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Jasim ES, Kadhum AS, Hasan I. Keeping the teeth in line: Exploring the necessity of bonded retainers in orthodontics: A narrative review. J Orthod Sci 2024; 13:20. [PMID: 38784083 PMCID: PMC11114454 DOI: 10.4103/jos.jos_159_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/15/2024] [Accepted: 01/28/2024] [Indexed: 05/25/2024] Open
Abstract
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.
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Affiliation(s)
- Esraa S. Jasim
- Department of Orthodontic, College of Dentistry, University of Baghdad, Iraq
| | - Ammar S. Kadhum
- Department of Orthodontic, College of Dentistry, University of Baghdad, Iraq
| | - Istabrak Hasan
- Department of Prosthetic Dentistry, Preclinical Education and Materials Science, Dental School, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany
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Martin C, Littlewood SJ, Millett DT, Doubleday B, Bearn D, Worthington HV, Limones A. Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database Syst Rev 2023; 5:CD002283. [PMID: 37219527 PMCID: PMC10202160 DOI: 10.1002/14651858.cd002283.pub5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
BACKGROUND Without a phase of retention after successful orthodontic treatment, teeth tend to 'relapse', that is, to return to their initial position. Retention is achieved by fitting fixed or removable retainers to provide stability to the teeth while avoiding damage to teeth and gums. Removable retainers can be worn full- or part-time. Retainers vary in shape, material, and the way they are made. Adjunctive procedures are sometimes used to try to improve retention, for example, reshaping teeth where they contact ('interproximal reduction'), or cutting fibres around teeth ('percision'). This review is an update of one originally published in 2004 and last updated in 2016. OBJECTIVES To evaluate the effects of different retainers and retention strategies used to stabilise tooth position after orthodontic braces. SEARCH METHODS An information specialist searched Cochrane Oral Health Trials Register, CENTRAL, MEDLINE, Embase and OpenGrey up to 27 April 2022 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA: Randomised controlled trials (RCTs) involving children and adults who had retainers fitted or adjunctive procedures undertaken to prevent relapse following orthodontic treatment with braces. We excluded studies with aligners. DATA COLLECTION AND ANALYSIS Two review authors independently screened eligible studies, assessed risk of bias and extracted data. Outcomes were stability or relapse of tooth position, retainer failure (i.e. broken, detached, worn out, ill-fitting or lost), adverse effects on teeth and gums (i.e. plaque, gingival and bleeding indices), and participant satisfaction. We calculated mean differences (MD) for continuous data, risk ratios (RR) or risk differences (RD) for dichotomous data, and hazard ratios (HR) for survival data, all with 95% confidence intervals (CI). We conducted meta-analyses when similar studies reported outcomes at the same time point; otherwise results were reported as mean ranges. We prioritised reporting of Little's Irregularity Index (crookedness of anterior teeth) to measure relapse, judging the minimum important difference to be 1 mm. MAIN RESULTS We included 47 studies, with 4377 participants. The studies evaluated: removable versus fixed retainers (8 studies); different types of fixed retainers (22 studies) or bonding materials (3 studies); and different types of removable retainers (16 studies). Four studies evaluated more than one comparison. We judged 28 studies to have high risk of bias, 11 to have low risk, and eight studies as unclear. We focused on 12-month follow-up. The evidence is low or very low certainty. Most comparisons and outcomes were evaluated in only one study at high risk of bias, and most studies measured outcomes after less than a year. Removable versus fixed retainers Removable (part-time) versus fixed One study reported that participants wearing clear plastic retainers part-time in the lower arch had more relapse than participants with multistrand fixed retainers, but the amount was not clinically significant (Little's Irregularity Index (LII) MD 0.92 mm, 95% CI 0.23 to 1.61; 56 participants). Removable retainers were more likely to cause discomfort (RR 12.22; 95% CI 1.69 to 88.52; 57 participants), but were associated with less retainer failure (RR 0.44, 95% CI 0.20 to 0.98; 57 participants) and better periodontal health (Gingival Index (GI) MD -0.34, 95% CI -0.66 to -0.02; 59 participants). Removable (full-time) versus fixed One study reported that removable clear plastic retainers worn full-time in the lower arch did not provide any clinically significant benefit for tooth stability over fixed retainers (LII MD 0.60 mm, 95% CI 0.17 to 1.03; 84 participants). Participants with clear plastic retainers had better periodontal health (gingival bleeding RR 0.53, 95% CI 0.31 to 0.88; 84 participants), but higher risk of retainer failure (RR 3.42, 95% CI 1.38 to 8.47; 77 participants). The study found no difference between retainers for caries. Different types of fixed retainers Computer-aided design/computer-aided manufacturing (CAD/CAM) nitinol versus conventional/analogue multistrand One study reported that CAD/CAM nitinol fixed retainers were better for tooth stability, but the difference was not clinically significant (LII MD -0.46 mm, 95% CI -0.72 to -0.21; 66 participants). There was no evidence of a difference between retainers for periodontal health (GI MD 0.00, 95% CI -0.16 to 0.16; 2 studies, 107 participants), or retainer survival (RR 1.29, 95% CI 0.67 to 2.49; 1 study, 41 participants). Fibre-reinforced composite versus conventional multistrand/spiral wire One study reported that fibre-reinforced composite fixed retainers provided better stability than multistrand retainers, but this was not of a clinically significant amount (LII MD -0.70 mm, 95% CI -1.17 to -0.23; 52 participants). The fibre-reinforced retainers had better patient satisfaction with aesthetics (MD 1.49 cm on a visual analogue scale, 95% CI 0.76 to 2.22; 1 study, 32 participants), and similar retainer survival rates (RR 1.01, 95% CI 0.84 to 1.21; 7 studies; 1337 participants) at 12 months. However, failures occurred earlier (MD -1.48 months, 95% CI -1.88 to -1.08; 2 studies, 103 participants; 24-month follow-up) and more gingival inflammation at six months, though bleeding on probing (BoP) was similar (GI MD 0.59, 95% CI 0.13 to 1.05; BoP MD 0.33, 95% CI -0.13 to 0.79; 1 study, 40 participants). Different types of removable retainers Clear plastic versus Hawley When worn in the lower arch for six months full-time and six months part-time, clear plastic provided similar stability to Hawley retainers (LII MD 0.01 mm, 95% CI -0.65 to 0.67; 1 study, 30 participants). Hawley retainers had lower risk of failure (RR 0.60, 95% CI 0.43 to 0.83; 1 study, 111 participants), but were less comfortable at six months (VAS MD -1.86 cm, 95% CI -2.19 to -1.53; 1 study, 86 participants). Part-time versus full-time wear of Hawley There was no evidence of a difference in stability between part-time and full-time use of Hawley retainers (MD 0.20 mm, 95% CI -0.28 to 0.68; 1 study, 52 participants). AUTHORS' CONCLUSIONS The evidence is low to very low certainty, so we cannot draw firm conclusions about any one approach to retention over another. More high-quality studies are needed that measure tooth stability over at least two years, and measure how long retainers last, patient satisfaction and negative side effects from wearing retainers, such as tooth decay and gum disease.
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Affiliation(s)
- Conchita Martin
- Orthodontic Department, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | | | - Declan T Millett
- Oral Health and Development, Cork University Dental School and Hospital, Cork, Ireland
| | | | - David Bearn
- School of Dentistry, University of Dundee, Dundee, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Alvaro Limones
- Faculty of Dentistry, Complutense Univesity of Madrid, Madrid, Spain
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Liu S, Silikas N, Ei-Angbawi A. Analysis of the effectiveness of the fiber-reinforced composite lingual retainer: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2022; 162:601-615.e2. [PMID: 36031511 DOI: 10.1016/j.ajodo.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Orthodontic fixed retainers are preferred as they depend less on patient compliance. Recently, researchers tried to use fiber-reinforced composite (FRC) to replace the multistranded stainless-steel wire (MSW) of the fixed retainers to enhance the mechanical properties and esthetics. This systematic review aimed to analyze the effectiveness of the FRC retainers. METHODS We searched the electronic databases (May 1, 2021), including Medline, the Cochrane Library, EMBASE, PubMed, Web of Science, and CINAHL. We applied no language or date restrictions in the searches of the databases. Only randomized controlled trials (RCTs) and prospective clinical controlled trials were included. The revised Cochrane risk of bias tool for randomized trials and risk of bias in nonrandomized studies of interventions were used to evaluate the risk of bias in RCTs and non-RCTs, respectively. The outcomes were pooled using Review Manager 5.4. The primary outcome of this review was teeth relapse, and the secondary outcomes were bonded retainer failure rate, adverse effect on oral health, and patient's satisfaction. RESULTS Eleven out of 99 studies, which included 873 participants, were used in this review, with the follow-up ranging from 6 months to 6 years. Ten studies compared the FRC retainers with MSW retainers, and 1 study compared FRC retainers with a different fiber material. Ten studies were RCT, and 1 was non-RCT. There was 0.39 less relapse with the FRC retainers than with MSW retainers (mean difference, -0.39; 95% confidence interval [CI], -0.41 to -0.37; P <0.00001). There was no statistically significant difference in the failure rate between the FRC and MSW with the whole retainer as an outcome unit risk ratio of 1.72 (95% CI, 0.57-5.14; P = 0.33) or with the teeth an as outcome unit risk ratio of 0.85 (95% CI, 0.47-1.52; P = 0.58). There was insufficient evidence to conduct the meta-analysis of the adverse effect on oral health and patient satisfaction. CONCLUSIONS Low-quality evidence is available to suggest that the effectiveness of the FRC is comparable to the MSW with no significant difference in the failure rate. However, we have very low certainty on these results. It is worth conducting future robust clinical studies to assess the effectiveness of FRC retainers with long follow-up.
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Affiliation(s)
- Shiyao Liu
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Nikolaos Silikas
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
| | - Ahmed Ei-Angbawi
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, United Kingdom.
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Jedliński M, Grocholewicz K, Mazur M, Janiszewska-Olszowska J. What causes failure of fixed orthodontic retention? - systematic review and meta-analysis of clinical studies. Head Face Med 2021; 17:32. [PMID: 34301280 PMCID: PMC8306281 DOI: 10.1186/s13005-021-00281-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/05/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual features, thus retention should be adjusted in the most optimal way. Bonding a retainer makes retention less dependent on patient's compliance. QUESTIONS ARISE What wire or fiber splint type provides the best treatment stability? What materials should be used to bond the wire or fiber splint? Should be the bonding procedure be direct or indirect? The aim of the study is to assess and synthesize available controlled trials investigating failures of fixed retainers. METHODS Literature searches of free text and MeSH terms were performed in Scopus, Web of Science, Embase and PubMed Central in order to find studies, referring to failures of fixed retention (12th February 2021). The keywords were: ("orthodontic retainers AND failure AND wire"). The framework of this systematic review according to PICO was: Population: orthodontic patients; Intervention: fixed orthodontic retainer bonding; Comparison: Different protocols of fixed orthodontic retention applied; Outcomes: failure rate, survival rate. Three different specific scales from the Cochrane Collaboration Handbook were used, according to each study type. Additionally, a meta-analysis was conducted to compare the effectiveness of retention using fiber reinforced composite and multistranded steel wire. RESULTS The search identified 177 potential articles: 114 from PubMed, 41 from Scopus, 20 from Web of Science and 2 from Embase. After excluding studies inconsistent with selection criteria, 21 studies were included and subjected to qualitative analysis. The main outcome investigated was failure rate. This systematic review has some potential limitations due to the heterogeneity of design between included studies. CONCLUSIONS No retainer is proved to guarantee a perfect stability of dental alignment. The retainer should be bonded to all adherent teeth, preferably with additional use of bonding resin. No wire or fiber splint present superior characteristics concerning failure rate. Fiber reinforced composite retention is more sensitive to operator skills, and with imperfect bonding technique, failure rate is much higher. During the first 6 months after bonding retainer the patient should be under frequent control. The study protocol was registered in PROSPERO database with the number CRD42021233406.
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Affiliation(s)
- Maciej Jedliński
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Katarzyna Grocholewicz
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Marta Mazur
- Department of Dental and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
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Orthodontic retention protocols: an evidence-based overview. Br Dent J 2021; 230:770-776. [PMID: 34117437 DOI: 10.1038/s41415-021-2954-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 01/06/2021] [Indexed: 12/15/2022]
Abstract
In view of the diversity of orthodontic presentations, a single optimal retention protocol does not exist, with approaches tailored based on pre-treatment characteristics, treatment-induced changes and general patient characteristics. However, orthodontic practitioners should be responsive to the best available evidence to formulate optimal retention protocols in terms of appliance type, design and regimen, in particular. Based on a comprehensive search strategy, we discuss fundamental aspects concerning orthodontic retention of particular interest both to orthodontists and general dentists. These include stability and periodontal outcomes, cost-effectiveness, patient experiences, survival and failure rates of retainers, and the duration of retention.
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Fixed retention: pitfalls and complications. Br Dent J 2021; 230:703-708. [PMID: 34117424 DOI: 10.1038/s41415-021-2892-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/08/2020] [Indexed: 11/08/2022]
Abstract
Long-term stability of orthodontic treatment results is problematic. Long-term or even lifelong retention with bonded retainers is being increasingly used among clinicians. Bonded retainers can provide an efficient and attractive method of retention, particularly because they require minimal compliance from patients. However, the use of bonded retainers is associated with relatively frequent complications, such as detachments of the adhesive layer or wire fractures, as well as unexpected complications with potentially severe consequences with associated periodontal and general health risks. It is imperative that the whole dental team are aware of these pitfalls and complications, and appreciate how to minimise and address these.
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Ohtonen J, Lassila L, Säilynoja E, Vallittu PK. The Effect of Material Type and Location of an Orthodontic Retainer in Resisting Axial or Buccal Forces. MATERIALS 2021; 14:ma14092319. [PMID: 33947055 PMCID: PMC8125435 DOI: 10.3390/ma14092319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 12/05/2022]
Abstract
The purpose of this study was to investigate the effect of retainer material and retainer position on a tooth to resist movement of the tooth in a simulation model. Bidirectional continuous glass fiber-reinforced composite (FRC) retainers and control retainers of steel wires were tested. The FRC retainers had a polymer matrix of bisphenol-A-glycidyldimethacrylate (bis-GMA) and poly(methylmethacrylate) (PMMA), and it was cured with a photoinitiator system. The retainers were adhered to a lower jaw Frasaco model in two different positions. Resistance against the movement of one tooth was measured from two directions. The average load values within the FRC retainer groups were higher than within the metal retainer groups. The load values for the groups loaded from the axial direction were higher than those loaded from the buccal direction. FRC retainers, which were located 1–2 mm from the incisal edge, showed higher load values than those located 4–5 mm from the incisal edge. There was a significant difference in load values between FRC retainers and metal retainers (p < 0.01). The wire position and the direction of force also had significant effects (p < 0.01). There were no significant differences between metal retainer groups. The results of this study suggest that metal retainers are more flexible, allowing for tooth movements of larger magnitude than with FRC retainers.
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Affiliation(s)
- Jaana Ohtonen
- BioCity Turku Biomaterials and Medical Device Research Program, Department of Biomaterials Science, Institute of Dentistry, University of Turku, 20520 Turku, Finland; (L.L.); (P.K.V.)
- City of Kotka Municipal Health Centre, 48600 Kotka, Finland
- Correspondence:
| | - Lippo Lassila
- BioCity Turku Biomaterials and Medical Device Research Program, Department of Biomaterials Science, Institute of Dentistry, University of Turku, 20520 Turku, Finland; (L.L.); (P.K.V.)
- Turku Clinical Biomaterials Centre—TCBC, Institute of Dentistry, University of Turku, 20520 Turku, Finland
| | - Eija Säilynoja
- Turku Clinical Biomaterials Centre—TCBC, Institute of Dentistry, University of Turku, 20520 Turku, Finland
- GC Group, Stick Tech Ltd., 20520 Turku, Finland;
| | - Pekka K. Vallittu
- BioCity Turku Biomaterials and Medical Device Research Program, Department of Biomaterials Science, Institute of Dentistry, University of Turku, 20520 Turku, Finland; (L.L.); (P.K.V.)
- Turku Clinical Biomaterials Centre—TCBC, Institute of Dentistry, University of Turku, 20520 Turku, Finland
- City of Turku Welfare Division, 20520 Turku, Finland
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Nagani NI, Ahmed I, Tanveer F, Khursheed HM, Farooqui WA. "Clinical comparison of bond failure rate between two types of mandibular canine-canine bonded orthodontic retainers- a randomized clinical trial". BMC Oral Health 2020; 20:180. [PMID: 32600325 PMCID: PMC7325010 DOI: 10.1186/s12903-020-01167-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 06/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bonded retainers are widely used as they are esthetically pleasing, easily acceptable, provide greater stability, compliance free and causes no soft tissue irritation and speech problems. Though, fracture and bond failure are their shortcomings. Therefore, the objectives of this study were to evaluate the number of bond failures and type of failure pattern between two types of mandibular canine-canine bonded retainers. METHODS Total 60 subjects were recruited initially and were assessed for eligibility, out of which 6 were excluded and 2 were lost to follow up. They were randomly divided into two groups. Fiber reinforced composite (FRC) retainers were inserted in group 1 subjects while group 2 subjects received multistranded stainless steel (MSW) retainers. The subjects were recalled after every 3 months over a period of 1 year. Bond failure rate and failure pattern based on adhesive remnant index were evaluated at each visit. The bond failure rate and failure pattern were compared between the two retainers by using Chi-square test. RESULTS The bond failure rates were 42.94% for FRC retainer and 31.41% for MSW retainer. Hence, total number of bond failures in both retainers were 37.17%. The difference of bond failure between two groups was statistically significant (p = 0.012). Type "0" failure pattern was detected commonly with both types of retainers (p < 0.001). CONCLUSION Our findings indicate that multistranded stainless steel wire retainer is a superior option to be used for fixed lingual retention in mandibular arch as it exhibited lower bond failure as compared to fiber reinforced composite retainer. Adhesive failure is the most common type of bond failure observed with both types of fixed retainers. TRIAL REGISTRATION ID NCT03881813 ( https://clinicaltrials.gov/ ); March 19, 2019, retrospective registration.
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Affiliation(s)
- Nasreen Iqbal Nagani
- Department Of Orthodontics, Dr. Ishrat-Ul-Ebad Khan Institute Of Oral Health Sciences (DIKIOHS), Dow University Of Health Sciences, Karachi, Pakistan. .,Present Address: Adam Plaza, flat no 103, opp: New Town Masjid, Gurumandir, Karachi, Pakistan.
| | - Imtiaz Ahmed
- Department Of Orthodontics, Dr. Ishrat-Ul-Ebad Khan Institute Of Oral Health Sciences (DIKIOHS), Dow University Of Health Sciences, Karachi, Pakistan
| | - Faiqa Tanveer
- Department Of Orthodontics, Dr. Ishrat-Ul-Ebad Khan Institute Of Oral Health Sciences (DIKIOHS), Dow University Of Health Sciences, Karachi, Pakistan
| | - Hafiza Marium Khursheed
- Department Of Orthodontics, Dr. Ishrat-Ul-Ebad Khan Institute Of Oral Health Sciences (DIKIOHS), Dow University Of Health Sciences, Karachi, Pakistan
| | - Waqas Ahmed Farooqui
- Department of Research, School of Public Health, Dow University Of Health Sciences Karachi, Karachi, Pakistan
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Arash V, Teimoorian M, Farajzadeh Jalali Y, Sheikhzadeh S. Clinical comparison between Multi-Stranded Wires and Single strand Ribbon wires used for lingual fixed retainers. Prog Orthod 2020; 21:22. [PMID: 32596755 PMCID: PMC7321843 DOI: 10.1186/s40510-020-00315-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 04/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Long-term retention with fixed retainers with a high success rate seems to be a reasonable solution to minimize or prohibit relapse of orthodontic treatment. METHODS Two hundred sixty patients between 13 and 30 years old were recruited for this study. The 0.0175 stainless steel twisted wire (G&H Orthodontics, USA) was compared with a single-strand ribbon titanium lingual retainer wire (Retainium, Reliance orthodontics, USA) was used. When treatment was completed, the retainers were bonded from canine to canine in the mandibular arch of the participants. In the follow-up visits, the patients were recalled every 3 months during the 24 months. Detachments, the time of debonding, and side effects were recorded. Statistical analysis was performed by a blinded statistician using a statistical package for Social Science (SPSS, Version20). After descriptive statistics, Kaplan-Meier analysis was performed to measure the survival rates of each retainer. P value < 0.05 was considered as significant. RESULTS Finally, 138 patients who received twisted wire splint and 112 patients who received ribbon wire were included in the analysis. The average duration of success was about 23 months for twisted wire and ribbon wire, according to the Kaplan-Meier estimates. The analysis showed no significant overall difference between the treatments (p = 0.13). Failure rates in terms of detachments in all groups occurred at the enamel junction, and it was 25 in twisted retainer group (18.1%) and was 10 in ribbon retainer group (8.9%); the Kaplan-Meier analysis test detected a significant difference in the failure rates between the groups (p = 0/006). CONCLUSIONS Although the conventional twisted stainless steel wire and single-strand titanium flat metal ribbon wire as fixed orthodontic retainers have the same clinical effects, it was shown that the ribbon wire has less failure in terms of detachments.
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Affiliation(s)
- Valiollah Arash
- Department of Orthodontics, School of Dentistry, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Mehran Teimoorian
- Department of Orthodontics, School of Dentistry, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Yasamin Farajzadeh Jalali
- Department of Orthodontics, School of Dentistry, Ilam University of Medical Sciences, Ilam, Islamic Republic of Iran
| | - Sedigheh Sheikhzadeh
- Dental Materials Research Center, Institute of Health, Babol University of Medical Sciences, Babol, Islamic Republic of Iran.
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Scribante A, Gallo S, Turcato B, Trovati F, Gandini P, Sfondrini MF. Fear of the Relapse: Effect of Composite Type on Adhesion Efficacy of Upper and Lower Orthodontic Fixed Retainers: In Vitro Investigation and Randomized Clinical Trial. Polymers (Basel) 2020; 12:polym12040963. [PMID: 32326201 PMCID: PMC7240513 DOI: 10.3390/polym12040963] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/09/2020] [Accepted: 04/19/2020] [Indexed: 12/03/2022] Open
Abstract
The aim of this laboratory and clinical study is to determine the reliability of the flowable nanocomposite Filtek Supreme XTE (FL) for the adhesion of orthodontic retainers, compared to highly filled orthodontic resin Transbond XT (XT). Portions of a round section multistranded wire (Ortosmail Krugg) were bonded to 40 bovine incisors with Scotchbond Universal in total-etch modality. For group one (XT, 20 samples), the orthodontic resin was used, whereas in group two (FL, 20 samples), the flowable one. Specimens were placed into a universal testing machine which applied a shear force on retainers with a crosshead speed of one/minute. Shear bond strength (SBS) and adhesive remnant index (ARI) scores were calculated. In the clinical trial, 100 patients requiring a canine-to-canine palatal and lingual retainer were randomly divided into two groups, according to the resin used for bonding procedure: the orthodontic in group one (XT, 50 participants) and the flowable in group two (FL, 50 participants). Monthly visits were carried out over a 24-month follow up to assess any detachment occurring on teeth of both arches. All data were submitted to statistical analysis. In vitro, FL reported a significant lower mean SBS, whereas no significant differences in ARI were reported between the two groups which both showed a major frequency of scores “1” and “2”. At the end of the 24-month follow up, FL reported significantly higher failure rates in both arches besides a significantly lower survival rate starting from the sixth month after retainers bonding. According to the results assessed in vitro and clinically, XT would be preferable to FL when performing retainers bonding procedure.
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Scribante A, Vallittu PK, Özcan M, Lassila LVJ, Gandini P, Sfondrini MF. Travel beyond Clinical Uses of Fiber Reinforced Composites (FRCs) in Dentistry: A Review of Past Employments, Present Applications, and Future Perspectives. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1498901. [PMID: 30426003 PMCID: PMC6217899 DOI: 10.1155/2018/1498901] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/02/2018] [Indexed: 12/17/2022]
Abstract
The reinforcement of resins with short or long fibers has multiple applications in various engineering and biomedical fields. The use of fiber reinforced composites (FRCs) in dentistry has been described in the literature from more than 40 years. In vitro studies evaluated mechanical properties such as flexural strength, fatigue resistance, fracture strength, layer thickness, bacterial adhesion, bonding characteristics with long fibers, woven fibers, and FRC posts. Also, multiple clinical applications such as replacement of missing teeth by resin-bonded adhesive fixed dental prostheses of various kinds, reinforcement elements of dentures or pontics, and direct construction of posts and cores have been investigated. In orthodontics, FRCs have been used also for active and passive orthodontic applications, such as anchorage units, en-masse movement units, and postorthodontic tooth retention. FRCs have been extensively tested in the literature, but today the advances in new technologies involving the introduction of nanofillers or new fibers along with understanding the design principles of FRC devices open new fields of research for these materials both in vitro and in vivo. The present review describes past and present applications of FRCs and introduces some future perspectives on the use of these materials.
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Affiliation(s)
- Andrea Scribante
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Italy
| | - Pekka K. Vallittu
- Department of Biomaterial Science and Turku Clinical Biomaterials Centre (TCBC), Institute of Dentistry, University of Turku, Turku, Finland
- City of Turku, Welfare Division, Turku, Finland
| | - Mutlu Özcan
- University of Zurich, Center for Dental and Oral Medicine, Dental Materials Unit, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Zurich, Switzerland
| | - Lippo V. J. Lassila
- Department of Biomaterial Science and Turku Clinical Biomaterials Centre (TCBC), Institute of Dentistry, University of Turku, Turku, Finland
| | - Paola Gandini
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Italy
| | - Maria Francesca Sfondrini
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Italy
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Swidi AJ, Taylor RW, Tadlock LP, Buschang PH. Recent Advances in Orthodontic Retention Methods: A Review article. J World Fed Orthod 2018. [DOI: 10.1016/j.ejwf.2018.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Maddalone M, Rota E, Mirabelli L, M Venino P, Porcaro G. Clinical Evaluation of Bond Failures and Survival of Mandibular Canine-to-canine Bonded Retainers during a 12-year Time Span. Int J Clin Pediatr Dent 2018; 10:330-334. [PMID: 29403224 PMCID: PMC5789134 DOI: 10.5005/jp-journals-10005-1460] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/16/2017] [Indexed: 11/23/2022] Open
Abstract
Aim The aim of this study was to assess the effectiveness of the 3-3 mandibular lingual stainless steel retainer to prevent a relapse of orthodontic treatment during the 12-year time span of the survey. Materials and methods Fifty patients with canine-to-canine bonded retainers (placed at least 10 years earlier) were recalled. All patients had been followed up annually during this period. Patients were screened for stability of the retainer and for the condition of hard and soft oral tissues. Results None of the patients reported a complete loss of the retainer; 14 patients reported single element partial losses and 13 reported multiple losses. Most partial failures were not perceived by patients, but noted by the orthodontist during the control visit. There was no notable variation of the gingival index occurring in these patients. In two cases patients had caries in the six teeth bonded with the retainer, but never on the lingual side; only in three teeth areas of decalcification in the proximity of bonded sites were reported. All patients showed good compliance with this kind of retention. Conclusion The composite adhesive technique allowed a reliable positioning system for directly bonded retainers and did not influence the occurrence of carious lesions or demin-eralized spots on fixed teeth. Full teeth fixation offered the possibility of stabilizing the irregularity index highlighted in various studies without increasing any side effects on gums and hard tissues.How to cite this article: Maddalone M, Rota E, Mirabelli L, Venino PM, Porcaro G. Clinical Evaluation of Bond Failures and Survival of Mandibular Canine-to-canine Bonded Retainers during a 12-year Time Span. Int J Clin Pediatr Dent 2017;10(4):330-334.
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Affiliation(s)
- Marcello Maddalone
- Chief, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Elisa Rota
- House Officer, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Luca Mirabelli
- House Officer, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Pier M Venino
- House Officer, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Gianluca Porcaro
- House Officer, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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14
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Jin C, Bennani F, Gray A, Farella M, Mei L. Survival analysis of orthodontic retainers. Eur J Orthod 2018; 40:531-536. [DOI: 10.1093/ejo/cjx100] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Carrol Jin
- Discipline of Orthodontics, Department of Oral Sciences, Sir John Walsh Research Institute, Dunedin, New Zealand
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Florence Bennani
- Discipline of Orthodontics, Department of Oral Sciences, Sir John Walsh Research Institute, Dunedin, New Zealand
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Andrew Gray
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Mauro Farella
- Discipline of Orthodontics, Department of Oral Sciences, Sir John Walsh Research Institute, Dunedin, New Zealand
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Li Mei
- Discipline of Orthodontics, Department of Oral Sciences, Sir John Walsh Research Institute, Dunedin, New Zealand
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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15
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Sfondrini MF, Gandini P, Tessera P, Vallittu PK, Lassila L, Scribante A. Bending Properties of Fiber-Reinforced Composites Retainers Bonded with Spot-Composite Coverage. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8469090. [PMID: 29130047 PMCID: PMC5654344 DOI: 10.1155/2017/8469090] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/27/2017] [Accepted: 09/06/2017] [Indexed: 11/27/2022]
Abstract
Orthodontic and periodontal splints are prepared with round or flat metallic wires. As these devices cannot be used in patients with allergy to metals or with aesthetic demands, fiber-reinforced composite (FRC) retainers have been introduced. Stiffness of FRC materials could reduce physiologic tooth movement. In order to lower rigidity of conventional FRC retainers, a modified construction technique that provided a partial (spot) composite coverage of the fiber has been tested and compared with metallic splints and full-bonded FRCs. Flat (Bond-a-Braid, Reliance Orthodontic Products) and round (Penta-one 0155, Masel Orthodontics) stainless steel splints, conventional FRC splints, and experimental spot-bonded FRC retainers (Everstick Ortho, StickTech) were investigated. The strength to bend the retainers at 0.1 mm deflection and at maximum load was measured with a modified Frasaco model. No significant differences were reported among load values of stainless steel wires and experimental spot-bonded FRC retainers at 0.1 mm deflection. Higher strength values were recoded for conventional full-bonded FRCs. At maximum load no significant differences were reported between metallic splints (flat and round) and experimental spot-bonded FRCs, and no significant differences were reported between spot- and full-bonded FRC splints. These results encourage further tests in order to evaluate clinical applications of experimental spot-bonded FRC retainers.
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Affiliation(s)
- Maria Francesca Sfondrini
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Paola Gandini
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Paola Tessera
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Pekka K. Vallittu
- Department of Biomaterial Science and Turku Clinical Biomaterials Centre (TCBC), Institute of Dentistry, University of Turku, Turku, Finland
- City of Turku, Welfare Division, Turku, Finland
| | - Lippo Lassila
- Department of Biomaterial Science and Turku Clinical Biomaterials Centre (TCBC), Institute of Dentistry, University of Turku, Turku, Finland
| | - Andrea Scribante
- Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
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Spot-Bonding and Full-Bonding Techniques for Fiber Reinforced Composite (FRC) and Metallic Retainers. Int J Mol Sci 2017; 18:ijms18102096. [PMID: 28976936 PMCID: PMC5666778 DOI: 10.3390/ijms18102096] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 10/01/2017] [Accepted: 10/02/2017] [Indexed: 11/20/2022] Open
Abstract
Fiber reinforced Composite (FRC) retainers have been introduced as an aesthetic alternative to conventional metallic splints, but present high rigidity. The purpose of the present investigation was to evaluate bending and fracture loads of FRC splints bonded with conventional full-coverage of the FRC with a composite compared with an experimental bonding technique with a partial (spot-) resin composite cover. Stainless steel rectangular flat, stainless steel round, and FRC retainers were tested at 0.2 and 0.3 mm deflections and at a maximum load. Both at 0.2 and 0.3 mm deflections, the lowest load required to bend the retainer was recorded for spot-bonded stainless steel flat and round wires and for spot-bonded FRCs, and no significant differences were identified among them. Higher force levels were reported for full-bonded metallic flat and round splints and the highest loads were recorded for full-bonded FRCs. At the maximum load, no significant differences were reported among spot- and full-bonded metallic splints and spot-bonded FRCs. The highest loads were reported for full bonded FRCs. The significant decrease in the rigidity of spot-bonded FRC splints if compared with full-bonded retainers suggests further tests in order to propose this technique for clinical use, as they allow physiologic tooth movement, thus presumably reducing the risk of ankylosis.
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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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Al-Moghrabi D, Pandis N, Fleming PS. The effects of fixed and removable orthodontic retainers: a systematic review. Prog Orthod 2016; 17:24. [PMID: 27459974 PMCID: PMC4961661 DOI: 10.1186/s40510-016-0137-x] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 06/30/2016] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE In the view of the widespread acceptance of indefinite retention, it is important to determine the effects of fixed and removable orthodontic retainers on periodontal health, survival and failure rates of retainers, cost-effectiveness, and impact of orthodontic retainers on patient-reported outcomes. METHODS A comprehensive literature search was undertaken based on a defined electronic and gray literature search strategy ( PROSPERO CRD42015029169). The following databases were searched (up to October 2015); MEDLINE via OVID, PubMed, the Cochrane Central Register of Controlled Trials, LILACS, BBO, ClinicalTrials.gov, the National Research Register, and ProQuest Dissertation and Thesis database. Randomized and non-randomized controlled clinical trials, prospective cohort studies, and case series (minimum sample size of 20) with minimum follow-up periods of 6 months reporting periodontal health, survival and failure rates of retainers, cost-effectiveness, and impact of orthodontic retainers on patient-reported outcomes were identified. The Cochrane Collaboration's Risk of Bias tool and Newcastle-Ottawa Scale were used to assess the quality of included trials. RESULTS Twenty-four studies were identified, 18 randomized controlled trials and 6 prospective cohort studies. Of these, only 16 were deemed to be of high quality. Meta-analysis was unfeasible due to considerable clinical heterogeneity and variations in outcome measures. The mean failure risk for mandibular stainless steel fixed retainers bonded from canine to canine was 0.29 (95 % confidence interval [CI] 0.26, 0.33) and for those bonded to canines only was 0.25 (95 % CI: 0.16, 0.33). A meta-regression suggested that failure of fixed stainless steel mandibular retainers was not directly related to the period elapsed since placement (P = 0.938). CONCLUSION Further well-designed prospective studies are needed to elucidate the benefits and potential harms associated with orthodontic retainers.
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Affiliation(s)
- Dalya Al-Moghrabi
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AD, UK.
| | - Nikolaos Pandis
- Dental School, Medical Faculty, University of Bern, Bern, Switzerland
| | - Padhraig S Fleming
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AD, UK
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Sobouti F, Rakhshan V, Saravi MG, Zamanian A, Shariati M. Two-year survival analysis of twisted wire fixed retainer versus spiral wire and fiber-reinforced composite retainers: a preliminary explorative single-blind randomized clinical trial. Korean J Orthod 2016; 46:104-10. [PMID: 27019825 PMCID: PMC4807147 DOI: 10.4041/kjod.2016.46.2.104] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/21/2015] [Accepted: 09/03/2015] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Traditional retainers (both metal and fiber-reinforced composite [FRC]) have limitations, and a retainer made from more flexible ligature wires might be advantageous. We aimed to compare an experimental design with two traditional retainers. METHODS In this prospective preliminary clinical trial, 150 post-treatment patients were enrolled and randomly divided into three groups of 50 patients each to receive mandibular canine-to-canine retainers made of FRC, flexible spiral wire (FSW), and twisted wire (TW). The patients were monitored monthly. The time at which the first signs of breakage/debonding were detected was recorded. The success rates of the retainers were compared using chi-squared, Kaplan-Meier, and Cox proportional-hazard regression analyses (α = 0.05). RESULTS In total, 42 patients in the FRC group, 41 in the FSW group, and 45 in the TW group completed the study. The 2-year failure rates were 35.7% in the FRC group, 26.8% in the FSW group, and 17.8% in the TW group. These rates differed insignificantly (chi-squared p = 0.167). According to the Kaplan-Meier analysis, failure occurred at 19.95 months in the FRC group, 21.37 months in the FSW group, and 22.36 months in the TW group. The differences between the survival rates in the three groups were not significant (Cox regression p = 0.146). CONCLUSIONS Although the failure rate of the experimental retainer was two times lower than that of the FRC retainer, the difference was not statistically significant. The experimental TW retainer was successful, and larger studies are warranted to verify these results.
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Affiliation(s)
- Farhad Sobouti
- Department of Orthodontics, Dental Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vahid Rakhshan
- The Research Council, Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran.; Department of Dental Anatomy and Morphology, Dental Branch, Islamic Azad University, Tehran, Iran
| | - Mahdi Gholamrezaei Saravi
- Department of Restorative Dentistry, Dental Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Zamanian
- Department of Restorative Dentistry, Dental Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahsa Shariati
- Craniomaxillofacial Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Labunet AV, Badea M. In vivo orthodontic retainer survival - a review. ACTA ACUST UNITED AC 2015; 88:298-303. [PMID: 26609260 PMCID: PMC4632886 DOI: 10.15386/cjmed-451] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 05/09/2015] [Accepted: 05/22/2015] [Indexed: 11/23/2022]
Abstract
Background Relapse following orthodontic treatment is a constant concern of orthodontists. Fixed retention is preferred especially for the lower arch by most orthodontists. Objectives This review focuses on in vivo studies. The main objective is to determine the survival rates of different types of retainer: glass-fiber reinforced composite resin, polyethylene or multistrand stainless steel wire bonded to each tooth from canine to canine in the mandibular arch. A second objective is to assess which of these types is less likely to cause additional problems and the third objective is to evaluate the factors that may influence retainer survival. Results and conclusions There were 8 studies identified that matched the objectives stated. Current in vivo studies on survival rate take little notice of the role of the material used for bonding of the fixed retainer. It is not possible to draw a conclusion on reliability of new types of retainers glass fiber reinforced composite resin or polyethylene compared to multistrand stainless steel wire. The multistrand wire remains the gold standard for fixed retention. Although it is a logical outcome that retainer survival is dependent on the application technique, there seems to be no research outcome proving that operator experience, moisture control are essential, nor does patient age or sex have statistically proven effects on survival rates. Adequate studies that involve such aspects should be performed.
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Affiliation(s)
- Anca Victoria Labunet
- Department of Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mîndra Badea
- Department of Preventive Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Van Rensburg JJJ. Fibre-reinforced composite (FRC) bridge--a minimally destructive approach. ACTA ACUST UNITED AC 2015; 42:360-2, 365-6. [PMID: 26062261 DOI: 10.12968/denu.2015.42.4.360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Replacing missing teeth is an integral part of the clinical services of the dental practitioner. The fibre-reinforced composite (FRC) bridge is a relatively new method for replacing missing teeth. This article will explain and discuss this alternative treatment option. Practical instructions on how to construct a FRC bridge will be given, by means of a clinical case. Different technique options will be illustrated to provide the reader with a good understanding of the most practical way to use the FRC strips. The fibre-reinforced composite provides a non-destructive, aesthetically pleasing and cost-effective way to restore missing teeth. Clinical Relevance: Minimally invasive options should always be considered and destruction of healthy enamel and dentine during the preparation phase of a replacement treatment should be avoided as much as possible.
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Failure of fixed orthodontic retainers: A systematic review. J Dent 2015; 43:876-96. [PMID: 25979824 DOI: 10.1016/j.jdent.2015.05.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 04/25/2015] [Accepted: 05/01/2015] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate the risk of failure of fixed orthodontic retention protocols. DATA Screening for inclusion eligibility, quality assessment of studies and data extraction was performed independently by two authors. SOURCES The electronic databases MEDLINE, EMBASE and CENTRAL were searched with no restrictions on publication date or language using detailed strategies. The main outcome assessed was bond failure. STUDY SELECTION Twenty-seven studies satisfied the inclusion criteria. Randomised controlled trials and prospective studies were evaluated according to the Cochrane risk of bias tool. Retrospective studies were graded employing the predetermined criteria of Bondemark. RESULTS Nine randomised controlled trials, four of which were of low quality, were identified. Six studies had a prospective design and all were of low quality. Twelve studies were retrospective. The quality of trial reporting was poor in general. Four studies assessing glass-fibre retainers, three RCTs and one prospective, reported bond failures from 11 to 71%, whereas twenty studies evaluating multistranded retainers – nine RCTs, two prospective and nine retrospective – reported failures ranging from 12 to 50%. One comparison was performed, multistranded wires vs. polyehtylene woven ribbon (RR: 1.74; 95% CI: 0.45, 6.73; p=0.42). CONCLUSION The quality of the available evidence is low. No conclusive evidence was found in order to guide orthodontists in the selection of the best protocol. CLINICAL SIGNIFICANCE Although fixed orthodontic retainers have been used for years in clinical practice, the selection of the best treatment protocol still remains a subjective issue. The available studies, and their synthesis, cannot provide reliable evidence in this field.
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