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Petsos H, Usherenko R, Dahmer I, Eickholz P, Kopp S, Sayahpour B. Influence of fixed orthodontic steel retainers on gingival health and recessions of mandibular anterior teeth in an intact periodontium - a randomized, clinical controlled trial. BMC Oral Health 2024; 24:236. [PMID: 38355505 PMCID: PMC10868120 DOI: 10.1186/s12903-024-03998-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 02/08/2024] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE Aim of this randomized clinical controlled trial was to evaluate the influence of fixed orthodontic steel retainers on gingival health and recessions of mandibular anterior teeth. MATERIALS AND METHODS After end of the orthodontic treatment, patients were randomly assigned into the test (fixed steel retainer) or control group (modified removable vacuum-formed retainer). Periodontal parameters (periodontal probing depth: PPD; recession: REC; bleeding on probing: BOP) as well as plaque and gingival index were assessed on mandibular anterior teeth directly before attaching/handing over the retainer (baseline: BL), 6 and 12 months after orthodontic treatment. RESULTS 37 patients (test: n = 15, mean age: 16.1±4.2 years; control: n = 17, mean age: 17.1±5.4 years) completed the study. REC and PPD failed to show significant pairwise differences. The number of patients showing gingival health in the area of the mandibular anterior teeth (test: BL n = 10, 6 months n = 9, 12 months n = 11; control: BL n = 10, 6 months n = 16, 12 months n = 15) revealed a significant difference for the intra-group comparison between BL and 6 months in the control group (p = 0.043). The inter-group comparisons failed to show significant differences. CONCLUSION Young orthodontically treated patients with fixed steel retainers show in 73.3% healthy gingival conditions after one year which are comparable to the control group (88.2%). Gingival recessions were in a clinically non-relevant range at any time of the examination. CLINICAL TRIAL NUMBER DRKS00016710.
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Affiliation(s)
- Hari Petsos
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany.
| | | | - Iulia Dahmer
- Institute of Biostatistics and Mathematical Modeling, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
- Center of Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Peter Eickholz
- Department of Periodontology, Center of Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Stefan Kopp
- Department of Orthodontics, Center of Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
| | - Babak Sayahpour
- Department of Orthodontics, Center of Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt/Main, Germany
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Sapata DM, Oliveira E Silva CD, Pascotto RC, Poleti TMFF, Arai MSI, Ramos AL. Periodontal indexes of two types of 3 x 3 retainers: 0.032-in SS V-loop versus 0.0215-in SS coaxial - a randomized crossover trial. Dental Press J Orthod 2024; 28:e2323175. [PMID: 38198390 PMCID: PMC10773445 DOI: 10.1590/2177-6709.28.6.e2323175.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/24/2023] [Indexed: 01/12/2024] Open
Abstract
OBJECTIVE This randomized crossover trial evaluated periodontal indexes of two types of 3 x 3 retainers (a modified 0.032-in SS V-loop retainer and a conventional 0.0215-in SS coaxial wire retainer) after bonded for six months. Also, bonded failure rate, and a questionnaire about comfort, ease of cleaning and overall preference were recorded. MATERIAL AND METHODS 15 patients were enrolled in this study who used both retainers for six months each, having a 15-day wash-out interval between each bonded retainer usage. The following periodontal index were recorded: Plaque Index (PI), Calculus Index (CI) and Gingival Index (GI). Patients answered a questionnaire to assess comfort, ease of cleaning and overall retainer-type preference. Rate of bonding failure was also evaluated. RESULTS V-Loop retainer showed higher PI (P<0.05) as compared to conventional 0.0215-in coaxial wire retainer. However, CI and GI presented no statistically significant differences between both types of retainers. The conventional 0.0215-in coaxial wire retainer was chosen as the most comfortable (p<0.05), although no statistically significant differences were found for all other questionnaire answers. Bonding failure events were more observed in the 3x3 V-Loop retainer (p<0.002), as compared to the conventional 0.0215-in coaxial retainer. CONCLUSION V-Loop retainer showed higher PI (p<0.05), higher bonding failure rate and less comfortable, as compared to conventional 0.0215-in coaxial wire.
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Affiliation(s)
- Diogo Marques Sapata
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
| | | | | | | | | | - Adilson Luiz Ramos
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
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Padula T, Wilhelmsson T, Naoumova J. Failure frequency of fixed mandibular retainers after pre-treatment of the enamel surface with pumice versus sandblasting-a randomized controlled trial. Eur J Orthod 2023; 45:637-644. [PMID: 37032532 DOI: 10.1093/ejo/cjad010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
BACKGROUND/OBJECTIVES To compare retainer survival, periodontal health, and caries implications of fixed lower retainers bonded after pre-treatment of the enamel surface with either pumice or sandblasting. TRIAL DESIGN Two-arm parallel-group, two-center randomized controlled clinical trial. METHODS One hundred sixty patients (101 females, 59 males, mean age: 17.9) requiring mandibular retainers were consecutively recruited. Patients were randomly allocated to have pre-treatment of the enamel surface with either pumice (n = 80) or sandblasting (n = 80). The primary outcome was retainer survival at 3 (T1) and 12 months (T2) control. Secondary outcomes were carious lesions and periodontal health: plaque index (PI), gingival index (GI), calculus index (CI), and probing depth (PD). The randomization sequence was generated using an online randomization and allocation concealment was secured by contacting the sequence generator for treatment assignment. Blinding was not possible at T0 due to the nature of the intervention. Statistical analyses were carried out using the t-test, Fisher's exact test, repeated measure analysis of variance, and log rank test. RESULTS Overall, the risk of bonding failure at T1 was 6.7 per cent and at T2 6.9 per cent. There were no statistically significant differences in failure rate between the two groups, neither at T1 (P = 1.000) nor at T2 (P = 0.360). No statistically significant differences were found for the intercanine periodontal indices GI, PI, CI, PD, and caries between the two groups at T0 and T1. At T2, significantly more gingivitis and plaque were seen in the sandblasting group (P = 0.05 and P = 0.047, respectively) compared with the pumice group. Calculus increased during the follow-up period in both groups (P ≤ 0.001) as well as plaque levels (P ≤ 0.001 and P = 0.025, respectively). No harm was reported. CONCLUSIONS Enamel sandblasting prior to bonding mandibular retainers is not better at preventing bonding failure. REGISTRATION 275767 (https://www.researchweb.org/is/sverige).
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Affiliation(s)
- Tommaso Padula
- Specialist Clinic of Orthodontics, Public Dental Service, Gothenburg, Region Västra Götaland, Sweden
| | - Teresia Wilhelmsson
- Specialist Clinic of Orthodontics, Public Dental Service, Alingsås, Region Västra Götaland, Sweden
| | - Julia Naoumova
- Specialist Clinic of Orthodontics, Public Dental Service, Gothenburg, Region Västra Götaland, Sweden
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Tsoukala E, Lyros I, Tsolakis AI, Maroulakos MP, Tsolakis IA. Direct 3D-Printed Orthodontic Retainers. A Systematic Review. CHILDREN 2023; 10:children10040676. [PMID: 37189925 DOI: 10.3390/children10040676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/05/2023]
Abstract
Three-dimensional (3D) printing technology has shed light on many fields in medicine and dentistry, including orthodontics. Direct 3D-printed prosthetics, implants or surgical devices are well-documented. The fabrication of orthodontic retainers using CAD technology and additive manufacturing is an emerging trend but the available data are scarce. The research approach of the present review included keywords in Medline, Scopus, Cochrane Library and Google Scholar up to December 2022. The searching process concluded with five studies eligible for our project. Three of them investigated directly 3D-printed clear retainers in vitro. The other two studies investigated directly 3D-printed fixed retainers. Among them, one study was in vitro and the second was a prospective clinical trial. Directly 3D-printed retainers can be evolved over time as a good alternative to all the conventional materials for retention. Devices that are 3D-printed are more time and cost efficient, offer more comfortable procedures for both practitioners and patients and the materials used in additive manufacturing can solve aesthetic problems, periodontal issues or problems with the interference of these materials with magnetic resonance imaging (MRI). More well-designed prospective clinical trials are necessary for more evaluable results.
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Affiliation(s)
- Efthimia Tsoukala
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
| | - Ioannis Lyros
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
| | - Apostolos I. Tsolakis
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
- Department of Orthodontics, School of Dentistry, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Michael P. Maroulakos
- Department of Orthodontics, National and Kapodistrian University of Athens, School of Dentistry, 11527 Athens, Greece
| | - Ioannis A. Tsolakis
- Department of Orthodontics, School of Dentistry, Case Western Reserve University, Cleveland, OH 44106, USA
- Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Quinzi V, Carli E, Mummolo A, De Benedictis F, Salvati SE, Mampieri G. Fixed and removable orthodontic retainers, effects on periodontal health compared: A systematic review. J Oral Biol Craniofac Res 2023; 13:337-346. [PMID: 36937559 PMCID: PMC10020103 DOI: 10.1016/j.jobcr.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 01/28/2023] [Accepted: 02/25/2023] [Indexed: 03/11/2023] Open
Abstract
The aim of this systematic review is to analyze the properties of the different types of orthodontic retainers, identify their differences and define which type of device is most effective and less harmful to periodontal health. Methods A literature search was carried out by a reviewer by consulting PubMed, Lilacs, Embase, Medline full text, Scopus, Web of Science, Cochrane library, and Science Direct electronic databases for biomedical and health literature as well as the grey literature and setting up the search from December 2010 without any restriction about articles languages. Results The results showed that patients who wear retainers for a long period have significant differences in clinical parameters compared to patients without retainers. The type of retainer chosen also significantly influences the overall periodontal health of patients. Fixed retainers, both glass-fibre reinforced and steel wire retainers, proved to be the retainer type with the highest plaque and calculus accumulation values compared to removable retainers. In addition, among fixed retainers, glass-fibre reinforced retainers proved to be those that mostly promote the plaque and calculus accumulation in the application site. Conclusion Fixed retainers are the best devices to maintain the alignment of mandibular anterior teeth in the long term. Among these devices, stainless steel lingual retainers, plain or braided, should remain the first choice. Although they are also susceptible to periodontal complications, their effect on periodontal health can be considered statistically insignificant if compared to glass-fibre reinforced retainers which, showing worse periodontal complications, should not be used.
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Affiliation(s)
- Vincenzo Quinzi
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Elisabetta Carli
- Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Alessandra Mummolo
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Federica De Benedictis
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Simone Ettore Salvati
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Gianluca Mampieri
- Department of Clinical Science and Translational Medicine, University of Rome, Tor Vergata, Italy
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Lyros I, Tsolakis IA, Maroulakos MP, Fora E, Lykogeorgos T, Dalampira M, Tsolakis AI. Orthodontic Retainers-A Critical Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020230. [PMID: 36832359 DOI: 10.3390/children10020230.pmid:36832359;pmcid:pmc9954726] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 05/25/2023]
Abstract
The achievement of aesthetic, functional occlusion should not mark the end of the orthodontic intervention. To prevent relapse, retention needs advance planning, and may vary in duration. This review aims to present and comment on the available means of retention. The ever-popular, passive Hawley-like removable appliances are credible in maintaining the desired occlusion. Modifications are the removable appliance Wrap Around, having the labial archwire extending to the premolars; the translucent retainer, Astics, a unique aesthetic Hawley-type device; and the reinforced removable retainer, which features a metallic grid reinforcing the acrylic base. Vacuum-formed retainers are easy to fabricate and are readily prescribed. By contrast, fixed retainers are made of orthodontic wire and composite resin bonded on the lingual or palatal surfaces of the anterior teeth. Patient-related variables need evaluation to select the appropriate retainer, while patients ought to realize the importance of retention and comply with offered guidance. Overall, the orthodontist is responsible for keeping the patient informed on the properties and the duration of retention, even before starting active orthodontic treatment.
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Affiliation(s)
- Ioannis Lyros
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Ioannis A Tsolakis
- Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54623 Thessaloniki, Greece
| | - Michael P Maroulakos
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Eleni Fora
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | | | - Apostolos I Tsolakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Orthodontics, Case Western Reserve University, Cleveland, OH 44106, USA
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Lyros I, Tsolakis IA, Maroulakos MP, Fora E, Lykogeorgos T, Dalampira M, Tsolakis AI. Orthodontic Retainers-A Critical Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020230. [PMID: 36832359 PMCID: PMC9954726 DOI: 10.3390/children10020230] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 01/23/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
The achievement of aesthetic, functional occlusion should not mark the end of the orthodontic intervention. To prevent relapse, retention needs advance planning, and may vary in duration. This review aims to present and comment on the available means of retention. The ever-popular, passive Hawley-like removable appliances are credible in maintaining the desired occlusion. Modifications are the removable appliance Wrap Around, having the labial archwire extending to the premolars; the translucent retainer, Astics, a unique aesthetic Hawley-type device; and the reinforced removable retainer, which features a metallic grid reinforcing the acrylic base. Vacuum-formed retainers are easy to fabricate and are readily prescribed. By contrast, fixed retainers are made of orthodontic wire and composite resin bonded on the lingual or palatal surfaces of the anterior teeth. Patient-related variables need evaluation to select the appropriate retainer, while patients ought to realize the importance of retention and comply with offered guidance. Overall, the orthodontist is responsible for keeping the patient informed on the properties and the duration of retention, even before starting active orthodontic treatment.
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Affiliation(s)
- Ioannis Lyros
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
| | - Ioannis A. Tsolakis
- Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54623 Thessaloniki, Greece
| | - Michael P. Maroulakos
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Eleni Fora
- Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | | | - Apostolos I. Tsolakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Orthodontics, Case Western Reserve University, Cleveland, OH 44106, USA
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Behm C, Nemec M, Weissinger F, Rausch MA, Andrukhov O, Jonke E. MMPs and TIMPs Expression Levels in the Periodontal Ligament during Orthodontic Tooth Movement: A Systematic Review of In Vitro and In Vivo Studies. Int J Mol Sci 2021; 22:6967. [PMID: 34203475 PMCID: PMC8268288 DOI: 10.3390/ijms22136967] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 12/11/2022] Open
Abstract
Background: During orthodontic tooth movement (OTM), applied orthodontic forces cause an extensive remodeling of the extracellular matrix (ECM) in the periodontal ligament (PDL). This is mainly orchestrated by different types of matrix metalloproteinases (MMPs) and their tissue inhibitors of matrix metalloproteinases (TIMPs), which are both secreted by periodontal ligament (PDL) fibroblasts. Multiple in vitro and in vivo studies already investigated the influence of applied orthodontic forces on the expression of MMPs and TIMPs. The aim of this systematic review was to explore the expression levels of MMPs and TIMPs during OTM and the influence of specific orthodontic force-related parameters. Methods: Electronic article search was performed on PubMed and Web of Science until 31 January 2021. Screenings of titles, abstracts and full texts were performed according to PRISMA, whereas eligibility criteria were defined for in vitro and in vivo studies, respectively, according to the PICO schema. Risk of bias assessment for in vitro studies was verified by specific methodological and reporting criteria. For in vivo studies, risk of bias assessment was adapted from the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional study. Results: Electronic article search identified 3266 records, from which 28 in vitro and 12 in vivo studies were included. The studies showed that orthodontic forces mainly caused increased MMPs and TIMPs expression levels, whereas the exact effect may depend on various intervention and sample parameters and subject characteristics. Conclusion: This systematic review revealed that orthodontic forces induce a significant effect on MMPs and TIMPs in the PDL. This connection may contribute to the controlled depletion and formation of the PDLs' ECM at the compression and tension site, respectively, and finally to the highly regulated OTM.
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Affiliation(s)
- Christian Behm
- Clinical Division of Orthodontics, University Clinic of Dentistry, Sensengasse 2A, 1090 Vienna, Austria; (C.B.); (M.N.); (M.A.R.); (E.J.)
- Competence Centre for Periodontal Research, University Clinic of Dentistry, Sensengasse 2A, 1090 Vienna, Austria;
| | - Michael Nemec
- Clinical Division of Orthodontics, University Clinic of Dentistry, Sensengasse 2A, 1090 Vienna, Austria; (C.B.); (M.N.); (M.A.R.); (E.J.)
| | - Fabian Weissinger
- Competence Centre for Periodontal Research, University Clinic of Dentistry, Sensengasse 2A, 1090 Vienna, Austria;
| | - Marco Aoqi Rausch
- Clinical Division of Orthodontics, University Clinic of Dentistry, Sensengasse 2A, 1090 Vienna, Austria; (C.B.); (M.N.); (M.A.R.); (E.J.)
- Competence Centre for Periodontal Research, University Clinic of Dentistry, Sensengasse 2A, 1090 Vienna, Austria;
| | - Oleh Andrukhov
- Competence Centre for Periodontal Research, University Clinic of Dentistry, Sensengasse 2A, 1090 Vienna, Austria;
| | - Erwin Jonke
- Clinical Division of Orthodontics, University Clinic of Dentistry, Sensengasse 2A, 1090 Vienna, Austria; (C.B.); (M.N.); (M.A.R.); (E.J.)
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Retention Protocols and Factors Affecting Retainer Choice among Iraqi Orthodontists. Int J Dent 2020; 2020:8810641. [PMID: 33149739 PMCID: PMC7603596 DOI: 10.1155/2020/8810641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/19/2020] [Accepted: 10/01/2020] [Indexed: 11/17/2022] Open
Abstract
Background To identify the most common retention protocols practiced by Iraqi orthodontists using a specially designed e-survey. Furthermore, this study aimed to assess the effect of sociodemographic factors on the participant's choice. Methods Two hundred and twenty-five questionnaires with 23 multiple choice questions were sent to members of the Iraqi Orthodontic Society. The questionnaire was organized into four sections representing information about sociodemographic status of the orthodontists, factors affecting the selection of the retention system, commonly used retainers in the upper arch and lower arch, and duration of the retention system. The chi-square test was used to test the significant association between different variable and sociodemographic factors. Results The response rate was 87.5%. The majority of the respondents considered the original malocclusion (80.2%) and clinical experience (49.7%) as the main factors for choosing the retention protocol. In the maxillary arch, a combination of vacuum-formed retainer and fixed retainer (35%) was mostly applied; in the mandibular arch, a fixed retainer was mainly used (46.7%). Most of the respondents recommended initial full-time wearing of a removable appliance (78.2%), especially in the first 3-6 months (47.2%). According to the respondents, bonding a fixed retainer to all anterior teeth was most common (79.7%), fabricated, and adapted directly inside the patient's mouth (75.1%). More than half used flowable composite (54.8%) and recommend leaving the retainer forever (53.8%). Most of the variables showed a statistically significant association between the sociodemographic factors and type, duration, and fabrication of the retainer used. Conclusions A combination of removable and fixed retainers was commonly used in orthodontics retention, and sociodemographic factors significantly affected retainer choice.
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Arn ML, Dritsas K, Pandis N, Kloukos D. The effects of fixed orthodontic retainers on periodontal health: A systematic review. Am J Orthod Dentofacial Orthop 2020; 157:156-164.e17. [PMID: 32005466 DOI: 10.1016/j.ajodo.2019.10.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The objective of this systematic review was to assess the available evidence in the literature for the effects of fixed orthodontic retainers on periodontal health. METHODS The following databases were searched up to August 31, 2019: Medline, EMBASE, the Cochrane Oral Health Group's Trials Register, CENTRAL, ClinicalTrials.gov, the National Research Register, and Pro-Quest Dissertation Abstracts and Thesis database. Randomized controlled trials (RCTs), controlled clinical trials, cohort studies of prospective and retrospective design, and cross-sectional studies reporting on periodontal measurements of patients who received fixed retention after orthodontic treatment were eligible for inclusion. The quality of the included RCTs was assessed per the revised Cochrane risk of bias tool for randomized trials (RoB 2.0), whereas the risk of bias of the included cohort studies was assessed using the Risk Of Bias In Nonrandomized Studies of Interventions tool. A modified version of the Newcastle-Ottawa scale was used for cross-sectional studies. RESULTS Eleven RCTs, 4 prospective cohort studies, 1 retrospective cohort study, and 13 cross-sectional studies fulfilled the inclusion criteria. The quality of evidence was low for most of the included studies. In contrast to the general consensus, 2 RCTs, 1 prospective cohort study, and 2 cross-sectional studies reported poorer periodontal conditions in the presence of a fixed retainer. The results of the included studies comparing different types of fixed retainers were heterogeneous. CONCLUSIONS According to the currently available literature, orthodontic fixed retainers seem to be a retention strategy rather compatible with periodontal health, or at least not related to severe detrimental effects on the periodontium.
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Affiliation(s)
- Marie-Laure Arn
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland
| | - Konstantinos Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland
| | - Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, School of Dentistry, University of Bern, Bern, Switzerland; Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force General Hospital, Athens, Greece.
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Ferreira LA, Sapata DM, Provenzano MGA, Hayacibara RM, Ramos AL. Periodontal parameters of two types of 3 x 3 orthodontic retainer: a longitudinal study. Dental Press J Orthod 2019; 24:64-70. [PMID: 31390451 PMCID: PMC6677337 DOI: 10.1590/2177-6709.24.3.064-070.oar] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 07/31/2018] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION bonded fixed retainers are often used to stabilize the results obtained with the orthodontic treatment. It is important that they do not prejudice dental health, as they will be used for a long period. OBJECTIVE The purpose of the present study was to compare periodontal indexes between two types of bonded fixed retainers, conventional 3 x 3 plain retainer (0.8-mm orthodontic wire, bonded to the canines only) and a manufactured braided retainer (0.2 x 0.7-mm stainless steel wire, bonded to all anterior teeth) after use. METHODS a test group of 15 volunteers (aged from 18 to 25 years) used both the conventional retainer and braided retainer for six months. A randomized longitudinal study design, with a two week washout interval, was applied. The dental plaque index, gingival index and dental calculus index were evaluated. Furthermore, the calculus accumulated along the retainer wire was measured and all patients answered a questionnaire about the use, acceptance and comfort of both types of retainers. RESULTS the scores for plaque and gingival indexes were higher for the braided retainer (p< 0.05) on the lingual and proximal surfaces. The same occurred with the calculus index on the lingual surfaces (p< 0.05). The calculus index along wire was higher for the braided retainer (p< 0.05). All patients preferred the conventional retainer, and said that it was also more comfortable to use. CONCLUSION it was concluded that the conventional retainer showed better periodontal indexes than the braided type.
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Affiliation(s)
- Larissa A Ferreira
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
| | - Diogo M Sapata
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
| | - Maria G A Provenzano
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
| | - Roberto M Hayacibara
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
| | - Adilson L Ramos
- Universidade Estadual de Maringá, Departamento de Odontologia (Maringá/PR, Brazil)
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Long-term effects of Class II orthodontic treatment on oral health. J Orofac Orthop 2018; 79:96-108. [PMID: 29464289 DOI: 10.1007/s00056-018-0125-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/08/2018] [Indexed: 10/18/2022]
Abstract
AIM To investigate the long-term (≥15 years) benefit of orthodontic Class II treatment (Tx) on oral health (OH). SUBJECTS AND METHODS All patients (Department of Orthodontics, University of Giessen, Giessen, Germany) who underwent Class II correction (Herbst-multibracket Tx, end of active Tx ≥ 15 years ago) and agreed to participate in a recall (clinical examination, interview, impressions, and photographs) were included. Records after active Tx were used to assess the long-term OH effects. Data were compared to corresponding population-representative age-cohorts as well as to untreated Class I controls without orthodontic Tx need during adolescence. RESULTS Of 152 treated Class II patients, 75 could be located and agreed to participate at 33.7 ± 3.0 years of age (pre-Tx age: 14.0 ± 2.7 years). The majority (70.8%) were fully satisfied with their teeth and with their masticatory system. The Decayed, Missing, Filled Teeth Index (DMFT) was 7.1 ± 4.8 and, thus, almost identical to that of the untreated Class I controls (7.9 ± 3.6). In contrast, the DMFT in the population-representative age-cohort was 56% higher. The determined mean Community Periodontal Index (CPI) maximum score (1.6 ± 0.6) was also comparable to the untreated Class I controls (1.7 ± 0.9) but in the corresponding population-representative age-cohort it was 19-44% higher. The extent of lower incisor gingival recessions did not differ significantly between the treated Class II participants and the untreated Class I controls (0.1 ± 0.2 vs. 0.0 ± 0.1 mm). CONCLUSION Patients with orthodontically treated severe Class II malocclusions had a lower risk for oral health impairment than the general population. The risk corresponded to that of untreated Class I controls (without orthodontic Tx need during adolescence).
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Storey M, Forde K, Littlewood SJ, Scott P, Luther F, Kang J. Bonded versus vacuum-formed retainers: a randomized controlled trial. Part 2: periodontal health outcomes after 12 months. Eur J Orthod 2017; 40:399-408. [DOI: 10.1093/ejo/cjx059] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Madeleine Storey
- Department of Orthodontics, Leeds Dental Institute, Clarendon Way, UK
| | | | | | - Paul Scott
- Department of Orthodontics, Montagu Hospital, Mexborough, Doncaster and Bassetlaw NHS Trust, UK
| | - Friedy Luther
- Department of Orthodontics, The Charles Clifford Dental Hospital, Sheffield, UK
| | - Jing Kang
- Department of Biostatistics, School of Dentistry, University of Leeds, UK
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Andriekute A, Vasiliauskas A, Sidlauskas A. A survey of protocols and trends in orthodontic retention. Prog Orthod 2017; 18:31. [PMID: 28990138 PMCID: PMC5632597 DOI: 10.1186/s40510-017-0185-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 08/14/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The 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. METHODS One 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. RESULTS The 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). CONCLUSIONS A 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.
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Affiliation(s)
- Alvyda Andriekute
- Clinic of Orthodontics, Lithuanian University of Health Sciences, Lukšos-Daumanto st. 6, LT-5016 Kaunas, Lithuania
| | - Arunas Vasiliauskas
- Clinic of Orthodontics, Lithuanian University of Health Sciences, Lukšos-Daumanto st. 6, LT-5016 Kaunas, Lithuania
| | - Antanas Sidlauskas
- Clinic of Orthodontics, Lithuanian University of Health Sciences, Lukšos-Daumanto st. 6, LT-5016 Kaunas, Lithuania
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