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Multistranded bonded orthodontic retainer in the upper (a) and lower (b) jaw. 

Multistranded bonded orthodontic retainer in the upper (a) and lower (b) jaw. 

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The objective of this study was to compare glass fibre reinforced (GFR) with multistranded bonded orthodontic retainers in terms of success rate and periodontal implications. A 2 year parallel study was conducted of 184 patients scheduled to receive bonded retainers in the upper and lower anterior segments. In three centres, the patients (mean age...

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... treatment results are potentially unstable and, therefore, often require retention in the anterior segment of the upper and lower jaw. Contemporary retaining strategies basically include removable and fixed retainers. As the former depend on patient compliance, fixed retainers are usually preferred. Zachrisson (1983) introduced the multistranded bonded lingual retainer. Apart from variations in wire types, diameters, and bonding procedures, this type of retainer has become the gold standard (Bearn, 1995). Multistranded bonded lingual retainers show success rates of between 60 and 95 per cent in the long-term, with most failures in the maxilla during the first year of function (Dahl and Zachrisson, 1991; Andrén et al. , 1998). Studies have indicated acceptable compatibility of metal-bonded retainers with periodontal health (Årtun, 1984; Årtun et al. , 1987, 1997; Heier et al. , 1997; Booth et al. , 2008). Limitations, however, include aesthetics and the fact that they cannot be used in patients with a nickel allergy. Therefore, alternatives have been developed such as polyethylene ribbon-reinforced retainers and glass fibre reinforced (GFR) retainers. Case reports have been published on the latter (Geserick et al. , 2004; Brauchli et al. , 2006); however, no large-scale long-term study has been undertaken documenting the success rate and periodontal implications. The objective of this study was to compare GFR with multistranded bonded orthodontic retainers in terms of success rate and periodontal implications. The study protocol was approved by the Ethics Committee of the University Hospital of Brussels (UZ Brussels). One hundred and eighty-four adolescents (mean age 14 years; 90 males and 94 females) who were scheduled to receive bonded lingual retainers (from lateral incisor to lateral incisor in the upper jaw and from canine to canine in the lower jaw) were enrolled for a parallel study. All patients had been orthodontically treated with fixed appliances in one of three private practices. The inclusion criteria were good general health, correct dental alignment, a Class I relationship with an overbite/ overjet between 1 and 3 mm, and the need for permanent orthodontic retention in the upper and lower anterior segments. The exclusion criteria were periodontal disease, advanced dental abrasion/attrition/erosion, and bruxism. After having obtained written informed consent, the patients were sequentially assigned to either a GFR500 retainer group ( n = 45), a GFR1000 retainer group ( n = 48), or a multistranded wire group ( n = 91). Thus, in the first patient GFR500 retainers were placed, in the second GFR1000 retainers, in the third and the fourth multistrand retainers, and so on. This type of randomization ensured comparable frequency distributions of the groups among the centres. In all centres, at least 61 patients were enrolled. In addition, 90 un-treated subjects were recruited at a high school and examined by one clinician (MPET) at the end of the study. The subjects in this control group were enrolled on the basis of the same selection criteria as the treated patients except for the need for permanent retention. All subjects ( n = 274) completed a questionnaire on daily home care prior to the start of the study. Table 1 shows the demographic details and data on oral hygiene habits. All groups were compatible in terms of gender, age, and pre-study oral hygiene habits. All retainers were bonded by three experienced clinicians (BVV, PDW, JA) at the different centres using a standardized protocol. For all types, the same etch gel (35 per cent phosphoric acid; Ortho Organizers ® , San Marcos, California, USA), bonding system (Excite ® , Vivadent, Schaan, Liechtenstein), and flowable composite (Tetric flow ® , Vivadent) were used (Elaut et al. , 2002). Retainers in the lower jaw were positioned half way up the lingual crown surface of the teeth avoiding contact with papillae; retainers in the upper jaw were placed more apically avoiding occlusal interference. Patients allocated to the GFR500 group received retainers containing 500 unidirectional glass fibres (EverStick ® Ortho 500, Stick Tech Ltd, Turku, Finland), which had been specifically manufactured for this study, while those in the GFR1000 group received commercially available retainers containing 1000 unidirectional glass fibres (EverStick ® Ortho 1000, Stick Tech Ltd). The rationale for including two GFR retainer groups was related to the hypothesis that a thinner retainer would result in less plaque accumulation and therefore superior periodontal conditions. All fibres were cut to the appropriate length, which had been measured on plaster casts using dental floss. Wedges were then placed interdentally to avoid interproximal contamination and ensure good access for subsequent cleaning. Lingual tooth surfaces were cleaned, sandblasted (Al 2 O 3 50 m ), and etched for 30 seconds. The teeth were air-dried and isolated using saliva ejectors and cotton rolls. The bonding agent was applied on all teeth, light cured with a light emitting diode (Ortholux; 3M Unitek, Monrovia, California, USA) for 5 seconds per tooth, followed by the application of the flowable composite. Light curing was carried out for each tooth for 10 seconds after the retainer had been correctly adjusted. The use of a wide instrument (Stickstepper ® , Stick Tech Ltd) prevented premature curing at neighbouring teeth. The procedure was repeated tooth by tooth followed by the application of a thin layer of flowable composite covering the glass fibres (Figure 1). In the multistranded retainer group, the subjects had six stranded 0.0215 inch coaxial wire (Ortho Organizers ® ) used for retention, which had been constructed on plaster casts. Tooth conditioning, isolation, and application/curing of the bonding agent was carried out in the same way as described for the GFR retainers. Subsequently, the coaxial wire was placed on to the teeth using a putty holder and flowable composite was used to attach the wire to the upper lateral incisors or lower canines. After removal of the holder, the same procedure was repeated for the other teeth (Figure 2). Each bonding procedure was completed by giving oral hygiene instructions with emphasis on interdental cleaning using dental floss (Superfloss ® , Oral-B Laboratories, Diegem, Belgium). The following clinical parameters were recorded by the same calibrated clinician (MPET) at the 6, 12, 18, and 24 month follow-up: 1. Success rate. A retainer was considered successful when it remained intact over the 2 year study period. When ...

Citations

... Deficient bonding procedures, such as inadequate moisture control or mishandling of the resin material, are reasons for debonding of the resin pad from the tooth [15]. Studies have reported variations of 49-95% in the survival rate of FRC as an orthodontic retainer [16,17]. The disagreement among such studies implies that further research for retainer comparisons is necessary. ...
Article
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This study aimed to fabricate nano-hydroxyapatite (nHA) grafted/non-grafted E-glass-fiber-based (nHA/EG) and E-glass fiber (EG) orthodontic retainers and to compare their properties with commercially available retainers. Stainless-steel (SS) retainers and everStick Ortho (EST) were used as control groups. The retainers were evaluated with Raman spectroscopy and bonded to bovine teeth. The samples were fatigued under cyclic loading (120,000 cycles) followed by static load testing. The failure behavior was evaluated under an optical microscope and scanning electron microscope. The strain growth on the orthodontic retainers was assessed (48h and 168h) by an adhesion test using Staphylococcus aureus and Candida albicans. The characteristic peaks of resin and glass fibers were observed, and the debonding force results showed a significant difference among all of the groups. SS retainers showed the highest bonding force, whereas nHA/EG retainers showed a non-significant difference from EG and EST retainers. SS retainers’ failure mode occurred mainly at the retainer–composite interface, while breakage occurred in glass-fiber-based retainers. The strains’ adhesion to EST and EG was reduced with time. However, it was increased with nHA/EG. Fabrication of nHA/EG retainers was successfully achieved and showed better debonding force compared to other glass-fiber-based groups, whereas non-linear behavior was observed for the strains’ adhesion.
... Failures of metal fixed retainers are reported to be as low as 3.5% 8 or, more realistically, between 35% and 50%. [9][10][11] Although midterm failure rates of different types of mandibular fixed retainers have been investigated prospectively, 9,[12][13][14] failure rates of fixed retainers bonded with indirect bonding have only been assessed in the short term (6 months), showing no significant difference in survival between retainers bonded with indirect bonding compared to direct bonding. 7,15 In addition to reducing chair time, indirect bonding of fixed retainers could also ensure that the retainer is completely passive during the bonding procedure. ...
Article
Introduction This 2-arm parallel trial aimed to assess the number of failures of mandibular fixed retainers bonded with direct and indirect bonding methods at a 5-year follow-up and investigate the stability of intercanine and interpremolar distances. Methods Consecutive patients from the clinic of the University of Geneva (Switzerland) were randomly allocated to either direct or indirect bonding of a mandibular fixed retainer at the end of orthodontic treatment. Inclusion criteria included the presence of all mandibular incisors and canines; and the absence of active caries, restorations, fractures, or periodontal disease of these teeth. The patients were randomized in blocks of 4 using an online randomization service, with allocation concealment secured by contacting the sequence generator for assignment. Two and 5 years (T5) after bonding the retainers, the patients were recalled, and impressions were taken. The primary outcome was the 5-year survival of the mandibular fixed retainer bonded with both bonding methods. The secondary outcomes were the intercanine and interpremolar distances and the assessment of unexpected posttreatment changes (ie, changes in torque and/or rotations of the mandibular incisors and canines). Blinding was applicable for outcome assessment only. Kaplan-Meier curves were generated, and a Cox proportional hazard regression model was fitted for bonding type, age, and treatment. Linear mixed models were fitted to intercanine and interpremolar distances: bonding type, time, age, and treatment were modeled as outcomes. Results Sixty-four patients were randomized in a 1:1 ratio. At T5, 6 patients without previous failure were lost to follow-up from each group. At T5, the fixed retainer was debonded in 14 patients (54%) for each group. The hazard ratio of indirect bonding to direct bonding was 1.09 (95% confidence interval, 0.26-4.60; P = 0.91); there was no statistically significant difference in survival between the groups. Regarding intercanine and interpremolar distances, none of the tested prognostic factors reached statistical significance. Unexpected posttreatment changes were observed in 6 failure-free patients, all bonded with the direct bonding method. Only 1 patient required debonding of the fixed retainer. No other serious harms were observed. Conclusions The 5-year survival rate for both direct and indirect bonding methods was 46%, without a statistically significant difference between bonding methods. Bonded retainers were effective in maintaining intercanine and interpremolar distances. Unexpected posttreatment changes were only observed with retainers bonded with the direct bonding method. Registration The trial was not registered. Protocol The protocol was not published before trial commencement. Funding No funding or conflict of interest to be declared.
... Many studies have demonstrated the influence of orthodontic retainers on periodontal tissue [11,12,[26][27][28][29][30][31][32]. Zachrisson [11] emphasized the importance of appropriate oral hygiene for periodontal health in patients who had fixed retainers. ...
... Multistranded bonded orthodontic retainers have been reported to exhibit risks of failure ranging from 12% [28] to 46.4% [35]. The present study showed that the CSR of fixed retainers in patients who had a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of fixed retainers in patients who had a CI ≥1 at the 12-month follow-up after bonding of fixed retainers (P<0.001). ...
... Salehi et al. [22] showed that the most frequent type of failure in multi-stranded retainers was retainer loosening, which was observed in 84.48% of cases in the maxilla and 96.42% of cases in the mandible, even though there were no significant differences between the survival times of the maxillary and mandibular retainers. However, Tacken et al. [28] reported that failure of retainers occurred more frequently in the maxilla than in the mandible. In addition, Radlanski and Zain [38] explained that the frequent failure of maxillary retainers is due to https://doi.org/10.5051/jpis.2003140157 ...
Article
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Purpose: The aim of this study was to evaluate clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients. Methods: In total, 52 patients with at least 2 years of follow-up after periodontal and orthodontic treatment were included in this study. After scaling and root planing, orthodontic treatment with fixed appliances or clear aligners was performed. Fixed retainers with twist-flex stainless steel wires were bonded to the palatal or lingual sides of anterior teeth. Changes in clinical parameters, including the plaque index, gingival index, calculus index (CI), probing pocket depth, and radiographic bone levels, were evaluated before bonding of fixed retainers and at a 12-month follow-up. Cumulative survival rates (CSRs) for retainer failure were evaluated according to sex, site, CI, stage of periodontitis, and the severity of the irregularity with the log-rank test and hazard ratios (HRs). Results: Twelve months after bonding of fixed retainers, improvements were observed in all clinical parameters except CI and radiographic bone gain. The overall CSR of the retainers with a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of the retainers with a CI ≥1 at the 12-month follow-up (log-rank test; P<0.001). Patients with stage III (grade B or C) periodontitis had a higher multivariate HR for retainer failure (5.4; 95% confidence interval, 1.22-23.91; P=0.026) than patients with stage I (grade A or B) periodontitis. Conclusions: Although fixed retainers were bonded in periodontitis patients, periodontal health was well maintained if supportive periodontal treatment with repeated oral hygiene education was provided. Nonetheless, fixed retainer failure occurred more frequently in patients who had stage III (grade B or C) periodontitis or a CI ≥1 at 12-month follow-up after bonding of fixed retainers.
... 24,33 The prevalence of common complications reported in the literature varies significantly, from 1% 34 up to 53%. 35 The wide range in reported prevalence of failure is due to influence from a number of factors, including: how the complications or failures are recorded, categorised and calculated; 24,25 selection bias; 25 experience of the clinician bonding the retainer; 25,33,36 difference in wire type and dimension, 21,22,24,35 and adhesive material used; 23,37,38 type of retainer; 14,25,28,34 and, possibly most importantly, the length of observational period. 24,25,39 If bonded retainers are left in place for the long term, it is almost inevitable that one of the common complications will occur at some stage. ...
... 21,45 Fibre-reinforced composite, fibre-reinforced plastic or even ceramic materials can be used. 28 However, fibre-reinforced retainers are prone to greater failure rates due to a lack of flexibility. 46 More recently, monofilament nickel-titanium wires constructed by CAD/ CAM procedures have been described and are currently being investigated. ...
... Failures of fixed retainers are more likely to occur in the upper arch. 24,28,41 This may be due to occlusal factors. Even when the wire is placed out of occlusion, occlusal contacts due to functional movements of the mandible cannot be excluded and these may lead to gradual wear of the adhesive layer or wire-fatigue fractures. ...
Article
Full-text available
Long-term stability of orthodontic treatment results is problematic. Long-term or even lifelong retention with bonded retainers is being increasingly used among clinicians. Bonded retainers can provide an efficient and attractive method of retention, particularly because they require minimal compliance from patients. However, the use of bonded retainers is associated with relatively frequent complications, such as detachments of the adhesive layer or wire fractures, as well as unexpected complications with potentially severe consequences with associated periodontal and general health risks. It is imperative that the whole dental team are aware of these pitfalls and complications, and appreciate how to minimise and address these. Encourages balanced discussion among the dental team concerning long-term retention with bonded retainers, focusing on the possible complications associated with the use of bonded retainers.Discusses the factors influencing occurrence of complications and the potential negative effects on adjacent tissues as well as general health.Stresses the importance of monitoring bonded retainers by all members of the dental team and early interception of complications in order to prevent development of severe clinical consequences. Encourages balanced discussion among the dental team concerning long-term retention with bonded retainers, focusing on the possible complications associated with the use of bonded retainers. Discusses the factors influencing occurrence of complications and the potential negative effects on adjacent tissues as well as general health. Stresses the importance of monitoring bonded retainers by all members of the dental team and early interception of complications in order to prevent development of severe clinical consequences.
... The FRC retainers are fully covered by a flowable resin composite, which thickens the retainer and lowers the flexibility of the retainer. This may have an influence on the retainer's longevity, especially with regard to the bonding durability of the retainer [12,16]. Placement of multistranded steel retainers is a relatively simple process for orthodontists. ...
... Placement of multistranded steel retainers is a relatively simple process for orthodontists. However, the placement of FRC retainers may be more challenging, which may also be a reason for the higher number of failures with FRC retainers compared to that of multistranded steel retainers [16]. ...
Article
Full-text available
The purpose of this study was to investigate the effect of retainer material and retainer position on a tooth to resist movement of the tooth in a simulation model. Bidirectional continuous glass fiber-reinforced composite (FRC) retainers and control retainers of steel wires were tested. The FRC retainers had a polymer matrix of bisphenol-A-glycidyldimethacrylate (bis-GMA) and poly(methylmethacrylate) (PMMA), and it was cured with a photoinitiator system. The retainers were adhered to a lower jaw Frasaco model in two different positions. Resistance against the movement of one tooth was measured from two directions. The average load values within the FRC retainer groups were higher than within the metal retainer groups. The load values for the groups loaded from the axial direction were higher than those loaded from the buccal direction. FRC retainers, which were located 1–2 mm from the incisal edge, showed higher load values than those located 4–5 mm from the incisal edge. There was a significant difference in load values between FRC retainers and metal retainers (p < 0.01). The wire position and the direction of force also had significant effects (p < 0.01). There were no significant differences between metal retainer groups. The results of this study suggest that metal retainers are more flexible, allowing for tooth movements of larger magnitude than with FRC retainers.
... Finally, the Kaplan-Meier survival curves clearly show a statistically higher survival rate for Scotchbond Universal (93.33%) following a 24-month follow up, rather than for the conventional Transbond XT Primer (78.17%). In any case, both these percentages are in accordance with the study of Tacken et al. [45], showing that the 2-year survival rate of multistrand retainers bonded with Excite ® (Vivadent, Schaan, Liechtenstein) was equal to 88%, considerably higher than the one reported by glass fiber reinforced bonded orthodontic retainers (49%). ...
Article
Full-text available
This study aims to assess the efficacy of a universal adhesive (Scotchbond Universal, 3M ESPE) (SB) in total-etch mode, compared to a traditional orthodontic primer (Transbond XT Primer, 3M ESPE) (XT Primer), to perform bonding of orthodontic fixed retainers along with the Transbond XT Light Cure Adhesive Paste (3M ESPE). For the in vitro study, a round section wire (Ortosmail Krugg) was bonded using XT Primer for 20 bovine incisors (Group 1) and SB for other 20 (Group 2). Samples were debonded in a universal testing machine applying a tangential force to specimens (crosshead speed of 1 millimeter per minute). Shear bond strength (SBS) and adhesive remnant index (ARI) scores were calculated. For the in vivo study, 100 patients needing upper and lower canine-to-canine fixed retainers after orthodontic treatment were randomly assigned to two groups of 50 participants each, i.e., group 1 (retainer bonding with XT Primer) and group 2 (retainer bonding with SB). Over two years, examinations were carried out monthly, and detachments were registered by considering the teeth and arches affected. In vitro, no statistically significant differences in SBS and ARI scores were demonstrated between the two groups, both showing a mean bond strength of about 12 MPa and major frequency of ARI “2” (>50% remnant adhesive on the enamel). Conversely, a significantly lower failure rate over 2 years was assessed clinically for group 2 in both arches. Independently of the adhesive and arch, incisors reported a significantly higher failure rate than canines. Scotchbond Universal used in total-etch mode could be a valid alternative to the traditional orthodontic Transbond XT Primer.
... They concluded that in terms of reliability, the direct-bonded multi-strand wire is superior to the plasma-treated polyethylene woven ribbon and resin retainer [12]. Similar findings have been described for glass fiber reinforced retainers [15]. In contrast with these studies, Scribante et al. showed no statistically significant differences in survival time after 12 months for the multi-strand wire and FRC. ...
Article
Full-text available
Background: Long-term retention with fixed retainers with a high success rate seems to be a reasonable solution to minimize or prohibit relapse of orthodontic treatment. Methods: Two hundred sixty patients between 13 and 30 years old were recruited for this study. The 0.0175 stainless steel twisted wire (G&H Orthodontics, USA) was compared with a single-strand ribbon titanium lingual retainer wire (Retainium, Reliance orthodontics, USA) was used. When treatment was completed, the retainers were bonded from canine to canine in the mandibular arch of the participants. In the follow-up visits, the patients were recalled every 3 months during the 24 months. Detachments, the time of debonding, and side effects were recorded. Statistical analysis was performed by a blinded statistician using a statistical package for Social Science (SPSS, Version20). After descriptive statistics, Kaplan-Meier analysis was performed to measure the survival rates of each retainer. P value < 0.05 was considered as significant. Results: Finally, 138 patients who received twisted wire splint and 112 patients who received ribbon wire were included in the analysis. The average duration of success was about 23 months for twisted wire and ribbon wire, according to the Kaplan-Meier estimates. The analysis showed no significant overall difference between the treatments (p = 0.13). Failure rates in terms of detachments in all groups occurred at the enamel junction, and it was 25 in twisted retainer group (18.1%) and was 10 in ribbon retainer group (8.9%); the Kaplan-Meier analysis test detected a significant difference in the failure rates between the groups (p = 0/006). Conclusions: Although the conventional twisted stainless steel wire and single-strand titanium flat metal ribbon wire as fixed orthodontic retainers have the same clinical effects, it was shown that the ribbon wire has less failure in terms of detachments.
... The results of our study are in accordance with the study conducted by Rose and Tacken [13,28]. They reported that multistranded stainless steel retainers are superior to the fiber reinforced in terms of reliability and bond failure. ...
Article
Full-text available
Background: Bonded retainers are widely used as they are esthetically pleasing, easily acceptable, provide greater stability, compliance free and causes no soft tissue irritation and speech problems. Though, fracture and bond failure are their shortcomings. Therefore, the objectives of this study were to evaluate the number of bond failures and type of failure pattern between two types of mandibular canine-canine bonded retainers. Methods: Total 60 subjects were recruited initially and were assessed for eligibility, out of which 6 were excluded and 2 were lost to follow up. They were randomly divided into two groups. Fiber reinforced composite (FRC) retainers were inserted in group 1 subjects while group 2 subjects received multistranded stainless steel (MSW) retainers. The subjects were recalled after every 3 months over a period of 1 year. Bond failure rate and failure pattern based on adhesive remnant index were evaluated at each visit. The bond failure rate and failure pattern were compared between the two retainers by using Chi-square test. Results: The bond failure rates were 42.94% for FRC retainer and 31.41% for MSW retainer. Hence, total number of bond failures in both retainers were 37.17%. The difference of bond failure between two groups was statistically significant (p = 0.012). Type "0" failure pattern was detected commonly with both types of retainers (p < 0.001). Conclusion: Our findings indicate that multistranded stainless steel wire retainer is a superior option to be used for fixed lingual retention in mandibular arch as it exhibited lower bond failure as compared to fiber reinforced composite retainer. Adhesive failure is the most common type of bond failure observed with both types of fixed retainers. Trial registration: ID NCT03881813 ( https://clinicaltrials.gov/ ); March 19, 2019, retrospective registration.
... Nowadays, multistranded flexible spiral wire retainers are considered the gold standard in orthodontics [38]. Manufacturers have introduced plenty of resins that can be used for bonding procedures. ...
Article
Full-text available
The aim of this laboratory and clinical study is to determine the reliability of the flowable nanocomposite Filtek Supreme XTE (FL) for the adhesion of orthodontic retainers, compared to highly filled orthodontic resin Transbond XT (XT). Portions of a round section multistranded wire (Ortosmail Krugg) were bonded to 40 bovine incisors with Scotchbond Universal in total-etch modality. For group one (XT, 20 samples), the orthodontic resin was used, whereas in group two (FL, 20 samples), the flowable one. Specimens were placed into a universal testing machine which applied a shear force on retainers with a crosshead speed of one/minute. Shear bond strength (SBS) and adhesive remnant index (ARI) scores were calculated. In the clinical trial, 100 patients requiring a canine-to-canine palatal and lingual retainer were randomly divided into two groups, according to the resin used for bonding procedure: the orthodontic in group one (XT, 50 participants) and the flowable in group two (FL, 50 participants). Monthly visits were carried out over a 24-month follow up to assess any detachment occurring on teeth of both arches. All data were submitted to statistical analysis. In vitro, FL reported a significant lower mean SBS, whereas no significant differences in ARI were reported between the two groups which both showed a major frequency of scores “1” and “2”. At the end of the 24-month follow up, FL reported significantly higher failure rates in both arches besides a significantly lower survival rate starting from the sixth month after retainers bonding. According to the results assessed in vitro and clinically, XT would be preferable to FL when performing retainers bonding procedure.
... Two of them found no difference in gingival bleeding and periodontal pocket depth 35 or calculus accumulation 41 between the groups. However, Tacken et al 38 and Torkan et al 37 agreed that multistranded wires were better in terms of gingival inflammation. Bazargani et al 34 reported that the application of resin during the bonding procedure reduces the deposition of calculus, whereas St€ ormann and Ehmer 42 found similar periodontal outcomes for customized wires when compared with prefabricated wires. ...
... On the other hand, fiber-reinforced composite retainers could be more deleterious to the periodontium than wire retainers. 37,38 Two studies 45,49 also showed that positioning the retainer more incisally or more gingivally does not seem to influence the periodontal outcomes. Nevertheless, because of the limitations of this review, recommendations on the best type of fixed retainer to use cannot be given. ...
... Tacken et al 2010 38 RCT In the upper arch, bonded to all incisors, and in the lower arch, bonded to all anterior teeth: À Glass fiber-reinforced retainer-500 unidirectional GF À Glass fiber-reinforced retainer-1000 unidirectional GF À 0.0215" Multistranded wire À Untreated subjects ...
Article
Introduction: The objective of this systematic review was to assess the available evidence in the literature for the effects of fixed orthodontic retainers on periodontal health. Methods: The following databases were searched up to August 31, 2019: Medline, EMBASE, the Cochrane Oral Health Group's Trials Register, CENTRAL, ClinicalTrials.gov, the National Research Register, and Pro-Quest Dissertation Abstracts and Thesis database. Randomized controlled trials (RCTs), controlled clinical trials, cohort studies of prospective and retrospective design, and cross-sectional studies reporting on periodontal measurements of patients who received fixed retention after orthodontic treatment were eligible for inclusion. The quality of the included RCTs was assessed per the revised Cochrane risk of bias tool for randomized trials (RoB 2.0), whereas the risk of bias of the included cohort studies was assessed using the Risk Of Bias In Nonrandomized Studies of Interventions tool. A modified version of the Newcastle-Ottawa scale was used for cross-sectional studies. Results: Eleven RCTs, 4 prospective cohort studies, 1 retrospective cohort study, and 13 cross-sectional studies fulfilled the inclusion criteria. The quality of evidence was low for most of the included studies. In contrast to the general consensus, 2 RCTs, 1 prospective cohort study, and 2 cross-sectional studies reported poorer periodontal conditions in the presence of a fixed retainer. The results of the included studies comparing different types of fixed retainers were heterogeneous. Conclusions: According to the currently available literature, orthodontic fixed retainers seem to be a retention strategy rather compatible with periodontal health, or at least not related to severe detrimental effects on the periodontium.