Abstract:Background
Recently, increasing attention has been paid to the periodontal health of orthodontic patients in the maintenance stage in clinical practice. The focus of this meta-analysis was to compare the effects of vacuum-formed retainers (VFR) and Hawley retainers (HR) on periodontal health, in order to provide a reference for clinical selection.
Methods
From the establishment of the database until November 2020, a large number of databases were searched to find relevant randomized control trials, including… Show more
“…Fixed retainers have been associated with a greater accumulation of dental plaque and calculus, and with minimally worse, albeit clinically unimportant, gingivitis in comparison with VFRs [97]. Moreover, patients using Hawley appliances may end up in an even better periodontal condition compared with those using VFRs [98]. Eroglu et al (2019) [99] found fixed and removable orthodontic retainers not statistically significantly different regarding the plaque index, the gingival index, bleeding on probing, and probing depth values.…”
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.
“…Fixed retainers have been associated with a greater accumulation of dental plaque and calculus, and with minimally worse, albeit clinically unimportant, gingivitis in comparison with VFRs [97]. Moreover, patients using Hawley appliances may end up in an even better periodontal condition compared with those using VFRs [98]. Eroglu et al (2019) [99] found fixed and removable orthodontic retainers not statistically significantly different regarding the plaque index, the gingival index, bleeding on probing, and probing depth values.…”
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.
“…Comparing the removable appliances, HRs provide better settling of the occlusion compared with VFRs, and they also seem to be more durable in terms of breakage [ 7 , 48 , 56 , 57 ]. Bowen Li et al concluded in their systematic review that patients using HRs showed healthier periodontal condition than those using VFRs [ 58 ]. In contrast to this, VFRs are more aesthetic, do not interfere with speech and are therefore more acceptable to the patient [ 55 , 59 , 60 ].…”
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.
“…In terms of post-treatment stability, patient satisfaction, and survival time, there seems to be no evidence to support the use of thermoplastic retainers over Hawley retainers [19] . Furthermore, patients wearing thermoplastic retainers are shown to be more prone to gingival inflammation [20] . The increasing use of plastic materials in orthodontics may be alarming and adds to the growing concern about plastic pollution worldwide [26] .…”
Section: Discussionmentioning
confidence: 99%
“…In contrast, systematic reviews show insufficient evidence to support the use of thermoplastic retainers over Hawley retainers in terms of effectiveness, survival time, and patient satisfaction [17][18][19] . In addition, the most recent meta-analysis concludes that in the short term, thermoplastic retainers have more adverse effects on periodontal health than Hawley retainers [20] .…”
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