Do orthodontic fixed retainers guarantee the stability of dental alignment at the end of orthodontic treatment?

ABSTRACT Objective: To investigate posttreatment changes in the maxillary and mandibular arches in patients who underwent orthodontic treatment during the mixed and permanent dentitions. Materials and Methods: The sample was collected retrospectively from three private practices and consisted of 42 patients who were at least 10 years out of orthodontic treatment. The longitudinal records of study casts and cephalometric radiographs were analyzed to quantify posttreatment changes. Results: Minimal changes in maxillary and mandibular irregularity occurred after an average of 16.98 years from completion of treatment. More than 10 years posttreatment, approximately 81% of the maxillary anterior teeth and 88% of the mandibular anterior teeth showed clinically acceptable incisor alignment (<3.5 mm). Mandibular fixed retainers greatly aided in maintaining the stability of the mandibular incisor alignment. However, posttreatment changes in maxillary incisor irregularity did not appear to be influenced by the presence of a mandibular fixed retainer. When compared with longitudinal changes observed in untreated subjects, the increase in incisor irregularity resembled a pattern similar to the regression line of untreated subjects and seems to be entirely age related. Arch width and arch depth was consistently decreased after treatment, but the magnitude of change was minimal at about 1 mm. No associations were found between any of the cephalometric measurements and changes in incisor irregularities. Conclusions: Orthodontic treatment stability can be achieved and mandibular fixed retention appears to be a valuable contributor, especially in patients with further growth expected.

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Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults

The Angle Orthodontist ◽

10.2319/101415-689.1 ◽

2016 ◽

Vol 86 (5) ◽

pp. 713-720 ◽

Cited By ~ 40

Author(s):

Sung-Hwan Choi ◽

Kyung-Keun Shi ◽

Jung-Yul Cha ◽

Young-Chel Park ◽

Kee-Joon Lee

Keyword(s):

Young Adults ◽

Treatment Modality ◽

Orthodontic Treatment ◽

Rapid Maxillary Expansion ◽

Maxillary Expansion ◽

Initial Examination ◽

The Stability ◽

Maxillary Deficiency ◽

Time Point

ABSTRACT Objective: To evaluate the stability of nonsurgical miniscrew-assisted rapid maxillary expansion (MARME) in young adults with a transverse maxillary deficiency. Materials and Methods: From a total of 69 adult patients who underwent MARME followed by orthodontic treatment with a straight-wire appliance, 20 patients (mean age, 20.9 ± 2.9 years) with follow-up records (mean, 30.2 ± 13.2 months) after debonding were selected. Posteroanterior cephalometric records and dental casts were obtained at the initial examination (T0), immediately after MARME removal (T1), immediately after debonding (T2), and at posttreatment follow-up (T3). Results: Suture separation was observed in 86.96% of subjects (60/69). An increase in the maxillary width (J-J; 1.92 mm) accounted for 43.34% of the total expansion with regard to the intermolar width (IMW) increase (4.43 mm; P < .001) at T2. The amounts of J-J and IMW posttreatment changes were −0.07 mm (P > .05) and −0.42 mm (P = .01), respectively, during retention. The postexpansion change in middle alveolus width increased with age (P < .05). The postexpansion change of interpremolar width (IPMW) was positively correlated with the amount of IPMW expansion (P < .05) but not with IMW. The changes of the clinical crown heights in the maxillary canines, first premolars, and first molars were not significant at each time point. Conclusions: Nonsurgical MARME can be a clinically acceptable and stable treatment modality for young adults with a transverse maxillary deficiency.

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Enigma of Fixed Retainers

Orthodontic Journal of Nepal ◽

10.3126/ojn.v7i2.20168 ◽

2018 ◽

Vol 7 (2) ◽

pp. 52-55

Author(s):

Jijo C Eapen ◽

Amit Prakash

Keyword(s):

Orthodontic Treatment ◽

Treatment Result ◽

Dental Arch ◽

Careful Evaluation ◽

Retention Period ◽

Treatment Situation ◽

Patient Cooperation ◽

Time Required ◽

Fixed Retainers ◽

Arch Shape

Fixed retainers are a reliable form of retention for avoiding relapse and maintaining dental arch shape. They function regardless of patient cooperation, and they fulfill high esthetic expectations. Teeth have tendency to return to their former position, as time required for retaining the treatment result. The most appropriate mode of retention for the post-treatment situation should be used, based on a careful evaluation of the patient’s pretreatment diagnostic records, habits, cooperation, growth pattern, and age. Retention after orthodontic intervention is as important part of the therapy as the active treatment. Age and maturity of the patients, result of the orthodontic intervention, origin and character of the anomaly, type of the retainer, compliance of the patients; all can influence the chance of relapse. The retention period should be twice longer than the active orthodontic treatment. This article covers various aspect of fixed retention in detail

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The Effect of the Supra-alveolar Soft Tissue on the Relapse of Orthodontic Treatment

British Journal of Orthodontics ◽

10.1179/bjo.10.1.50 ◽

1983 ◽

Vol 10 (1) ◽

pp. 50-52 ◽

Cited By ~ 3

Author(s):

Erik Larsson ◽

György Schmidt

Keyword(s):

Soft Tissue ◽

Connective Tissue ◽

Orthodontic Treatment ◽

Histological Analysis ◽

Inflammatory Cells ◽

Connective Tissues ◽

Control Side ◽

Definite Difference ◽

The Stability

Orthodontic closure in cases of aplasia as also in patients with spaces of other genesis is often associated with problems of relapse. In this study ten patients were treated orthodontically in order to close unacceptable interdental spaces. Five patients had paired aplasia. The remaining five patients had interdental spaces of different genesis. Supra-crestal connective tissue fibres w re surgically removed in all patients but only on one side of the jaw in the children with paired aplasia. The non-operated side of these children served as a control side. The stability of the orthodontic treatment was acceptable. No definite difference between the operated and the control side was recorded. The histological analysis of the removed tissue did not reveal anything unexpected but a rich infiltration of inflammatory cells. It is suggested that inflammation might aid the reorganization of the connective tissues in this area.

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The Efficacy of Retention Appliances after Fixed Orthodontic Treatment: A Systematic Review and Meta-Analysis

Applied Sciences ◽

10.3390/app10093107 ◽

2020 ◽

Vol 10 (9) ◽

pp. 3107 ◽

Cited By ~ 2

Author(s):

Antonino Lo Giudice ◽

Gaetano Isola ◽

Lorenzo Rustico ◽

Vincenzo Ronsivalle ◽

Marco Portelli ◽

...

Keyword(s):

Clinical Trials ◽

Orthodontic Treatment ◽

Randomized Clinical Trials ◽

Data Extraction ◽

Meta Analysis ◽

Mean Difference ◽

Anterior Crowding ◽

Study Selection ◽

Statistical Heterogeneity ◽

Fixed Retainers

The purpose of this article is to evaluate the amount of the relapse of anterior crowding and the efficacy of retention appliances by reviewing the best available scientific evidence. A survey of articles published up to November 2019 about the stability of dental alignment and retention after fixed orthodontic treatment was performed using seven electronic databases. Study Selection: Only randomized clinical trials investigating patients previously treated with multi-bracket appliances with a follow-up period longer than 6 months were included. Data Extraction: Two authors independently performed the study selection, data extraction, and risk of bias assessment. All pooled data analyses were performed using a random-effects model. Statistical heterogeneity was evaluated. In total, eight randomized clinical trials (RCTs) were included, grouping data from 987 patients. The ages of the patients varied across the studies, ranging between 13 and 17 years. The observation period ranged between 6 and 24 months. The data showed no significant intercanine width modifications during the retention period with both fixed and removable retainers. A significant modification of Little’s Index was found for the mandibular removable retainers with a mean difference of 0.72 mm (95% Cl, 0.47 to 0.98) and for the maxillary removable retainers with a mean difference of 0.48 mm (95% Cl, 0.27 to 0.68). No significant changes were found by evaluating Little’s Index modification for the mandibular fixed retainers. The results of this meta-analysis showed that all the considered retainers were effective in maintaining dental alignment after fixed orthodontic treatment. However, fixed retainers showed greater efficacy compared to removable retainers.

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Orthodontic treatment stability predictors: A retrospective longitudinal study

The Angle Orthodontist ◽

10.2319/053116-435.1 ◽

2016 ◽

Vol 87 (2) ◽

pp. 223-229 ◽

Cited By ~ 8

Author(s):

Paloma González-Gil de Bernabé ◽

José María Montiel-Company ◽

Vanessa Paredes-Gallardo ◽

Jose Luis Gandía-Franco ◽

Carlos Bellot-Arcís

Keyword(s):

Longitudinal Study ◽

Orthodontic Treatment ◽

Protective Factor ◽

Peer Assessment ◽

Anterior Segment ◽

End Of Treatment ◽

The Mean ◽

The Difference ◽

The Stability

ABSTRACTObjective: To examine medium- to long-term orthodontic treatment stability and its possible association with certain variables.Materials and Methods: In a retrospective longitudinal study of 70 postretention patients, the Peer Assessment Rating (PAR) index was measured at the start (T1) and end (T2) of treatment and between 4 and 10 years afterwards (T3). The stability was considered absolute when the T2 and T3 values were identical and relative when the difference was within the ±5 range.Results: Among the 70 patients, 65.8% were female and 34.2% were male. Their mean age was 14.5 years. The mean treatment length was 2.4 years. The mean retention phase was 3.3 years. The mean pre- and posttreatment PAR scores were 29.8 (T1) and 6.3 (T2). The mean T1–T2 difference was 23.6. The mean T2–T3 difference was −0.39.Conclusions: Within the study, 7.1% presented absolute stability and 68.6% presented relative stability. Lower anterior segment alignment and overbite were the most unstable occlusal features and tended to worsen. Fixed retainer (odds ratio [OR] 0.31; 95% confidence interval [CI] 0.10–0.98) as a protective factor and years without retention (OR 1.32; 95% CI 1.03–1.68) as a risk factor are predictor variables of instability in the case of lower anterior segment alignment. The PAR value at the end of treatment (OR 1.29; 95% CI 1.08–1.54) and extractions (OR 4.76; 95% CI 1.05–21.6) before treatment are predictors for midline instability.

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Some considerations for increasing the stability of orthodontic treatment

Progress in Orthodontics ◽

10.1034/j.1600-9975.2000.d01-7.x ◽

2000 ◽

Vol 1 (1) ◽

pp. 43-48

Author(s):

J. Philippe

Keyword(s):

Orthodontic Treatment ◽

The Stability

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Lower Fixed Retainers: Bonded On All Teeth Or Only On Canines? A Systematic review

The Angle Orthodontist ◽

10.2319/013019-63.1 ◽

2019 ◽

Vol 90 (1) ◽

pp. 125-143

Author(s):

Larissa Barbosa Moda ◽

Ana Luiza Correa da Silva Barros ◽

Nathalia Carolina Fernandes Fagundes ◽

David Normando ◽

Lucianne Cople Maia ◽

...

Keyword(s):

Risk Of Bias ◽

Cochrane Library ◽

Evaluation Tool ◽

Qualitative Synthesis ◽

Assessment Development ◽

Anterior Teeth ◽

Randomized Studies ◽

Breakage Rate ◽

The Stability ◽

Fixed Retainers

ABSTRACT Objective To evaluate the stability after orthodontic treatment between two types of lower fixed retainers: those bonded onto all anterior teeth or those bonded only onto the canines. Materials and Methods The following electronic databases were consulted: PubMed, Scopus, Web of Science, Cochrane Library, Lilacs, OpenGrey, ClinicalTrials, and Google Scholar. No restriction of language or year were applied. After selection of studies, risk-of-bias evaluation and qualitative synthesis of the included studies were performed using The Cochrane Collaboration's tool for randomized studies and the “Risk of Bias in Non-randomized Studies of Interventions” (ROBINS-I) tool for nonrandomized studies, and a summary of the overall strength of evidence was presented using the “Grading of recommendations, assessment, development and evaluation” tool. Results Among the 180 studies retrieved from the searches, five were included in this review. Three of them showed a low risk of bias, while two presented a high risk of bias. With regard to stability, two studies reported better stability for retainers bonded to all six teeth, while the other three showed no difference. The retainer bonded to all teeth presented a higher breakage rate in one study. Conclusions Stability seems better with lower fixed retainers bonded on all anterior teeth. The breakage rate may not change according to the bonding. However, studies with greater methodological soundness are necessary to reach a more reliable conclusion.

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Evaluation of the Biomechanical Properties of Austenitic Stainless Steel Fixed Retainers

Revista de Chimie ◽

10.37358/rc.20.9.8342 ◽

2020 ◽

Vol 71 (9) ◽

pp. 320-324

Author(s):

Silvia Izabella Pop ◽

Zakarias Szabolcs ◽

Dana Cristina Bratu ◽

Mircea Dudescu ◽

Mariana Pacurar ◽

...

Keyword(s):

Mechanical Properties ◽

Stainless Steel ◽

Orthodontic Treatment ◽

Biomechanical Properties ◽

Mechanical Parameters ◽

Bending Properties ◽

Steel Wires ◽

Fixed Appliances ◽

Fixed Retainers ◽

Fixed Retention

The insertion of the fixed retention is an important stage of the orthodontic treatment after fixed appliances. The fixed retainers used in orthodontic treatments must be passive towards teeth, without developing any stress. This characteristic is challenging to achieve due to the mechanical properties (bending properties, stiffness) of the materials the retainers are manufactured from. Residual stress might be generated because of their flexibility and because the chemical composition of the stainless steel wires.This study aims to determine the mechanical properties of different austenitic stainlees steel wires used in retention. Also, we have compared the mechanical properties of wires with different sizes, as well as wires with the same size, new and intra-orally used. The results confirm that the mechanical parameters of the two types of wires used in fixed retention (3 braided round wires and 6 braided Flat wires) present statistically insignificant differences. The study also reflects that the mechanical properties of the intra-orally used wires showed decreased values of the parameters.

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Effects of Three Different Orthodontic Treatment Methods on the Stability of Mandibular Incisor Alignment

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4628-41.6.13 ◽

2017 ◽

Vol 41 (6) ◽

pp. 486-493 ◽

Cited By ~ 1

Author(s):

Hande Gorucu-Coskuner ◽

Ezgi Atik ◽

Ilken Kocadereli

Keyword(s):

Orthodontic Treatment ◽

Dental Arch ◽

Mandibular Incisor ◽

Lower Incisor ◽

Retention Period ◽

Welch Test ◽

The Stability ◽

Cephalometric Measurements ◽

Extraction Treatment ◽

Lower Incisors

Objective: To compare the effects of extraction, non-extraction and air-rotor stripping treatments on mandibular dental arch dimensions, lower incisor positions and evaluate their effects on the stability of the treatment. Study design: The sample consisted of 44 patients with Class I malocclusion and moderate crowding including 15 patients treated with extraction, 13 with air-rotor stripping (ARS), and 16 with non-extraction treatment. The records were taken at pretreatment (T0), end of active orthodontic treatment (T1), minimum 3 years post-treatment (T2). The model and cephalometric measurements were evaluated. For statistical analyses ANOVA and Welch test was applied. Results: At post-retention period Little's irregularity indices were increased to 1.96 mm, 2.38 mm and 3.59 mm for extraction, ARS and non-extraction groups respectively (p<0.05). At T1-T2, intercanine widths were decreased significantly at all groups (p<0.05). The arch length and arch depth decreased significantly at extraction group (p<0.05) from T0 to T1 and remained the same at T2 (p>0.05). The lower incisors were retroclined with treatment and slightly proclined at post-retention period in extraction group. In ARS and non-extraction group, lower incisors proclined with treatment and remained the same at post-retention. Conclusion: At all groups the irregularity indices relapsed but did not return to pretreatment values. Although significant increase at intercanine width was only observed in non-extraction treatment, at post-retention phase, intercanine widths were significantly decreased at all groups. The changes at lower incisor inclinations relapsed slightly in extraction group but remained the same in the other groups.

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