Removable Retainers Research Articles

Interdisciplinary management of Class III malocclusion with cleft lip and palate

Background: A cleft lip and palate (CLP) is one of the most common birth defects of the face. Individuals with CLP often have a significant growth disturbance of the maxilla along three dimensions, resulting in skeletal Class III malocclusion and cross bite. Oral rehabilitation can be complicated. Purpose: The purpose of this case study was to highlight the necessity of sequential interdisciplinary management to improve facial esthetics and correct functional disturbances for a patient with CLP. Case: The patient was a 20-year-old woman complaining of the unpleasant appearance of her upper front teeth. She had a concave profile with Class III skeletal patterns (SNA: 78O; SNB: 82O; ANB: -4O), cleft lip and palate, and an anterior and posterior crossbite. Case Management: A combined orthodontic, endodontic, conservative, periodontic, and prosthetic approach was proposed to achieve normal occlusion, function, and a harmonious profile. The combination of rapid maxillary expansion and fixed orthodontics (standard edgewise appliance) established good general alignment and a Class I relationship. After 15 months of treatment, both the posterior and anterior crossbite had been completely corrected. In order to address the gingival margin differences, the patient was instructed to make another appointment with the periodontist and was referred to the restorative dentist for veneer restorations and the prosthodontist for fabrication of a removable retainer with obturator. Conclusion: This interdisciplinary approach greatly improved both esthetics and function. The patient was satisfied with the results achieved.

Accuracy of thermal microsensors embedded in orthodontic retainers of different material composition and thickness: An in vitro study

Abstract Objectives: The present research aimed to assess the accuracy and precision of the TheraMon® microsensor embedded in different thicknesses of Hawley retainers (HR) for comparison with vacuum formed retainers (VFR). Methods: Thirty microsensors contained within different thicknesses and composition of retainers were divided into three equal groups: Group A thick coverage HR (3 mm), Group B thin coverage HR (1 mm), and Group C VFR (1 mm). The microsensors were immersed in thermostatic water at a controlled temperature of 35°C, which corresponds to the average intra-oral temperature. After 1 week, data were gathered using the TheraMon® client software and analysed using ANOVA and Turkey’s HSD tests. Results: All TheraMon® microsensors were functional and produced uninterrupted recordings during the 1-week test period. Thermal detection differed between the three removable retainer groups. A near accurate thermostatic water detection was noticed with the thin HR with a mean temperature of 34.81 ± 0.04°C, followed by VFR 34.77 ± 0.09°C, and finally the thick HR 34.73 ± 0.05°C (ANOVA p-value = 0.025). A between-group comparison showed a significant mean difference (MD) between the thin and thick HR groups (MD: 0.08, p-value = 0.01). However, there were no significant differences between VFR and neither the thick Hawley (MD: 0.04, p-value = 0.27) nor the thin Hawley group (MD: -0.03, p-value = 0.39). Conclusion: A removable retainer’s variation in material thickness and composition could induce small but detectable changes in the precision of thermal detection by TheraMon® microsensors.

A cross-sectional study into the reasons behind orthodontic re-treatment.

This study aims to identify the motivations behind orthodontic re-treatment in Saudi Arabia. This is a cross-sectional study performed through a patient questionnaire. The questionnaire elicited data on the respondents' socio-demographic data, type of previous orthodontic treatment, retention, satisfaction level, and reasons for undergoing orthodontic re-treatment. Four hundred and nineteen responses were received during the study period from June to July 2022. The result showed a pre-dominant female predilection (83, 29%), with the majority belonging to the 21-25 age group (47.26%). Most participants had had one previous orthodontic treatment (77%), with an active treatment time of approximately 1-3 years (55.85%). There was no significant difference between the satisfaction of outcomes after the initial treatment and at the time of the survey. Most participants received retention appliances (69.45%) and were informed about the importance of appliances. The type of retention was mainly removable retainers (47.5%). Around one-third of the sample (31.98%) were interested in seeking orthodontic re-treatment, with self-motivation as the primary drive and improving the smile as the predominant reason. The study's findings show that a large portion of the population is seeking orthodontic re-treatment, which must be considered. Self-motivation was a driving force rather than external motivation. The most common reason for seeking orthodontic re-treatment was to improve their smile and the increased esthetic demand.

The development of a novel Orthodontic Alignment Index and its use to evaluate the effect of residual overjet on the stability of the alignment of the maxillary anterior dentition

BackgroundIt is thought that achieving a normal overjet may help to stabilise the alignment of the maxillary anterior dentition. Little’s Irregularity Index is limited in assessing discrete post-orthodontic changes, fails to account for reciprocal rotations and is not sensitive to dental changes in three planes. A more holistic tool for the assessment of post-treatment change is therefore required.AimTo compare the post-treatment stability of maxillary anterior dental alignment in subjects treated either to a Class I incisor relationship or an increased overjet (> 4 mm) following fixed appliance-based orthodontics using a novel measurement tool.Materials and methodsThe Orthodontic Alignment Index (OAI) was developed and validated using a panel of 63 raters. The new index accounts for a range of weighted features including contact point displacement, spacing, reciprocal rotations, inclination, angulation and vertical discrepancy. A retrospective cohort study was undertaken at the Institute of Dentistry, Queen Mary University of London. Recruitment took place over a 4-year period. All participants had removable retainers in the maxillary arch only. The stability of maxillary anterior teeth was assessed using Little’s Irregularity Index (LII) and the OAI. Subjects were recruited at least 12 months following completion of dual-arch fixed appliance-based treatment.ResultsEighty-two participants were included with a positive correlation observed between LII and OAI at the 12-month post-treatment review with a 1-mm increase in LII associated with a 2-point increase in the OAI (P < 0.001). Limited relapse was observed in both groups: normal overjet group (OAI = 1.28; LII = 0.52); residual overjet group (OAI = 0.88; LII = 0.47). Median regression analysis failed to identify a significant association between an increased overjet at debond and the alignment of the maxillary anterior segment when assessed with OAI (P = 0.389) and LII (P = 0.577). Furthermore, age, gender, extraction protocols and retention regime were not predictive of post-treatment change.ConclusionsUsing a novel index (OAI) and LII, there was limited post-treatment relapse in alignment of the maxillary anterior dentition over a 12-month period. Based on this retrospective evaluation, achieving a normal overjet at the end of treatment may have little bearing on the post-treatment stability of maxillary anterior alignment at 12 months.

Orthodontic retention experience of university students: A qualitative study.

To explore university students' experience of retention and identify potential barriers and facilitators to long-term adherence. Cross-sectional qualitative study using virtual focus groups. University of Leeds. Dental and non-dental students from the University of Leeds, who had previously undergone orthodontic treatment and had received removable retainers. Students were invited to participate via email. Virtual focus groups were undertaken using Microsoft Teams. A topic guide was used to explore the experience of orthodontic retention including factors that influence long-term retainer wear. Focus groups were recorded and analysed using an inductive thematic approach. In total, 23 students participated in four focus groups, including 13 dental students. The period since the end of orthodontic treatment varied from 9 months to 10 years. Of the 23 participants, 8 (35%) were no longer wearing their retainers. Four themes were identified: (1) experience of orthodontic treatment including knowledge of relapse; (2) experience of retainer wear, including motivators and barriers; (3) role of others; and (4) increasing adherence. Key factors influencing use of retainers were the importance placed on maintaining treatment outcomes, awareness of unwanted tooth movement and understanding of the role of the retainer, access to replacement retainers, and ongoing support to encourage retainer wear. Greater knowledge and dental awareness reported by dental students did not necessarily increase adherence. Adherence to removable retainer wear is an important aspect of orthodontic treatment but it is recognised that long-term retainer wear is highly variable. The understanding of relapse and retention is variable. Challenges in gaining access to replacement retainers are a common cause of cessation of retainer wear. Dental professionals are perceived to be important in encouraging and supporting retainer wear and individuals reported they would like more follow-up.

Post orthodontic periodontal evaluation of patients with different removable retainers: Hawleys Vs Essix

Prevention of unwanted post-treatment changes remains one of the biggest challenges in orthodontics. Retention using removable appliance is important, which can alter the oral hygiene and oral microbial flora, overall increase in the Streptococcus mutans can lead to caries formation which can lead to a missing tooth that can spoil the overall appearance of the patient. 24 post orthodontic subjects were divided in to two groups and group I was given Essix retainer and Group II was given Hawleys Retainer, Supra gingival plaque collected and bacterial colony count done using digital colony counter OHI-S and PI are recorded at T0 (start of treatment) T1 (30 days) T2 (60 days). Essix group has a significant increase in the streptococcus mutans count OHI-S and PI scores are higher for hawleys retainer group. This study advocates the use of a better appliance which along with aesthetics can also ensure better oral hygiene Care should be taken to provide detailed hygiene instructions for both appliance and teeth.

Assessment of the Bacterial Loads of Vacuum-Thermoformed Removable Retainers (VTRR) in Patients under Retention Therapy: A Randomized Clinical Trial.

Retention devices are essential after orthodontic treatment in order to avoid the risk of relapse. For this goal, vacuum-thermoformed removable retainers (VTRRs) are useful tools in clinical practice. The main limitation related to them is the accumulation of plaque. The aim of this study was to investigate the bacterial loads present on VTRRs (Essix ACE Plastic, Dentsply Sirona) in patients under retention therapy. Patients were randomly divided into three groups, depending on the product used for the cleansing of the VTRR: Geldis, Polident tablets, and simple water, respectively. Microbiological samples were taken from the retainers at the baseline, after 1 and after 2 months, with the collection of Bleeding on Probing (BoP), Plaque Index (PI), Basic Erosive Wear Examination (BEWE) and Schiff Air Sensitivity test (SAI). A total of 15 patients were recruited and for each product, 5 patients were allocated. No significant intragroup and intergroup differences were observed at any time point for PI, SAI, BoP, Red Complex, Total Pathogen and Total Saprophyte loads. A significant intragroup and intergroup difference was assessed at T1 and T2 for BEWE in the control group. According to the results of this study, the bacterial load on VTRR retainers is not influenced by the cleaning methods tested.

Stability of transverse dental arch dimension with passive self-ligating brackets: a 6-year follow-up study

ObjectiveThe stability of the transverse expansion in passive self-ligating bracket treatments is a debated topic in orthodontics. However, to date, only 3 reports are available in the literature, with the maximum follow-up of 3 years after the end of therapy. The present study aims to evaluate the stability of orthodontic treatment with self-ligating brackets in a 6-year follow-up period of time.Materials and methodsA sample of 56 non-extractive cases (of whom 33 females, mean age 16.9, SD = 9.0 years) consecutively treated with Damon® system was retrospectively selected. All patients received fixed retainers from canine to canine in both arches at the end of treatment, and no removable retainers were provided. The mean values of the transverse intercusp, transverse centroid and transverse lingual distances were evaluated for all teeth from canines to second molars in both arches. Each measure was calculated at four timepoints: before treatment (T0), at the end of treatment (T1), one year after treatment (T2) and six years after treatment (T3). Transverse diameters were measured for all teeth, starting from the canines to the second molars, for a total of 1680 observations, and subsequently compared in order to evaluate intra-treatment and post-treatment modifications.ResultsThere were increases in all transverse dental measurements during active treatment. A statistically significant (p < .05) reduction of the transverse diameter was found, for upper and lower premolars, from T1 to T3.ConclusionThe 6-year follow-up analysis detected that the initial transverse expansion showed a statistically significant relapse in premolars. No relapse was detected at the level of canines, due to the presence of fixed retainers, and minimal at first molars.

Young people's experiences of orthodontic retainers: A qualitative study.

To investigate young people's experiences of retainers, the associated impact of retainers on their lives and their perceptions of what influences their own co-operation. Qualitative, cross-sectional study. An orthodontic department in a UK dental hospital. Purposive sampling was used to recruit young people, aged 11-17 years, wearing a range of different types of retainers. Semi-structured interviews were conducted and transcribed. The resultant data were analysed using codebook thematic analysis. Ten patients were recruited before thematic saturation was achieved. Four themes were identified: impact and experiences of wearing retainers; facilitators and barriers to retainer adherence; finding out about retainers; and, finally, involvement in decisions about retainers. Although some initial negative impacts were described, participants generally adapted quickly to retainers. Several factors were perceived to influence co-operation with removable retainers, including concerns about relapse and the associated waste of personal effort and wider resources. There were perceived deficiencies in the information provided by clinicians, which led participants to seek advice from other sources, including social media. Some young people wanted to be more involved in decisions about their retainers. While patients perceived retainers to be easier to wear than active appliances, some transient negative impacts occurred, largely related to initial periods of full-time wear. There were a range of factors which patients perceived to influence their adherence with removable retainers.

Efficacy of fixed versus removal retianer post orthodontic treatment

The dearth of prolonged, prospective evaluation, the relative impact of fixed and the removable retainers eventualities can only be speculated upon. Hence in this study was to compare the stability of orthodontic outcomes with fixed and removable retainers over a period of at least 4 years. Of the 82 participants included in the previous RCT, data were obtained from 48 at 18-month follow up. Orthodontic stability was based chiefly on the irregularity of the mandibular incisors using Little’s Irregularity Index to assign a cumulative score for the contact point displacement in 4 the mandibular inter-canine region. Eighty-two participants were enrolled in the original RCT. After adjusting for confounders, the median between-groups difference was 1.64mm higher in those wearing vacuum-formed retainers (P= 0.02; 95% CI: 0.30, 2.98mm). No statistical difference was found between the treatment groups in terms of inter-canine (P= 0.52; 95% CI: -1.07, 0.55) and inter-molar widths (P= 0.55; 95% CI: -1.72, 0.93), arch length (P= 0.99; 95% CI: -1.15, 1.14) and extraction space opening (P= 0.84; 95% CI: -1.54, 1.86).

Post-treatment Stability in Orthodontic Retention with Twistflex Retainers—Do Patients Benefit from Additional Removable Retainers?

ObjectivesTo evaluate post-treatment movements of lower anterior teeth during orthodontic retention in patients with fixed twistflex retainers versus those with combined fixed and removable retainers.Materials and MethodsThis study was based on a retrospective data analysis of 57 adult patients during orthodontic retention. They were assigned to two groups: In group 1 (n = 30) the lower jaw was provided with twistflex retainers only and in group 2 (n = 27) with a twistflex combined with a removable retainer for night-time use. Orthodontic study models of the lower jaw were digitalized and superimposed. Tooth movements were analyzed at the retainer bonding (t0) and follow-up appointment ≥ six months later (t1). Rotational tooth movements (°) were measured around the x-axis (mesial/distal direction), the y-axis (buccal/lingual direction) and the z-axis (longitudinal direction, tooth axis). Translational tooth movements (mm) were registered along the x-axis (buccal/lingual direction), the y-axis (mesial/distal direction) and the z-axis (apical/coronal direction).ResultsCanine and incisor position changes during orthodontic retention were more pronounced in group 1 compared to group 2 except for canine rotations around the z-axis. In both groups in most of the cases stable lower incisor alignment could be found, but the proportion was significant higher in group 2 (group 1: 56.7% vs. group 2: 81.5%). Severe misalignment was present in 13.3% of the participants of group 1 and only in 7.4% of group 2. The extent of canine tipping and movements along the x- and y-axis in severe misalignment cases was significantly lower in group 2 compared to 1.ConclusionsLower incisor alignment was more stable in patients with combined fixed and removable retainers compared to fixed retainers only.Clinical RelevanceBased on the present findings, the routinely application of supplementary removable retainers can be recommended to enhance anterior tooth alignment in patients with fixed twistflex retainers.

Remote digital monitoring during the retention phase of orthodontic treatment: A prospective feasibility study.

ObjectiveTo evaluate if a remote digital monitoring system added at the end of orthodontic treatment could positively influence the retention phase by reducing the occurrence of misfit of removable appliances, number of emergency appointments (EA), and orthodontic relapse.MethodsTwenty-seven patients who completed active orthodontic treatment were divided into the study and control groups. In addition to the standard chairside follow-up appointments at month 1 (T1), month 3 (T2), month 6 (T3), the study group patients were monitored using Dental Monitoring® with monthly intra-oral scans. Occurrence of misfit of removable retainers, number of EAs, and intercanine width change were recorded for both groups. Differences in EAs and retainer fit were assessed using the chi-square test. Intra-group and inter-group differences in the intercanine width were assessed with Friedman test and Mann–Whitney U test, respectively (α = 0.05).ResultsThe study group showed a significantly lower occurrence of misfit of removable retainers (p = 0.027) compared to the control group. No significant inter- and intra-group difference was found in the EAs and intercanine width change at each time-point.ConclusionsIntegrating remote monitoring systems, such as Dental Monitoring®, to the retention phase of the orthodontic treatment may lower the occurrence of misfit of removable retainers. However, a small sample size and a short observation period limit the strength of this evidence. These preliminary results tentatively suggest that remote monitoring technologies may be beneficial, especially during the COVID-19 pandemic, when the regularity of in-office visits might be disrupted.

Retention decisions and protocols among orthodontists practicing in Canada: A cross-sectional survey

This study aimed to survey retention protocols and retainer characteristics among orthodontists practicing in Canada. An online questionnaire was distributed to 576 orthodontists registered with the Canadian Association of Orthodontists. It included respondents' demographic details, preferred orthodontic retainers and prescribed wear protocol, adjunctive retention procedures, the timing of retention follow-ups, retainer choice in specific situations, and retainer characteristics. Chi-square tests and Fisher's exact tests were used to test the associations between variables. An 18% response rate was recorded (n= 101). Vacuum-formed retainers were the most commonly used retainers in the maxilla (50.5%), whereas bonded retainers were preferred in the mandible (54.5%). An initial full-time removable retainer wear period was commonly prescribed (63.0%-67.0%). Retainer checks were carried out by 85.1%-89.1% of orthodontists for 1 or 2 years after the end of active orthodontic treatment. Only 44.6%-56.4% were comfortable with general dentists continuing retainer checks. Most (72.5%-84.1%) retainers were fabricated in the orthodontists' office laboratory. Indefinite retainer wear was commonly suggested and was significantly influenced by the number of years in practice. Most orthodontists' preferred retainer was the vacuum-formed retainers in the maxilla and the bonded retainers in the mandible. A variety of retention protocols and retainer characteristics was evident among orthodontists that reflect the considerable variation in malocclusion traits we face day-to-day. There seems to be a potential dichotomy between orthodontists being uncomfortable about allowing general dental practitioners to manage retention and orthodontists unwilling to provide retention care indefinitely.

Dental aspects of quality of life in orthodontic patients

Relevance. Previous studies have shown an improvement in orthodontic patients’ health-related quality of life. It is interesting to study the effect of various orthodontic appliances on the patients’ quality of life. Purpose – to study the changes in dental parameters of the quality of life in patients with malocclusion before orthodontic treatment, during treatment with metal and ceramic vestibular braces and after treatment, using removable retainers.Materials and methods. Using a validated Russian version of Oral Health Impact Profile (OHIP-49RU), we surveyed the quality of life in four patient groups: 1 - with malocclusion (n = 35), 2 – with removable retainers (n = 32), 3 – with metal brackets (n = 30), 4 – with ceramic brackets (n = 33). Statistical processing was carried out in Statistics 10. The study used descriptive statistics methods, e.g., nonparametric test methods determined the significance of sign differences: using the Kruskal-Wallis H, z tests and the χ2 test with Yates' correction.Results. OHIP-49 score analysis revealed statistically significant differences among the studied groups of pa- tients (1 - functional limitation (H = 9.15; p &lt;0.05), 2 - physical pain (H = 13.98; p &lt; 0.01), 3 - psychological discomfort (H = 23.04; p &lt;0.001), 4 - physical disability (H = 24.73; p &lt;0.001), 5 - psychological disability (H = 11.03; p &lt; 0.05), 6 - social disability (H = 16.21; p &lt;0.01), 7 - handicap (H = 7.91; p &lt;0.05)).Conclusions. The patients, who had completed the orthodontic treatment and used removable retainers at night, demonstrated the best score in most sections of the questionnaire and the patients with malocclusion, who had presented to an orthodontist - the worst. Patients with the brackets had a higher score on the "Physical pain" section of the questionnaire (6.5 (3.0-8.0) with metal braces and 4.0 (2.0-7.0) with ceramic bracket system). The quality of life in patients with metal and ceramic brackets did not have statistically significant differences.

Cost analysis of two types of fixed maxillary retainers and a removable vacuum-formed maxillary retainer: a randomized controlled trial.

SummaryBackgroundThere has been an increased interest in conducting healthcare economic evaluations. Also, orthodontic treatments have gathered focus from an economic point of view, however orthodontic research seldom examines both clinical and economic outcomes.ObjectiveTo evaluate and compare the costs of three retention methods: a bonded retainer to the maxillary four incisors, a bonded retainer to the maxillary four incisors and canines, and a removable vacuum-formed retainer (VFR) in the maxilla. The null hypothesis was that there was no difference in costs for the three types of retention methods.Trial designThree-arm, parallel group, single-centre, randomized controlled trial.Materials and methodsNinety adolescent patients, 54 girls and 36 boys, treated with fixed or removable retainers in the maxilla, were recruited to the study. The patients were randomized in blocks of 30, by an independent person, to one of three groups: bonded multistranded PentaOne (Masel Orthodontics) retainer 13-23, bonded multistranded PentaOne (Masel Orthodontics) retainer 12-22, and removable VFR. A cost analysis was made regarding chair time costs based on the costs per hour for the specialist in orthodontics, and material costs plus any eventual costs for repairs of the appliance. Changes in Little’s irregularity index and in single contact point discrepancies (CPDs) were measured on digitalized three-dimensional study casts. Data were evaluated on an intention-to-treat basis. The analysis was performed at 2 years of retention.ResultsNo statistically significant difference in costs between the maxillary fixed retainers and the VFRs was found, however, the material and emergency costs were significantly higher for the VFR compared with the bonded retainers. All three retention methods showed equally effective retention capacity, and no statistically significant differences in irregularity or CPDs of the maxillary anterior teeth in the three groups was detected.LimitationsIt was a single-centre trial, and hence less generalizable. Costs depended on local factors, and consequently, cannot be directly transferred to other settings.ConclusionsAll three retention methods can be recommended when considering costs and retention capacity.Trial registrationNCT04616755.

Evaluation of Diastema Closure Stability in Orthodontically Treated Patients

Evidence addressing the stability following a midline diastema closure is believed to be poor, and a paucity of research on this topic has been observed. The study aims to determine diastema closure stability in orthodontically treated patients who underwent a fixed or removable retainer. Forty individuals who received orthodontic treatment for diastema closure were identified using treatment records in orthodontic clinics of a private university hospital in Riyadh city, Saudi Arabia. Panoramic

Comparative evaluation of patient satisfaction following the use of two different orthodontic removable retainers: A prospective randomized controlled trial

Comparative evaluation of patient satisfaction following the use of two different orthodontic removable retainers: A prospective randomized controlled trial

Challenging malocclusion in orthodontics

The term open bite is referred as no contact between anterior or posterior teeth. The complexity of open bite is attributed to a combination of skeletal, dental and habitual factors. Etiology of open bite can be attributed to genetics, anatomic and environmental factors. However, the tendency toward relapse after conventional or surgical orthodontic treatment has been indicated. Therefore, open bite is considered one of the most challenging dentofacial deformities to treat. The aim of this article is to emphasize on early etiological diagnosis, dentofacial morphology and classification, which are essential for the successful outcome of the technical intervention. Failure of tongue posture adaptation subsequent to orthodontic and/or surgical treatment might be the primary reason for relapse of open bite. Prolonged retention with fixed or removable retainers is advisable and necessary in most cases of open bite treatment. The treatment of open bite remains a tough challenge to the clinician; careful diagnosis and timely intervention with proper treatment modalities and appliance selection will improve the treatment outcomes and long-term stability.

Removable retainers in Orthodontics

One of the most challenging phase for an orthodontist is to retain the corrections achieved during the course of orthodontic treatment. Retainers are passive orthodontic appliances that help in maintaining and stabilizing the position of teeth long enough to permit reorganization of supporting structures after the active phase of orthodontic therapy. This article provides a comprehensive review about the various types of orthodontic retainers available today.

A Systematic Review of Efficiency of Retention and Periodontal Effects of the Lingual Bonded Retainers

Introduction: The fixed lingual bonded retainers have gained preference over removable retainers because they are more aesthetic, comfortable, convenient and free of patient compliance, but their periodontal effects, the incidences of breakages and failure to maintain incisor alignment are the some concerns. Therefore, this study aims to systematically evaluate the efficiency of retention and periodontal effects of lingual bonded retainers in orthodontically treated patients. Materials and Methods: The PRISMA guidelines were followed. The databases of Cochrane Library, PubMed and Google Scholar were systematically searched. All human, original research studies in English evaluating the fixed lingual bonded retainers, in orthodontically treated patients, in single group or in comparison with different fixed lingual bonded retainers, with or without control were included. All articles were subjected to assessment of risk of bias. Results: A total of 17 studies were selected meeting the inclusion criteria. These were divided into two Group 1 - addressing the periodontal status; Group 2 - addressing the lower incisor stability. The 7 selected studies for group 1, reported that periodontal effects like gingival inflammation, plaque and calculus accumulation are associated with all kinds of lingual bonded retainers, but more in multistranded retainer. The lower incisor stability and alignment during retention phase was shown to be very efficient with multistranded retainers compared to others, in the 14 selected studies for group 2. From the 17 selected studies, 8 studies had a high risk of bias, 5 studies had a medium of bias and 4 studies had a low risk of bias. Conclusion: Even though newer types of retainers are being introduced to improve the survival rate, the multistranded retainers still prove to be a good choice with respect to maintenance of incisor alignment.