Abstract
We aimed at comparing the performance of vacuum-formed thermoplastic retainers (VFR) worn either full-time or part-time, in maintaining orthodontic treatment results in terms of tooth alignment, arch form and occlusion. We reviewed randomized and prospective controlled clinical trials comparing VFR wearing protocols and searched databases, without restrictions, for published and unpublished literature. The risk of bias was assessed using the Cochrane Risk of Bias tool and the overall level of certainty in the evidence following ADA methodology. 184 studies were initially identified and reduced to the 3 randomized controlled trials included in the systematic review by means of specific criteria. One study followed patients 1 year into retention, and the other two for 6 months. Little’s Irregularity Index, intermolar and intercanine width, arch length, overjet and PAR score did not differ significantly between the patients wearing their retainers part time or full time. We observed a slight increase in the overbite in the part-time group in only one trial. With a moderate level of certainty, we found that during the observation period, full-time VFR wear is not superior to part-time, bearing in mind the potential implications for health burden, retainer longevity and cost-effectiveness, as well as patient satisfaction and compliance.
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References
Johnston C, Burden D, Morris D. Clinical guidelines: orthodontic retention (Revised by Parvizi F, Morris D, Atack N). London: British Orthodontic Society; 2013.
Joondeph DR. Stability, retention and relapse. In: Graber TM, Vanarsdall RL, Vig KWL (eds) Orthodontics. Current principles and techniques, 5th edn. Philadelphia: Elsevier; 2011.
Blake M, Garvey MT. Rationale for retention following orthodontic treatment. J Can Dent Assoc. 1998;64:640–1.
Little RM. The irregularity index: a quantitative score of mandibular anterior alignment. Am J Orthod. 1975;68:554–63.
Blake M, Bibby K. Retention and stability: a review of the literature. Am J Orthod Dentofac Orthop. 1998;114:299–306.
Melrose C, Millett DT. Toward a perspective on orthodontic retention? Am J Orthod Dentofac Orthop. 1998;113:507–14.
Ingervall B. Cheek pressure and head posture. Angle Orthod. 1988;58:47–57.
Sinclair PM, Little RM. Maturation of untreated normal occlusions. Am J Orthod. 1983;83:114–23.
Heier EE, De Smit AA, Wijgaerts IA, Adriaens PA. Periodontal implications of bonded versus removable retainers. Am J Orthod Dentofac Orthop. 1997;112:607–16.
Ackerman MB, Thornton B. Posttreatment compliance with removable maxillary retention in a teenage population: a short-term randomized clinical trial. Orthod (Chic.). 2011;12:22–7.
Sheridan JJ. The three keys of retention. J Clin Orthod. 1991;25:717–8.
Meade MJ, Millett D. Retention protocols and use of vacuum-formed retainers among specialist orthodontists. J Orthod. 2013;40:318–25.
Vandevska-Radunovic V, Espeland L, Stenvik A. Retention: type, duration and need for common guidelines. A survey of Norwegian orthodontists. Orthodontics (Chic.). 2013;14:e110–7.
Pratt MC, Kluemper GT, Hartsfield JK Jr, Fardo D, Nash DA. Evaluation of retention protocols among members of the American Association of Orthodontists in the United States. Am J Orthod Dentofac Orthop. 2011;140:520–6.
Valiathan M, Hughes E. Results of a survey-based study to identify common retention practices in the United States. Am J Orthod Dentofac Orthop. 2010;137:170–7.
Renkema AM, Sips ET, Bronkhorst E, Kuijpers- Jagtman AM. A survey on orthodontic retention procedures in the Netherlands. Eur J Orthod. 2009;31:423–37.
Singh P, Grammati S, Kirschen R. Orthodontic retention patterns in the United Kingdom. J Orthod. 2009;36:115–21.
Wong PM, Freer TJ. A comprehensive survey of retention procedures in Australia and New Zealand. Aust Orthod J. 2004;20:99–106.
Hichens L, Rowland H, Williams A, Hollinghurst S, Ewings P, Clark S, Ireland A, Sandy J. Cost-effectiveness and patient satisfaction: Hawley and vacuum-formed retainers. Eur J Orthod. 2007;29:372–8.
Wong P, Freer TJ. Patients’ attitudes towards compliance with retainer wear. Aust Orthod J. 2005;21:45–53.
Sawhney B. Orthodontic retainers: a survey of patient compliance and satisfaction. Dissertation. London: University of Western Ontario; 2013.
Mollov ND, Lindauer SJ, Best AM, Shroff B, Tufekci E. Patient attitudes toward retention and perceptions of treatment success. Angle Orthod. 2010;80:468–73.
Lindauer SJ, Shoff RC. Comparison of Essix and Hawley retainers. J Clin Orthod. 1998;32:95–7.
Haydar B, Karabulut G, Ozkan S, Aksoy AU, Ciger S. Effects of retainers on the articulation of speech. Am J Orthod Dentofac Orthop. 1996;110:535–40.
Sun J, Yu YC, Liu MY, Chen L, Li HW, Zhang L, Zhou Y, Ao D, Tao R, Lai WL. Survival time comparison between Hawley and clear overlay retainers: a randomized trial. J Dent Res. 2011;90:1197–201.
Reitan K. Clinical and histological observations on tooth movement during and after orthodontic treatment. Am J Orthod. 1967;53:721–45.
Reitan K. Principles of retention and avoidance of posttreatment relapse. Am J Orthod. 1969;55:776–90.
Rowland H, Hichens L, Williams A, Hills D, Killingback N, Ewings P, Clark S, Ireland AJ, Sandy JR. The effectiveness of Hawley and vacuum-formed retainers: a single-center randomized controlled trial. Am J Orthod Dentofac Orthop. 2007;132:730–7.
Wang F. A new thermoplastic retainer. J Clin Orthod. 1997;31:754–7.
Lai CS, Grossen JM, Renkema AM, Bronkhorst E, Fudalej PS, Katsaros C. Orthodontic retention procedures in Switzerland. Swiss Dent J. 2014;124:655–61.
Clark JD, Kerr WJ, Davis MH. CASES—clinical audit; scenarios for evaluation and study. Br Dent J. 1997;183:108–11.
Sheridan JJ, Armbruster P, Moskowitz E, Nguyen P. Avoiding demineralization and bite alteration from full-coverage plastic appliances. J Clin Orthod. 2001;35:444–8.
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Open Med. 2001;3:123–130.
Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration; 2011.
Richmond S, Shaw WC, O’Brien KD, Buchanan IB, Jones R, Stephens CD, Roberts CT, Andrews M. The development of the PAR Index (Peer Assessment Rating): reliability and validity. Eur J Orthod. 1992;14:125–39.
Richmond S, Shaw WC, Roberts CT, Andrews M. The PAR Index (Peer Assessment Rating): methods to determine outcome of orthodontic treatment in terms of improvement and standards. Eur J Orthod. 1992;14:180–7.
American Dental Association. ADA clinical practice guideline handbook: 2013 Update. Chicago: American Dental Association; 2013.
Gill DS, Naini FB, Jones A, Tredwin CJ. Part-time versus full-time retainer wear following fixed appliance therapy: a randomized prospective controlled trial. World J Orthod. 2007;8:300–6.
Thickett E, Power S. A randomized clinical trial of thermoplastic retainer wear. Eur J Orthod. 2010;32:1–5.
Jäderberg S, Feldmann I, Engström C. Removable thermoplastic appliances as orthodontic retainers—a prospective study of different wear regimens. Eur J Orthod. 2012;34:475–9.
Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, Gøtzsche PC, Lang T, CONSORT GROUP (Consolidated Standards of Reporting Trials). The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med. 2001;134:663–94.
Aslan BI, Dinçer M, Salmanli O, Qasem MA. Comparison of the effects of modified and full-coverage thermoplastic retainers on occlusal contacts. Orthodontics (Chic.). 2013;14:e198–208.
Dinçer M, Meral O, Tümer N. The investigation of occlusal contacts during the retention period. Angle Orthod. 2003;73:640–6.
Little RM, Robert M. Little on the University of Washington post-retention studies. J Clin Orthod. 2009;43:723–7.
Mortensen MG, Kiyak HA, Omnell L. Patient and parent understanding of informed consent in orthodontics. Am J Orthod Dentofac Orthop. 2003;124:541–50.
Sergl HG, Klages U, Zentner A. Functional and social discomfort during orthodontic treatment—effects on compliance and prediction of patients’ adaptation by personality variables. Eur J Orthod. 2000;22:307–15.
Bartsch A, Witt E, Sahm G, Schneider S. Correlates of objective patient compliance with removable appliance wear. Am J Orthod Dentofac Orthop. 1993;104:378–86.
Lee SJ, Ahn SJ, Kim TW. Patient compliance and locus of control in orthodontic treatment: a prospective study. Am J Orthod Dentofac Orthop. 2008;133:354–8.
Bos A, Kleverlaan CJ, Hoogstraten J, Prahl-Andersen B, Kuitert R. Comparing subjective and objective measures of headgear compliance. Am J Orthod Dentofac Orthop. 2007;132:801–5.
Brandao M, Pinho HS, Urias D. Clinical and quantitative assessment of headgear compliance: a pilot study. Am J Orthod Dentofac Orthop. 2006;129:239–44.
Kyriacou PA, Jones DP. Compliance monitor for use with removable orthodontic headgear appliances. Med Biol Eng Comput. 1997;35:57–60.
Cureton SL, Regennitter F, Orbell MG. An accurate, inexpensive headgear timer. J Clin Orthod. 1991;25:749–54.
Sahm G, Bartsch A, Witt E. Micro-electronic monitoring of functional appliance wear. Eur J Orthod. 1990;12:297–301.
Ackerman MB, McRae MS, Longley WH. Microsensor technology to help monitor removable appliance wear. Am J Orthod Dentofac Orthop. 2009;135:549–51.
Schäfer K, Ludwig B, Meyer-Gutknecht H, Schott TC. Quantifying patient adherence during active orthodontic treatment with removable appliances using microelectronic wear-time documentation. Eur J Orthod. 2015;37:73–80.
Schott TC, Göz G. Applicative characteristics of new microelectronic sensors Smart Retainer® and TheraMon® for measuring wear time. J Orofac Orthop. 2010;71:339–47.
Schott TC, Ludwig B, Glasl BA, Lisson JA. A microsensor for monitoring removable appliance wear. J Clin Orthod. 2011;45:518–20.
Schott TC, Ludwig B. Microelectronic wear-time documentation of removable orthodontic devices detects heterogeneous wear behavior and individualizes treatment planning. Am J Orthod Dentofac Orthop. 2014;146:155–60.
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Appendix 1
Appendix 1
Search in Medline through PubMed, 31.08.2014.
#1 | Orthodontic retention | 1285 |
#2 | (Orthodontic retention) AND removable[Title/Abstract] | 112 |
#3 | (Orthodontic retention) AND essix[Title/Abstract] | 11 |
#4 | (Orthodontic retention) AND Vacuum[Title/Abstract] | 13 |
#5 | (Orthodontic retention) AND transparent[Title/Abstract] | 3 |
#6 | (Orthodontic retention) AND splint[Title/Abstract] | 35 |
#7 | (Orthodontic retention) AND thermoplastic[Title/Abstract] | 10 |
#8 | Orthodontic retainer | 1036 |
#9 | (Orthodontic retainer) AND essix[Title/Abstract] | 25 |
#10 | (Orthodontic retainer) AND removable[Title/Abstract] | 113 |
#11 | (Orthodontic retainer) AND transparent[Title/Abstract] | 3 |
#12 | (Orthodontic retainer) AND vacuum[Title/Abstract] | 22 |
#13 | (Orthodontic retainer) AND splint[Title/Abstract] | 45 |
#14 | (Orthodontic retainer) AND thermoplastic[Title/Abstract] | 20 |
#15 | Orthodontic retention[MeSH Major Topic] Schema: all | 0 |
#16 | Orthodontic retainer[MeSH Terms] | 766 |
#17 | Orthodontic retainer[MeSH Terms]) AND Essix[Title/Abstract] | 21 |
#18 | (Orthodontic retainer[MeSH Terms]) AND splint[Title/Abstract] | 30 |
#19 | (Orthodontic retainer[MeSH Terms]) AND removable[Title/Abstract] | 67 |
#20 | (Orthodontic retainer[MeSH Terms]) AND transparent[Title/Abstract] | 2 |
#21 | (Orthodontic retainer[MeSH Terms]) AND Vacuum[Title/Abstract] | 15 |
#22 | Orthodontic retainer[MeSH Terms]) AND thermoplastic[Title/Abstract] | 17 |
#23 | ((Orthodont*[Title/Abstract]) AND (Retention OR retainer[Title/Abstract])) | 749 |
NOT (Bonded OR fixed[Title/Abstract]) | ||
#24 | ((((Orthodont*[Title/Abstract]) AND (Retention OR retainer[Title/Abstract])) | 8 |
NOT (Bonded OR fixed[Title/Abstract]))) AND Essix[Title/Abstract] | ||
#25 | ((((Orthodont*[Title/Abstract]) AND (Retention OR retainer[Title/Abstract])) | 7 |
NOT (Bonded OR fixed[Title/Abstract]))) AND Vacuum[Title/Abstract] | ||
#26 | ((((Orthodont*[Title/Abstract]) AND (Retention OR retainer[Title/Abstract])) | 1 |
NOT (Bonded OR fixed[Title/Abstract]))) AND Transparent[Title/Abstract] | ||
#27 | ((((Orthodont*[Title/Abstract]) AND (Retention OR retainer[Title/Abstract])) | 42 |
NOT (Bonded OR fixed[Title/Abstract]))) AND removable[Title/Abstract] | ||
#28 | (((Orthodont*[Title/Abstract]) AND (Retention OR retainer[Title/Abstract])) | 18 |
NOT (Bonded OR fixed[Title/Abstract]))) AND splint[Title/Abstract] |
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Kaklamanos, E.G., Kourakou, M., Kloukos, D. et al. Performance of clear vacuum-formed thermoplastic retainers depending on retention protocol: a systematic review. Odontology 105, 237–247 (2017). https://doi.org/10.1007/s10266-016-0254-5
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DOI: https://doi.org/10.1007/s10266-016-0254-5