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Sapata DM, Oliveira E Silva CD, Pascotto RC, Poleti TMFF, Arai MSI, Ramos AL. Periodontal indexes of two types of 3 x 3 retainers: 0.032-in SS V-loop versus 0.0215-in SS coaxial - a randomized crossover trial. Dental Press J Orthod 2024; 28:e2323175. [PMID: 38198390 PMCID: PMC10773445 DOI: 10.1590/2177-6709.28.6.e2323175.oar] [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] [Received: 08/06/2023] [Accepted: 10/24/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE This randomized crossover trial evaluated periodontal indexes of two types of 3 x 3 retainers (a modified 0.032-in SS V-loop retainer and a conventional 0.0215-in SS coaxial wire retainer) after bonded for six months. Also, bonded failure rate, and a questionnaire about comfort, ease of cleaning and overall preference were recorded. MATERIAL AND METHODS 15 patients were enrolled in this study who used both retainers for six months each, having a 15-day wash-out interval between each bonded retainer usage. The following periodontal index were recorded: Plaque Index (PI), Calculus Index (CI) and Gingival Index (GI). Patients answered a questionnaire to assess comfort, ease of cleaning and overall retainer-type preference. Rate of bonding failure was also evaluated. RESULTS V-Loop retainer showed higher PI (P<0.05) as compared to conventional 0.0215-in coaxial wire retainer. However, CI and GI presented no statistically significant differences between both types of retainers. The conventional 0.0215-in coaxial wire retainer was chosen as the most comfortable (p<0.05), although no statistically significant differences were found for all other questionnaire answers. Bonding failure events were more observed in the 3x3 V-Loop retainer (p<0.002), as compared to the conventional 0.0215-in coaxial retainer. CONCLUSION V-Loop retainer showed higher PI (p<0.05), higher bonding failure rate and less comfortable, as compared to conventional 0.0215-in coaxial wire.
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Affiliation(s)
- Diogo Marques Sapata
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
| | | | | | | | | | - Adilson Luiz Ramos
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
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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.
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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
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Quinzi V, Carli E, Mummolo A, De Benedictis F, Salvati SE, Mampieri G. Fixed and removable orthodontic retainers, effects on periodontal health compared: A systematic review. J Oral Biol Craniofac Res 2023; 13:337-346. [PMID: 36937559 PMCID: PMC10020103 DOI: 10.1016/j.jobcr.2023.02.015] [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: 01/28/2022] [Revised: 01/28/2023] [Accepted: 02/25/2023] [Indexed: 03/11/2023] Open
Abstract
The aim of this systematic review is to analyze the properties of the different types of orthodontic retainers, identify their differences and define which type of device is most effective and less harmful to periodontal health. Methods A literature search was carried out by a reviewer by consulting PubMed, Lilacs, Embase, Medline full text, Scopus, Web of Science, Cochrane library, and Science Direct electronic databases for biomedical and health literature as well as the grey literature and setting up the search from December 2010 without any restriction about articles languages. Results The results showed that patients who wear retainers for a long period have significant differences in clinical parameters compared to patients without retainers. The type of retainer chosen also significantly influences the overall periodontal health of patients. Fixed retainers, both glass-fibre reinforced and steel wire retainers, proved to be the retainer type with the highest plaque and calculus accumulation values compared to removable retainers. In addition, among fixed retainers, glass-fibre reinforced retainers proved to be those that mostly promote the plaque and calculus accumulation in the application site. Conclusion Fixed retainers are the best devices to maintain the alignment of mandibular anterior teeth in the long term. Among these devices, stainless steel lingual retainers, plain or braided, should remain the first choice. Although they are also susceptible to periodontal complications, their effect on periodontal health can be considered statistically insignificant if compared to glass-fibre reinforced retainers which, showing worse periodontal complications, should not be used.
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Affiliation(s)
- Vincenzo Quinzi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Elisabetta Carli
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Alessandra Mummolo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Federica De Benedictis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Simone Ettore Salvati
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Gianluca Mampieri
- Department of Clinical Science and Translational Medicine, University of Rome, Tor Vergata, Italy
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Lennholm C, Westerlund A, Lund H. Assessment of thin bony structures using cone-beam computed tomography. Angle Orthod 2023; 93:490740. [PMID: 36795048 PMCID: PMC10117211 DOI: 10.2319/090922-633.1] [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: 09/01/2022] [Accepted: 01/01/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES To investigate the validity and reliability of marginal bone level measurements on cone-beam computed tomography (CBCT) images of thin bony structures using various reconstruction techniques, two image resolutions, and two viewing modes. MATERIALS AND METHODS CBCT and histologic measurements of the buccal and lingual aspects of 16 anterior mandibular teeth from 6 human specimens were compared. Multiplanar (MPR) and three-dimensional (3D) reconstructions, standard and high resolutions, and gray scale and inverted gray scale viewing modes were assessed. RESULTS Validity of radiologic and histologic comparisons were highest using the standard protocol, MPR, and the inverted gray scale viewing mode (mean difference = 0.02 mm) and lowest using a high-resolution protocol and 3D-rendered images (mean difference = 1.10 mm). Mean differences were significant (P < .05) at the lingual surfaces for both reconstructions, viewing modes (MPR windows), and resolutions. CONCLUSIONS Varying the reconstruction technique and viewing mode does not improve the observer's ability to visualize thin bony structures in the anterior mandibular region. The use of 3D-reconstructed images should be avoided when thin cortical borders are suspected. The small difference when using a high-resolution protocol is unjustified due to the higher radiation dose required. Previous studies have focused on technical parameters; the present study explores the next link in the imaging chain.
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Three-Dimensional Evaluation on Cortical Bone During Orthodontic Surgical Treatment. J Craniofac Surg 2021; 31:1637-1646. [PMID: 32502113 DOI: 10.1097/scs.0000000000006592] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Adult patients' severe malocclusions, especially the skeletal ones, cannot be exclusively solved by the orthodontic treatment and therefore a combined orthodontic-surgical treatment is necessary. Today, numerous software allows to plane and to visualize the final treatment results simulating the best therapeutic option. This is a retrospective experimental study that aims to analyze the changes in the buccal cortical bone in patients undergoing orthodontics surgeries and to evaluate the correlation between the dental movement and the changes in the relative bone cortex. The study sample consists of 32 subjects. By applying the CBCT radiographic examinations, the measurements were made in well-defined points of reference. The 3D study of the dental changes of position and the cortical buccal bone related variation, suggests how the determined orthodontic movement of the dental element does not achieve an easily predictable bone variation. Therefore, it also suggests that there is no direct proportionality relationship between the extent of bone apposition/reabsorption and dental movement.
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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.
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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.
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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: 33] [Impact Index Per Article: 8.3] [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.
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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.
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Ferreira LA, Sapata DM, Provenzano MGA, Hayacibara RM, Ramos AL. Periodontal parameters of two types of 3 x 3 orthodontic retainer: a longitudinal study. Dental Press J Orthod 2019; 24:64-70. [PMID: 31390451 PMCID: PMC6677337 DOI: 10.1590/2177-6709.24.3.064-070.oar] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 07/31/2018] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION bonded fixed retainers are often used to stabilize the results obtained with the orthodontic treatment. It is important that they do not prejudice dental health, as they will be used for a long period. OBJECTIVE The purpose of the present study was to compare periodontal indexes between two types of bonded fixed retainers, conventional 3 x 3 plain retainer (0.8-mm orthodontic wire, bonded to the canines only) and a manufactured braided retainer (0.2 x 0.7-mm stainless steel wire, bonded to all anterior teeth) after use. METHODS a test group of 15 volunteers (aged from 18 to 25 years) used both the conventional retainer and braided retainer for six months. A randomized longitudinal study design, with a two week washout interval, was applied. The dental plaque index, gingival index and dental calculus index were evaluated. Furthermore, the calculus accumulated along the retainer wire was measured and all patients answered a questionnaire about the use, acceptance and comfort of both types of retainers. RESULTS the scores for plaque and gingival indexes were higher for the braided retainer (p< 0.05) on the lingual and proximal surfaces. The same occurred with the calculus index on the lingual surfaces (p< 0.05). The calculus index along wire was higher for the braided retainer (p< 0.05). All patients preferred the conventional retainer, and said that it was also more comfortable to use. CONCLUSION it was concluded that the conventional retainer showed better periodontal indexes than the braided type.
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Affiliation(s)
- Larissa A Ferreira
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
| | - Diogo M Sapata
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
| | - Maria G A Provenzano
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
| | - Roberto M Hayacibara
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
| | - Adilson L Ramos
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
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Kartal Y, Kaya B. Fixed Orthodontic Retainers: A Review. Turk J Orthod 2019; 32:110-114. [PMID: 31294414 DOI: 10.5152/turkjorthod.2019.18080] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 12/25/2018] [Indexed: 11/22/2022]
Abstract
Orthodontic retention is defined as maintaining teeth in optimal aesthetic and functional position after treatment. Despite the necessity of retention phase and the factors influencing the stability of the teeth after orthodontic treatment was discussed by the orthodontist for a long time, it is accepted that a retention phase is essential for stability of orthodontic treatment results nowadays. Therefore, the application of a suitable retention method is important both for prevention of relapse after orthodontic treatment and for increasing patient satisfaction. Removable appliances had been used for many years for retention purposes. Later, fixed retainers were introduced to prevent relapse as having a number of advantages, such as better aesthetics, no need for patient cooperation, effectiveness, and suitability for lifelong retention. However, their need for precise bonding technique, fragility, and tendency to cause periodontal problems by weakening oral hygiene are some of their disadvantages.
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Affiliation(s)
- Yasemin Kartal
- Department of Orthodontics, Private Practice, Antalya, Turkey
| | - Burçak Kaya
- Department of Orthodontics, Başkent University School of Dentistry, Ankara, Turkey
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Long-term effects of Class II orthodontic treatment on oral health. J Orofac Orthop 2018; 79:96-108. [PMID: 29464289 DOI: 10.1007/s00056-018-0125-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/08/2018] [Indexed: 10/18/2022]
Abstract
AIM To investigate the long-term (≥15 years) benefit of orthodontic Class II treatment (Tx) on oral health (OH). SUBJECTS AND METHODS All patients (Department of Orthodontics, University of Giessen, Giessen, Germany) who underwent Class II correction (Herbst-multibracket Tx, end of active Tx ≥ 15 years ago) and agreed to participate in a recall (clinical examination, interview, impressions, and photographs) were included. Records after active Tx were used to assess the long-term OH effects. Data were compared to corresponding population-representative age-cohorts as well as to untreated Class I controls without orthodontic Tx need during adolescence. RESULTS Of 152 treated Class II patients, 75 could be located and agreed to participate at 33.7 ± 3.0 years of age (pre-Tx age: 14.0 ± 2.7 years). The majority (70.8%) were fully satisfied with their teeth and with their masticatory system. The Decayed, Missing, Filled Teeth Index (DMFT) was 7.1 ± 4.8 and, thus, almost identical to that of the untreated Class I controls (7.9 ± 3.6). In contrast, the DMFT in the population-representative age-cohort was 56% higher. The determined mean Community Periodontal Index (CPI) maximum score (1.6 ± 0.6) was also comparable to the untreated Class I controls (1.7 ± 0.9) but in the corresponding population-representative age-cohort it was 19-44% higher. The extent of lower incisor gingival recessions did not differ significantly between the treated Class II participants and the untreated Class I controls (0.1 ± 0.2 vs. 0.0 ± 0.1 mm). CONCLUSION Patients with orthodontically treated severe Class II malocclusions had a lower risk for oral health impairment than the general population. The risk corresponded to that of untreated Class I controls (without orthodontic Tx need during adolescence).
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Juloski J, Glisic B, Vandevska-Radunovic V. Long-term influence of fixed lingual retainers on the development of gingival recession: A retrospective, longitudinal cohort study. Angle Orthod 2017; 87:658-664. [PMID: 28686089 DOI: 10.2319/012217-58.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the long-term influence of fixed lingual retainers on the development of mandibular gingival recession and to compare the prevalence with untreated individuals. MATERIALS AND METHODS The material consisted of 144 subjects: 96 orthodontically treated patients followed for 5 years after therapy and 48 untreated age-matched subjects. The treated patients were divided in two groups: one receiving a fixed mandibular retainer (n = 48) and one receiving no form of retention in the mandible (n = 48). The presence or absence of gingival recession and calculus accumulation were scored before treatment (T0), after debonding (T1), and 5 years after debonding (T5) for each tooth in the mandibular intercanine region using plaster models and intraoral photographs. The chi-square test, one-way ANOVA, and Cochran's Q test were used to evaluate inter- and intragroup differences. RESULTS The prevalence of patients with recession increased gradually and significantly throughout the observation periods in all groups, but the intergroup differences at T5 were not significant. Significantly more calculus accumulation was observed at T5 in the retainer group compared with the group without retainers. CONCLUSIONS Long-term presence of fixed lingual retainers does not seem to increase the development of mandibular gingival recession, but does increase calculus accumulation.
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