3D-analysis of unwanted tooth movements despite bonded orthodontic retainers: a pilot study

Abstract

Background Recently, reports of unwanted tooth movements despite intact orthodontic bonded retainers have increased. These movements are not subject to relapse but are classified as a new developed malocclusion. The aims of the present pilot study were to analyze the prevalence of unwanted tooth movements despite intact bonded cuspid-to-cuspid retainers and to identify possible predisposing factors. Materials and methods Plaster casts of all patients finishing orthodontic treatment during three consecutive years were assessed before treatment (T0), after multibracket appliance debonding (T1) and after two years of retention (T2). After multibracket appliance treatment, all patients received a cuspid-to-cuspid flexible spiral wire retainer bonded to each tooth of the retained segment in the upper and lower jaw. The study group (SG) consisted of 44 patients (16 male, 28 female) with tooth movements (T1–T2) of the retained segment despite intact bonded cuspid-to-cuspid retainer and the control group (CG) of 43 patients (19 male, 24 female) without unwanted tooth movements. The casts of the SG were digitized, superimposed and measured. Using the Chi-square test, Fisher´s exact test and Mann–Whitney-U-test (p < 0.05), mandibular plane angle, incisor proclination, oral dysfunctions or habits (T0) and intercanine distance, overjet and interincisal relationship (T0, T1, T2) were compared between SG and CG. Results The prevalence of patients with unwanted tooth movements in one or both jaws was 27.0%. Maxillary retainers were affected more often (20.9%) than mandibular retainers (14.1%). The median amount of tooth movements was 0 to 0.66 mm with large interindividual variations. Oral dysfunctions or habits at T0, such as a lack of interincisal contact at all time points, were associated with unwanted tooth movements. Conclusion Unwanted tooth movements occurred more often with maxillary than mandibular retainers. Patients with oral dysfunctions/habits and without interincisal contact had a higher prevalence of unwanted tooth movements.

“Wire Syndrome” Following Bonded Orthodontic Retainers: A Systematic Review of the Literature

“…Dental consequences: WS is responsible for displacement of the affected teeth in all spatial dimensions with a large range of variations. These displacements can be slight, according to the study by Klaus et al [ 22 ], which mentioned a median magnitude of unwanted movement from 0 to 0.66 mm. However, extreme movement of the tooth can cause rupture of the vascular–nervous bundle and loss of vitality of the tooth [ 14 , 15 ] associated with the exposure of the root until the apex [ 5 ].…”

“…Most cases of WS are seen in the presence of round, twisted, stainless steel wires [ 1 , 2 , 3 , 4 , 5 , 10 , 11 , 12 , 13 , 14 , 16 , 17 , 18 , 21 , 23 ], although flat, braided chains are also concerned [ 3 ], as well as single-stranded, round wires bonded only on the canines [ 5 ] and round, coaxial, stainless steel wires [ 22 ].…”

Clinical effects with customized brackets and CAD/CAM technology: a prospective controlled study

“…For superimposition of virtual set-ups with the corresponding scans of the treatment results, only data of the maxilla were used leading to a smaller data set. However, the method of superimposing landmarks of the palate was used in several studies before and is considered the most accurate superimposition approach applied to teeth of the maxilla [ 14 ]. So far, no valid method for superimposition of intraoral scans exists.…”

“…Usage of CBCT data might have been a more accurate way, since this allows the registration of mandibular tooth movements. But generating CBCTs for patients that fit our inclusion criteria would have been ethically not acceptable [ 14 ].…”

Stability of aligned maxillary anterior teeth after orthodontic treatment: amount of changes with different retention methods and without retention

“…They are rather independent of cooperation and can be used for long periods (65,87,104,105), although there are few studies on real long-term use. Bonded retainers are, on the other hand, operative sensitive and retainer failures are common (86,101,106,107) especially in the maxilla (106,108). Hawley retainers, Jensen retainers, and VFRs allow prosthetic pontics for missing teeth in the aesthetic zone.…”