Development of a clinical practice guideline for orthodontic retention

Abstract

Structured AbstractObjectivesTo develop a clinical practice guideline (CPG) for orthodontic retention (OR).Materials and MethodsThe CPG was developed according to the AGREE II instrument and EBRO (Dutch methodology for evidence‐based guideline development). Reporting was done according the RIGHT statement. A Task Force developed clinical questions regarding OR. To answer these questions, a systematic literature search in PubMed and EMBASE was performed. Two independent researchers identified and selected studies, assessed risk of bias using Cochrane RoB tool and rated quality of evidence using GRADE. The Task Force formulated considerations and recommendations after discussing the evidence. The concept CPG was sent for commentary to all relevant stakeholders.ResultOne systematic review—with 15 studies—met the inclusion criteria. In case of low evidence and lack of outcome measures, expert‐based considerations were developed. Over four meetings, the Task Force reached consensus on considerations and recommendations, after which the concept CPG was ready for the commentary phase. After processing the comments, the CPG was presented to the Dutch Association of Orthodontists, whereafter authorization followed.LimitationsThe paucity of evidence‐based studies concerning OR and the reporting of measurable patient outcomes.ConclusionThis CPG offers practitioner recommendations for best practice regarding OR, may reduce variation between practices and assists with patient aftercare. A carefully chosen retention procedure for individual patients, combined with clear information and communication between orthodontist, dentist and patient will contribute to long‐term maintenance of orthodontic treatment results.

Innovative customized CAD/CAM nickel-titanium lingual retainer versus standard stainless-steel lingual retainer: A randomized controlled trial

“… 7 Furthermore, in the present study, the inclusion criteria ensured that the patients had good oral brushing habits, since fixed retainers are restricted to patients who pay attention to their oral hygiene. 26 According to the literature, CAD/CAM retainer characteristics contribute to the decrease in periodontal events. 8 , 27 Firstly, CAD/CAM nitinol wires exhibit higher flexibility, which allows physiological dental mobility and also reduces the risk of further periodontal problems.…”

Retencija Po Ortodontinio Gydymo

“…Lyginant Hawley tipo reteinerius su vakuuminiais pastebima, kad pastarieji sukelia mažiau diskomforto ir mažiau paveikia paciento kalbą pirmuosius 6 retencijos mėnesius [8,9], tačiau nėra pakankamai įrodymų, galinčių pagrįsti vieno ar kito išimamo reteinerio klinikinį pranašumą [10]. Vakuuminiai reteineriai gali būti efektyvesni išlaikant pavienių dantų stabilumą po rotacijos, o Hawley tipo reteineriai yra kiek atsparesni, ilgalaikiškesni bei tinkamesni pacientams, kurių prasta burnos higiena [5,[10][11][12].…”

“…Ši komplikacija įvyksta, kai vielutė lūžta, tačiau lieka prisiklijavusi prie kelių ar visų dantų, kai vielutė susilanksto arba ne pasyviai priklijuota. Kuo kietesnė vielutė, tuo didesnė dantų pajudėjimo rizika, tačiau kuo vielutė minkštesnė, tuo didesnė jos lūžimo rizika [12,14]. Paprastai reteinerio nesėkmė pastebima per pirmuosius 6 mėnesius [1].…”

“…Gydytojas odontologas turėtų priklijuoti atsilaisvinusią vielutę. Jei vielutė yra įskilusi, sulūžusi ar visiškai atsiklijavusi, tokį pacientą reikėtų siųsti gydytojo ortodonto konsultacijai ir fiksuoto reteinerio pakeitimui [2,5,12].…”

Could medications and biologic factors affect post‐orthodontic tooth movement changes? A systematic review of animal studies

“…[20][21][22][23][24] On the basis of the findings of the present review of animal studies, it may be said that the administration of specific substances may have an effect on the rate of relapse. Since information concerning the most appropriate retention strategy is still not complete, 52,53 the orthodontist should be knowledgeable about medications and biologic factors that may affect tooth movement in patients who have completed their orthodontic treatment and are in the phase of retention.…”