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Kumar SO, Srinidhi S, Visshishta J, Sirisha S, Ranganathan S, Priya K, Moulvi S, Mani B. Evaluation of Orthodontic Retention Protocol among Orthodontist and General Dentist-A Cross-Sectional Survey. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1588-S1590. [PMID: 38882740 PMCID: PMC11174164 DOI: 10.4103/jpbs.jpbs_1099_23] [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: 10/24/2023] [Revised: 11/02/2023] [Accepted: 12/07/2023] [Indexed: 06/18/2024] Open
Abstract
Aim The current study was conducted with the aim of evaluating the retention protocol followed by orthodontists in India. Material and Methods A cross-sectional web-based questionnaire survey was carried out to evaluate the retention protocol. To determine the sample size, a pilot study was carried out, and the final sample arrived was 250 subjects. The current study's inclusion criteria took into account those who had finished their BDS&MDS (Orthodontist). Results The data were statistically examined when the surveys were received and completed. The choice for fixed retainers was 67.4%. Retainer wear time preferences ranged widely, with 60% preferring 12-18 hours. The initial post-retention check appointment was planned by the majority of orthodontists (47.6%) within the next three months. Recall appointments for retention checks were only planned by the majority of orthodontists (56.3%) once every three months. Regular involvement by patients at their retention check appointments was (38%). Conclusion The most commonly used and preferred type of retainer is fixed retainer, and dentist preferences range around 12-18 hours of wear time. Furthermore, the duration of the retainer wear preferred by most orthodontists/dentists is 10 months to 2 years.
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Affiliation(s)
- S Ojass Kumar
- Department of Orthodontics and Dentofacial Orthopaedics, Malla Reddy Dental College for Women. Hyderabad, Telangana, India
| | - S Srinidhi
- Department of Public Health Dentistry, Karpaga Vinayaga Institute of Dental Sciences, Chengelpattu, Chennai, Tamil Nadu, India
| | - J Visshishta
- Department of Orthodontics and Dentofacial Orthopaedics, Mallareddy Institute of Dental Sciences, Hyderabad, India
| | - Sapasetty Sirisha
- Private Practitioner, Department of Orthodontics and Dentofacial Orthopaedics, Hyderabad, India
| | - Sukanya Ranganathan
- Department of Orthodontics and Dentofacial Orthopedics, Madha Dental College and Hospital, Madha Nagar, Kundrathur, Chennai, Tamil Nadu, India
| | - K Priya
- Department of Orthodontics and Dentofacial Orthopedics, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Chennai, Tamil Nadu, India
| | - Smm Moulvi
- The FACE OMFS Centre, Chennai, Tamil Nadu, India
| | - Bhuvaneswari Mani
- Department of Orthodontics and Dentofacial Orthopaedics, Karpaga Vinayaga Institute of Dental Sciences, Chengelpattu, Chennai, Tamil Nadu, India
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Medina MCG, Santos CCOD, Lima BO, Ferreira MB, Normando D. Impact of fixed orthodontic retainers on oral health-related quality of life: a longitudinal prospective study. Dental Press J Orthod 2024; 29:e242317. [PMID: 38451568 PMCID: PMC10914318 DOI: 10.1590/2177-6709.29.1.e242317.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: 01/25/2023] [Accepted: 01/01/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVE The aim of the present study was to assess the impact of orthodontic retainers on oral health-related quality of life (OHRQoL) in the short and long terms after orthodontic treatment. METHODS Data from 45 patients up to three years after orthodontic treatment (T0) were analyzed. Patients were reassessed four years (T1) after T0. OHRQoL was measured using the OHIP-14 (Oral Health Impact Profile-14) questionnaire. The presence of a fixed retainer in the upper and/or lower arches, sex, and age were the predictive variables evaluated at T0 and T1. The occurrence of retainer fracture at T0 was clinically evaluated. Due to the COVID-19 pandemic, clinical examination on T1 was not possible, so the OHIP-14 and the self-perception of changes in teeth position and fracture of retainers were examined using an on-line questionnaire. RESULTS At the initial examination, the presence of upper retainers had a negative impact on quality of life (p=0.018). The OHIP-14 value increased significantly from T0 to T1 (p=0.014), regardless of the presence of retainers. The fracture or debonding of the retainer reported by the patient was the only variable that had a negative impact on OHRQoL (p=0.05). CONCLUSION The use of fixed upper retainers suggests a negative impact on the quality of life of the orthodontic patient after the end of orthodontic treatment. This impact, however, is negligible in the long term, except when associated with fracture or debonding. This study emphasizes the need for continuous follow-up of orthodontic patients during the retention period.
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Affiliation(s)
| | | | - Beatriz Oliveira Lima
- Associação Brasileira de Odontologia, Especialização em Ortodontia (Belém/PA, Brazil)
| | - Marina Bosi Ferreira
- Associação Brasileira de Odontologia, Especialização em Ortodontia (Belém/PA, Brazil)
| | - David Normando
- Universidade Federal do Pará, Faculdade de Odontologia, Departamento de Ortodontia (Belém/PA, Brazil)
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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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Tran G, Rucker R, Foley P, Bankhead B, Adel SM, Kim KB. Relapse and failure rates between CAD/CAM and conventional fixed retainers: a 2-year follow-up of a randomized controlled clinical trial. Eur J Orthod 2024; 46:cjad079. [PMID: 38168815 DOI: 10.1093/ejo/cjad079] [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: 01/05/2024]
Abstract
BACKGROUND Retention has been always considered a major challenge in orthodontics. Recently computer-aided design/computer-aided manufacturing (CAD/CAM) fixed retainers (FRs) have been introduced as a marked development in retainer technology, offering potential advantages. OBJECTIVE The objective of this study was to compare the differences in relapse and failure rates in patients treated with FRs using CAD/CAM technology, lab-based technique, and chairside method. TRIAL DESIGN A double-blinded, prospective, randomized controlled clinical trial was conducted over a 2-year period at a single centre. METHODS INTERVENTIONS These patients were divided into three groups: CAD/CAM group with multistranded Stainless Steel wires (CAD/CAM, n = 14), lab group with the same multistranded wires (lab, n = 15), and a chairside group with Stainless Steel Ortho-FlexTech wires (chairside, n = 14). OUTCOMES Inter-canine width (ICW) and Little's irregularity index were digitally measured from scans at the orthodontic debonding (T1), 6-month retention (T2), 1-year retention (T3), and 2-year retention (T4) visits. All forms of failure were documented and analyzed. RANDOMIZATION Participants were randomly assigned to the three groups using online randomization software (randomization.com) by a statistician who was not involved in the study. BLINDING Patients were blinded in terms of the FR group to which they were each randomly assigned. The principal investigator was blinded upon data analysis since patients' records were coded to minimize observer and measurement bias. RESULTS Initially 81 patients were assessed for eligibility. Seventy-five patients were randomly allocated into the three study groups. After 2-year follow-up, 43 patients came back for the follow-up and were analyzed. The CAD/CAM group showed significantly less reduction in ICW compared to the chairside group at all time intervals (P < .05) and compared to the lab group at 6 months (P = .038). In terms of LII, the CAD/CAM group exhibited significantly less change than the chairside and lab groups at all time intervals (P < .05). The CAD/CAM group had the lowest failure rate (21.4%), followed by chairside group (28.6%) and then lab group (33.3%), however the differences were insignificant. No harms were observed in the current study. CONCLUSION Within 2 years of fixed retention, CAD/CAM FRs showed significantly less relapse than lab-based and chairside FRs. However, there was no significant difference in failure rates among the groups. TRIAL REGISTRATION NCT05915273.
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Affiliation(s)
- Giau Tran
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
| | - Ryan Rucker
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
| | - Patrick Foley
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
| | - Brent Bankhead
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
| | - Samar M Adel
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Alexandria 21526, Egypt
| | - Ki Beom Kim
- Department of Orthodontics, Saint Louis University, Saint Louis, MO 63104, USA
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Wang M, Wang J, Jin X, Liu D, Bian H, Zhao Y, Li Y. Impact of occlusal contact pattern on dental stability and oromandibular system after orthodontic tooth movement in rats. Sci Rep 2023; 13:22276. [PMID: 38097596 PMCID: PMC10721791 DOI: 10.1038/s41598-023-46668-x] [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: 05/09/2023] [Accepted: 11/03/2023] [Indexed: 12/17/2023] Open
Abstract
How to ensure dental stability in new positions and reduce the likelihood of relapse is a major clinical concern in the orthodontic field. Occlusal contacts between arches may affect the transmission of masticatory forces, thereby influencing the biological response of the periodontal and the oromandibular system. Occlusion factors that may influence the stability after orthodontic tooth movement (OTM) remain largely unknown. Hence, this research was conducted in order to investigate the influence of different occlusal contact patterns on tooth stability and oromandibular system including the masseter muscle and the temporomandibular joint following OTM. By modifying the occlusal surfaces, in vivo animal study models with distinct occlusal patterns corresponding to clinical circumstances were established. The relapse distance of teeth and the level of inflammatory factors in the gingival cervical fluid were analyzed. We also closely observed the histological remodeling of periodontal tissue, masseter tissue, and joint tissue after one week of relapse. Moreover, genes expression in the alveolar bone was analyzed to illustrate the potential biological mechanisms of relapse under the influence of different occlusal contact patterns following OTM. Different occlusal contact patterns after OTM in rats were established. The intercuspation contact between cusp and fossa group exhibited the lowest level of relapse movement, inflammatory factors and osteoclast activity (P < 0.05). On the other hand, groups with interferences or inadequate contacts exhibited more relapse movement, and tend to promote inflammation of periodontal tissue and activate bone resorption (P < 0.05). Adequate occlusal contacts without interference may enhance tooth stability and reduce the likelihood of relapse. After active orthodontic treatment, necessary occlusal adjustment should be made to achieve the desired intercuspation contact relationship and ensure adequate contact between the arches. The elimination of occlusal interferences is crucial to achieving optimal stability and promoting overall healthy condition of the oromandibular system.
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Affiliation(s)
- Menglin Wang
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
- Department of Stomatology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, China
| | - Jing Wang
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Xiang Jin
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Dedi Liu
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China
| | - Huan Bian
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China.
| | - Yantao Zhao
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China.
- Department of Orthopedics, The Fourth Medical Center, Chinese PLA General Hospital, Beijing, 100048, China.
- Beijing Engineering Research Center of Orthopedics Implants, Beijing, 100048, China.
- State Key Laboratory of Military Stomatology, Xi'an, 710032, China.
| | - Yanfeng Li
- Department of Stomatology, The Fourth Medical Center, Chinese PLA General Hospital, No. 51 Fucheng Road, Haidian District, Beijing, 100048, China.
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Tee SHM, Shahid S, Al-Moghrabi D, Fleming PS. An assessment of the impact of adhesive coverage and wire type on fixed retainer failures and force propagation along two types of orthodontic retainer wires: an in vitro study. Angle Orthod 2023; 93:712-720. [PMID: 37246952 PMCID: PMC10633805 DOI: 10.2319/110722-765.1] [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: 11/01/2022] [Accepted: 04/01/2023] [Indexed: 05/30/2023] Open
Abstract
OBJECTIVES To evaluate the force required to promote the failure of fixed orthodontic retainers with different adhesive (composite) coverage and to assess the presence and extent of force propagation with two different orthodontic retainer wires. MATERIALS AND METHODS Ortho-FlexTech and Ortho-Care Perform (0.0175 inches), each of 15-cm length, were bonded on acrylic blocks with different adhesive surface diameters (2 mm, 3 mm, 4 mm, and 5 mm). The samples (n = 160) were subjected to a tensile pull-out test, and debonding force was recorded. Fixed retainers using two different wires and 4-mm adhesive diameter were bonded on acrylic bases resembling a maxillary dental arch (n = 72). The retainers were loaded occluso-apically until the first sign of failure while being video recorded. Individual frames of the recordings were extracted and compared. A force propagation scoring index was developed to quantify the extent of force transmission under load. RESULTS A 4-mm adhesive surface diameter required the highest debonding force for both retainer wires with significant differences compared with 2 mm (P < .001; 95% confidence interval [CI]: 8.69, 21.69) and 3 mm (P = .026; 95% CI: 0.60, 13.59). Force propagation scores were significantly higher for Ortho-Care Perform. CONCLUSIONS Based on this laboratory-based assessment, consideration should be given to the fabrication of maxillary fixed retainers using a minimum of 4-mm diameter composite coverage on each tooth. Force appeared to propagate more readily with Ortho-Care Perform than with a flexible chain alternative. This may risk stress accumulation at the terminal ends with potential for associated unwanted tooth movement in the presence of intact fixed retainers.
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Affiliation(s)
- Selena H. M. Tee
- Corresponding author: Dr Selena Hui Ming Tee, Institute of Dentistry, Queen Mary University of London, The Royal London Dental Hospital, Department of Orthodontics, Turner Street, London E1 1FR, UK (e-mail: )
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7
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Mecenas P, Cardoso PC, Maia NG, Maia FA, Normando D. Effect of the quality of orthodontic finishing on the stability of anterior tooth alignment. Angle Orthod 2023; 93:652-658. [PMID: 37200475 PMCID: PMC10633801 DOI: 10.2319/101722-722.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 10/01/2022] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES To evaluate whether the quality of orthodontic finishing influences long-term stability of anterior tooth alignment. MATERIALS AND METHODS This retrospective study evaluated 38 patients. Data were obtained at the beginning of treatment (T0), at the end (T1), and at least 5 years after T1 (T2). At this point, the individuals were no longer wearing retainers. Anterior tooth alignment was measured using Little's index (LI). Effect on alignment stability was tested with multiple linear regression using LI-T0, LI-T1, intercanine width difference T1-T0, overbite (T1), overjet (T1), age, gender, time without retention, and presence of third molars as predictor variables. Well-aligned (LI < 1.5 mm) and misaligned (LI > 1.5 mm) cases were compared at T2. RESULTS At T2, the alignment stability in the upper arch was inversely associated with the alignment quality (R2 = 0.378, P < .001) and directly associated with overbite (R2 = 0.113, P = .008) at T1. Posttreatment changes caused cases finished with poor alignment to become similar to those finished with excellent alignment (P = .917). In the mandible, posttreatment changes were directly associated only with overjet (R2 = 0.152, P = .015) and well-finished cases displayed better alignment than poorly finished cases (P = .011). Other variables showed no significant association. CONCLUSIONS In arches without retention, better quality of orthodontic finishing does not guarantee the stability of anterior alignment. In the maxilla, long-term changes were more significant the greater the overbite and the better the quality of alignment at end of treatment. In the mandible, changes were not dependent on the quality of finishing but were associated with greater overbite at T2.
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Affiliation(s)
- Paulo Mecenas
- Corresponding author: Dr Paulo Mecenas, Department of Orthodontics, Federal University of Pará (UFPA), Rua Augusto Correa 01, Belém, Pará 66075-110, Brazil (e-mail: )
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Tsoukala E, Lyros I, Tsolakis AI, Maroulakos MP, Tsolakis IA. Direct 3D-Printed Orthodontic Retainers. A Systematic Review. CHILDREN 2023; 10:children10040676. [PMID: 37189925 DOI: 10.3390/children10040676] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023]
Abstract
Three-dimensional (3D) printing technology has shed light on many fields in medicine and dentistry, including orthodontics. Direct 3D-printed prosthetics, implants or surgical devices are well-documented. The fabrication of orthodontic retainers using CAD technology and additive manufacturing is an emerging trend but the available data are scarce. The research approach of the present review included keywords in Medline, Scopus, Cochrane Library and Google Scholar up to December 2022. The searching process concluded with five studies eligible for our project. Three of them investigated directly 3D-printed clear retainers in vitro. The other two studies investigated directly 3D-printed fixed retainers. Among them, one study was in vitro and the second was a prospective clinical trial. Directly 3D-printed retainers can be evolved over time as a good alternative to all the conventional materials for retention. Devices that are 3D-printed are more time and cost efficient, offer more comfortable procedures for both practitioners and patients and the materials used in additive manufacturing can solve aesthetic problems, periodontal issues or problems with the interference of these materials with magnetic resonance imaging (MRI). More well-designed prospective clinical trials are necessary for more evaluable results.
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Affiliation(s)
- Efthimia Tsoukala
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
| | - Ioannis Lyros
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
| | - Apostolos I. Tsolakis
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
- Department of Orthodontics, School of Dentistry, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Michael P. Maroulakos
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
| | - Ioannis A. Tsolakis
- Department of Orthodontics, School of Dentistry, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Krämer A, Sjöström M, Apelthun C, Hallman M, Feldmann I. Post-treatment stability after 5 years of retention with vacuum-formed and bonded retainers-a randomized controlled trial. Eur J Orthod 2022; 45:68-78. [PMID: 35968668 PMCID: PMC9912701 DOI: 10.1093/ejo/cjac043] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Retention after orthodontic treatment is still a challenge and more evidence about post-treatment stability and patients' perceptions of different retention strategies is needed. OBJECTIVES This trial compares removable vacuum-formed retainers (VFR) with bonded cuspid-to-cuspid retainers (CTC) after 5 years of retention. TRIAL DESIGN A single centre two-arm parallel-group randomized controlled trial. METHODS This trial included 104 adolescent patients, randomized into two groups (computer-generated), using sequentially numbered, opaque, and sealed envelopes. All patients were treated with fixed appliances in both jaws with and without tooth extractions. Patients in the intervention group received a VFR in the mandible (n = 52), and patients in the active comparator group received a CTC (n = 52). Both groups had a VFR in the maxilla. Dental casts at debond (T1), after 6 months (T2), after 18 months (T3), and after 5 years (T4) were digitized and analysed regarding Little's Irregularity Index (LII), overbite, overjet, arch length, and intercanine and intermolar width. The patients completed questionnaires at T1, T2, T3, and T4. RESULTS Post-treatment changes between T1 and T4 in both jaws were overall small. In the maxilla, LII increased significantly (median difference: 0.3 mm), equally in both groups. In the mandible, LII increased significantly in the group VFR/VFR (median difference: 0.6 mm) compared to group VFR/CTC (median difference: 0.1 mm). In both groups, overjet was stable, overbite increased, and arch lengths decreased continuously. Intercanine widths and intermolar width in the mandible remained stable, but intermolar width in the maxilla decreased significantly. No differences were found between groups. Regardless of retention strategy, patients were very satisfied with the treatment outcome and their retention appliances after 5 years. LIMITATIONS It was not possible to perform blinded assessments of digital models at follow-up. CONCLUSIONS Post-treatment changes in both jaws were small. Anterior alignment in the mandible was more stable with a bonded CTC retainer compared to a removable VFR after 5 years of retention. Patients were equally satisfied with fixed and removable retention appliances. TRIAL REGISTRATION ClinicalTrials.gov (NCT03070444).
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Affiliation(s)
- Anke Krämer
- Correspondence to: Anke Krämer, Orthodontic Clinic, Box 57, Gävle 801 02, Sweden. E-mail:
| | - Mats Sjöström
- Department of Odontology/Oral and Maxillofacial Surgery, Umeå University, Umeå, Sweden
| | - Catharina Apelthun
- Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden
| | - Mats Hallman
- Department of Odontology/Oral and Maxillofacial Surgery, Umeå University, Umeå, Sweden
| | - Ingalill Feldmann
- Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden
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Chacón-Moreno A, Ramírez-Mejía MJ, Zorrilla-Mattos AC. Relapse and inadvertent tooth movement post orthodontic treatment in individuals with fixed retainers: A review. REVISTA CIENTÍFICA ODONTOLÓGICA 2022; 10:e116. [PMID: 38389556 PMCID: PMC10880701 DOI: 10.21142/2523-2754-1003-2022-116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/06/2022] [Indexed: 02/24/2024] Open
Abstract
Orthodontists must fully inform patients about the implications of orthodontic treatment and the subsequent need for retention. This review provides an update on relapse, unwanted movements and different factors that can cause loss of stability following orthodontic treatment. Since it is difficult to predict which patients will present some degree of loss of stability after treatment, it is important that they be treated as if they have a high potential for relapse. The present review included a bibliographic search in the main sources of scientific review including Medline via PubMed, Scopus and the Cochrane library. The search strategy was carried out until May 5, 2022. Only 34 studies fulfilling the selection criteria. Our results showed that maintaining teeth in the correct position following orthodontic treatment is a great challenge for orthodontists. The etiology of relapse is complex and not yet clearly established. Its origin is attributed to factors such as the time of gingival and periodontal tissue reorganization and changes produced by growth, compromising the stability of the results achieved with orthodontic treatment. The retention phase is necessary after orthodontic treatment to avoid relapse or loss of the occlusion results obtained. However, fixed retainers may induce unwanted tooth movement that may occur despite these retainers being attached and intact. There is currently no consensus among orthodontists regarding the ideal type of wire for fixed containment. We concluded that post-orthodontic treatment relapse is the result of a regression towards the original malocclusion. However, changes in the position of the teeth can also occur, which are considered as unwanted movements and have a multifactorial origin.
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Affiliation(s)
- Alicia Chacón-Moreno
- School of Dentistry, Nacional Federico Villareal University, Lima, Peru. Universidad Nacional Federico Villarreal School of Dentistry Nacional Federico Villareal University Lima Peru
| | - María Jimena Ramírez-Mejía
- School of Dentistry, Peruana de Ciencias Aplicadas University, Lima, Peru. Universidad Peruana de Ciencias Aplicadas School of Dentistry Peruana de Ciencias Aplicadas University Lima Peru
| | - Ana Carolina Zorrilla-Mattos
- School of Dentistry, Privada Antenor Orrego University, Trujillo, Peru. Universidad Privada Antenor Orrego School of Dentistry Privada Antenor Orrego University Trujillo Peru
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Sangalli L, Savoldi F, Dalessandri D, Visconti L, Massetti F, Bonetti S. Remote digital monitoring during the retention phase of orthodontic treatment: A prospective feasibility study. Korean J Orthod 2022; 52:123-130. [PMID: 35321951 PMCID: PMC8964474 DOI: 10.4041/kjod.2022.52.2.123] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/27/2021] [Accepted: 11/03/2021] [Indexed: 01/24/2023] Open
Abstract
Objective To evaluate if a remote digital monitoring system added at the end of orthodontic treatment could positively influence the retention phase by reducing the occurrence of misfit of removable appliances, number of emergency appointments (EA), and orthodontic relapse. Methods Twenty-seven patients who completed active orthodontic treatment were divided into the study and control groups. In addition to the standard chairside follow-up appointments at month 1 (T1), month 3 (T2), month 6 (T3), the study group patients were monitored using Dental Monitoring® with monthly intra-oral scans. Occurrence of misfit of removable retainers, number of EAs, and intercanine width change were recorded for both groups. Differences in EAs and retainer fit were assessed using the chi-square test. Intra-group and inter-group differences in the intercanine width were assessed with Friedman test and Mann-Whitney U test, respectively (α = 0.05). Results The study group showed a significantly lower occurrence of misfit of removable retainers (p = 0.027) compared to the control group. No significant inter- and intra-group difference was found in the EAs and intercanine width change at each time-point. Conclusions Integrating remote monitoring systems, such as Dental Monitoring®, to the retention phase of the orthodontic treatment may lower the occurrence of misfit of removable retainers. However, a small sample size and a short observation period limit the strength of this evidence. These preliminary results tentatively suggest that remote monitoring technologies may be beneficial, especially during the COVID-19 pandemic, when the regularity of in-office visits might be disrupted.
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Affiliation(s)
- Linda Sangalli
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
- Department of Oral Health Science, Division of Orofacial Pain, College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - Fabio Savoldi
- Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Domenico Dalessandri
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Luca Visconti
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Francesca Massetti
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Stefano Bonetti
- Dental School, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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12
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Kuznetsova MY, Sevbitov AV, Tikhonov VE, Platonova VV, Zangieva OT, Enina YI. [The quality of life of patients after orthodontic treatment depending on the use of different types of retention appliances]. STOMATOLOGIIA 2022; 101:40-45. [PMID: 35184532 DOI: 10.17116/stomat202210101140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIM To assess the impact of the type of retention device on the quality of life of orthodontic patients. MATERIAL AND METHODS 311 patients were divided into four groups according to age. At the end of active orthodontic treatment, retainers were installed. After 6 months, a questionnaire was conducted using the standard OHIP-14 questionnaire in order to identify the attitude to the equipment used, the presence or absence of relapses and satisfaction with the state of the dental system. RESULTS The number of relapses in all groups is approximately at the same level, which indicates almost equal opportunities for retainers to retain the achieved result. There is no correlation between the convenience of using a particular type of retainer and the willingness to do so. CONCLUSION The motivation of patients to use removable or non-removable retention devices to a certain extent depends not only on the type of retainer, but also on the age at which the treatment was performed.
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Affiliation(s)
- M Yu Kuznetsova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A V Sevbitov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | - V V Platonova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | - Yu I Enina
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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13
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Berbert M, Cotrin P, Oliveira RCGD, Oliveira RGD, Valarelli FP, Freitas MRD, Freitas KMS. The influence of 3x3 bonded retainer on anterior crowding relapse in mandibular incisor extraction cases. Dental Press J Orthod 2021; 26:e212081. [PMID: 34932714 PMCID: PMC8690515 DOI: 10.1590/2177-6709.26.6.e212081.oar] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 08/31/2020] [Indexed: 12/01/2022] Open
Abstract
Objective: To evaluate the 3x3 bonded retainer influence on the mandibular anterior crowding in cases treated with mandibular incisor extraction Methods: The sample comprised pretreatment, posttreatment and follow-up orthodontic records of 16 subjects (10 females and 6 males) with Class I malocclusion treated with extraction of a single mandibular incisor. The mean ages (± SD) at pretreatment, posttreatment and follow-up evaluation were 23.45 ± 9.14 years, 25.50 ± 8.95 years and 30.11 ± 8.59 years, respectively. The mean (± SD) treatment time and posttreatment evaluation time were 2.05 ± 0.45 years and 4.60 ± 1.85 years , respectively. Little irregularity index and interdental widths were evaluated using dental casts. The sample was divided into two subgroups, according to the presence of the 3x3 bonded retainer at follow-up. Results: The subgroup without 3x3 bonded retainer presented a greater relapse at the follow-up, when compared to 3x3 bonded retainer subgroup. Conclusion: There was a significant relapse in cases treated with mandibular incisor extraction at follow-up. The subgroup without 3x3 bonded retainer showed a significant relapse at the follow-up when compared to the retainer group.
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Affiliation(s)
- Marcelo Berbert
- Centro Universitário Ingá, Faculdade de Odontologia (Maringá/PR, Brazil)
| | - Paula Cotrin
- Centro Universitário Ingá, Faculdade de Odontologia (Maringá/PR, Brazil)
| | | | | | | | - Marcos Roberto de Freitas
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Odontologia (Bauru/SP, Brazil)
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Rahimi H, Albright DA, Hughes JA, Dutra V, Turkkahraman H. Three-dimensional analysis of the posttreatment displacements of mandibular anterior teeth with rigid and flexible lingual retainers. Am J Orthod Dentofacial Orthop 2021; 161:628-637. [PMID: 34953659 DOI: 10.1016/j.ajodo.2020.11.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/01/2020] [Accepted: 11/01/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The purpose of this study was to analyze any posttreatment changes in the positions of mandibular anterior teeth retained by 2 different fixed retention methods (rigid or flexible) and their effectiveness in minimizing postorthodontic tooth movement. METHODS Thirty patients were selected for inclusion in this retrospective study. Group I consisted of 15 patients with 0.032-in stainless steel rigid retainers bonded to canines only. Group II consisted of 15 patients with 0.0215-in twisted stainless steel flexible retainer bonded to all mandibular anterior teeth. Geomagic Control (3DS Systems, Rock Hill, SC) software was used to quantify the changes between selected points. Paired t test was used for intragroup comparisons in all 3 coordinates, and an independent-sample t test was used for intergroup comparison. RESULTS In the transverse dimension, significant intergroup differences were found in displacements of distoincisal points of the right lateral (P <0.05) and left central incisors (P <0.01). In the sagittal dimension, significant intergroup differences were found in the displacements of mesioincisal point of the right central incisor (P <0.05) and distoincisal point of the left central incisor (P <0.01). Examining total displacement, there were significant intergroup differences in mesioincisal point on the right central incisor, distoincisal point on the left lateral incisor (P <0.05). CONCLUSIONS Our results suggested that central incisor contacts were more likely to shift with the rigid retainers, especially in sagittal and transverse dimensions. However, no statistically or clinically significant changes were noted in the third-order or vertical positions of the teeth with either retention method.
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Affiliation(s)
- Hajir Rahimi
- Department of Orthodontics and Oral Facial Genetics, Indiana University, School of Dentistry, Indianapolis, Ind
| | - David A Albright
- Department of Orthodontics and Oral Facial Genetics, Indiana University, School of Dentistry, Indianapolis, Ind
| | - Jay A Hughes
- Department of Orthodontics and Oral Facial Genetics, Indiana University, School of Dentistry, Indianapolis, Ind
| | - Vinicius Dutra
- Department of Oral Pathology, Medicine, and Radiology, Indiana University, School of Dentistry, Indianapolis, Ind
| | - Hakan Turkkahraman
- Department of Orthodontics and Oral Facial Genetics, Indiana University, School of Dentistry, Indianapolis, Ind.
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15
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Angst C, Eliades T, Papageorgiou SN. Stability of occlusal outcome during long-term retention: the time-dependent variation of the American Board of Orthodontics index. Eur J Orthod 2021; 43:1-7. [PMID: 32144422 DOI: 10.1093/ejo/cjaa004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The aim of this retrospective cohort study was to assess long-term occlusal changes at debond and a median of 8 years afterwards (in retention) with the American Board of Orthodontics (ABO) objective grading system and identify risk factors. MATERIALS AND METHOD Fifty patients (median age: 14.3 years at debond; 60% female) treated with fixed appliances (25 with and 25 without premolar extractions) were included. The occlusal outcome was assessed with the ABO tool and analyzed statistically at 5%. RESULTS Extraction treatment was associated with better occlusal outcome than non-extraction treatment (34.2 versus 40.9 points; P = 0.009). In retention, ABO scores improved by 7.4 points, while patients with worse debond finishing improved more afterwards (P = 0.001). Alignment/rotations deteriorated in 58% of the cases and occlusal relationships in 38% of the cases. Marginal ridges improved more for extraction than non-extraction patients (28% versus 0%; P = 0.001). Occlusal relationships improved more for cases that 'passed' the ABO requirements at debond than failed cases (64% versus 28%; P = 0.02). Furthermore, patients with worse debond ABO scores were more likely to deteriorate at alignment/rotations in retention. Finally, the proportion of cases passing the ABO requirements improved considerably between debond (28%) and in retention (54%) as half (47%) of the cases that had failed the ABO requirements at debond passed them in retention. CONCLUSIONS Considerable long-term occlusal changes are seen post-debond, which mostly favour improved settling. Extraction treatment and higher finishing quality at debond significantly influenced the chance for improvement. However, setting a cut-off score to denote treatment excellence showed considerable instability through time.
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Affiliation(s)
- Christine Angst
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Assessment of the effect of vacuum-formed retainers and Hawley retainers on periodontal health: A systematic review and meta-analysis. PLoS One 2021; 16:e0253968. [PMID: 34242289 PMCID: PMC8270199 DOI: 10.1371/journal.pone.0253968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/16/2021] [Indexed: 11/19/2022] Open
Abstract
Background Recently, increasing attention has been paid to the periodontal health of orthodontic patients in the maintenance stage in clinical practice. The focus of this meta-analysis was to compare the effects of vacuum-formed retainers (VFR) and Hawley retainers (HR) on periodontal health, in order to provide a reference for clinical selection. Methods From the establishment of the database until November 2020, a large number of databases were searched to find relevant randomized control trials, including the Cochrane Library databases, Embase, PubMed, Medline via Ovi, Web of Science, Scopus, Grey Literature in Europe, Google Scholar and CNKI. Related literature was manually searched and included in the analysis. Two researchers screened the literature according to relevant criteria. The size of the effect was determined using RevMan5.3 software, and the mean difference and 95% confidence intervals (CI) were used to estimate the results using a random effects model. Results This meta-analysis included six randomized controlled trials involving 304 patients. The results of the meta-analysis showed that there was no statistical difference in sulcus probing depth status between the VFR group and the HR group, including at 1, 3, and 6 months. Compared with the VFR group, the HR group showed a lower gingival index at 1 month (mean difference = 0.12, 95%CI: 0.06 to 0.19) and 3 months (mean difference = 0.11, 95%CI: 0.06 to 0.17), while there was no statistically significant difference at 6 months (mean difference = 0.10, 95%CI: -0.07 to 0.27). The plaque index of the HR group also showed a good state at 1 month (mean difference = 0.06, 95%CI: 0.01 to 0.12), 3 months (mean difference = 0.12, 95%CI: 0.08 to 0.16), and 6 months (mean difference = 0.19, 95%CI: 0.09 to 0.29). Subgroup analysis of PLI showed that when all teeth were measured, PLI status was lower in the HR group at 6 months (mean difference = 0.32, 95%CI: 0.18 to 0.46). PLI status was also low for the other teeth group (mean difference = 0.15, 95%CI: 0.08 to 0.22). Conclusion Our meta-analysis showed that patients using the Hawley retainer had better periodontal health compared with those using vacuum-formed retainers. However, more research is needed to look at the periodontal health of patients using these two retainers.
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17
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The rationale for orthodontic retention: piecing together the jigsaw. Br Dent J 2021; 230:739-749. [PMID: 34117429 DOI: 10.1038/s41415-021-3012-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
Retaining teeth in their corrected positions following orthodontic treatment is one of the most challenging aspects of orthodontic practice. Despite much research, the rationale for retention is not entirely clear. Teeth tend to revert to their pre-treatment positions due to periodontal and gingival, soft tissue, occlusal and growth factors. Changes may also follow normal dentofacial ageing and are unpredictable with great variability. In this overview, each of these factors are discussed with their implications for retention, along with adjunctive procedures to minimise relapse. The state of current knowledge, methods used to assess relapse, factors regarded as predictive of or associated with stability as well as overcorrection are outlined. Potential areas requiring further investigation are suggested. The way in which the clinician may manage current retention practice, with a need for individualised retention plans and selective retainer wear, is also considered.
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18
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Orthodontic treatment planning: can we plan for stability? Br Dent J 2021; 230:717-721. [PMID: 34117426 DOI: 10.1038/s41415-021-2891-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/01/2020] [Indexed: 11/09/2022]
Abstract
Careful orthodontic treatment planning should involve the delineation of clear treatment objectives within each dental arch. Treatment planning decisions are underpinned by aesthetic goals, dental health considerations and the prospect of stability, with these factors often competing. There is also a near-universal acceptance of the requirement for some form of retention. A novel hierarchy of orthodontic stability is proposed. As further evidence emerges and technical refinement continues, it is likely that this will undergo further adaptation. Ultimately, however, this knowledge will ensure that our understanding of the merits of orthodontic intervention, allied to the burden of retention, can be clearly presented to prospective orthodontic patients.
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19
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Rafflenbeul F, Hanriat C, Lefebvre F, Renkema AM, Bolender Y. How do general dental practitioners perceive and deal with orthodontic bonded retainers? Am J Orthod Dentofacial Orthop 2021; 160:e1-e8. [PMID: 33985877 DOI: 10.1016/j.ajodo.2020.12.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/01/2020] [Accepted: 12/01/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Long-term follow-up and management of orthodontic bonded retainers require a strong collaboration between orthodontists and general dental practitioners (GDPs). This study aimed to evaluate if Eastern French GDPs were aware of bonded retainers' complications and side effects and if they were willing to take part in their long-term follow-up. METHODS Two-hundred and eighteen randomly selected GDPs were invited to answer an online questionnaire. The initial sections covered their experience and management with bonded retainers. In the final sections, GDPs were asked their opinion on the responsibility for long-term follow-up of patients wearing fixed retainers and on the mutual communication between orthodontists and GDPs. Statistical analysis involved descriptive statistics and Fisher exact tests. RESULTS Response rate was 32.6% (n = 71). The vast majority of GDPs were familiar with loose retainers, but only 45.2% were willing to repair them. Respondents offering orthodontic services on a regular basis were more likely to insert retainers and repair loose or broken retainers (P < 0.001). Approximately 18.6% of GDPs were aware of third-order side effects encountered with unintentionally active retainers bonded to all 6 anterior teeth. For 88.8% of GDPs, permanent retention was justified, whereas 90% of the dentists refused to be responsible for long-term supervision of fixed retainers. In addition, 67.1% were interested in further training on orthodontic retention, and 92.9% would appreciate clinical guidelines. CONCLUSIONS Knowledge about the harmful side effects of bonded retainers was evaluated as insufficient among surveyed GDPs. Long-term follow-up of patients wearing bonded retainers raises issues that should be addressed globally by enhancing mutual communication, practitioners' education, and patients' involvement.
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Affiliation(s)
- Frédéric Rafflenbeul
- Department of Dento-Facial Orthopedics, Faculty of Dental Surgery, Strasbourg University, Strasbourg, France.
| | - Clémence Hanriat
- Department of Dento-Facial Orthopedics, Faculty of Dental Surgery, Strasbourg University, Strasbourg, France
| | - François Lefebvre
- Division of Public Health, Methodology and Biostatistics, University Hospitals of Strasbourg, Strasbourg, France
| | - Anne-Marie Renkema
- Department of Orthodontics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Yves Bolender
- Department of Dento-Facial Orthopedics, Faculty of Dental Surgery, Strasbourg University, Strasbourg, France
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20
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Naraghi S, Ganzer N, Bondemark L, Sonesson M. Comparison of post-treatment changes with and without retention in adolescents treated for maxillary impacted canines-a randomized controlled trial. Eur J Orthod 2021; 43:121-127. [PMID: 32133486 PMCID: PMC8023368 DOI: 10.1093/ejo/cjaa010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective To evaluate whether retention is needed after orthodontic treatment of impacted maxillary canines. Trial design Two-arm parallel group single-centre randomized controlled trial. Materials and methods Sixty-three patients, 39 girls and 24 boys, were recruited to the study. The inclusion criteria were patients with at least one impacted or unerupted maxillary canine, and moderate irregularity of the maxillary six anterior teeth according to Little’s index (LI). After gaining informed consent from the patient and their custodians, the patients were randomized to one of two groups, i.e. to a non-retention group or a retention group. The randomization process was prepared and carried out by an independent person not involved in the trial and the randomization used blocks of 20 (10 + 10). Primary outcomes were changes in single contact point discrepancy, and LI measured on digitalized three-dimensional study casts 1-year post-treatment. The study casts were anonymized before assessment and the changes were blinded for the assessor. Data were evaluated on an intention-to-treat basis. Thus, all randomized patients were incorporated into the final analysis. In the non-retention group a 10-week interim period was used to detect patients who eventually have a relapse immediately after treatment. If so, the patient got the arch-wire reinserted. Most patients in the retention group received a vacuum-formed retainer and pretreatment spacing cases got a bonded retainer. Results Mean irregularity change was 0.4 mm in the retention and 1.3 mm in the non-retention group (P < 0.001). Maximum change was 2.5 mm in the retention and 3.2 mm in the non-retention group (P < 0.001). Most changes in the non-retention group occurred during the 10-week interim period. In the non-retention group, one patient developed contact point discrepancy of >2 mm during the interim period and was realigned. Harms One patient met the stopping guideline criteria. This patient had the arch wire reinserted for 2 months. After realignment, the patient received a retention appliance. Limitations The trial was a single-centre study and short-term changes were evaluated. Conclusions Changes between the retention and the non-retention group were statistically but not clinically significant. Since satisfactory clinical results 1-year post-treatment were found in the non-retention group, retention does not appear to be needed. The 10-week interim period was useful in detecting patients who might have a relapse immediately after treatment. Trial registration The trial was not registered.
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Affiliation(s)
- Sasan Naraghi
- Orthodontic Clinic, National Health Service, Växjö, Sweden.,Department of Orthodontics, University of Malmö, Sweden
| | - Niels Ganzer
- Department of Orthodontics, University of Malmö, Sweden.,Orthodontic Clinic, Public Dental Health, Gävle, Sweden.,Centre for Research and Development Uppsala University/Region Gävleborg, Gävle, Sweden
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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: 17] [Impact Index Per Article: 4.3] [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.
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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
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Klaus K, Xirouchaki F, Ruf S. 3D-analysis of unwanted tooth movements despite bonded orthodontic retainers: a pilot study. BMC Oral Health 2020; 20:308. [PMID: 33148238 PMCID: PMC7643263 DOI: 10.1186/s12903-020-01304-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/29/2020] [Indexed: 11/24/2022] Open
Abstract
Background Recently, reports of unwanted tooth movements despite intact orthodontic bonded retainers have increased. These movements are not subject to relapse but are classified as a new developed malocclusion. The aims of the present pilot study were to analyze the prevalence of unwanted tooth movements despite intact bonded cuspid-to-cuspid retainers and to identify possible predisposing factors.
Materials and methods Plaster casts of all patients finishing orthodontic treatment during three consecutive years were assessed before treatment (T0), after multibracket appliance debonding (T1) and after two years of retention (T2). After multibracket appliance treatment, all patients received a cuspid-to-cuspid flexible spiral wire retainer bonded to each tooth of the retained segment in the upper and lower jaw. The study group (SG) consisted of 44 patients (16 male, 28 female) with tooth movements (T1–T2) of the retained segment despite intact bonded cuspid-to-cuspid retainer and the control group (CG) of 43 patients (19 male, 24 female) without unwanted tooth movements. The casts of the SG were digitized, superimposed and measured. Using the Chi-square test, Fisher´s exact test and Mann–Whitney-U-test (p < 0.05), mandibular plane angle, incisor proclination, oral dysfunctions or habits (T0) and intercanine distance, overjet and interincisal relationship (T0, T1, T2) were compared between SG and CG. Results The prevalence of patients with unwanted tooth movements in one or both jaws was 27.0%. Maxillary retainers were affected more often (20.9%) than mandibular retainers (14.1%). The median amount of tooth movements was 0 to 0.66 mm with large interindividual variations. Oral dysfunctions or habits at T0, such as a lack of interincisal contact at all time points, were associated with unwanted tooth movements. Conclusion Unwanted tooth movements occurred more often with maxillary than mandibular retainers. Patients with oral dysfunctions/habits and without interincisal contact had a higher prevalence of unwanted tooth movements.
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Affiliation(s)
- Katharina Klaus
- Department of Orthodontics, Justus-Liebig-University Giessen, Schlangenzahl 14, 35392, Giessen, Germany.
| | - Faidra Xirouchaki
- Private Practice, Ethnomartiron 70A, 71409, Heraklion (Iraclio), Crete, Greece
| | - Sabine Ruf
- Department of Orthodontics, Justus-Liebig-University Giessen, Schlangenzahl 14, 35392, Giessen, Germany
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Azami N, Chen PJ, Mehta S, Kalajzic Z, Dutra EH, Nanda R, Yadav S. Raloxifene administration enhances retention in an orthodontic relapse model. Eur J Orthod 2020; 42:371-377. [PMID: 32065225 PMCID: PMC7485273 DOI: 10.1093/ejo/cjaa008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Orthodontic relapse is a physiologic process that involves remodelling of the alveolar bone and principle periodontal ligament fibres. Raloxifene is an Food and Drug Administration (FDA)-approved selective oestrogen receptor modulator that inhibits systemic bone loss. In our study, we examined the effects of Raloxifene on alveolar bone modelling and orthodontic relapse in a rodent model. MATERIALS AND METHODS The efficacy of raloxifene was evaluated in 15-week-old male Wistar rats, 8 in each group (Control, Raloxifene, Raloxifene + 7-day relapse, Raloxifene + 14-day relapse) for a total of 42 days. All animals had 14 days of orthodontic tooth movement with a closed nickel-titanium coil spring tied from incisors to right first molar applying 5-8 gm of force. On the day of appliance removal, impression was taken with silicon material and the distance between first molar and second molar was filled with light-cured adhesive resin cement for retention phase. Raloxifene Retention, Raloxifene Retention + 7D, Raloxifene Retention + 14D groups received 14 daily doses of raloxifene (2.0 mg/kg/day) subcutaneously after orthodontic tooth movement during retention. After 14 days of retention, the retainer was removed and right first molar was allowed to relapse for a period of 14 days. Raloxifene injection continued for the Raloxifene + 14-day relapse group during relapse phase too. Control group received saline injections during retention. Animals were euthanized by CO2 inhalation. The outcome measure included percentage of relapse, bone volume fraction, tissue density, and histology analysis using tartrate-resistant acid phosphatase staining and determining receptor activator of nuclear factor-кB-ligand (RANKL) and osteoprotegerin expression. RESULTS Raloxifene Retention + 14D group had significantly less (P < 0.05) orthodontic relapse when compared with other groups. There was a significant increase (P < 0.05) in bone volume fraction and tissue density in the Raloxifene Retention + 14D group when compared with other groups. Similarly, there was significant decrease in number of osteoclasts and RANKL expression in Raloxifene Retention + 14D group when compared with Raloxifene Retention + 7D group (P < 0.05). CONCLUSION Raloxifene could decrease post-orthodontic treatment relapse by decreasing bone resorption and indirectly enhancing bone formation.
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Affiliation(s)
- Niloufar Azami
- Division of Orthodontics, UConn Health, Farmington, CT, USA
| | - Po-Jung Chen
- Division of Orthodontics, UConn Health, Farmington, CT, USA
| | - Shivam Mehta
- Division of Orthodontics, UConn Health, Farmington, CT, USA
| | - Zana Kalajzic
- Department of Oral Health and Diagnostic Sciences, Division of Oral and Maxillofacial Radiology, UConn Health, Farmington, CT, USA
| | - Eliane H Dutra
- Division of Orthodontics, UConn Health, Farmington, CT, USA
| | - Ravindra Nanda
- Division of Orthodontics, UConn Health, Farmington, CT, USA
| | - Sumit Yadav
- Division of Orthodontics, UConn Health, Farmington, CT, USA
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Booij JW, Kuijpers-Jagtman AM, Bronkhorst EM, Livas C, Ren Y, Kuijpers MAR, Katsaros C. Class II Division 1 malocclusion treatment with extraction of maxillary first molars: Evaluation of treatment and post-treatment changes by the PAR Index. Orthod Craniofac Res 2020; 24:102-110. [PMID: 32725964 PMCID: PMC7891627 DOI: 10.1111/ocr.12412] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/12/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate occlusal result and post-treatment changes after orthodontic extraction of maxillary first permanent molars in patients with a Class II division 1 malocclusion. SETTING AND SAMPLE Retrospective longitudinal study in a private practice, with outcome evaluation by an independent academic hospital. Ninety-six patients (53 males, 43 females) consecutively treated by one orthodontist with maxillary first permanent molar extraction were studied, divided into three facial types, based on pre-treatment cephalometric values: hypodivergent (n = 18), normodivergent (n = 21) and hyperdivergent (n = 57). METHODS Occlusal outcome was scored on dental casts at T1 (pre-treatment), T2 (post-treatment) and T3 (mean follow-up 2.5 ± 0.9 years) using the weighted Peer Assessment Rating (PAR) Index. The paired sample t test and one-way ANOVA followed by Tukey's post hoc test were used for statistical analysis. RESULTS PAR was reduced by 95.7% and 89.9% at T2 and T3, respectively, compared with the start of treatment. The largest post-treatment changes were found for overjet and buccal occlusion. Linear regression analysis did not reveal a clear effect (R-Square 0.074) of age, sex, PAR score at T1, incremental PAR score T2-T1, overjet and overbite at T1, and facial type on the changes after treatment (incremental PAR score T3-T2). CONCLUSIONS The occlusal outcome achieved after Class II division 1 treatment with maxillary first permanent molar extractions was maintained to a large extent over a mean post-treatment follow-up of 2.5 years. Limited changes after treatment were found, for which no risk factors could be discerned.
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Affiliation(s)
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, Groningen, The Netherlands.,Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Bern, Switzerland.,Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Ewald M Bronkhorst
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Yijin Ren
- Department of Orthodontics, University Medical Center Groningen, Groningen, The Netherlands.,Department of Orthodontics and W.J. Kolff Institute for Biomedical Engineering and Materials Science, University Medical Center Groningen, Groningen, The Netherlands
| | - Mette A R Kuijpers
- Department of Dentistry - Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Bern, Switzerland
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Vodolatsky VM, Makatov RS. Retention period in pediatric patients with vertical dislocation of the dentition. Pediatr Dent 2020. [DOI: 10.33925/1683-3031-2020-20-1-49-53] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Relevance. An open bite in children and adolescents makes up about 2-3% of all dentoalveolar disorders and is one of the most difficult pathological bites to treat. Aesthetic changes in children with vertical dislocation of the dentition are complicated by impaired functions of chewing, breathing and speech formation. The treatment of this pathology is complicated by an extensive list of etiological factors affecting the development of this pathology of the dentition. In most cases, after a successful hardware correction of an open bite, the pathology appears again after the completion of the active phase of orthodontic treatment.Purpose. To analyze the retention period in children and adolescents with vertical disocclusion of the dentition. Materials and methods. In order to analyze the retention period in children and adolescents with vertical disocclusion of the dentition, 17 children aged 5 to 15 years were taken for orthodontic treatment. Six of them showed vertical disocclusion (mild, 1 degree) of the dentition. 7 children and adolescents had vertical disocclusion of moderate severity. 4 patients aged 13-15 years had an open bite of a severe form. All patients underwent orthodontic treatment using removable and non-removable orthodontic appliances.Results. During the retention period in all patients of different groups specially made for this purpose were used demountable and non- removable devices , such as the Hawley device, medical devices in the inactivated state, non- removable wire retainers, single- jawed retention Kappa, retainers of their own design. ign. Examination of patients 6 and 12 months after the beginning of the retention period showed stability of the achieved therapeutic result in patients aged 5-12 years , and in patients of the older age group, the retention period was extended to 18-24 months due to the need to adapt bone structures.Conclusions. The analysis of the retention period of pediatric patients with vertical disocclusion of the dentition revealed a number of significant temporal differences. The average retention period in patients with open bite from the age of 5-12 years was 8-12 months. Its duration in patients aged 13-15 years was 15-24 months.
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Moda LB, da Silva Barros ALC, Fagundes NCF, Normando D, Maia LC, dos Anjos Mendes SM. Lower fixed retainers: bonded on all teeth or only on canines? A systematic review. Angle Orthod 2020; 90:125-143. [PMID: 31536378 PMCID: PMC8087051 DOI: 10.2319/013019-63.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 07/01/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the stability after orthodontic treatment between two types of lower fixed retainers: those bonded onto all anterior teeth or those bonded only onto the canines. MATERIALS AND METHODS The following electronic databases were consulted: PubMed, Scopus, Web of Science, Cochrane Library, Lilacs, OpenGrey, ClinicalTrials, and Google Scholar. No restriction of language or year were applied. After selection of studies, risk-of-bias evaluation and qualitative synthesis of the included studies were performed using The Cochrane Collaboration's tool for randomized studies and the "Risk of Bias in Non-randomized Studies of Interventions" (ROBINS-I) tool for nonrandomized studies, and a summary of the overall strength of evidence was presented using the "Grading of recommendations, assessment, development and evaluation" tool. RESULTS Among the 180 studies retrieved from the searches, five were included in this review. Three of them showed a low risk of bias, while two presented a high risk of bias. With regard to stability, two studies reported better stability for retainers bonded to all six teeth, while the other three showed no difference. The retainer bonded to all teeth presented a higher breakage rate in one study. CONCLUSIONS Stability seems better with lower fixed retainers bonded on all anterior teeth. The breakage rate may not change according to the bonding. However, studies with greater methodological soundness are necessary to reach a more reliable conclusion.
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Trimetsuntorn K, Manosudprasit A, Manosudprasit A, Phaoseree N, Pisek A, Pisek P. Evaluation of Postorthodontic Changes in the Treatment of Cleft Lip and Palate Patients Using the PAR Index. Cleft Palate Craniofac J 2019; 57:29-34. [DOI: 10.1177/1055665619860038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objective: To evaluate dental changes in cleft patients after undergoing orthodontic treatment for at least 2 years. Hypothesis: The dental change would decline significantly after 2 years of completing orthodontic treatment. Design: This is a retrospective study. Patient: Eighteen repaired cleft lip and palate patients from the Faculty of Dentistry, KhonKaen University, Thailand, participated in this study. Mean Outcome Measures: A dental model with before treatment (T0), completed treatment (T1), and retention period (T2) data was analyzed using the peer assessment rating (PAR) index. Result: The results showed that the PAR score improved enormously after treatment; from T0 to T1, it was 34.00 ± 10.01 to 4.67 ± 2.47, and there was a reversion in the retention period. There was statistical significance between T0, T1, and T2, with P values <.001, .005, and <.001 when comparing T0 with T1, T1 with T2, and T0 with T2, respectively. Conclusion: Occlusion in cleft lip and palate patients changed from the time of completing treatment to the final results after the retention period. To sustain satisfactory results, orthodontists should plan carefully for the retention period before performing the treatment.
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Affiliation(s)
- Kunakorn Trimetsuntorn
- Faculty of Dentistry, Orthodontic Department, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Amornrut Manosudprasit
- Faculty of Dentistry, Orthodontic Department, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Aggasit Manosudprasit
- Faculty of Dentistry, Orthodontic Department, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Natthawee Phaoseree
- Faculty of Dentistry, Orthodontic Department, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Araya Pisek
- Faculty of Dentistry, Division of Dental Public Health, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Poonsak Pisek
- Faculty of Dentistry, Orthodontic Department, Department of Preventive Dentistry, Khon Kaen University, Khon Kaen, Thailand
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Kaya Y, Tunca M, Keskin S. Comparison of Two Retention Appliances with Respect to Clinical Effectiveness. Turk J Orthod 2019; 32:72-78. [PMID: 31294409 PMCID: PMC6605886 DOI: 10.5152/turkjorthod.2019.18045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 09/26/2018] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The aim of this study was to compare the clinical effectiveness of Essix and Hawley retainers during the retention period. METHODS A total of 30 subjects whose fixed orthodontic treatment results were evaluated according to the American Board of Orthodontics Phase III Objective Grading system were included in this study. After the removal of orthodontic attachments, the study participants were equally divided into two retention protocols: upper-lower Essix and upper-lower Hawley. The subjects were instructed to wear their retainers full time for 6 months, except during meals, and during nights only for 6 months. The clinical effectiveness of the retainers was evaluated according to the overjet, overbite, maxillary, and mandibular intercanine widths, intermolar widths, arch lengths, irregularity indexes, and lateral cephalometric measurements. All dental model and lateral cephalometric measurements were performed by the same investigator during three periods: pre-treatment, post-treatment, and post-retention. RESULTS The overjet, overbite, maxillary, and mandibular intercanine widths; intermolar widths; and arch lengths and lateral cephalometric measurements were not statistically significantly different between the groups and identified time periods. Although the maxillary and mandibular irregularity indexes increased from the post-treatment to post-retention periods, the difference was not statistically significant. Pre-treatment, post-treatment, and post-retention lateral cephalometric measurements were not statistically significantly different between and within the groups. CONCLUSION According to the results of a repeated-measures analysis of variance with two factors, and although an increase was found in the maxillary and mandibular irregularity indexes, the clinical effectiveness of Essix and Hawley retainers was found to be similar during the retention period.
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Affiliation(s)
- Yeşim Kaya
- Department of Orthodontics, Yüzüncü Yıl University School of Dentistry, Van, Turkey
| | - Murat Tunca
- Department of Orthodontics, Yüzüncü Yıl University School of Dentistry, Van, Turkey
| | - Sıddık Keskin
- Department of Biostatistics, Yüzüncü Yıl University School of Dentistry, Van, Turkey
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Peacock ZS, Lee CC, Troulis MJ, Kaban LB. Long-Term Stability of Condylectomy and Costochondral Graft Reconstruction for Treatment of Idiopathic Condylar Resorption. J Oral Maxillofac Surg 2019; 77:792-802. [DOI: 10.1016/j.joms.2018.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 09/17/2018] [Accepted: 10/07/2018] [Indexed: 10/28/2022]
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Wouters C, Lamberts TA, Kuijpers-Jagtman AM, Renkema AM. Development of a clinical practice guideline for orthodontic retention. Orthod Craniofac Res 2019; 22:69-80. [PMID: 30771260 PMCID: PMC6850190 DOI: 10.1111/ocr.12302] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/31/2019] [Accepted: 02/02/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To develop a clinical practice guideline (CPG) for orthodontic retention (OR). MATERIALS AND METHODS The CPG was developed according to the AGREE II instrument and EBRO (Dutch methodology for evidence-based guideline development). Reporting was done according the RIGHT statement. A Task Force developed clinical questions regarding OR. To answer these questions, a systematic literature search in PubMed and EMBASE was performed. Two independent researchers identified and selected studies, assessed risk of bias using Cochrane RoB tool and rated quality of evidence using GRADE. The Task Force formulated considerations and recommendations after discussing the evidence. The concept CPG was sent for commentary to all relevant stakeholders. RESULT One systematic review-with 15 studies-met the inclusion criteria. In case of low evidence and lack of outcome measures, expert-based considerations were developed. Over four meetings, the Task Force reached consensus on considerations and recommendations, after which the concept CPG was ready for the commentary phase. After processing the comments, the CPG was presented to the Dutch Association of Orthodontists, whereafter authorization followed. LIMITATIONS The paucity of evidence-based studies concerning OR and the reporting of measurable patient outcomes. CONCLUSION This CPG offers practitioner recommendations for best practice regarding OR, may reduce variation between practices and assists with patient aftercare. A carefully chosen retention procedure for individual patients, combined with clear information and communication between orthodontist, dentist and patient will contribute to long-term maintenance of orthodontic treatment results.
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Affiliation(s)
- Cleo Wouters
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Toon A Lamberts
- Knowledge Institute of the Federation of Medical Specialists, Utrecht, The Netherlands
| | - Anne Marie Kuijpers-Jagtman
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne Marie Renkema
- Department of Dentistry, Section of Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, The Netherlands
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Zotti F, Zotti R, Albanese M, Nocini PF, Paganelli C. Implementing post-orthodontic compliance among adolescents wearing removable retainers through Whatsapp: a pilot study. Patient Prefer Adherence 2019; 13:609-615. [PMID: 31118585 PMCID: PMC6498955 DOI: 10.2147/ppa.s200822] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 03/12/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose: To determine whether the use of social media is useful in improving compliance and follow-up attendance among patients wearing retainers after orthodontic treatment. Patients and methods: Sixty post-orthodontic patients (aged 16-19 years), randomized in two groups: follow-up supported by participation in WhatsApp chat group (SG), and Control Group (CG). All patients were scheduled for quarterly check-ups for monitoring of orthodontic stability by measurement of intercanine width at the beginning of the study (t0) and every 4 months t1, t2, t3) for 1 year of observation. Patients in the SG additionally participated in a WhatsApp chat group, where they would send, on a weekly basis, snapshots showing his/her occlusion. Every month, the orthodontist acting as the moderator awarded the best five snapshots by publishing a ranking in the chat. Results: Participants in the SG featured smaller changes from the intercanine widths at baseline (at debonding) compared to the CG patients at all times during 1 year of follow-up. Follow-up attendance was regular in both groups in the first 8 months of follow-up. After that, patient compliance decreased in the CG, with eight patients missing check-up appointments. Conclusion: Engaging adolescent patients directly through WhatsApp activity seems to increase regularity in wearing removable retainers, attendance to follow-up schedule, and yield better long-term outcome in terms of orthodontic stability and compliance.
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Affiliation(s)
- Francesca Zotti
- Department of Surgery, Dentistry, Paediatric and Gynecology, University of Verona, 37134Verona, Italy
- Correspondence: Francesca ZottiDepartment of Surgery, Dentistry, Paediatric and Gynecology, University of Verona, P.Le L.A. Scuro, 10, 37134Verona, ItalyTel +39 045 812 6938Email
| | - Rinaldo Zotti
- Department of Orthodontics, School of Dentistry, University of Brescia, 25100Brescia, Italy
| | - Massimo Albanese
- Department of Surgery, Dentistry, Paediatric and Gynecology, University of Verona, 37134Verona, Italy
| | - Pier Francesco Nocini
- Department of Surgery, Dentistry, Paediatric and Gynecology, University of Verona, 37134Verona, Italy
| | - Corrado Paganelli
- Department of Orthodontics, School of Dentistry, University of Brescia, 25100Brescia, Italy
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Bjering R, Vandevska-Radunovic V. Occlusal changes during a 10-year posttreatment period and the effect of fixed retention on anterior tooth alignment. Am J Orthod Dentofacial Orthop 2018; 154:487-494. [DOI: 10.1016/j.ajodo.2017.12.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 10/28/2022]
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Crory PVM. British Orthodontic Society's initiative on orthodontic retention, A GDP's perspective. Br Dent J 2018; 224:481-486. [PMID: 29622800 DOI: 10.1038/sj.bdj.2018.227] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 11/10/2022]
Abstract
The British Orthodontic Society (BOS) recently published a number of news articles aimed at drawing attention to its 'Hold that Smile' campaign which promotes lifelong retainer wear. The BOS's stated intention is to 'generate a viral #HoldthatSmile campaign in order to build awareness of its message that retainers are for life'. The campaign also seeks to recruit the support of GDPs and DCPs, including nurses, in motivating patients to wear retainers for life. It suggests that orthodontists and GDPs need to work collaboratively and suggests that dentists would need to check patients are taking care of their retainers over the long term. This article discusses a number of aspects of the BOS's initiative on retention including the public campaign, the evidence base, long-term retention care, retrospective support, the impact on consent, considerations for GDPs and record-keeping with suggestions on improving long-term support for patients.
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Affiliation(s)
- P V Mc Crory
- General Dental Practitioner, Cheadle, Stockport, Cheshire SK8 1LN, United Kingdom
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