Patients' perception of orthodontic retainers: a systematic review.

BACKGROUND: Orthodontic retainers are widely used to prevent relapses after orthodontic treatment; however, evidence about patients' perceptions of retainers is lacking. OBJECTIVE: To assess patients' perception of orthodontic retainers. SEARCH METHODS: PubMed, Web of Science, Scopus, LILACS, LIVIVO, Cochrane Library, and gray literature (Google Scholar) were searched without date or language restrictions. A manual search of the reference lists of the included articles was also performed. SELECTION CRITERIA: Studies comparing patients' perceptions of wearing orthodontic retainers were included. DATA COLLECTION AND ANALYSIS: According to the study design, the risk of bias (RoB) assessment was performed using RoB 2.0 or ROBINS-I. The level of evidence was assessed through the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) tool. RESULTS: Seventeen studies met the eligibility criteria. After the RoB assessment, 12 randomized controlled trials presented a high RoB, and 4 non-randomized controlled trials presented a moderate RoB. The certainty of evidence was classified as very low for the four assessed outcomes. The studies generally reported an initial temporary negative impact of orthodontic retainers. Different esthetic, functional, and ease-of-use advantages are reported using removable and fixed retainers. A quantitative analysis was not performed due to the considerable clinical and methodological heterogeneity among the studies. CONCLUSION: The current evidence, although very limited, suggests that orthodontic retainers have an initial negative impact related to discomfort and functional limitations, but they seem to regress over time. There is a preference for thermoplastic over Hawley-type retainers. However, thermoplastic retainers cause different functional difficulties, and bonded retainers present the advantage of affecting speech function less than orthodontic removable retainers, although they can facilitate oral hygiene problems. REGISTRATION: PROSPERO (CRD42022306665).

Comparison of multistranded wire and fiber-reinforced composite retainers effects on periodontium: A randomized clinical trial.

INTRODUCTION: Fixed orthodontic retainers are very important for treatment stability; however, adverse effects on the health of periodontium can be caused as a result of deposition of plaque and calculus. OBJECTIVES: To compare and determine the effects of two mandibular fixed lingual retainers on the periodontal status, and to test the null hypothesis that there would be no significant difference on the periodontium health between the patients using fiber-reinforced composite (FRC) or multistranded wire (MSW) fixed retainers. METHODS: A total of 60 subjects were recruited, out of which 6 were excluded and 2 dropped out during the study. Hence, 52 subjects with mean age of 21.5 ± 3.6 years were included in the study. The sample was composed by 8 males (15.4%) and 44 females (84.6%). The participants were randomly divided into two groups: Group 1 received fiber-reinforced composite retainer, while Group 2 received multistranded wire retainer. After insertion, plaque index, calculus index, gingival index and bleeding on probing were compared, after three months (T1), six months (T2), nine months (T3) and twelve months (T4), using Mann-Whitney test with p-value ≤ 0.05 as significant. RESULTS: It could be seen that the health of periodontium deteriorated with the passage of time from T1 to T4 in both group of retainers. However, no statistically significant differences were found between the two groups (p> 0.05). CONCLUSION: The results of the study indicate that there was no significant difference on the health of periodontium between the patients with FRC and MSW fixed retainers, hence, the null hypothesis was accepted.

Analysis of the periodontal status of patients with mandibular-bonded retainers / Análise da condição periodontal de pacientes portadores de contenção ortodôntica ântero-inferior fixa

Purpose: This clinical study evaluated the periodontal status of patients with bonded retainers as compared to a non-treated control group. Methods: Forty dental students were included in the sample and divided into the following two groups: 1) a test group of 20 subjects that, after orthodontic treatment, have been bonded retainer users for at least 2 years and 2) a control group of 20 patients that never experienced orthodontic treatment nor used any bonded retainer. The region associated with the retainer in the test group and the lower canine-to-canine region in the control group were examined according to the following clinical parameters: plaque index (PI), bleeding on probing (BOP), gingival recession (GR), clinical attachment level (CAL) and probing depth (PD). Results: No differences were observed for GR or BOP (P>0.05). In contrast, the test group showed higher values of CAL and PD at proximal sites when compared to controls (P<0.05). In addition, IP was significantly increased at buccal and lingual sites (P<0.05). Conclusion: The placement of orthodontic bonded retainers negatively affected periodontal health, resulting in increased PI, PD and CAL.

Objetivo: Este estudo avaliou clinicamente a condição periodontal de pacientes portadores de contenção ortodôntica ântero-inferior fixa comparando com um grupo que nunca fez uso desse aparato ortodôntico. Metodologia: Foram selecionados para o estudo 40 voluntários, estudantes de Odontologia, divididos em dois grupos. Grupo teste: 20 pacientes que fizeram uso de contenção ortodôntica fixa por mais de 2 anos; e grupo controle: 20 pacientes que nunca utilizaram qualquer tipo de contenção fixa. Os dentes ântero-inferiores envolvidos pela contenção no grupo teste, e de canino-a-canino no grupo controle, foram examinados segundo os seguintes parâmetros clínicos: Índice de placa (IP), sangramento à sondagem (SS), posição da margem gengival (PMG), nível de inserção clínica (NIC) e profundidade de sondagem (PS). Resultados: Não foram observadas diferenças significantes entre os grupos para recessão gengival e sangramento à sondagem (P>0,05). Já para o nível de inserção clínica e profundidade de sondagem observaram-se diferenças significantes (P<0,05) em relação às faces proximais. Além disso, um maior acúmulo de placa (IP) foi detectado nas faces livres (P<0,05). Conclusão: A contenção ortodôntica ântero-inferior fixa influenciou negativamente a condição periodontal em relação aos índices IP, NIC e PS.

Allergy to auto-polymerized acrylic resin in an orthodontic patient.

This article reports on a 60-year-old woman who had an allergic reaction to methylmethacrylate self-curing acrylic resin during orthodontic treatment. A localized hypersensitive reaction appeared on the palate after an orthodontic retainer was placed. Samples of the acrylic were removed and analyzed with gas chromatography to evaluate the residual monomer level. The residual monomer content was between 0.745% and 0.78%, which did not exceed international standards for this material. Patch tests were performed with several methylmethacrylate resin samples and processed with various techniques; they showed positive reactions. Despite the many alternative products available, self-curing acrylic resin remains widely used because of its low cost, ease of use, and diversity of indications. Orthodontists should be aware that allergic reactions can occur.

Consideraçöes sobre a estabilidade e as alteraçöes nos arcos dentarios pós-tratamento ortodôntico / Considerations about stability and changes of dental arches following orthodontic treatment

O propósito deste levantamento bibliográfico é estudar as alteraçöes dos arcos dentários e sua implicaçöes com a estabilidade dos mesmos pós-tratamento ortodôntico. Estas alteraçöes se referem principalmente às mudanças no comprimento dos arcos, distâncias intercaninos e intermolares, sobremordida, sobressaliência, relaçäo interarcos no sentido ântero-posterior, e que têm como sequência principal o apinhamento dos dentes ântero-inferiores. Com base nos autores consultados, foi concluído que a manutençäo do alinhamento dentário conseguido com a terapia ortodôntica é menor que 50 por cento, por isto o conhecimento destas alteraçöes é primordial para o ortodontista, pois a estabilidade e täo importante quanto a funçäo e a estética