Impact of fixed orthodontic retainers on oral health-related quality of life: a longitudinal prospective study

ABSTRACT Objective: The aim of the present study was to assess the impact of orthodontic retainers on oral health-related quality of life (OHRQoL) in the short and long terms after orthodontic treatment. Methods: Data from 45 patients up to three years after orthodontic treatment (T0) were analyzed. Patients were reassessed four years (T1) after T0. OHRQoL was measured using the OHIP-14 (Oral Health Impact Profile-14) questionnaire. The presence of a fixed retainer in the upper and/or lower arches, sex, and age were the predictive variables evaluated at T0 and T1. The occurrence of retainer fracture at T0 was clinically evaluated. Due to the COVID-19 pandemic, clinical examination on T1 was not possible, so the OHIP-14 and the self-perception of changes in teeth position and fracture of retainers were examined using an on-line questionnaire. Results: At the initial examination, the presence of upper retainers had a negative impact on quality of life (p=0.018). The OHIP-14 value increased significantly from T0 to T1 (p=0.014), regardless of the presence of retainers. The fracture or debonding of the retainer reported by the patient was the only variable that had a negative impact on OHRQoL (p=0.05). Conclusion: The use of fixed upper retainers suggests a negative impact on the quality of life of the orthodontic patient after the end of orthodontic treatment. This impact, however, is negligible in the long term, except when associated with fracture or debonding. This study emphasizes the need for continuous follow-up of orthodontic patients during the retention period.

RESUMO Objetivo: O objetivo deste estudo foi avaliar o impacto das contenções ortodônticas na qualidade de vida relacionada à saúde bucal (QVRSB) em curto e longo prazos após o tratamento ortodôntico. Métodos: Foram analisados dados de 45 pacientes até três anos após o tratamento ortodôntico (T0). Os pacientes foram reavaliados quatro anos (T1) após T0. A QVRSB foi mensurada usando o questionário OHIP-14 (Oral Health Impact Profile-14). A presença da contenção fixa nas arcadas superior e/ou inferior, o sexo e a idade foram as variáveis preditoras em T0 e T1. A ocorrência de quebra da contenção em T0 foi avaliada clinicamente. Em razão da pandemia da COVID-19, não foi possível o exame clínico em T1; assim, a autopercepção das alterações na posição dos dentes e a quebra ou descolagem das contenções foram registradas por meio de um questionário online. Resultados: No exame inicial, a presença da contenção superior apresentou um impacto negativo na qualidade de vida (p=0,018). Em T1, o valor de OHIP-14 aumentou significativamente em comparação a T0 (p=0,014), independentemente da presença das contenções. A quebra ou descolagem da contenção relatada pelo paciente foi a única variável que apresentou um impacto negativo na QVRSB (p=0,05). Conclusão: O uso de contenção fixa superior sugere um impacto inicial negativo na qualidade de vida do paciente após o fim do tratamento ortodôntico. Esse impacto, entretanto, é insignificante em longo prazo, exceto quando associado à descolagem ou quebra das contenções ortodônticas. Esse estudo enfatiza a necessidade de acompanhamento contínuo das contenções fixas após a finalização do tratamento ortodôntico.

Relación entre la inclinación de los incisivos con la estabilidad en la alineación del sector anterior según criterios del índice PAR

Introducción : el objetivo de este estudio fue el evaluar la relación entre la inclinación de los incisivos al finalizar tratamiento de ortodoncia con la estabilidad de la alineación de dientes anteriores usando índice PAR. Métodos: estudio analítico de corte transversal, en 47 pacientes que finalizaron ortodoncia, con radiografía lateral inicial y final, se evaluó el ángulo formado entre plano (Silla-Nasion) (U1-NS) e inclinación del incisivo superior y el ángulo entre inclinación axial del incisivo inferior y plano mandibular (Go-Gn). Se aplicó el índice PAR del sector anterior a modelos pretratamiento (T0), postratamiento (T1) y de seguimiento (T2). El análisis estadístico se realizó mediante distribuciones de frecuencias y porcentuales, prueba T, Anova I, Anova II y Manova; significancia P= 0.05. Resultados: no se encontró asociación entre la inclinación del incisivo superior e inferior, la estabilidad en alineación y el puntaje ponderado del PAR entre T2-T1 (P>0.05). El PAR disminuyó 75.29% de T0 a T1 y 58.79% de T0 aT2, con recidiva de 16,5%. No hubo asociación entre tipo de retenedor y puntaje ponderado del PAR. De T0 a T2 hubo asociación entre la interacción de la inclinación del incisivo superior (P=0.03) e inferior (P=0.04), con el puntaje total ponderado del índice PAR. Conclusión: no hubo asociación entre la modificación de la inclinación de los incisivos con la estabilidad del sector anterior. Al terminar ortodoncia se presentó un nivel de corrección alto en el sector antero-superior e inferior, sin embargo, hubo recidiva de 16.5%.

Introduction: the objective of this study was to evaluate the relationship between incisor inclination at the end of orthodontic treatment with the anterior teeth alignment stability using PAR index. Methods: analytical cross-sectional study, the angle formed between the plane (Silla-Nasion) (U1-NS) and the inclination of the upper incisor and the angle between axial inclination of the lower incisor and mandibular plane (Go-Gn), were measured in 47 initial and final lateral radiographs of patients who finished orthodontic treatment. The anterior sector PAR index was applied to pretreatment (T0), posttreatment (T1) and follow-up (T2) casts. Statistical analysis was performed using frequency and percentage distributions, T test, Anova I, Anova II and Manova; significance p = 0,05. Results: no association was found between upper and lower incisor inclination, alignment stability and PAR weighted score between T2-T1 (p> 0,05). The PAR decreased 75,29% from T0 to T1 and 58,79% from T0 to T2, with a recurrence of 16,5%. There was no association between retainer type and PAR weighted score. From T0 to T2 there was an association between the interaction of the incisor inclination of upper (p = 0,03) and lower (p = 0,04), with the weighted total score of the PAR index. Conclusion: there was no association between the modification of the incisor inclination with the stability of the anterior sector. At the end of orthodontic treatment there was a high level of correction in the anterior-superior and inferior sector, however, there was a recurrence of 16,5%.

Retenedores de Ortodoncia y su Efecto sobre la Salud Periodontal. Revisión de la Literatura

RESUMEN: Existe una prescripción generalizada de retenedores fijos y removibles, con indicación indefinida, luego del tratamiento ortodóncico. El objetivo de este estudio fue dilucidar el impacto de los retenedores de ortodoncia sobre la salud periodontal de los dientes. Se realizó una búsqueda y análisis de artículos científicos de las bases de datos PubMed, ScienceDi rect, SciELO, LILACS y Google Scholar. Los artículos seleccionados fueron publicados entre los años 2015 y 2020 en base a criterios de inclusión y exclusión. Nuestra revisión sugiere que la indicación de un retenedor fijo o removible presenta mayores benefici os que riesgos y no significa, cuando son consideradas las características individuales de cada paciente, el detrimento de la salud periodontal. Sin embargo, son necesarios nuevos estudios prospectivos, con un tiempo de seguimiento suficiente y la presencia de un grupo control, para poder extrapolar resultados y los potenciales daños asociados con los retenedores de ortodoncia.

ABSTRACT: Due to the high prescription after orthodontic treatment of fixed and removable retainers with an indication of indefinite use, the aim of this study was to find the impact of orthodontic retainers on the periodontal health of the teeth. we proceed to search and analyze scientific articles from databases PubMed, ScienceDirect, SciELO, LILACS and Google Scholar, selected articles were published between 2015 and 2020 based on inclusion and exclusion criteria. Our review suggests that the indication of a fixed or removable retainer presents greater benefits than risks and does not mean, when considering the individual characteristics of each patient, the detriment of periodontal health. However, new prospective studies with a longer follow- up time and the presence of a control group are necessary to be able to extrapolate results and elucidate the possible damages associated with orthodontic retainers.

Penggunaan Aplians Penahan Ortodontik Boleh Tanggal Bagi Pengekalan Hasil Rawatan Ortodontik - Ulasan The Use of Removable Retainers to Maintain the Results of Post-Orthodontic Treatment – A Review / Jurnal Sains Kesihatan Malaysia

@#Retention phase is fundamental in orthodontic treatment. Around 70% of patients are subjected to relapse postorthodontic treatment. The risk of relapse can be minimized by prescribing a retainer suitable to a patient’s pre-treatment clinical condition and based on retention characteristics of retainers. When removable retainers are prescribed, responsibility of maintaining tooth stability lies on patients. Recent idea has been proposed that removable retainer should be worn indefinitely in order to maintain the treatment result. Therefore, the understanding of retention characteristics of removable retainers is important for promoting patient compliance and satisfaction. This article focuses on reviewing the use of removable retainers in relation to preferences among clinicians, patient acceptability, effectiveness, compliance, as well as retention regimes. An electronic search was conducted in the PubMed/MEDLINE, ScienceDirect and Scopus database. The search was performed up to June 2020 using a variety of keywords including orthodontic retainers, Hawley, vacuum formed and retention. Among the 248 publications that were initially searched, total of 56 publications were finally included. Twenty-seven were observational (6 prospective; 16 cross-sectional, 4 retrospective, and 1 case series), fourteen experimental, fourteen review articles, and one opinion piece. Although quite a number of reviews on removable retainers were available, several significant papers have been published recently. Furthermore, a guideline on retention regime is warranted.

Mechanical and non-mechanical orthodontic procedures in relapse and retention: scoping review / Procedimientos ortodónticos mecánicos y no mecánicos en recidiva y retención: revisión de cobertura temática

Abstract Introduction: stability after orthodontic treatment is an important goal for orthodontists. This issue has been highly important in orthodontics, so its progress and content require constant analysis. Methods: a panoramic and analytical review of citations and keywords from Web of Science helped create a body of information on the current advances in research on this field. Results: several fields of research arise from the analysis, dealing with surgery as an approach, molecular concepts, orthodontists' experiences in professional practice, and the use of lasers and other applications. Conclusions: information on relapse and retention within orthodontics is still valid and requires further research on current issues to understand this complex phenomenon for both academia and clinical use.

Resumen Introducción: la estabilidad postortodóncica es uno de los objetivos que persigue el ortodoncista. Esta temática siempre ha tenido una importancia relevante en la ortodoncia y requiere continuo análisis de sus avances y contenidos. Métodos: mediante una revisión panorámica y analítica de citas y palabras clave desde Web of Science, se establece un cuerpo de información con base en el cual se plantea el avance actual de la investigación en este campo. Resultados: en el análisis emergen varios campos de investigación que tienen que ver con la cirugía como medio de abordaje, los conceptos moleculares, las experiencias de los ortodoncistas en la práctica profesional y el uso de láser y otras aplicaciones. Conclusiones: dentro de la ortodoncia, la información sobre recidiva y retención sigue vigente e invita a la construcción de trabajos en relación con las temáticas actuales para comprender este fenómeno complejo no solo para la academia, sino además para su utilidad clínica.

Periodontal parameters of two types of 3 x 3 orthodontic retainer: a longitudinal study

ABSTRACT Introduction: bonded fixed retainers are often used to stabilize the results obtained with the orthodontic treatment. It is important that they do not prejudice dental health, as they will be used for a long period. Objective: The purpose of the present study was to compare periodontal indexes between two types of bonded fixed retainers, conventional 3 x 3 plain retainer (0.8-mm orthodontic wire, bonded to the canines only) and a manufactured braided retainer (0.2 x 0.7-mm stainless steel wire, bonded to all anterior teeth) after use. Methods: a test group of 15 volunteers (aged from 18 to 25 years) used both the conventional retainer and braided retainer for six months. A randomized longitudinal study design, with a two week washout interval, was applied. The dental plaque index, gingival index and dental calculus index were evaluated. Furthermore, the calculus accumulated along the retainer wire was measured and all patients answered a questionnaire about the use, acceptance and comfort of both types of retainers. Results: the scores for plaque and gingival indexes were higher for the braided retainer (p< 0.05) on the lingual and proximal surfaces. The same occurred with the calculus index on the lingual surfaces (p< 0.05). The calculus index along wire was higher for the braided retainer (p< 0.05). All patients preferred the conventional retainer, and said that it was also more comfortable to use. Conclusion: it was concluded that the conventional retainer showed better periodontal indexes than the braided type.

RESUMO Introdução: as contenções ortodônticas fixas são amplamente utilizadas após o tratamento ortodôntico, sendo fundamental que esses dispositivos não se tornem prejudiciais à saúde dentária, já que serão usados por um longo período. Objetivo: o presente estudo teve como objetivo a avaliação periodontal da região da arcada inferior, comparando as condições de acúmulo de placa e cálculo ao longo do fio e na margem gengival, em decorrência do uso da contenção convencional (fio 0,8 mm de aço inoxidável colado apenas nos caninos) ou de uma contenção pré-fabricada com fio trançado (0,2 x 0,7 mm colado em todos os dentes anteroinferiores) após exposição ao meio bucal. Métodos: participaram do estudo 15 voluntários adultos jovens (idades entre 18 e 25 anos) que utilizaram dois tipos de contenções, por seis meses cada. Foi utilizado um modelo de estudo longitudinal, randomizado, com washout de 15 dias. Os parâmetros periodontais utilizados foram: índice gengival, índice de placa e índice de cálculo. O cálculo acumulado ao longo da contenção foi avaliado e todos os pacientes responderam a um questionário sobre o uso, aceitação e conforto de ambos os tipos de contenção. Resultados: observou-se que o índice de placa foi maior para a contenção com fio trançado (p<0,05), assim como o índice gengival (p<0,05). O mesmo ocorreu para o índice de cálculo nas faces proximais e lingual (p<0,05). O índice de cálculo ao longo do fio também foi significativamente maior para a contenção com fio trançado (p<0,05). Em relação ao questionário aplicado, 60% dos voluntários consideraram que a contenção com fio trançado foi mais desconfortável, e todos eles preferiram a contenção convencional. Conclusão: concluiu-se que a contenção convencional apresentou melhores resultados periodontais, quando comparada à contenção pré-fabricada com fio trançado.

Users' perceptions and preferences towards maxillary removable orthodontic retainers: a crossover randomized clinical trial

Abstract The aim of this study was to assess, correlate, and compare users' perceptions and preference related to maxillary removable retainers. Volunteers were recruited to use four retainer types: conventional wrap-around (CWA), wrap-around with an anterior opening (OWA), "U" wrap-around (UWA), and clear thermoplastic retainer (CT). The main outcomes were the volunteers' perceptions, evaluated with a 100-mm visual analogue scale, and their preferred retainer. The retainers were used for 21 days each (washout intervals of 7 days). Nineteen volunteers (27 ± 4.53 years) were randomly divided into four groups that used the four retainers, but with a different sequence. Perceptions were evaluated immediately after the use of each retainer and the preference at the end of the research. Repeated measures ANOVA and Friedman tests with post-hoc Tukey's test (intergroup comparisons), and Pearson and Spearman analyses (correlations between perceptions) were applied. The WA retainers did not significantly differ among themselves. The CT was rated significantly worse in speech (p ≤ 0.001), discomfort (p < 0.001), and occlusal interference (p < 0.001), and did not significantly differ from the others in esthetics. Users preferred significant more the WA retainers in comparison with the CT retainers. The occlusal interference caused by the CT was positively correlated to other perceptions, such as changes in speech and discomfort. WA retainers presented similar preference and perceptions, but were significantly better than the CT. The CT occlusal coverage appeared to be the primary cause of its rejection.

Factors affecting stability after fixed orthodontic treatment / 中华口腔医学杂志

Objective@#To analyze factors affecting stability after fixed orthodontic treatment.@*Methods@#Five hundred and forty-four patients who had finished fixed orthodontic treatment more than two years in First Department of Orthodontics, China Medical University from January, 2000 to December, 2017 were investigated and the rate of regular revisit was counted. The data of 288 patients were successfully collected by calling or sending text messages and the rate of standard use of retainers as prescribed (patients wore retainers for 24 months or longer) was counted. According to the variation of peer assessment rating (PAR) index at the start of retention and the time the data collected, the patients were divided into relapse group (variation of PAR index >5) and non-relapse group (variation of PAR index ≤5). Difference significance analysis and multiple-factor logistic regression analysis were used. Sixty patients wearing retainers well were collected and the curative effects of Hawley retainer and vacuum formed retainer (VFR) were compared, which included overbite, overjet, maxillary irregularity index, mandibular irregularity index, width betwenn canine and width between first molar.@*Results@#The rate of regular revisit was 41.0% (223/544). Two hundred and one of 288 patients (69.8%) who were visited successfully had regular revisit, and 60.4%(174/288) of the patients wore retainers well; 30.2% (87/288) of the patients who were visited successfully didn't have regular revisit, and 10.4% (30/288) of the patients wore retainers well. Difference significance analysis showed that there was highly significant difference between relapse group and non-relapse group in the type of retainer and duration of retention (P<0.01). One hundred and forty of 224 patients (62.5%) in non-relapse group and 37.5% (24/64) of the patients in relapse group used VFR, and the duration of retention in non-relapse group was significantly longer than that in relapse group (P<0.01). Multiple-factor Logistic regression analysis showed that wearing Hawley retainers (OR=3.067, P<0.05) was the risk factor influencing relapse. The duration of retention (OR=0.832, P<0.01) was the protective factor influencing relapse. Independent-sample t test indicated that the variations of maxillary [(0.82±0.36) mm] and mandibular [(1.05±0.22) mm] irregularity index in Hawley retainer group were larger than maxillary [(0.64±0.29) mm] and mandibular [(0.72±0.35) mm)] irregularity index in VFR group, respectively. The differences between the two groups were significant (P<0.05).@*Conclusions@#Duration of retention was implicated in stability after orthodontic treatment. VFR had better effect in the aspects of irregularity index than Hawley retainer.

Comparison between fiber-reinforced polymers and stainless steel orthodontic retainers / 대한치과교정학회지

OBJECTIVE: The aim of this study was to examine the properties of fiber-reinforced composite and stainless steel twisted retainers for orthodontic retention. METHODS: Three different span lengths (5.0, 8.0, and 14.0 mm) of fiber-reinforced composite were investigated. The three fiber-reinforced composite retainer groups were subdivided according to the storage condition (dry and wet), resulting in a total of six groups. Each stainless steel and fiber-reinforced composite group was comprised of six specimens. The three-point bending flexural test was conducted using a universal testing machine. ANOVA was used to assess differences in the maximum load and maximum stress according to the span length, material, and storage condition. Post-hoc comparisons were performed if necessary. RESULTS: The maximum stress and maximum load were significantly (p < 0.001) associated with the span length, material, and storage condition. The significant interaction between the material and span length (p < 0.001) indicated the differential effects of the material for each span length on the maximum stress and maximum load, with the difference between materials being the highest for the maximum span length. CONCLUSIONS: Our findings suggest that fiber-reinforced composite retainers may be an effective alternative for orthodontic retention in patients with esthetic concerns or allergy to conventional stainless steel wires.

Acúmulo de biofilme na contenção Curado / Biofilm retention in Curado's retaine

As contenções ortodônticas são frequentemente utilizadas após tratamento ortodôntico. Uma limitação das contenções fixas é a dificuldade de higienização dos dentes envolvidos, uma vez que o fio de contenção gera áreas que são difíceis de serem limpas, favorecendo a formação de biofilme ao redor dos dentes. A contenção Curado foi idealizada visando minimizar o acúmulo de tártaro e facilitar a higiene da região tanto para o cirurgião dentista quanto para seu usuário. Através de dois relatos de caso, este trabalho propõe-se a apresentar acompanhamento clínico de uma contenção ortodôntica 3x3 fixa que foi desenvolvida e patenteada pelo autor deste estudo, sob o número de registro BR2020140103045 no Instituto Nacional de Propriedade Industrial (INPI), com depósito realizado em 29/04/2014. São descritas as consultas de retorno dos indivíduos que utilizaram esse dispositivo pelo período de dois anos, ressaltando o acúmulo de biofilme antes e depois de corar placa bacteriana com evidenciador de placa. Através da coloração de placa, observou-se que o maior acúmulo de biofilme aconteceu ao redor da resina composta. Pouco impacto foi observado no periodonto. Os pacientes consideraram a contenção confortável e de rápida adaptação. A contenção Curado descrita neste trabalho possibilita fácil acesso do fio dental na região interproximal e interior do sulco gengival, permitindo o controle do biofilme. A contenção permite também a passagem do instrumental para raspagem e alisamento coronário realizado pelo cirurgião dentista, com livre trânsito nas regiões interproximais e cervical, por fim, considera-se o desempenho da Contenção Curado bastante satisfatório.(AU)

Orthodontic retainers are frequently used after the orthodontic treatment. One of its limitations is to reach a quality oral hygiene, once the wire creates areas that are hard to clean properly, favoring biolfim formation. The Contenção Curado was idealized aiming to minimize biofilm accumulation as well as make oral hygiene easier, not only for the dentist but specially for the patient. Through two case reports, this article aims to present the clinical monitoring of a 3x3 orthodontic retainer that was developed and patented by the author of this study, under the registration number BR2020140103045 at the Instituto Nacional de Propriedade Industrial (INPI), submitted in 04/29/2014. In this study, appointments attended by patients that wear this disposal for two years are described, emphasizing biofilm accumulation before and after dental plaque disclosing. Through dental plaque disclosing, it was possible to observe that the greater biofilm accumulation was around the composite resin. Little impact was observed in the periodontal tissue. According to patients that wore the appliance, it was comfortable and of quick adaptation. The Curado's retainer described in this study enables easy access to dental floss in interproximal area and inside gingival sulcus, allowing biofilm control. The appliance also allows access to periodontal scaling and root planing instruments by the dentist, with free access to interproximal and cervical areas. Therefore, we can consider the performance very satisfactory.(AU)

Effectiveness of two retainer types in dental and occlusal stability / Efectividad de la estabilidad dentaria y oclusal con dos tipos de retenedores

ABSTRACT Introduction: with the purpose of providing additional details on the selection of retainer type, this study sought to assess the stability of dental and occlusal position during retention phase using two types of retainers in individuals with no remnant growth who completed orthodontic treatment at the Universidad de Antioquia School of Dentistry, Universidad CES, and in private practice in Medellín in 2011. Methods: this was a controlled clinical study with a sample of 47 patients aged 15 to 45 years, randomly selected into two treatment groups: 22 patients with Essix retainer and 25 patients with Hawley plate in both arches. Cephalometric X-rays and study models were taken on all patients at baseline and six months later with monthly clinical evaluations. Results: the clinical and radiographic results showed significant differences in some tooth rotations in terms of upper intercanine distance and molar relationship, but overall there were no statistically significant differences between both retainers in the three space planes. Conclusion: there were no statistically significant differences between the retainers in a six-month evaluation period.

RESUMEN Introducción: con el propósito de ofrecer mayor evidencia sobre la selección del tipo de retenedor, este estudio pretendió evaluar la estabilidad de la posición dentaria y oclusal durante el tratamiento de retención con dos tipos de retenedores en individuos sin crecimiento remanente que finalizaron tratamiento ortodóncico en la Facultad de Odontología de la Universidad de Antioquia, de la Universidad CES y en la práctica privada en Medellín en el año 2011. Métodos: se hizo un ensayo clínico controlado con una muestra de 47 pacientes con edades entre 15 y 45 años, divididos aleatoriamente en dos grupos de tratamiento: 22 pacientes con retenedor tipo Essix y 25 pacientes con placa de Hawley en ambos arcos. A todos los pacientes se les tomó radiografía cefálica lateral y modelos de estudio, al inicio y seis meses después, y se hizo evaluación clínica mensual. Resultados: los resultados clínicos y radiográficos mostraron diferencias significativas en algunas rotaciones dentarias, en la distancia intercanina superior y en la relación molar, pero en general no se encontraron diferencias estadísticamente significativas entre los dos retenedores en los tres planos del espacio. Conclusión: no se encontraron diferencias estadísticamente significativas entre los retenedores en una evaluación a seis meses.

Two-year survival analysis of twisted wire fixed retainer versus spiral wire and fiber-reinforced composite retainers: a preliminary explorative single-blind randomized clinical trial / 대한치과교정학회지

OBJECTIVE: Traditional retainers (both metal and fiber-reinforced composite [FRC]) have limitations, and a retainer made from more flexible ligature wires might be advantageous. We aimed to compare an experimental design with two traditional retainers. METHODS: In this prospective preliminary clinical trial, 150 post-treatment patients were enrolled and randomly divided into three groups of 50 patients each to receive mandibular canine-to-canine retainers made of FRC, flexible spiral wire (FSW), and twisted wire (TW). The patients were monitored monthly. The time at which the first signs of breakage/debonding were detected was recorded. The success rates of the retainers were compared using chi-squared, Kaplan-Meier, and Cox proportional-hazard regression analyses (α = 0.05). RESULTS: In total, 42 patients in the FRC group, 41 in the FSW group, and 45 in the TW group completed the study. The 2-year failure rates were 35.7% in the FRC group, 26.8% in the FSW group, and 17.8% in the TW group. These rates differed insignificantly (chi-squared p = 0.167). According to the Kaplan-Meier analysis, failure occurred at 19.95 months in the FRC group, 21.37 months in the FSW group, and 22.36 months in the TW group. The differences between the survival rates in the three groups were not significant (Cox regression p = 0.146). CONCLUSIONS: Although the failure rate of the experimental retainer was two times lower than that of the FRC retainer, the difference was not statistically significant. The experimental TW retainer was successful, and larger studies are warranted to verify these results.

Novo desenho para a contenção ortodôntica 3x3 fixa / New design of 3x3 fixed orthodontic retainer

As contenções ortodônticas são frequentemente utilizadas após tratamento. Na arcada inferior, a contenção fixa é a mais empregada. Através de um relato de caso, este trabalho se propõe a apresentar os detalhes técnicos de um novo desenho para a contenção ortodôntica 3 x 3 fixa que foi desenvolvido e patenteado pelo autor deste estudo sob o número de registro BR2020140103045 no Instituto Nacional de Propriedade Industrial (INPI). Neste trabalho são descritos os materiais e as etapas para a correta confecção, posicionamento e instalação dessa nova proposta de contenção fixa. Dentre as vantagens desse novo desenho evidencia-se uma higienização adequada da região interproximal dos dentes envolvidos, através de um fácil acesso do fio dental; situar-se distante do periodonto de proteção e permitir acesso dos instrumentos periodontais para raspagem e polimento coronário

Orthodontic retainers are frequently used after treatment. Fixed retention is more used in the lower arch. Through a case report, this article proposes to present technical details of a brand new design of 3 x 3 fixed orthodontic retention, which was developed by the author and patented at the Brazilian National Institute of Industrial Property under registration BR202014010345. This work describes the materials and steps for correct manufacturing, positioning and installation of this new fixed retention proposed. Among the advantages of this new design are evident an adequate cleaning of the interproximal area of the involved teeth, through easy access of dental floss, it is located far from the periodontal and allows easy access to periodontal instruments for crown scaling and polishing.

Alterações dimensionais dos arcos dentários decorrentes do tratamento com o aparelho Pendulum associado ao fixo: avaliação longitudinal / Maxillary molar distalization by Pendulum appliance: a prospective study in digital 3d models

Objetivo: avaliar, por meio de modelos digitalizados, o comportamento transversal do arco dentário superior de pacientes submetidos ao tratamento da má oclusão de Classe II, corrigida com o aparelho Pendulum, seguido de aparelhagem ortodôntica fixa nos períodos inicial, pós-distalização, pós-tratamento e longo tempo póstratamento. Material e Métodos: Oitenta modelos de 20 pacientes (14 do gênero feminino e 6 do masculino), foram digitalizados no aparelho REXCAN DS2. A média da idade, ao início do tratamento (T1), foi de 14,02 ± 1,62 anos, pós-distalização (T2), foi de 14,54 ± 1,61, ao final do tratamento (T3), 18,38 ± 1,84 anos, e no póstratamento (T4), 22,94 ± 1,34 anos. As distâncias intercaninos, interpré-molares e intermolares foram realizadas no programa Geomagic Studio 5®. A análise de variância dependente para medidas repetidas (ANOVA) foi utilizada para avaliar as alterações entre os períodos. Resultados: não ocorreram alterações transversais na distância intercaninos nas fases estudadas. Os pré-molares demostram um aumento na fase de aparelhagem fixa (T2-T3), para os segundos pré-molares a diferença foi observada entre o período inicial (T1) e os período pós-tratamento (T3). A distância dos primeiros molares alterou durante a fase de distalização (T1-T2), retornando aos valores iniciais durante a fase pós-tratamento (T3). Para os segundos molares, as alterações ocorreram durante o período de distalização (T2) e pós-tratamento (T3). Não ocorreram alterações na fase de longo tempo pós-tratamento. Conclusão: Os resultados permitem concluir que, durante o tratamento com o aparelho Pendulum seguido pelo fixo, ocorrem alterações transversais no arco superior, no entanto, estas alterações permanecem estáveis cinco anos pós-tratamento.

Objective: The aim of this longitudinal study was to asses transversal changes in maxillary dental arch in twenty patients between 14 and 18 years old, treated first by Pendulum and followed by fixed appliances. Material and Methods: Dental measurements in eighty digital 3D models were obtained in pretreatment, postdistalization, post-treatment and long-term post-treatment phases. The statistical analysis was performed by ANOVA test. Results: Premolars and molars distances increased during the fixed appliance treatment (post-distalization and post-treatment phase) and in the long post-treatment phase there were no significant changes. No significant difference was observed in canines transversal distance. Conclusion: It was concluded that Pendulum followed by the fixed appliances, changes dental arch width during the full treatment and it was stable in the long-term post-treatment.

Alterações dimensionais dos arcos dentários decorrentes do tratamento com o aparelho Pendulum associado ao fixo: avaliação longitudinal / Maxillary molar distalization by Pendulum appliance: a prospective study in digital 3d models

Objetivo: avaliar, por meio de modelos digitalizados, o comportamento transversal do arco dentário superior de pacientes submetidos ao tratamento da má oclusão de Classe II, corrigida com o aparelho Pendulum, seguido de aparelhagem ortodôntica fixa nos períodos inicial, pós-distalização, pós-tratamento e longo tempo póstratamento. Material e Métodos: Oitenta modelos de 20 pacientes (14 do gênero feminino e 6 do masculino), foram digitalizados no aparelho REXCAN DS2. A média da idade, ao início do tratamento (T1), foi de 14,02 ± 1,62 anos, pós-distalização (T2), foi de 14,54 ± 1,61, ao final do tratamento (T3), 18,38 ± 1,84 anos, e no póstratamento (T4), 22,94 ± 1,34 anos. As distâncias intercaninos, interpré-molares e intermolares foram realizadas no programa Geomagic Studio 5®. A análise de variância dependente para medidas repetidas (ANOVA) foi utilizada para avaliar as alterações entre os períodos. Resultados: não ocorreram alterações transversais na distância intercaninos nas fases estudadas. Os pré-molares demostram um aumento na fase de aparelhagem fixa (T2-T3), para os segundos pré-molares a diferença foi observada entre o período inicial (T1) e os período pós-tratamento (T3). A distância dos primeiros molares alterou durante a fase de distalização (T1-T2), retornando aos valores iniciais durante a fase pós-tratamento (T3). Para os segundos molares, as alterações ocorreram durante o período de distalização (T2) e pós-tratamento (T3). Não ocorreram alterações na fase de longo tempo pós-tratamento. Conclusão: Os resultados permitem concluir que, durante o tratamento com o aparelho Pendulum seguido pelo fixo, ocorrem alterações transversais no arco superior, no entanto, estas alterações permanecem estáveis cinco anos pós-tratamento.

Objective: The aim of this longitudinal study was to asses transversal changes in maxillary dental arch in twenty patients between 14 and 18 years old, treated first by Pendulum and followed by fixed appliances. Material and Methods: Dental measurements in eighty digital 3D models were obtained in pretreatment, postdistalization, post-treatment and long-term post-treatment phases. The statistical analysis was performed by ANOVA test. Results: Premolars and molars distances increased during the fixed appliance treatment (post-distalization and post-treatment phase) and in the long post-treatment phase there were no significant changes. No significant difference was observed in canines transversal distance. Conclusion: It was concluded that Pendulum followed by the fixed appliances, changes dental arch width during the full treatment and it was stable in the long-term post-treatment.

Comparação de parâmetros periodontais após utilização de contenção ortodôntica com fio trançado e contenção modificada / Comparison of periodontal parameters after the use of orthodontic multi-stranded wire retainers and modified retainers

OBJECTIVE: The objective of the present study was to compare two types of fixed orthodontic retainers (a multi-stranded wire retainer and a modified retainer) in relation to established periodontal parameters. The multi-stranded wire retainer is commonly used, and the modified retainer has bends to enable free access of dental floss to interproximal areas. METHODS: For this crossover study, 12 volunteers were selected and used the following retainers for six months: (A) a multi-stranded wire retainer and (B) a modified retainer. Both retainers were fixed to all anterior lower teeth.After this experimental period, the following evaluations were made: Dental Plaque Index, Gingival Index, Dental Calculus Index and Retainer Wire Calculus Index. The volunteers also responded to a questionnaire about the use, comfort and hygiene of the retainers. RESULTS: It was observed that the plaque index and the gingival index were higher on the lingual surface (p<0.05) for the modified retainer. Furthermore, the calculus index was statistically higher (p<0.05) for the lingual and proximal surfaces when using the modified retainer. The retainer wire calculus index values were also significantly higher (p<0.05) for the modified retainer. In the questionnaire, 58 percent of the volunteers considered the modified retainer to be less comfortable and 54 percent of them preferred the multi-stranded wire retainer. CONCLUSION: From the results obtained, it could be concluded that the multi-stranded wire retainer showed better results than the modified retainer according to the periodontal parameters evaluated, as well as providing greater comfort and being the retainer preferred by the volunteers.

OBJETIVO: o presente estudo teve como objetivo comparar dois tipos de contenções ortodônticas fixas, em relação a parâmetros periodontais estabelecidos. A contenção com fio trançado é a mais comumente utilizada e a contenção modificada apresenta dobras que têm a finalidade de permitir o livre acesso do fio dental às áreas interproximais.MÉTODOS: para esse estudo cruzado, foram selecionados 12 voluntários que utilizaram, por 6 meses, A) Contenção com fio trançado e B) Contenção modificada — sendo essas fixadas em todos os dentes do segmento anterior. Após esse período experimental, foram feitas as seguintes avaliações: Índice de Placa Dentária, Índice Gengival, Índice de Cálculo Dentário e Índice de Cálculo ao longo do fio de contenção. Os voluntários também responderam a um questionário com relação à utilização, conforto e higienização das contenções.RESULTADOS: foi observado que o índice de placa e o índice gengival foram maiores nas faces linguais (p<0,05) para a contenção modificada. Além disso, o índice de cálculo foi estatisticamente maior (p<0,05) considerando-se as faces linguais e proximais na utilização da contenção modificada. O índice de cálculo ao longo do fio também apresentou valores significativamente maiores (p<0,05) na contenção modificada. Em relação ao questionário, 58% dos voluntários consideraram que a contenção modificada é mais desconfortável; e 54% deles preferiram a contenção com fio trançado.CONCLUSÃO: a partir dos resultados obtidos, pode-se concluir que a contenção com fio trançado apresentou melhores resultados do que a contenção modificada, de acordo com os parâmetros periodontais avaliados, além de apresentar maior conforto e preferência na sua utilização.