An In Vivo Study to Compare the Clinical Effectiveness of Clear Retainer Made on a Conventional and a Digitally Fabricated Model Over a Six-Month Period After Debonding.

Abstract

Background With the advent of 3D printing, many more possibilities have arisen for treatment planning. 3D rapid prototyping has enabled us to see a whole other dimension that has helped us to give the best possible care for our patients. With more and more advancements being made in this subject, it becomes necessary to check the reliability of the equipment and its effectiveness in the management of the problem at hand. This original study was conducted with the aim of checking the accuracy, dimensional stability, and reliability of orthodontic retainers made on a conventional and digitally fabricated model over a six-month period after debonding. Material and methods The patients were selected from those who have completed fixed orthodontic mechanotherapy from the Department of Orthodontics and Dentofacial Orthopaedics, Sri Guru Ram Das Institute of Dental Sciences and Research, Sri Amritsar. Fifty patients received a clear retainer, which was fabricated for the upper and lower arch after removing the brackets. Patients were included in this study irrespective of their age groups.The manual method used a vacuum-forming machine to fabricate six retainers on stone models. In the digital method, new impressions were taken after three months, and digital models were obtained through 3D scanning and printing, followed by clear retainer fabrication. The data were gathered through a systematic process involving manual and digital methods for clear retainer fabrication and subsequent evaluation. The data obtained was computed for statistical evaluation and comparison. Results Mean and standard deviations of conventional (manual) and digital variables in the two groups were calculated. An ANOVA test was used to evaluate statistically significant differences for mesiodistal widthand buccolingual width, and a post hoc Tuckey test was applied for multiple comparisons. The results indicated that most mesiodistal and buccolingual width measurements showed non-significant variations and exhibited a good correlation. Extraction space opening, assessed through an independent t-test for both the maxilla and mandible, also yielded non-significant and comparable results. Additionally, intra-operator and inter-operator measurements using a digital caliper demonstrated high agreement. Intra-class correlation (ICC) values exceeded 0.75, and inter-operator ICC results reflected a high level of agreement ranging from 0.8 to 0.99. Conclusion The primary objective of this study was to establish a correlation between the accuracy, dependability, and clinical efficacy of orthodontic retainers produced using both conventional and digitally created models. This investigation spanned a duration of six months following the removal of orthodontic brackets. The results showed that most of the statistically significant values were due to the inherent potential of the 3D printer for polymerization shrinkage, which, being a stereolithographic 3D printer, had a potential for a slight dimensional shift in the transverse dimension. However, the mean difference between all the models printed was slight and clinically insignificant.