Background: Orthodontic therapy always ends with retention to prevent the return of the final occlusal outcome and to maintain the teeth in the correct position after the end of orthodontic therapy. This research aimed to survey retention practices, factors affecting retention protocol and differences regarding retention among orthodontists in North Macedonia. Material and methods: 150 questionnaire copies were distributed by mail or personally to orthodontics in North Macedonia. The survey included 24 single or multiple-answer questions, about retention system, frequently used fixed and removable retainers in certain malocclusions, the duration of the retention period, retainer supervision, instructions for patients, and the need for retention guidelines in order to determine habits and knowledge, and reasons for choosing a particular retention regime. Results : Out of 150 questionnaires, 93 were appropriately filled out and returned, so response rate was 62%. 90% give oral information about retention, only 25% informed their patients both oral and written. The most preferred retainer in maxilla (54%) was vacuum-formed appliance, than removable acrylic plate appliance (41%) and only 9% bonded retainer. In mandible, mostly used are VFR (45%), then acrylic plate appliance (29%), bonded retainers (20%). Dual retention was used more in upper jaw. The retention period was 4 to 5 years or lifelong; the choice of retention device in 77% depended on malocclusion. The reason for the choice of VFR are availability (50,5%), quality (36,56%), low-cost (33,3%). Protocol was influenced by clinical experience (75%), knowledge from residency (58%), courses (56%) and from colleagues (40%). 83% made changes in retention protocol in past years, in appliance time (20%) or in retention period (19%). 95,7% of the surveyed orthodontists believe that general guidelines for retention are needed. Conclusions: The most preferred retainers in North Macedonia were vacuum-formed appliance, than removable acrylic plate appliance and at least bonded retainer. Combination of fixed and removable appliance in mandible were used less than in upper jaw. Reason for choosing was malocclusion. Retention protocols are influenced mostly by the clinical experience. Common retention guidelines are required for most orthodontists.
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