Retention Protocols and Factors Affecting Retainer Choice among Iraqi Orthodontists

Keeping the teeth in line: Exploring the necessity of bonded retainers in orthodontics: A narrative review

In most recent studies, long-term retention after orthodontic treatment has been hypothesized that may be necessary to maintain the stability of the dentition and avoid post-treatment changes. The bonded fixed retainer is characterized by its clinical effectiveness, patient acceptance, and lack of patient complaints as compared with a removable retainer. An electronic database (such as PubMed, PubMed Central, Web of Science, Science Direct, Cochrane Library, Scopus, and ResearchGate) has been collected using specific keywords. Of the 152 articles, only randomized clinical trials that investigated different types of fixed retainers or compared fixed with removable retainers were illustrated in tables and included in this review. The present review has gone some way towards enhancing our understanding of the bonded fixed retainer, types, material, bonding methods, and how to improve its the success rate, besides the importance of new technology in fixed orthodontic retention.

Blanket or tailored prescription of retainers in orthodontics: a questionnaire-based study

OBJECTIVE

To explore retainer protocols and how they are influenced by orthodontic presentation and the nature of occlusal correction.

MATERIALS AND METHODS

A prepiloted 45-item online questionnaire targeting orthodontists was developed. The questionnaire covered clinical preferences in terms of retainer type, fabrication, and follow-up during retention; the clinical indications for adjunctive surgical procedures; and the use of active designs to mitigate relapse in specific malocclusions.

RESULTS

A total of 206 responses were obtained. The majority of the respondents prescribed maxillary removable and mandibular fixed retainers, with almost half (49.1%) reviewing patients for more than 1 year primarily in person (95.1%). The majority prescribed vacuum-formed (69.6%) 1-mm-thick (44.3%) retainers. Only 37.3% were aware of the type of material used, with polyethylene terephthalate glycol copolymer, followed by polypropylene, being the most common. Hawley retainers were preferred following nonsurgical maxillary expansion and with suboptimal interdigitation. A preference for clear retainers and/or fixed retainers was found in open-bite cases and deep-bite cases. Supracrestal fiberotomy was prescribed commonly (61.1%) for rotations greater than 90°. No retainer was rarely prescribed except after the correction of an anterior crossbite.

CONCLUSIONS

Blanket prescription of orthodontic retention is common, with limited awareness of clear plastic retainer materials. Future trials evaluating the effectiveness of approaches for retainer prescription based on the presenting malocclusion would be timely.

Orthodontic Retainers-A Critical Review

The achievement of aesthetic, functional occlusion should not mark the end of the orthodontic intervention. To prevent relapse, retention needs advance planning, and may vary in duration. This review aims to present and comment on the available means of retention. The ever-popular, passive Hawley-like removable appliances are credible in maintaining the desired occlusion. Modifications are the removable appliance Wrap Around, having the labial archwire extending to the premolars; the translucent retainer, Astics, a unique aesthetic Hawley-type device; and the reinforced removable retainer, which features a metallic grid reinforcing the acrylic base. Vacuum-formed retainers are easy to fabricate and are readily prescribed. By contrast, fixed retainers are made of orthodontic wire and composite resin bonded on the lingual or palatal surfaces of the anterior teeth. Patient-related variables need evaluation to select the appropriate retainer, while patients ought to realize the importance of retention and comply with offered guidance. Overall, the orthodontist is responsible for keeping the patient informed on the properties and the duration of retention, even before starting active orthodontic treatment.

Orthodontic Retainers-A Critical Review

The achievement of aesthetic, functional occlusion should not mark the end of the orthodontic intervention. To prevent relapse, retention needs advance planning, and may vary in duration. This review aims to present and comment on the available means of retention. The ever-popular, passive Hawley-like removable appliances are credible in maintaining the desired occlusion. Modifications are the removable appliance Wrap Around, having the labial archwire extending to the premolars; the translucent retainer, Astics, a unique aesthetic Hawley-type device; and the reinforced removable retainer, which features a metallic grid reinforcing the acrylic base. Vacuum-formed retainers are easy to fabricate and are readily prescribed. By contrast, fixed retainers are made of orthodontic wire and composite resin bonded on the lingual or palatal surfaces of the anterior teeth. Patient-related variables need evaluation to select the appropriate retainer, while patients ought to realize the importance of retention and comply with offered guidance. Overall, the orthodontist is responsible for keeping the patient informed on the properties and the duration of retention, even before starting active orthodontic treatment.

Relapse and inadvertent tooth movement post orthodontic treatment in individuals with fixed retainers: A review

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.

Orthodontic Retention-Protocols and Materials-A Questionnaire Pilot Study among Polish Practitioners

The aim of the study was to analyze retention protocols and materials for fixed retainers used by clinicians providing orthodontic treatment in Poland. The survey was carried out from February to April 2021. The questionnaire was designed using the Google Forms tool. After validation, the questionnaire was delivered to verified active orthodontists gathered in a closed social media group of 615 members. Finally, 104 answers were received. Answers to individual questions were provided in percentages and tabularized. A chi-squared test of proportion was used to compare: the proportion of clinicians using retainers of different characteristics and the proportions of clinicians indicating the superiority of a given clinical solution. Rectangular steel braided wire was rated as most reliable. However, doctors who declared to use gold chain were mostly solely using this type of wire. Multistranded round wire was rated the worst. Fiber-reinforced composite was mainly used in periodontal patients. The protocols used by Polish orthodontic practitioners relied on double long-term retention with regular follow-up. The most popular material was stainless steel braided rectangular wire bonded with a flowable composite. Most clinicians believed they could maintain the treatment results, but they declared that patients’ cooperation was a challenge.