 1, 2016, and December 31, 2019, were included. The patients were divided into a control group (n = 20, traditional direct bonding) and a test group (n = 20, OrthGuide computer-aided indirect bonding). The American Board of Orthodontics (ABO) measurement was performed on patients using Uceph cephalometric analysis software to compare intragroup and intergroup differences, and the treatment cycles of all patients were recorded. Results After treatment, U1-NA (mm), ∠U1-SN (°), LL-EP (mm), and UL-EP (mm) in the control group were significantly lower than before treatment, and there was no significant difference in other ABO measurement indexes, while the test group showed no marked difference in all ABO measurements between pre- and posttreatment. Further, intergroup comparison showed no significant difference in ABO measurements in pre- and posttreatment between the two groups. The test group had a shorter treatment cycle than the control group, with an average treatment cycle of 21.20 ± 7.14 months in the control group and 17.17 ± 4.16 months in the test group. Conclusion There was no significant difference in the therapeutic effects between the direct and indirect bonding techniques. However, OrthGuide computer-assisted indirect bonding demonstrated a significantly shorter treatment cycle and might be more efficient than traditional direct bonding.
Collapse
|
13
|
Knaup I, Schulte U, Bartz JR, Niederau C, Craveiro RB, Jäger A, Wolf M. Post-treatment Stability in Orthodontic Retention with Twistflex Retainers-Do Patients Benefit from Additional Removable Retainers? Clin Oral Investig 2022; 26:5215-5222. [PMID: 35474552 PMCID: PMC9381486 DOI: 10.1007/s00784-022-04490-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/12/2022] [Indexed: 11/14/2022]
Abstract
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.
Collapse
Affiliation(s)
- Isabel Knaup
- Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany.
| | - Ulrike Schulte
- Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany
- Private Dental Office, Cologne, Germany
| | - Jenny Rosa Bartz
- Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany
| | - Christian Niederau
- Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany
| | | | - Andreas Jäger
- Department of Orthodontics, Bonn University Hospital, Bonn, Germany
| | - Michael Wolf
- Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany
| |
Collapse
|
14
|
Efficacy of CAD/CAM Technology in Interventions Implemented in Orthodontics: A Scoping Review of Clinical Trials. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5310555. [PMID: 35692590 PMCID: PMC9184227 DOI: 10.1155/2022/5310555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/22/2022] [Accepted: 05/18/2022] [Indexed: 11/18/2022]
Abstract
Objectives. To evaluate the efficacy of computer-aided design/computer-aided manufacturing (CAD/CAM) technology in interventions implemented in orthodontics. Methods. A scoping review of scientific evidence was accomplished, involving different databases. MesH terms and keywords were provided to examine clinical trials (CTs) in all languages. Exclusively CTs that fulfilled the eligibility criteria were admitted. Results. Eight CTs were chosen. These experiments evaluated 542 patients. Four CTs compared the computer-aided indirect bonding method versus the traditional direct bonding of orthodontic brackets. Three CTs compared CAD/CAM retainers with other types of retainers, and one CT compared the CAD/CAM group with multistranded stainless steel wires versus stainless steel wires. Regarding the efficacy of the interventions with CAD/CAM technology used in orthodontics, variable results were found. The indirect bonded customized CAD/CAM brackets presented just a slight effect on the treatment efficacy and therapy results. Two CTs showed that an indirect bonding self-ligating standard system had a similar quality of therapy in comparison with the CAD/CAM customized bracket system. Concerning the clinical failure rate, no differences were presented between the CAD/CAM retainer and other retainers. A CAD/CAM system had more loose brackets than a noncustomized system and was observed also a greater amount of immediate debonding with CAD/CAM indirect bonding than with direct bonding. CAD/CAM fixed retainers revealed inferior relapse and fewer failures than lab-based and conventional chairside retainers. No changes between treatment groups were observed regarding the total therapy time, amount of appointments, and quantity of archwire bends. Conclusions. In general terms, no greater efficacy of CAD/CAM technology was observed over traditional therapies used in orthodontics. However, it was found that gingival inflammation and the accumulation of bacterial plaque and dental calculus were lower when CAD/CAM retainers were used. When comparing interventions that include CAD/CAM systems with conventional therapies, no significant reduction in care times was found.
Collapse
|
15
|
Shim H, Foley P, Bankhead B, Kim KB. Comparative assessment of relapse and failure between CAD/CAM stainless steel and standard stainless steel fixed retainers in orthodontic retention patients. Angle Orthod 2022; 92:87-94. [PMID: 34464438 DOI: 10.2319/121720-1015.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To compare relapse and failure rates of computer-aided design/computer-aided manufacturing (CAD/CAM) and standard fixed retainers. MATERIALS AND METHODS This single-center, single-blinded, prospective randomized clinical trial included 46 patients who completed active orthodontic treatment and complied with retention visits. The patients were randomly assigned to three groups: CAD/CAM group with multistranded stainless steel wires (CAD/CAM, n = 16), Lab group with the same multistranded wires (lab, n = 16), and control group with stainless steel Ortho-FlexTech wires (traditional, n = 14). Intraoral scans were obtained at placement of fixed retainers (T1), 3-month visit (T2), and 6-month visit (T3) and measured for intercanine width and Little's Irregularity Index. Failures were recorded. RESULTS The CAD/CAM group experienced less intercanine width decrease than the traditional group at 3 months (mean difference, 0.83 ± 0.16 mm; 95% confidence interval [CI], 0.44-1.22; P < .001) and 6 months (mean difference, 1.23 ± 0.40 mm; 95% CI, 0.19-2.27; P < .05). The CAD/CAM group experienced less increase in Little's Irregularity Index compared with the lab group within 3 months (mean difference, 0.81 ± 0.27 mm; 95% CI, 0.12-1.49; P < .05). Failures from greatest to least were experienced by the lab group (43.8%), the CAD/CAM group (25%), and the traditional group (14.3%). CONCLUSIONS Within 6 months of bonding fixed retainers, CAD/CAM fixed retainers showed less relapse than lab-based and traditional chairside retainers and less failures than lab-based retainers.
Collapse
|
16
|
Keerthana P, SB P, Chitra P. In Vivo Comparison of Ultimate Tensile Strength and Surface Topography of Three Different Nickel–Titanium Archwires. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2021. [DOI: 10.1177/0301574221990131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To investigate the surface topography and ultimate tensile strength of 3 types of nickel–titanium (NiTi) wires before and after 3 months of intraoral use and to assess the efficiency of the wires in cases requiring extensive alignment. Methods: NiTi wires of 0.016″ (0.40 mm) were divided into 3 groups—martensitic stabilized NiTi™ (group 1), austenitic active Copper NiTi™ 27°C (group 2), and martensitic active copper NiTi™ 35°C (group 3)—each further divided into 2 subgroups: (a) as-received wires; and (b) used wires. Each wire was subjected to scanning electron microscopy (SEM) analysis and tensile testing. Ultimate tensile strength data were analyzed using one-way analysis of variance (ANOVA) and Tukey testing at the .05 level of significance. Results: Martensitic stabilized archwires had a significantly lower ultimate tensile strength (93.99 ± 0.23 MPa) than martensitic active (116.96 ± 0.43 MPa) and austenitic active (106.94 ± 0.36 MPa) archwires. Among the used archwires, the martensitic stabilized ones showed the most and the martensitic active ones the least surface degradation. Conclusion: Ultimate tensile strength was the highest for martensitic active archwires with superior surface properties and the lowest for martensitic stabilized archwires with an increased amount of surface degradation.
Collapse
Affiliation(s)
| | - Puneeth SB
- Birla Institute of Technology and Science, Hyderabad, Telangana, India
| | - Prasad Chitra
- Army College of Dental Sciences, Chennapur, Secunderabad, Telangana, India
| |
Collapse
|
17
|
Adanur-Atmaca R, Çokakoğlu S, Öztürk F. Effects of different lingual retainers on periodontal health and stability. Angle Orthod 2021; 91:468-476. [PMID: 33587126 PMCID: PMC8259753 DOI: 10.2319/110220-904.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/01/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To evaluate the effects of different lingual retainers on periodontal health and stability of mandibular anterior teeth at the 1-year follow-up. MATERIALS AND METHODS One hundred thirty-two patients were randomly allocated to four groups using different lingual retainers: group 1, 0.016 × 0.022-in dead-soft wire; group 2, 0.0215-in 5-strand stainless steel wire; group 3, 0.014 × 0.014-in computer-aided design/computer-aided manufacturing nitinol retainer (Memotain); group 4, connected bonding pads. Plaque, gingival, and calculus indexes were used to evaluate periodontal health, and Little's irregularity index, intercanine width, and arch length measurements were performed to evaluate stability. All measurements were performed at each time point (debonding and 3, 6, 9, and 12 months). RESULTS The mean value of the gingival index obtained in group 3 was lower than the mean value for all other groups. The mean value of the calculus index was the lowest in group 3, and there was a significant difference between group 3 and groups 1 and 2. No differences were found among the groups in terms of plaque index, intercanine width, and arch length. The least irregularity was obtained in groups 2 and 3. There were no significant differences between these groups and groups 1 and 4. CONCLUSIONS Gingival inflammation and calculus accumulation were the lowest in group 3 (Memotain). The irregularity for Memotain and stainless steel retainers was less than or the other groups. However, no clinically significant worsening of periodontal health or relapse were seen in any groups after 1 year.
Collapse
|
18
|
Gelin E, Seidel L, Bruwier A, Albert A, Charavet C. Innovative customized CAD/CAM nickel-titanium lingual retainer versus standard stainless-steel lingual retainer: A randomized controlled trial. Korean J Orthod 2020; 50:373-382. [PMID: 33144526 PMCID: PMC7642231 DOI: 10.4041/kjod.2020.50.6.373] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/23/2020] [Accepted: 06/26/2020] [Indexed: 12/22/2022] Open
Abstract
Objective To compare computer-aided design and computer-aided manufacturing (CAD/CAM) customized nitinol retainers with standard stainlesssteel 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 stainlesssteel lingual retainers in terms of dental anterior stability and retainer survival. Both retainers eventually appeared to be equally effective in maintaining periodontal health.
Collapse
Affiliation(s)
- Emilie Gelin
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital of Liège, Liège, Belgium
| | - Laurence Seidel
- Department of Biostatistics and Medico-economic Information, University Hospital of Liège, University of Liège, Liège, Belgium
| | - Annick Bruwier
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital of Liège, Liège, Belgium
| | - Adelin Albert
- Department of Biostatistics and Medico-economic Information, University Hospital of Liège, University of Liège, Liège, Belgium
| | - Carole Charavet
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital of Liège, Liège, Belgium
| |
Collapse
|
19
|
Alrawas MB, Kashoura Y, Tosun Ö, Öz U. Comparing the effects of CAD/CAM nickel‐titanium lingual retainers on teeth stability and periodontal health with conventional fixed and removable retainers: A randomized clinical trial. Orthod Craniofac Res 2020; 24:241-250. [DOI: 10.1111/ocr.12425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/27/2020] [Accepted: 08/18/2020] [Indexed: 01/05/2023]
Affiliation(s)
| | - Yaman Kashoura
- Department of Orthodontics School of Dentistry Near East University Nicosia Turkey
| | - Özgür Tosun
- Department of Biostatistics School of Medicine Near East University Nicosia Turkey
| | - Ulaş Öz
- Department of Orthodontics School of Dentistry Near East University Nicosia Turkey
| |
Collapse
|
20
|
Kartal Y, Kaya B, Polat-Özsoy Ö. Comparative evaluation of periodontal effects and survival rates of Memotain and five-stranded bonded retainers : A prospective short-term study. J Orofac Orthop 2020; 82:32-41. [PMID: 32780168 DOI: 10.1007/s00056-020-00243-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 05/12/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To prospectively compare the short-term periodontal effects and survival rates of mandibular lingual canine-to-canine Memotain (CA-Digital, Mettmann, Germany) and five-stranded bonded retainers. METHODS In all, 52 patients requiring retention after orthodontic treatment were assigned to 2 study groups (n = 26 in each group). Retention was provided by Memotain retainers which were fabricated digitally using CAD-CAM (computer-aided design and computer-aided manufacturing) technology in the first group and by five-stranded retainers which were fabricated manually using a conventional bending method in the second group. The patients were examined at the following time points: 1 week, 1 month, 3 months and 6 months. Plaque index, gingival index, probing depth, marginal recession, bleeding on probing, failure rate per tooth, and survival rate of retainer wires were analyzed by Mann-Whitney U, Friedman, Wilcoxon signed-rank, and χ2 tests. RESULTS The differences between the groups were nonsignificant for plaque index, gingival index, probing depth, marginal recession, bleeding on probing, failure rate per tooth and survival rate of retainer wires. Significant differences were observed within the groups throughout the follow-up period for plaque index and probing depth. The survival rates of retainer wires were 77% for the Memotain retainers and 73% for the five-stranded retainers for the 6‑month follow-up period. CONCLUSIONS Periodontal outcomes and survival rates of Memotain and five-stranded mandibular lingual bonded retainers were similar. Furthermore, periodontal health was maintained and considerably high survival rates were achieved with both retainer types.
Collapse
Affiliation(s)
| | - Burçak Kaya
- Department of Orthodontics, Faculty of Dentistry, Başkent University, Ankara, Turkey. .,Dis Hekimligi Fakultesi, Ortodonti Anabilim Dali, Baskent Universitesi, 1. Cad No: 107, 06490, Bahcelievler-Ankara, Turkey.
| | | |
Collapse
|
21
|
Arn ML, Dritsas K, Pandis N, Kloukos D. The effects of fixed orthodontic retainers on periodontal health: A systematic review. Am J Orthod Dentofacial Orthop 2020; 157:156-164.e17. [PMID: 32005466 DOI: 10.1016/j.ajodo.2019.10.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The objective of this systematic review was to assess the available evidence in the literature for the effects of fixed orthodontic retainers on periodontal health. METHODS The following databases were searched up to August 31, 2019: Medline, EMBASE, the Cochrane Oral Health Group's Trials Register, CENTRAL, ClinicalTrials.gov, the National Research Register, and Pro-Quest Dissertation Abstracts and Thesis database. Randomized controlled trials (RCTs), controlled clinical trials, cohort studies of prospective and retrospective design, and cross-sectional studies reporting on periodontal measurements of patients who received fixed retention after orthodontic treatment were eligible for inclusion. The quality of the included RCTs was assessed per the revised Cochrane risk of bias tool for randomized trials (RoB 2.0), whereas the risk of bias of the included cohort studies was assessed using the Risk Of Bias In Nonrandomized Studies of Interventions tool. A modified version of the Newcastle-Ottawa scale was used for cross-sectional studies. RESULTS Eleven RCTs, 4 prospective cohort studies, 1 retrospective cohort study, and 13 cross-sectional studies fulfilled the inclusion criteria. The quality of evidence was low for most of the included studies. In contrast to the general consensus, 2 RCTs, 1 prospective cohort study, and 2 cross-sectional studies reported poorer periodontal conditions in the presence of a fixed retainer. The results of the included studies comparing different types of fixed retainers were heterogeneous. CONCLUSIONS According to the currently available literature, orthodontic fixed retainers seem to be a retention strategy rather compatible with periodontal health, or at least not related to severe detrimental effects on the periodontium.
Collapse
Affiliation(s)
- Marie-Laure Arn
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland; Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece.
| |
Collapse
|