Orthodontic Retention Protocols: Evaluating the Effectiveness of Different Retention Protocols in Maintaining Post-Treatment Tooth Alignment

Snigdha Pattanaik; Vishnu Priya Veeraraghavan; Arun Kumar Dasari; Kaladhar Reddy Aileni; Santosh Rayagouda Patil

Authors

Snigdha Pattanaik
Vishnu Priya Veeraraghavan
Arun Kumar Dasari
Kaladhar Reddy Aileni
Santosh Rayagouda Patil

Keywords:

Orthodontics, Therapeutics, Orthodontic Retainers, Orthodontic Appliances, Fixed

Abstract

Objective: To evaluate the effectiveness of various orthodontic retention protocols, including removable retainers, fixed retainers, and a combination of both. Material and Methods: A cohort of orthodontic patients (n=240) was divided into four groups: Removable Retainer Group, Fixed Retainer Group, Combination Protocol Group, and Control Group. Tooth alignment stability, patient satisfaction, compliance, and adverse event occurrence were assessed over two years. Data analysis included regression analysis and comparisons between groups. Results: Fixed retainers demonstrated superior effectiveness in maintaining tooth alignment stability compared to removable retainers and the combination protocol, with the slightest deviation from baseline alignment. The Fixed Retainer Group also reported the highest patient satisfaction and compliance rates. Adverse events and complications, such as retainer breakage and discomfort, were more frequent in the Removable Retainer Group. Conclusion: Fixed retainers offer superior tooth alignment stability, patient satisfaction, and compliance, while adverse events are relatively infrequent and manageable. However, patient preferences and needs should be considered when choosing the most appropriate retention strategy.

References

Jeyaraj P, Chakranarayan A. Rationale, relevance, and efficacy of "surgery first, orthodontics later" approach in the management of cases of severe malocclusion with skeletal discrepancy. Ann Maxillofac Surg 2019; 9(1):57-71. https://doi.org/10.4103/ams.ams_272_18

Bondemark L, Holm AK, Hansen K, Axelsson S, Mohlin B, Brattstrom V, et al. Long-term stability of orthodontic treatment and patient satisfaction. A systematic review. Angle Orthod 2007; 77(1):181-191. https://doi.org/10.2319/011006-16R.1

Alassiry AM. Orthodontic retainers: A Contemporary Overview. J Contemp Dent Pract 2019; 20(7):857-862.

Andriekute A, Vasiliauskas A, Sidlauskas A. A survey of protocols and trends in orthodontic retention. Prog Orthod 2017; 18(1):31. https://doi.org/10.1186/s40510-017-0185-x

Jedliński M, Mazur M, Schmeidl K, Grocholewicz K, Ardan R, Janiszewska-Olszowska J. Orthodontic retention-protocols and materials-A questionnaire pilot study among Polish practitioners. Materials 2022; 15(2):666. https://doi.org/10.3390/ma15020666

Littlewood SJ, Millett DT, Doubleday B, Bearn DR, Worthington HV. Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database Syst Rev 2016; 2016(1):CD002283. https://doi.org/10.1002/14651858.CD002283.pub4. Update in: Cochrane Database Syst Rev 2023; 5:CD002283.

Chawla R, Ansari FM, Chekka M, Akhilesh M, Deepak VA, Datla PKV, et al. Assessment of orthodontic retention protocols and their effects on treatment stability. J Pharm Bioallied Sci. 2024 Jul;16(Suppl 3):S2403-S2406. https://doi.org/10.4103/jpbs.jpbs_270_24

Molyneaux C, Sandy JR, Ireland AJ. Orthodontic retention and the role of the general dental practitioner. Br Dent J 2021; 230(11):753-757. https://doi.org/10.1038/s41415-021-2875-5

Hotchandani KD, Thangadurai J, Parate AS, Nixon JZ, Kamble RH, Meghalapriya P. The effects of fixed versus removable orthodontic retainers on stability and periodontal health: 4-year follow-up of a randomized controlled trial. J Pharm Bioallied Sci 2023; 15(Suppl 1):S502-S507. https://doi.org/10.4103/jpbs.jpbs_587_22

Al-Moghrabi D, Johal A, O'Rourke N, Donos N, Pandis N, Gonzales-Marin C, et al. Effects of fixed vs removable orthodontic retainers on stability and periodontal health: 4-year follow-up of a randomized controlled trial. Am J Orthod Dentofacial Orthop 2018; 154(2):167-174.e1. https://doi.org/10.1016/j.ajodo.2018.01.007

Little RM, Riedel RA, Artun J. An evaluation of changes in mandibular anterior alignment from 10 to 20 years postretention. Am J Orthod Dentofacial Orthop 1988; 93(5):423-428. https://doi.org/10.1016/0889-5406(88)90102-3

Vaida LL, Bud ES, Halitchi LG, Cavalu S, Todor BI, Negrutiu BM, et al. The behavior of two types of upper removable retainers-Our clinical experience. Children 2020;7 (12):295. https://doi.org/10.3390/children7120295

Krämer A, Sjöström M, Apelthun C, Hallman M, Feldmann I. Post-treatment stability after 5 years of retention with vacuum-formed and bonded retainers-A randomized controlled trial. Eur J Orthod 2023; 45(1):68-78. https://doi.org/10.1093/ejo/cjac043

Bibona K, Shroff B, Best AM, Lindauer SJ. Factors affecting orthodontists' management of the retention phase. Angle Orthod 2014; 84(2):225-230. https://doi.org/10.2319/051313-372.1

Zachrisson BU. Clinical experience with direct-bonded orthodontic retainers. Am J Orthod 1977; 71(4):440-448. https://doi.org/10.1016/0002-9416(77)90247-0

Kartal Y, Kaya B. Fixed orthodontic retainers: A review. Turk J Orthod 2019; 32(2):110-114. https://doi.org/10.5152/TurkJOrthod.2019.18080

Lyros I, Tsolakis IA, Maroulakos MP, Fora E, Lykogeorgos T, Dalampira M, et al. Orthodontic retainers-A critical review. Children 2023; 10(2):230. https://doi.org/10.3390/children10020230