Stability and Side Effects of Orthodontic Retainers - A Systematic Review

Westerlund, Anna; Daxberg, Eva-Lotte; Liljegren, Ann; Oikonomou, Charitini; Ransjö, Maria; Samuelsson, Ola; Sjögren, Petteri

doi:10.4172/2161-1122.1000258

Cited by 22 publications

(20 citation statements)

References 35 publications

(48 reference statements)

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“…Most removable retainers are constructed of polymethyl methacrylates (PMMA), which are held by metal clasps around the posterior teeth. Because removable retainers are worn in a moist intraoral environment with fluctuating pH for at least one year 5 , bacteria and fungi may accumulate on or within the retainers in the form of multi-species plaque biofilms that act as reservoirs of these microorganisms 6 7 8 . This may result in increased incidence of proximal dental caries 9 or oral candidiasis 10 .…”

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confidence: 99%

Antimicrobial activity of a quaternary ammonium methacryloxy silicate-containing acrylic resin: a randomised clinical trial

Liu

Tonggu

Niu

et al. 2016

Sci Rep

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Quaternary ammonium methacryloxy silicate (QAMS)-containing acrylic resin demonstrated contact-killing antimicrobial ability in vitro after three months of water storage. The objective of the present double-blind randomised clinical trial was to determine the in vivo antimicrobial efficacy of QAMS-containing orthodontic acrylic by using custom-made removable retainers that were worn intraorally by 32 human subjects to create 48-hour multi-species plaque biofilms, using a split-mouth study design. Two control QAMS-free acrylic disks were inserted into the wells on one side of an orthodontic retainer, and two experimental QAMS-containing acrylic disks were inserted into the wells on the other side of the same retainer. After 48 hours, the disks were retrieved and examined for microbial vitality using confocal laser scanning microscopy. No harm to the oral mucosa or systemic health occurred. In the absence of carry-across effect and allocation bias (disks inserted in the left or right side of retainer), significant difference was identified between the percentage kill in the biovolume of QAMS-free control disks (3.73 ± 2.11%) and QAMS-containing experimental disks (33.94 ± 23.88%) retrieved from the subjects (P ≤ 0.001). The results validated that the QAMS-containing acrylic exhibits favourable antimicrobial activity against plaque biofilms in vivo. The QAMS-containing acrylic may also be used for fabricating removable acrylic dentures.

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mentioning

confidence: 99%

Antimicrobial activity of a quaternary ammonium methacryloxy silicate-containing acrylic resin: a randomised clinical trial

Liu

Tonggu

Niu

et al. 2016

Sci Rep

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“…2,6 According to a recent systematic review, it was uncertain whether periodontal outcomes and presence of calculus differ between different retainer regimens, but the evidence was of low quality. 11 It is important to note that the included studies compared orthodontically treated groups with different b T0 indicates before treatment; T1, after debonding; T5, 5 years after debonding. c Uppercase letters represent the difference between groups at each assessment period; lowercase letters, intragroup difference between different assessment periods; same letters, no statistically significant differences were present; different letters, statistically significant differences.…”

Section: Discussionmentioning

confidence: 99%

“…5,9 Compared with untreated controls, the prevalence of gingival recession in mandibular incisors was found to be higher in patients 5 years after orthodontic treatment. 3 It is unclear whether orthodontic treatment per se, proclination of incisors, 10 or the presence of fixed retention has more influence on the development of gingival recession, 3,11 but the type of fixed retainer did not seem to play a significant role. 5,12 Previous studies have not resolved the question of whether fixed lingual retainers cause gingival recession.…”

Section: Introductionmentioning

confidence: 99%

Long-term influence of fixed lingual retainers on the development of gingival recession: A retrospective, longitudinal cohort study

Juloski

Glišić

Vandevska‐Radunovic

2017

The Angle Orthodontist

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Objective: To investigate the long-term influence of fixed lingual retainers on the development of mandibular gingival recession and to compare the prevalence with untreated individuals. Materials and Methods: The material consisted of 144 subjects: 96 orthodontically treated patients followed for 5 years after therapy and 48 untreated age-matched subjects. The treated patients were divided in two groups: one receiving a fixed mandibular retainer (n ¼ 48) and one receiving no form of retention in the mandible (n ¼ 48). The presence or absence of gingival recession and calculus accumulation were scored before treatment (T0), after debonding (T1), and 5 years after debonding (T5) for each tooth in the mandibular intercanine region using plaster models and intraoral photographs. The chi-square test, one-way ANOVA, and Cochran's Q test were used to evaluate inter-and intragroup differences. Results: The prevalence of patients with recession increased gradually and significantly throughout the observation periods in all groups, but the intergroup differences at T5 were not significant. Significantly more calculus accumulation was observed at T5 in the retainer group compared with the group without retainers. Conclusions: Long-term presence of fixed lingual retainers does not seem to increase the development of mandibular gingival recession, but does increase calculus accumulation. (Angle Orthod. 2017;87:658-664.)

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“…However, there is now widespread acceptance of the necessity for indefinite retention to minimize both relapse and maturational changes [ 5 , 8 ]. Prolonged retention may pose increased risk to the periodontium and dental hard tissues; it is therefore important to investigate the implications of the long-term use of fixed and removable retainers on the supporting tissues [ 3 , 9 , 10 ].…”

Section: Reviewmentioning

confidence: 99%

The effects of fixed and removable orthodontic retainers: a systematic review

2016

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ObjectiveIn the view of the widespread acceptance of indefinite retention, it is important to determine the effects of fixed and removable orthodontic retainers on periodontal health, survival and failure rates of retainers, cost-effectiveness, and impact of orthodontic retainers on patient-reported outcomes.MethodsA comprehensive literature search was undertaken based on a defined electronic and gray literature search strategy (PROSPERO: CRD42015029169). The following databases were searched (up to October 2015); MEDLINE via OVID, PubMed, the Cochrane Central Register of Controlled Trials, LILACS, BBO, ClinicalTrials.gov, the National Research Register, and ProQuest Dissertation and Thesis database. Randomized and non-randomized controlled clinical trials, prospective cohort studies, and case series (minimum sample size of 20) with minimum follow-up periods of 6 months reporting periodontal health, survival and failure rates of retainers, cost-effectiveness, and impact of orthodontic retainers on patient-reported outcomes were identified. The Cochrane Collaboration’s Risk of Bias tool and Newcastle-Ottawa Scale were used to assess the quality of included trials.ResultsTwenty-four studies were identified, 18 randomized controlled trials and 6 prospective cohort studies. Of these, only 16 were deemed to be of high quality. Meta-analysis was unfeasible due to considerable clinical heterogeneity and variations in outcome measures. The mean failure risk for mandibular stainless steel fixed retainers bonded from canine to canine was 0.29 (95 % confidence interval [CI] 0.26, 0.33) and for those bonded to canines only was 0.25 (95 % CI: 0.16, 0.33). A meta-regression suggested that failure of fixed stainless steel mandibular retainers was not directly related to the period elapsed since placement (P = 0.938).ConclusionFurther well-designed prospective studies are needed to elucidate the benefits and potential harms associated with orthodontic retainers.

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Stability and Side Effects of Orthodontic Retainers - A Systematic Review

Abstract: Background: The role of orthodontic retainers in maintaining stability after orthodontic treatment, and side effects associated with orthodontic retainers have not been well established.

Cited by 22 publications

References 35 publications

Antimicrobial activity of a quaternary ammonium methacryloxy silicate-containing acrylic resin: a randomised clinical trial

Antimicrobial activity of a quaternary ammonium methacryloxy silicate-containing acrylic resin: a randomised clinical trial

Long-term influence of fixed lingual retainers on the development of gingival recession: A retrospective, longitudinal cohort study

The effects of fixed and removable orthodontic retainers: a systematic review

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