Comparison of efficacy of thermoplastic retainer with round and rectangular bonded lingual wire retainer in the mandible two years after orthodontic treatment: a randomised controlled trial.

Abstract

To analyse three protocols in maintaining the stability of orthodontic therapy results and their effect on gingival health. Sixty-six subjects (pre-therapeutic age 11-18 years; 68% female) randomly allocated into three retention groups of equal size were analysed. The first group had a 0.673 × 0.268mm (0.027 × 0.011 inches) rectangular braided steel retention wire bonded to the lingual surfaces of all mandibular teeth from canine to canine, and the second group had a 0.406mm (0.016 inches) round twisted steel wire. The third group was the control, without wires, and only with vacuum-formed retainers. All three groups had vacuum-formed removable retainers in the maxilla. The frequency of wire detachment/breakage/loss of retainer, the occurrence of crowding of mandibular incisors, and changes in intercanine width and gingival health were monitored. Incidence and severity of relapse differed between groups (p = 0.001 and 0.049) being most common in the removable retainer group (incidence 68.2%; severity 0.7 ± 1.0mm), followed by the round wire group (36.4%; 0.5 ± 1.2mm) and rectangular wire group (13.6%; 0.1 ± 0.1mm). The intercanine width decreased more without a bonded retainer (incidence 68.2%; severity 0.5 ± 0.7mm) and with the round wire more (45.5%; 0.5 ± 0.7mm) than with the rectangular (27.3%; 0.1 ± 0.3mm). The difference was significant for incidence (p = 0.025), but not severity. Detaching of the wires/breakage/loss of retainer was similar. There were no significant differences in the accumulation of biofilm, calculus and gingivitis between appliances. A rectangular wire is the most effective in retention, and the impact of retention appliances on gingival health is similar. ClinicalTrials.gov, NCT05121220. Registered 02 October 2021 - Retrospectively registered. Studying guidelines for reducing relapse, proper use of materials and appliances, the behavior of retention wires according to their profile in the retention phase, and possibilities of maintaining oral health will contribute to improving the stability of orthodontic therapy results.