Evaluation of retention protocols among members of the American Association of Orthodontists in the United States.

INTRODUCTION: Little research has been conducted to evaluate protocols and trends in orthodontic retention. The purpose of this study was to identify the general retention protocols used by orthodontists in the United States. Additionally, our goal was to identify trends in these orthodontic retention protocols by evaluating how they have changed over the past 5 years and how they might continue to change in the next 5 years. METHODS: The study was conducted via a 36-question electronic survey (REDCap, Nashville, Tenn) with branching logic on certain questions. The survey was sent to all 9143 practicing members of the American Association of Orthodontists in the United States, and 1632 (18%) responded. RESULTS AND CONCLUSIONS: Mean retention protocols of the surveyed population showed predominant use of Hawley or vacuum-formed retainers in the maxillary arch and fixed retention in the mandibular arch. For both arches, there is a current shift away from Hawley retainers and toward vacuum-formed retainers and fixed retention. Respondents who extract fewer teeth reported increased use of fixed retention in the maxillary (P = 0.041) and mandibular (P = 0.003) arches. Respondents who extract fewer teeth and use removable retainers were more likely to tell their patients to wear their retainers at night for the rest of their lives (P = 1.63 × 10(-6)).

Patient compliance with orthodontic retainers in the postretention phase.

INTRODUCTION: Retention is an important, even critical, component of orthodontic treatment. There is little research on practice protocols and patient compliance with long-term or short-term retention. This lack of information leaves our specialty with many opinions and practice protocols. The purposes of this study were to evaluate and quantify orthodontic retainer wear according to several variables, including patient age, sex, time in retention, and retainer type, and to identify predictors of compliance and reasons for noncompliance with removable orthodontic retainers. METHODS: Questionnaires were mailed to patients who finished full fixed appliance therapy in either the orthodontic graduate clinic or the orthodontic faculty practice at the University of Kentucky within the past 6 years. Of the 1085 questionnaires mailed, 280 were returned (25.8%). A logistic regression model that described the probabilities of retainer wear was created (P <0.0001). RESULTS: Patient compliance was greater with vacuum-formed retainers (VFRs) for the first 2 years after debonding. However, compliance with VFRs decreased at a much faster rate than with Hawley retainers. Because of this, patient compliance was greater with Hawley retainers at any time longer than 2 years after debonding, and patient compliance overall was greater with Hawley retainers. CONCLUSIONS: This evidence disagrees with the current anecdotal trend of orthodontists who favor switching from Hawley retainers to VFRs. An unexpected finding was that patients reported few esthetic concerns about retainers, and the few that were reported were equally distributed between Hawley retainers and VFRs.