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Bruxism’s Implications on Fixed Orthodontic Retainer Adhesion. Dent J (Basel) 2022; 10:dj10080141. [PMID: 36005239 PMCID: PMC9406861 DOI: 10.3390/dj10080141] [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: 06/28/2022] [Revised: 07/15/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Fixed retainers assist in maintaining the outcomes of orthodontic treatment. Fixed retention may be affected by bruxism. Objective: Evaluate two adhesives (an ormocer and a flowable composite) used for fixed orthodontic retention in simulated bruxism settings, compared to regular mastication, using a dual axis chewing simulator. Methods: Eighty human teeth were used. Periodontal tissues were simulated and exposed to 120,000 mechanical cycles, corresponding to 6 months of clinical service. Each set of two teeth was supplied with a pre-shaped, fixed, multi-braided, stainless steel wire retainer, in 1.5 cm portions, to establish passive contact with the lingual surface of the teeth. The Adhesive Remnant Index (ARI) was used to evaluate the shear bond strength. A stereomicroscope was used to assess the micro-infiltration. Results: There was no significant difference in the mean value of micro-infiltration between adhesives in the mastication group but in the bruxism group. During testing, one composite sample (ARI score 1) was broken in the mastication group, while three ormocer samples (ARI score 2) and one composite sample (ARI score 1) were broken in the bruxism group. Conclusions: The mean value for micro-infiltration in composite (0.31) was more than double that in ormocer (0.13).
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Post-treatment Stability in Orthodontic Retention with Twistflex Retainers-Do Patients Benefit from Additional Removable Retainers? Clin Oral Investig 2022; 26:5215-5222. [PMID: 35474552 PMCID: PMC9381486 DOI: 10.1007/s00784-022-04490-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/12/2022] [Indexed: 11/14/2022]
Abstract
Objectives To evaluate post-treatment movements of lower anterior teeth during orthodontic retention in patients with fixed twistflex retainers versus those with combined fixed and removable retainers. Materials and Methods This study was based on a retrospective data analysis of 57 adult patients during orthodontic retention. They were assigned to two groups: In group 1 (n = 30) the lower jaw was provided with twistflex retainers only and in group 2 (n = 27) with a twistflex combined with a removable retainer for night-time use. Orthodontic study models of the lower jaw were digitalized and superimposed. Tooth movements were analyzed at the retainer bonding (t0) and follow-up appointment ≥ six months later (t1). Rotational tooth movements (°) were measured around the x-axis (mesial/distal direction), the y-axis (buccal/lingual direction) and the z-axis (longitudinal direction, tooth axis). Translational tooth movements (mm) were registered along the x-axis (buccal/lingual direction), the y-axis (mesial/distal direction) and the z-axis (apical/coronal direction). Results Canine and incisor position changes during orthodontic retention were more pronounced in group 1 compared to group 2 except for canine rotations around the z-axis. In both groups in most of the cases stable lower incisor alignment could be found, but the proportion was significant higher in group 2 (group 1: 56.7% vs. group 2: 81.5%). Severe misalignment was present in 13.3% of the participants of group 1 and only in 7.4% of group 2. The extent of canine tipping and movements along the x- and y-axis in severe misalignment cases was significantly lower in group 2 compared to 1. Conclusions Lower incisor alignment was more stable in patients with combined fixed and removable retainers compared to fixed retainers only. Clinical Relevance Based on the present findings, the routinely application of supplementary removable retainers can be recommended to enhance anterior tooth alignment in patients with fixed twistflex retainers.
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Mummolo S, Quinzi V, Nota A, Marino C, Pittari L, Manenti RJ, Tecco S. Metal versus Fiberglass Post-Orthodontic Retainers Short-Term Effects on Plaque Index and Microbial Colonization: An Observational Study. Life (Basel) 2022; 12:life12030331. [PMID: 35330082 PMCID: PMC8948786 DOI: 10.3390/life12030331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 11/16/2022] Open
Abstract
In orthodontics, post-treatment retention phase is crucial for maintaining the obtained clinical results. In cases of crowding, a bonded fixed retainer is often chosen to maintain teeth alignment in the anterior sector of the lower dental arch. A fixed retainer can remain in the mouth for years. Therefore, it is important that it is applied with harmless materials for the level of plaque control. The present study aimed to investigate the salivary concentrations of Streptococcus mutans (S. mutans) and Lactobacilli, and the Sillness and Loe plaque index, in patients wearing metal wire versus fiberglass orthodontic retainers. Forty post-orthodontic patients were included in the sample: in 20 subjects a metal wire retainer was applied (MR), while in the others a fiberglass retainer was applied (FR). The variables were recorded at baseline (T0), after 1 month (T1), and after 2 months (T2) of follow-up. The percentage of patients with a level of S. mutans and Lactobacilli colonization > 105 increased over time in the FR group (T0 = 0%, T1 = 5%, T2 = 35%), compared with the MR group. PI increased in the FR group (T0 = 0, T1 = 14, T2 = 27), and remained almost the same in the MR group (T0 = 3, T1 = 0, T2 = 2). From the present results it appears that the metal wire retainer is better than the fiberglass retainer for the level of plaque control performed by the patients.
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Affiliation(s)
- Stefano Mummolo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.M.); (V.Q.); (C.M.); (R.J.M.)
| | - Vincenzo Quinzi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.M.); (V.Q.); (C.M.); (R.J.M.)
| | - Alessandro Nota
- Dental School, Vita-Salute San Raffaele University and IRCCS, San Raffaele Hospital, 20132 Milan, Italy; (A.N.); (L.P.)
| | - Carla Marino
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.M.); (V.Q.); (C.M.); (R.J.M.)
| | - Laura Pittari
- Dental School, Vita-Salute San Raffaele University and IRCCS, San Raffaele Hospital, 20132 Milan, Italy; (A.N.); (L.P.)
| | - Rebecca Jewel Manenti
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (S.M.); (V.Q.); (C.M.); (R.J.M.)
| | - Simona Tecco
- Dental School, Vita-Salute San Raffaele University and IRCCS, San Raffaele Hospital, 20132 Milan, Italy; (A.N.); (L.P.)
- Correspondence:
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Costa RSMD, Vedovello SAS, Furletti-Góes VF, Custodio W, Venezian GC. Orthodontist and periodontist's knowledge, attitudes and aspects of clinical practice, regarding fixed lower orthodontic retainers. Dental Press J Orthod 2021; 26:e2119276. [PMID: 34468561 PMCID: PMC8405138 DOI: 10.1590/2177-6709.26.4.e2119276.oar] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 04/23/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE This study aimed to assess the knowledge, attitudes, and aspects of the clinical practice of orthodontists and periodontists, regarding lower fixed orthodontic retainers. METHODS The orthodontists (n=502) and periodontists (n=269) who participated in this cross-sectional observational study received, via e-mail, questions related to the type of lower fixed retainer, dental biofilm accumulation, oral hygiene, and potential periodontal changes. The data were subjected to chi-square and Fisher's exact tests, at 5% significance level. RESULTS Both orthodontists (72.3%) and periodontists (58.7%) reported that hygienic retainers accumulate more dental biofilm (p< 0.05), and 64.1% of orthodontists and 58.7% of periodontists considered that modified retainers may lead to periodontal changes (p< 0.05). There was no significant difference between the dental specialties, regarding the type of lower fixed retainer considered the easiest for the patient to perform hygiene (p> 0.05), whereas 48.6% of professionals chose the modified type. CONCLUSION The modified retainer accumulates a greater amount of dental biofilm and, in the perception of orthodontists and periodontists, it may cause periodontal changes.
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Affiliation(s)
- Ruth Suzanne Maximo da Costa
- Centro Universitário da Fundação Hermínio Ometto, Faculdade de Odontologia, Departamento de Ortodontia (Araras/SP, Brasil)
| | | | - Vivian Fernandes Furletti-Góes
- Centro Universitário da Fundação Hermínio Ometto, Faculdade de Odontologia, Departamento de Ortodontia (Araras/SP, Brasil)
| | - William Custodio
- Centro Universitário da Fundação Hermínio Ometto, Faculdade de Odontologia, Departamento de Ortodontia (Araras/SP, Brasil)
| | - Giovana Cherubini Venezian
- Centro Universitário da Fundação Hermínio Ometto, Faculdade de Odontologia, Departamento de Ortodontia (Araras/SP, Brasil)
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Han JY, Park SH, Kim J, Hwang KG, Park CJ. Clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients: a retrospective study. J Periodontal Implant Sci 2021; 51:163-178. [PMID: 34114380 PMCID: PMC8200384 DOI: 10.5051/jpis.2003140157] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 01/15/2021] [Accepted: 03/22/2021] [Indexed: 02/02/2023] Open
Abstract
PURPOSE The aim of this study was to evaluate clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients. METHODS In total, 52 patients with at least 2 years of follow-up after periodontal and orthodontic treatment were included in this study. After scaling and root planing, orthodontic treatment with fixed appliances or clear aligners was performed. Fixed retainers with twist-flex stainless steel wires were bonded to the palatal or lingual sides of anterior teeth. Changes in clinical parameters, including the plaque index, gingival index, calculus index (CI), probing pocket depth, and radiographic bone levels, were evaluated before bonding of fixed retainers and at a 12-month follow-up. Cumulative survival rates (CSRs) for retainer failure were evaluated according to sex, site, CI, stage of periodontitis, and the severity of the irregularity with the log-rank test and hazard ratios (HRs). RESULTS Twelve months after bonding of fixed retainers, improvements were observed in all clinical parameters except CI and radiographic bone gain. The overall CSR of the retainers with a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of the retainers with a CI ≥1 at the 12-month follow-up (log-rank test; P<0.001). Patients with stage III (grade B or C) periodontitis had a higher multivariate HR for retainer failure (5.4; 95% confidence interval, 1.22-23.91; P=0.026) than patients with stage I (grade A or B) periodontitis. CONCLUSIONS Although fixed retainers were bonded in periodontitis patients, periodontal health was well maintained if supportive periodontal treatment with repeated oral hygiene education was provided. Nonetheless, fixed retainer failure occurred more frequently in patients who had stage III (grade B or C) periodontitis or a CI ≥1 at 12-month follow-up after bonding of fixed retainers.
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Affiliation(s)
- Ji Young Han
- Division of Periodontology, Department of Dentistry, Hanyang University College of Medicine, Seoul, Korea
| | - Seo Hee Park
- Division of Periodontology, Department of Dentistry, Hanyang University Medical Center, Seoul, Korea
| | - Joohyung Kim
- Division of Orthodontics, Department of Dentistry, Hanyang University Medical Center, Seoul, Korea
| | - Kyung Gyun Hwang
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, Hanyang University College of Medicine, Seoul, Korea
| | - Chang Joo Park
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, Hanyang University College of Medicine, Seoul, Korea.
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Knaup I, Bartz JR, Schulze-Späte U, Craveiro RB, Kirschneck C, Wolf M. Side effects of twistflex retainers-3D evaluation of tooth movement after retainer debonding. J Orofac Orthop 2020; 82:121-130. [PMID: 33258981 DOI: 10.1007/s00056-020-00265-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 08/16/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Evaluation of tooth movement after retainer debonding in retainer-associated misalignment cases. METHODS This pilot study is based on a retrospective data analysis. Adult patients (age 25.5 ± 4.9 years) wearing fixed twistflex retainers and having visible retainer-associated misalignment were included and examined for tooth movement after retainer debonding. Orthodontic study models were taken at retainer debonding (t0) and 14 (±1) weeks later (t1). They were digitally superimposed using 2D/3D dental imaging software and tooth movement was analyzed in all three dimensions. RESULTS A total of 23 teeth (12 upper teeth: 10 incisors, 2 canines; 11 lower teeth: 7 incisors, 4 canines) were analyzed. Mean overall tipping was 1.11 ± 0.82° in the mesial/distal direction (angulation, x‑axis), 2.02 ± 1.9° in the buccal/lingual direction (inclination, y‑axis) and 1.28 ± 0.99° around the tooth axis (z-axis). Mean overall bodily movement was 0.30 ± 0.31 mm in the mesial/distal direction (angulation, x‑axis), 0.10 ± 0.13 mm in the buccal/lingual direction (inclination, y‑axis), and mean in- or extrusion 0.22 ± 0.24 mm (z-axis). Mean tipping and bodily movement were more pronounced in the upper jaw. CONCLUSION The present data shows that tooth movement after debonding of twistflex retainers can be expected in misalignment cases.
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Affiliation(s)
- Isabel Knaup
- Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany.
| | - Jenny Rosa Bartz
- Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany
| | - Ulrike Schulze-Späte
- Section of Geriodontics, Department of Conservative Dentistry and Periodontology, Jena University Hospital, Jena, Germany
| | | | | | - Michael Wolf
- Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany
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Talic NF. Failure Rates of Orthodontic Fixed Lingual Retainers bonded with Two Flowable Light-cured Adhesives: A Comparative Prospective Clinical Trial. J Contemp Dent Pract 2016; 17:630-4. [PMID: 27659078 DOI: 10.5005/jp-journals-10024-1902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION This comparative prospective randomized clinical trial examined the in vivo failure rates of fixed mandibular and maxillary lingual retainers bonded with two light-cured flowable composites over 6 months. MATERIALS AND METHODS Consecutive patients were divided into two groups on a 1:1 basis. Two hundred fixed lingual retainers were included, and their failures were followed for 6 months. One group (n = 50) received retainers bonded with a nano-hybrid composite based on nano-optimized technology (Tetric-N-Flow, Ivoclar Vivadent). Another group (n = 50) received retainers bonded with a low viscosity (LV) composite (Transbond Supreme LV, 3M Unitek). RESULTS There was no significant difference between the overall failure rates of mandibular retainers bonded with Transbond (8%) and those bonded with Tetric-N-Flow (18%). However, the odds ratio for failure using Tetric-N-flow was 2.52-fold greater than that of Transbond. The failure rate of maxillary retainers bonded with Transbond was higher (14%), but not significantly different, than that of maxillary retainers bonded with Tetric-N-flow (10%). There was no significant difference in the estimated mean survival times of the maxillary and mandibular retainers bonded with the two composites. CONCLUSION Both types of composites tested in the current study can be used to bond fixed maxillary and mandibular lingual retainers, with low failure rates.
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Affiliation(s)
- Nabeel F Talic
- Associate Professor and Consultant, Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia, e-mail:
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