"Wire Syndrome" Following Bonded Orthodontic Retainers: A Systematic Review of the Literature.

Carole Charavet,Sophie-Myriam Dridi,Sofia Aroca,France Vives

doi:10.3390/healthcare10020379

Abstract

(1) Background and objective: Tooth movements described as unexplained, aberrant, unexpected, unwanted, or undesirable can occur in the presence of an intact orthodontic retention wire, without detachment or fracture. This iatrogenic phenomenon, known little or not by many practitioners, responsible for significant dental and periodontal complications, both functional and aesthetic, is called “Wire Syndrome” (WS). It is therefore considered an undesirable event of bonded orthodontic retainers, which must be differentiated from an orthodontic relapse. The objective was to perform, for the first time, a systematic review of the literature in order to define the prevalence of WS and to study its associated clinical characteristics. (2) Methods: A systematic review of the literature was performed following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and recommendations using an electronic search strategy on four databases complemented by a manual search. All the prospective and retrospective clinical studies, including case reports and series, written in English or French, clearly mentioning the description, detection, or management of WS were included. Three independent blinding review authors were involved in study selection, data extraction, and bias assessment using the Mixed Methods Appraisal Tool (MMAT). (3) Results: Of 1891 results, 20 articles published between 2007 and 2021 fulfilled the inclusion criteria, with a globally high risk of bias since 16 articles were case report/series. The analysis of each article allowed the highlighting of WS through 13 categories, as follows: prevalence, apparition delay, patient characteristics, arch and tooth involved, families of movements, dental and periodontal consequences, type of wire, risk factors, etiologies, treatment, and preventive approach. (4) Conclusion: This systematic review of the literature elaborated a synthesis on WS, allowing general practitioners, periodontists, and orthodontists to understand this adverse event, to facilitate the diagnostic approach, and to underline preventive measures against WS. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; number CRD42021269297).

Highlights

The long-term follow-up of orthodontic bonded retainers remains a challenge for orthodontists, and for periodontists, as well as general practitioners
The synthesis of clinical experience evoked by the authors cited above allows us to define and characterize Wire Syndrome (WS) as follows: Fixed orthodontic retainers can provoke aberrant, unexpected, unwanted, or unexplained tooth movement on teeth still bonded by a fixed retainer placed after orthodontic treatment, which could induce progressively iatrogenic dental and periodontal complications, functional and/or aesthetic, ranging from minor teeth displacement to teeth expulsion from the bone with loss of vitality
Participants (P): Patients with “Wire Syndrome” (WS), i.e., dental movements described as aberrant, unexpected, unexplained, unwanted, or excessive; Interventions (I): Fixed orthodontic retainer bonded at the maxilla and/or mandible after orthodontic treatment; Comparisons (C): Patients not affected by “Wire Syndrome”; Outcomes (O): Define the prevalence of “Wire Syndrome” and the characteristics associated with it

Summary

Introduction

The long-term follow-up of orthodontic bonded retainers remains a challenge for orthodontists, and for periodontists, as well as general practitioners. In 2007, Katsaros et al [1] were the first to describe this problem, which occurs when the orthodontic retainer is always bonded to the anterior teeth, inducing serious complications on these teeth under the name “unexpected complications of bonded mandibular lingual retainers” This phenomenon was thereafter described by some authors under different names, such as “severe complication of a bonded mandibular lingual retainer” [2] in 2012, “Syndrome du Fil” [3] in 2015, “inadvertent tooth movement with fixed lingual retainers” [4] in 2016, or “extreme complication of a fixed lingual mandibular lingual retainer” [5] in 2021. WS is not a classic orthodontic relapse, and the position of the teeth does not correspond to any previous situation

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Discussion

Conclusion