Removable Retainers Research Articles

Fixed and removable orthodontic retainers and periodontal health.

Data sourcesMedline, PubMed, Cochrane Central Register of Controlled Trials, LILACS and BBO databases with no language restrictions; unpublished literature was searched in Proquest Dissertations and Theses database, clinicaltrials.gov and controlled-trials.com.Study selectionRandomised and nonrandomised controlled clinical trials, prospective cohort studies, and case series (with a minimum sample size of 20 patients) in patients who underwent fixed or removable appliance orthodontic therapy with a minimum follow-up period of six months. The primary outcome was periodontal health; while failure rates, impact of orthodontic retainers on patient-reported outcomes and cost-effectiveness served as secondary outcomes.Data extraction and synthesisFull texts of relevant abstracts were retrieved and data extracted using pre-piloted data collection forms by two authors. Study quality was assessed with Cochrane Collaboration's Risk of Bias tool (RCTs) and Newcastle-Ottawa Scale (NOS) for non-randomised studies. Only RCTs at low or unclear risk of bias and non-randomised studies of moderate or high methodological quality were included in the meta-analysis (MA). If moderate to high heterogeneity was present (I2 > 50%), MA was not performed.ResultsOut of the 18 included RCTs, 11 were assessed to be of low risk of bias while five out of six prospective cohort studies were considered high quality using the NOS. The authors did not perform MA because of significant heterogeneity that existed among different studies.With regards to periodontal health, there was no significant difference in probing depth and bleeding on probing between fixed mandibular stainless steel (SS) retainers (bonded to anterior teeth or canines only), fibre reinforced composite retainers or Hawley retainers at three-year follow-up. However, there was increased plaque accumulation around fibre reinforced composite retainers compared to SS retainers. The failure rates of mandibular stainless steel fixed retainers bonded from canine to canine was 0.29 (95 % confidence interval [CI], 0.26, 0.33) over a follow-up period of six to 36 months. The failure risk for mandibular stainless steel fixed retainers bonded to canines only was 0.25 (CI, 0.16, 0.33) over a follow-up period of one to three years. A meta-regression showed that follow-up period was not a predictor of failure rate for mandibular stainless steel fixed retainers. The failure rates of removable retainers (Hawley's or vacuum formed retainers) are lower than the bonded fixed retainers. Removable Hawley's retainer was associated with increased discomfort as well as higher levels of embarrassment with speech and aesthetics. In terms of cost-effectiveness, vacuum-formed retainers were found to be significantly more cost-effective than Hawley retainers or mandibular stainless steel fixed retainers bonded to canines.ConclusionsThere is a lack of high-quality evidence to endorse the use of one type of orthodontic retainer based on their effect on periodontal health, risk of failure, patient-reported outcomes and cost-effectiveness.

Comparison Between Removable and Fixed Orthodontic Retainers

Background: There are two kinds of retainers: removable retainer and fixed retainer. Removable retainer is an orthodontic retainer which can be inserted and removed by the patient, whereas fixed retainer is bonded permanently on teeth, it cannot be removed by the patient. It is important to know which retainer that most effective based on the existing case. Purpose: To identify the comparison between removable and fixed retainers in orthodontic treatment. Review: Hawley retainer, Beggs retainer, clip on retainer, Kesling’stooth positioners and invisible retainer are removable retainers whereas fixed retainers include banded retainer, bonded retainer and band & spur type retainer. Comparison between removable and fix retainer can be evaluated from several aspects such as: cost, aesthetics, fabrication process, durability, occlusion, hygiene and convenience of use. Conclusion: Whether removable or fixed retainers can be effectively used to prevent relapse post orthodontic treatment depending onthe existing case.

A survey of protocols and trends in orthodontic retention

BackgroundThe objectives of this study were to evaluate retention procedures and protocols which are used by the orthodontists in Lithuania and to identify commonly used types of dental retainers.MethodsOne hundred seven questionnaires in total with 28 multiple-choice questions were sent to all members of the Lithuanian Orthodontic Society. The questionnaire was organized into eight sections representing specific information about socio-demographic status of the respondents, selection of a retention system, details of commonly used fixed and removable retainers, the duration of the retention period, supervision of the retainers, instructions for patients, and necessity of common retention guidelines.ResultsThe overall response rate was 75.7%. All of the respondents prescribed retainers after the orthodontic therapy. More than 40% of the respondents combined fixed and removable retainers in different clinical situations, but the first-choice option after an expansion of the maxillary dental arch was the removable retainer (54.3%); meanwhile, a fixed retainer was used after a correction of any rotations of the mandibular anterior teeth (49.4%). The Hawley retainer was preferred by 90.1% of the respondents for a maxillary dental arch, and 74.1% of them preferred it for a mandibular dental arch. The most preferable fixed retainer was the retainer bonded to all six anterior teeth (in the upper dental arch—by 71.6%; in the lower one—by 80.2%). There was no consensus on the duration of a retention period. Most of the orthodontists checked up retainers three times during the first year (fixed ones—by 42.0%; removable ones—by 30.0%) and once per year after the 1-year retention period (fixed ones—by 44.4%; removable ones—by 40.7%). All orthodontists gave instructions for taking care of an orthodontic retainer. It was observed that the orthodontists with less than 10 years of experience used a protocol based on the skills learned during their postgraduate studies, while orthodontists with more than 10 years of experience used retention procedures based on their orthodontic work practice (p < 0.05).ConclusionsA combination of fixed and removable retainers was the most often used in an orthodontic retention. Evidence-based guidelines are desired for a common retention protocol.

Periodontal implication of bonded and removable retainers: A comparative study

The purpose of this study is to compare the periodontal health of the lower anterior teeth retained with the use of removable and fixed retainers. Fifty four cases receiving comprehensive orthodontic treatment in between 10 to 30 years were randomly selected and divided into 2 groups of 27 each. One group was given removable retainers and other was given fixed retainers. The periodontal status of the patients was accessed with bleeding on probing index, Plaque index and Calculus index. The mean plaque index in case of removable retainers at 1st, 3rd and 6th month were 0.5, 1.0 and 1.7 where as in case of fixed retainers that were 1.8, 3.0 and 4.5. The mean dental calculus index in case of removable retainers at 1st, 3rd and 6th month were 0.0, 0.1 and 0.1 where as in case of fixed retainers that were 0.1, 0.9 and 1.8. In conclusion, removable retainers are superior in oral hygiene maintenance, yet the use of fixed retainers cannot be denied.

A Survey-Based Study on Misplaced or Damaged Removable Retainers

Retention is one of the most important challenges faced by the orthodontist Patient rsquo s need to be reminded that retention phase is a continuation of orthodontic treatment and preserving treatment results successfully will depend on their compliance towards wearing and maintaining appropriate appliances The Retention plan among clinicians can vary from removable or fixed appliances but the most common regime has been an upper removable appliance and a lower fixed appliance The removable retainers are often prescribed for full time wear for the first months Patients often return to the dental office requesting new retainers due to damage or because they lost them We did a study to identify the most common ways removable retainers are lost or damaged and how patients can be educated during delivery of removable retainers to avoid these causes

Performance of Hawley-type retainers: a systematic review of randomized clinical trials.

Although post-treatment changes are almost inevitable, and retention has long been recognized as one of the most critical and routine problems faced by orthodontists, there remains a lack of certainty regarding the parameters of any definitive retention protocol following orthodontic treatment. To investigate the performance of the Hawley-type retainers. Search without restrictions in 15 databases and hand searching until December 2016. Randomized clinical trials comparing the performance of Hawley-type retainers to other removable appliances or comparing different Hawley-type retainers' wearing schedules. Following study retrieval and selection, data extraction and individual study risk of bias assessment using the Cochrane Risk of Bias Tool took place. The overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. Finally, 10 studies were identified involving 854 individuals, followed for up to 1 year after debonding. Eight studies compared subjects using Hawley and clear thermoplastic retainers; another compared Hawley to positioner and, finally, one trial involved individuals allocated to different Hawley appliance wearing schedules. Three studies were considered as being of low, four of unclear, and three of high risk of bias. In general, few differences were observed between the Hawley and other removable retainers regarding outcomes relevant to maxillary and mandibular dental arch measurements, dental arch relationships and occlusal contacts, speech evaluation, patient reported outcomes, adverse effects, and problems related to the appliances, as well as economic evaluation related outcomes. Moreover, no differences were observed between the compared Hawley wearing schedules. Overall, the quality of the available evidence was considered low. Given the overall quality of the available evidence and the multitude of parameters, which may have affected the results of the included trials, good practice would suggest further research in the respective field in order to increase both the quantity and quality of information available. PROSPERO (CRD42015029279). No funding was received for the present systematic review.

Clear retainer

A clear retainer is a removable retainer that is popular in the present day. Compared with conventional fixed and removable orthodontic retainers, it is a more esthetic, comfortable, and inexpensive appliance. Although several studies have been published about clear retainers, it could be difficult to interpret the results because of the variety of study designs, sample sizes, and research methods. This article is intended to compile the content from previous studies and discuss advantages, disadvantages, fabrication, insertion, and adjustment. Moreover, the effectiveness in maintaining dental position, occlusion, retention protocols, thickness, and survival rate of clear retainers is discussed.

Effects of a new type of clear overlay retainer on occlusal contacts.

The popularity of clear overlay retainers (CORs) has increased recently because of their advantages such as better esthetics, cost effectiveness, easy fabrication, and good compliance. However, a deficiency in posterior occlusal settling is a reported limitation of CORs. The aim of this study was to evaluate the posterior occlusal contact changes in a new type of clear orthodontic retainer called Oral-treaper (OTP), which consists of three layers and has stronger mechanical characteristics than do conventional retainers. Three patients who completed fixed orthodontic treatment received OTP as a removable retainer. Cast models were fabricated after the removal of fixed appliances (T1) and after 4 to 11 months of using the retainers (T2). We evaluated all the cast models to compare the post-orthodontic settling pattern during the use of the OTPs. The depth of occlusal contacts was evaluated using color maps. The OTP did not prevent vertical settling in all patients but resulted in an improvement in posterior occlusal contact points.

Orthodontic retention to have and to hold.

Data sourcesCochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, US National Institutes of Health Trials Registry and The World Health Organization (WHO) Clinical Trials Registry Platform, abstracts from the British Orthodontic Conference, the European Orthodontic Conference and the International Association for Dental Research (IADR) from 2011 to 2015 and the bibliographies of identified studies.Study selectionRandomised controlled trials (RCTs) involving children and adults who had had retainers fitted or adjunctive procedures undertaken to prevent relapse following orthodontic treatment with braces were considered.Data extraction and synthesisTwo reviewers independently selected studies, abstracted data and assessed study quality. For continuous data mean differences (MD) with 95% confidence intervals (CI) were calculated with ratios (RR) and 95% CI for dichotomous outcomes.ResultsFifteen studies involving a total of 1722 patients were included. Seven studies were considered to be at high risk of bias, four at low risk and four at unclear risk. For removable retainers versus fixed retainers (three studies) there was low quality evidence that thermoplastic removable retainers provided slightly poorer stability in the lower arch than multistrand fixed retainers: MD (Little's Irregularity Index, 0 mm is stable) 0.6 mm (95% CI 0.17 to 1.03) and of less gingival bleeding with removable retainers: RR 0.53 (95%CI; 0.31 to 0.88). Patients found fixed retainers more acceptable to wear, with a mean difference on a visual analogue scale (VAS; 0 to 100; 100 being very satisfied) of -12.84 (95% CI -7.09 to -18.60).For different types of fixed retainers (four studies) data from three studies (228 patients) comparing polyethylene ribbon bonded retainer versus multistrand retainer were pooled showing no evidence of a difference in failure rates. RR = 1.10 (95%CI; 0.77 to 1.57).Pooled data from two trials (174 patients) comparing the same types of upper fixed retainers, showed a similar finding: RR =1.25 (95%CI; 0.87 to 1.78).For different types of removable retainers (eight studies) one study at low risk of bias comparing upper and lower part-time thermoplastic versus full-time thermoplastic retainers showed no evidence of a difference in relapse (graded moderate quality evidence). Another study, comparing part-time and full-time wear of lower Hawley retainers, found no evidence of any difference in relapse (low quality evidence). Two studies at high risk of bias suggested that stability was better in the lower arch for thermoplastic retainers versus Hawley, and for thermoplastic full-time versus Begg (fulltime) (both low quality evidence). In one study, participants wearing Hawley retainers reported more embarrassment more often than participants wearing thermoplastic retainers: RR 2.42 (95% CI 1.30 to 4.49; one trial, 348 participants, high risk of bias, low quality evidence). They also found Hawley retainers harder to wear. There was conflicting evidence about survival rates of Hawley and thermoplastic retainers.For combination of upper thermoplastic and lower bonded versus upper thermoplastic with lower adjunctive procedures versus positioner (one study) there was no evidence of a difference in relapse between the combination of an upper thermoplastic and lower canine to canine bonded retainer and the combination of an upper thermoplastic retainer and lower interproximal stripping, without a lower retainer. Both these approaches are better than using a positioner as a retainer.ConclusionsWe did not find any evidence that wearing thermoplastic retainers fulltime provides greater stability than wearing them part-time, but this was assessed in only a small number of participants. Overall, there is insufficient high quality evidence to make recommendations on retention procedures for stabilising tooth position after treatment with orthodontic braces. Further high quality RCTs are needed.

Effects of different orthodontic retention protocols on the periodontal health of mandibular incisors.

To test the following two hypotheses: 1) different types of retainers result in distinct levels of biomarkers in gingival crevicular fluid (GCF) and 2) the retainer bonded to all mandibular anterior teeth induces more detrimental outcomes to the periodontium. The Department of Orthodontics at the University of Florida. The population consisted of individuals in the retention phase of orthodontic treatment. This was a cross-sectional study that enrolled 36 individuals. Subjects in group 1 had retainers bonded to the mandibular canines only. Group 2 consisted of individuals having retainers bonded to all mandibular anterior teeth. Group 3 included patients using mandibular removable retainers. After clinical examination, GCF was collected from the mandibular incisor and biomarker levels were compared between the groups. Plaque accumulation and gingivitis differed significantly among groups, with the highest median values in group 2 subjects. Pairwise comparison of the groups with respect to gingivitis showed significant differences between groups 1 and 2. Significant differences among groups were detected for RANKL, OPG, OPN, M-CSF, MMP-3, and MMP-9. The ratio RANKL/OPG was significantly higher in group 2 subjects, with pairwise comparisons indicating that groups 1 and 2 differed from group 3. An association was found between orthodontic retention groups and GCF biomarker levels, which should be further explored in longitudinal studies. The presence of retainers bonded to all anterior teeth seems to increase plaque accumulation and gingivitis.

Retention practices and factors affecting retainer choice among orthodontists in Saudi Arabia.

Objectives:To identify the retention protocols practiced by orthodontists in Saudi Arabia, and the factors affecting retainer choice.Methods:This cross-sectional study took place between February and March of 2015 at the College of Dentistry, University of Dammam, Dammam, Saudi Arabia. A previously tested electronic survey of 34 items was sent to all 1,200 orthodontic members of the Saudi Orthodontic Society. The questionnaire elicited data on the subjects’ demographics, orthodontic treatment practices, retention, and post-retention protocols.Results:One hundred and sixty-seven (13.9%) responses were received during the study period. The results showed predominant use of Hawley in the maxillary arch (61.3%), and fixed lingual in the mandibular arch (58.5%). Approximately 90.3% recommended full-time maxillary removable retainer wear. Overall, orthodontists who performed fewer extractions tended to use fixed retainers, and those who performed more extractions used removable retainers (p=0.018). Interproximal enamel reduction was used by 28% of the respondents as an adjunct procedure to enhance retention. Approximately 64% practiced a post-retention phase of retainer wear. Participants who used removable retainers most commonly prescribed lifetime retention.Conclusion:Hawley in the maxilla, and fixed lingual in the mandible were the most common retention protocols prescribed. Lifetime retention was the most common choice for participants who used removable retainers, especially when extractions were carried out.

Antibacterial properties of retainers with silver nanoparticles

We read with interest the article entitled “Streptococcus mutans counts in patients wearing removable retainers with silver nanoparticles vs those wearing conventional retainers: A randomized clinical trial” in the February issue of the Journal.1Farhadian N. Usefi Mashoof R. Khanizadeh S. Ghaderi E. Farhadian M. Miresmaeili A. Streptococcus mutans counts in patients wearing removable retainers with silver nanoparticles vs those wearing conventional retainers: a randomized clinical trial.Am J Orthod Dentofacial Orthop. 2016; 149: 155-160Abstract Full Text Full Text PDF Scopus (44) Google Scholar Since we are also working in this area, we had a few questions and would like some explanations, if possible. Regarding the synthesis of silver nanoparticles:•Silver nanoparticles can be synthesized by chemical, physical, and biological methods,2Iravani S. Korbekandi H. Mirmohammadi S.V. Zolfaghari B. Synthesis of silver nanoparticles: chemical, physical and biological methods.Res Pharm Sci. 2014; 9: 385-406Google Scholar and cytotoxicity varies accordingly.3de Lima R. Seabra A.B. Durán N. Silver nanoparticles: a brief review of cytotoxicity and genotoxicity of chemically and biogenically synthesized nanoparticles.J Appl Toxicol. 2012; 32: 867-879Crossref Scopus (399) Google Scholar How did the authors synthesize their silver nanoparticles?•Was the antimicrobial resin synthesized in bulk to standardize the amounts of silver nanoparticles in retainers delivered to patients? The cytotoxcity of stored silver nanoparticles is greater as compared with freshly prepared silver nanoparticles.4Kittler S. Greulich C. Diendorf J. Koller M. Epple M. Toxicity of silver nanoparticles increases during storage because of slow dissolution under release of silver ions.Chem Mater. 2010; 22: 4548-4554Crossref Scopus (923) Google Scholar•What was the ratio of polymer to silver nanoparticles? Was the minimum inhibitory concentration (that is, the concentration at which at least 50% of the bacteria are killed) calculated? Regarding the antibacterial properties:•Which species of S mutans was present in McFarland suspensions? The antibacterial effect can vary according to the species (eg, ATCC 25175). Regarding the intervention:•After appliance delivery, were the patients given any oral hygiene instructions or directed to use any mouthwashes? Coexposure of silver nanoparticles and sodium fluoride also affects the cytotoxicity.5Inkielewicz-Stepniak I. Santos-Martinez M.J. Medina C. Radomski M.W. Pharmacological and toxicological effects of co-exposure of human gingival fibroblasts to silver nanoparticles and sodium fluoride.Int J Nanomedicine. 2014; 9: 1677-1687Google Scholar Regarding patient-related outcomes:•The authors claimed that the color of the final appliance, which could be gray to black depending on the concentration of the silver nanoparticles (shown in the Fig), was acceptable to patients. Could colorless silver nanoparticles have been used instead?•Was there any reason to carry out the T2 test after 7 weeks, since the retention period was 1 year? Perhaps the antibacterial activity could have been analyzed at regular intervals, since there could be differences in silver ions released during the long term.•Cytotoxicity to human gingival fibroblasts should have been tested at the first stage before conducting the in-vivo study because silver has been claimed to have not only cytotoxicity but also genotoxicity.6AshaRani P.V. Low Kah Mun G. Hande M.P. Valiyaveettil S. Cytotoxicity and genotoxicity of silver nanoparticles in human cells.ACS Nano. 2008; 3: 279-290Crossref Scopus (2931) Google Scholar The urinalyses and hematologic tests should have been done as mentioned in the Discussion. We acknowledge the scientific inputs of Meryam S. Rizvi, associate professor, and Jahirul Mazumder, PhD student, Department of Bioscience, Jamia Millia Islamia University, Delhi, India, for their critical review of the study by Farhadian et al. Streptococcus mutans counts in patients wearing removable retainers with silver nanoparticles vs those wearing conventional retainers: A randomized clinical trialAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 149Issue 2PreviewThe rough surface of Hawley removable appliances provides an environment for plaque accumulation, leading to enamel demineralization. The aim of this study was to evaluate the effect of silver nanoparticles incorporated into acrylic baseplates of orthodontic retainers on Streptococcus mutans colony-forming units. Full-Text PDF Authors' responseAmerican Journal of Orthodontics and Dentofacial OrthopedicsVol. 150Issue 2PreviewWe appreciate being given the opportunity to discuss the details of our study1 and hope the following explanation will be helpful. Full-Text PDF

Antimicrobial activity of a quaternary ammonium methacryloxy silicate-containing acrylic resin: a randomised clinical trial.

Quaternary ammonium methacryloxy silicate (QAMS)-containing acrylic resin demonstrated contact-killing antimicrobial ability in vitro after three months of water storage. The objective of the present double-blind randomised clinical trial was to determine the in vivo antimicrobial efficacy of QAMS-containing orthodontic acrylic by using custom-made removable retainers that were worn intraorally by 32 human subjects to create 48-hour multi-species plaque biofilms, using a split-mouth study design. Two control QAMS-free acrylic disks were inserted into the wells on one side of an orthodontic retainer, and two experimental QAMS-containing acrylic disks were inserted into the wells on the other side of the same retainer. After 48 hours, the disks were retrieved and examined for microbial vitality using confocal laser scanning microscopy. No harm to the oral mucosa or systemic health occurred. In the absence of carry-across effect and allocation bias (disks inserted in the left or right side of retainer), significant difference was identified between the percentage kill in the biovolume of QAMS-free control disks (3.73 ± 2.11%) and QAMS-containing experimental disks (33.94 ± 23.88%) retrieved from the subjects (P ≤ 0.001). The results validated that the QAMS-containing acrylic exhibits favourable antimicrobial activity against plaque biofilms in vivo. The QAMS-containing acrylic may also be used for fabricating removable acrylic dentures.

Retention procedures for stabilising tooth position after treatment with orthodontic braces.

Retention procedures for stabilising tooth position after treatment with orthodontic braces.

The quality of information on the Internet on orthodontic retainer wear: a cross-sectional study

The objectives of this study were to assess the accessibility, usability, reliability and quality of information on the Internet written for the lay public about orthodontic retainers, and to elucidate the different retention protocols encouraged. A cross-sectional, observational study. Online, using a computer connected to the Internet in Australia. Two search terms; 'orthodontic retainer' and 'how long should someone wear a retainer after their braces are removed?' were entered alternatively into five search engines. Twenty results for each search term per search engine that fulfilled the inclusion criteria were evaluated in terms of accessibility, usability, reliability and quality of information using the LIDA and DISCERN instruments, ensuring there were no internal or cross-search engine duplicates. Any information about frequency and duration of retainer wear was also collected. Two hundred different websites were identified and assessed. The median overall LIDA score was 72%, corresponding to a moderate quality level. The median total DISCERN score was 47%. Twenty-two websites recommended patients adhere to the specific protocol prescribed to them by their practitioner. There were 45 (22.5%) and 28 (14%) websites advising indefinite use of removable and bonded retainers respectively. Information about retainers on the Internet is easily accessible and usable, though the quality of the content is generally of a moderate level. However, the information is not always accurate and reliable. Both full-time and part-time wear of removable retainers was suggested over greatly varying time periods. Indefinite wear of removable and bonded retainers was also advocated.

A survey on retention practice among orthodontists in Malaysia.

ObjectiveThe aim of this study was to evaluate retention practices commonly employed by orthodontists. The objectives were to identify the types of retainer frequently used and to investigate the variations in retention practice.MethodsA total of 97 orthodontists were randomly selected, and a questionnaire consisting of 25 multiple-choice questions sent to them by mail. Upon receiving of the completed questionnaires, the data were statistically analyzed.ResultsA total of 32 responses were received; among these, 59.4% of orthodontists' practiced is in a government setting and 40.6% were in private practice. A vacuum-formed retainer was the most commonly used removable retainer for both maxillary (46.9%) and mandibular (46.9%) arches, followed by a Hawley retainer (maxilla, 43.8%; mandible, 37.5%), and a fixed retainer (maxilla, 3.1%; mandible, 9.4%). Of the responding orthodontists, 78.1% prescribed full-time wear (more than 20 h per day) for a duration of 3–9 months for a maxillary arch, compared to 71.9% for the mandibular arch. Only 18.8% of the orthodontists prescribed part-time wear of the retainer for the maxillary arch, compared to 21.9% for the mandibular arch. The majority of orthodontists did not instruct their patients to stop wearing removable retainers (71.9%) or fixed retainers (66.8%) at any specific time and they preferred their patients to continue wearing retainers.ConclusionsVacuum-formed retainers are the most commonly used retainers among orthodontists. The majority of orthodontists prescribed full-time wear for more than 20 h per day with a duration of 3–9 months and preferred indefinite use of the retainer.

Assessment of Factors Affecting Adolescent Patients' Compliance with Hawley and Vacuum Formed Retainers.

Success of orthodontic retention with removable retainers almost entirely depends on patients' compliance. This study was carried out to investigate the relationship between adolescent orthodontic patients' compliance and various clinical and social factors. The data were collected from 77 orthodontic patients aged 7-11 years old who had finished the full fixed appliance therapy. Hawley's retainers were used in 34 patients and 43 patients used Vacuum Formed Retainers (VFRs). The subjects completed a questionnaire including several identifiers allowing the respondents to be classified into subgroups. They were also asked to indicate how long they wore their retainers during the day, by writing the number of hours in the report-card for the next three months. Comparison of the results was performed by one-way ANOVA and independent sample-t tests. No significant differences were found between males and females. Type of the retainer, patients' grade of study, mothers' occupation, clinicians' and parents' attitudes and filling the report cards had significant effect on mean wear hours per day. When compliance of the patients was assessed according to treatment location, Living place, parents' educational degrees and ethnicity, no significant differences could be found. The adolescent patients' compliance was greater with VFRs than with Hawley's retainers. Parental attitude and doctor-patient relationship had a great impact on adolescent patients' compliance.

Posttreatment and retention outcomes with and without periodontally accelerated osteogenic orthodontics assessed using ABO objective grading system

Background: The posttreatment and retention outcomes following nonextraction orthodontic therapy, with and without corticotomy, were assessed using the American Board of Orthodontists objective grading system (OGS). Purpose: The purpose was to determine if the course of retention was any different following alveolar decortication and augmentation bone grafting, i.e., periodontally accelerated osteogenic orthodontics (PAOO). Materials and Methods: Study casts and panoramic radiographs of patients with and without PAOO (28 subjects each) were selected on the basis of the following: (1) comprehensive nonextraction orthodontic treatment using straight wire edgewise appliances for Class I crowding, (2) availability of immediate posttreatment records and retention records at least 1 year post de-bracketing, and (3) use of Hawley removable retainers with similar wearing instructions. Results: Independent and paired t -test statistical testing revealed the following: (1) Posttreatment orthodontic outcomes were the same, with or without corticotomy. (2) During retention, 5 of 8 ABO grading criteria improved for the sample without corticotomy, and 6 of 8 ABO grading criteria improved for the group with corticotomy. (3) Retention outcome scores were lower (better) for alignment and marginal ridges in the corticotomy-facilitated group. (4) The total score was significantly lower (better) for the corticotomy group at retention and the increment of total score change decreased (improved) significantly more during retention following corticotomy. Conclusions: The retention phase was more favorable following corticotomy because the amount of OGS total score change demonstrated a significantly improved retention outcome following PAOO therapy.

Orthodontic occlusion and temporary removable retainers

Implementing retention at end of orthodontic treatment is not straightforward: it may induce harmful side-effects on occlusion, muscles, joints and posture.To foresee and prevent such risks, exhaustive clinical examination should be performed ahead of the retention phase: history taking, intra- and extra-oral examination, and static and dynamic analysis. The choice of type of retention appliance will result from this appraisal:The practitioner should be rigorous in producing the device (form and choice of material), fitting it (fixity, stabilization), adjusting it (balance), and above all in follow-up.Whatever the selected retention system, regular clinical follow-up is mandatory, to monitor ongoing adaptive balance: teeth, joints, muscles, etc.

Dental materials: The multi-stranded wire retainer

Fixed retainers offer many advantages for the orthodontic patient, including reduced need for patient compliance, better aesthetics and long-term stability, with the multi-stranded wire retainer, the gold standard, explains J. I. J. Green Retention is the phase of orthodontics that aims to preserve teeth in their desired positions after active orthodontic treatment and is achieved with fixed or removable retainers. Fixed retainers offer many advantages over the removable type: reduced need for patient compliance, better aesthetics and predictable long-term stability. The first fixed retainer consisted of a stainless steel wire soldered to bands on the canines or premolars but today they are usually bonded to the teeth with light-cured composite. Many materials and wire diameters have been proposed; this article focuses on the multi-stranded wire retainer, which has become the gold standard for maintaining incisor alignment.