Gingival health and relapse tendency: a split mouth randomized controlled trial of two positions of lower fixed retainers.

Abstract

To compare between lower permanent retainers placed in the middle of the incisal third and retainers placed in the middle of lower incisors in terms of gingival condition, lower incisors stability and retainers' failure rate. This is a split-mouth clinical trial. Fifty patients finished fixed orthodontic treatment and required fixed permanent retainer in the lower arch were recruited. A multistranded (0.0215 inch) retainer, with a vertical step in the midline placing half of the retainer in the incisal third and the other half in the middle of the lower incisors was attached to all the teeth in the lower labial segment. After one year, all the subjects were recalled. The primary outcome was to evaluate the plaque index (PI) and the gingival index (GI) of the lower labial segment teeth. The secondary outcome was to assess retainers' failure rate and the relapse in lower labial segment alignment. The GI and the PI scores were significantly smaller on the side where the retainer was placed incisally (P = 0.004, P < 0.001, respectively). There was no statistical difference in the average Irregularity Index (IRI) and the retainer's failure rate between the two sides (P = 0.52, P = 0.76, respectively). Placing lower fixed retainers in the incisal third will improve the lower labial segment oral hygiene and gingival health in the lingual area without affecting the efficiency or the integrity of the retainers. This trial was not registered Null Hypothesis: Placing the lower permanent retainer in the middle of the lingual surfaces of the lower labial segment' teeth or in the incisal third will not affect the gingival health of the lower incisors.