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Head & Face Medicine Jul 2021Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Orthodontic retention aims to maintain optimal teeth positions after active treatment. The stability is affected by numerous factors, including patients' individual features, thus retention should be adjusted in the most optimal way. Bonding a retainer makes retention less dependent on patient's compliance.
QUESTIONS ARISE
What wire or fiber splint type provides the best treatment stability? What materials should be used to bond the wire or fiber splint? Should be the bonding procedure be direct or indirect? The aim of the study is to assess and synthesize available controlled trials investigating failures of fixed retainers.
METHODS
Literature searches of free text and MeSH terms were performed in Scopus, Web of Science, Embase and PubMed Central in order to find studies, referring to failures of fixed retention (12th February 2021). The keywords were: ("orthodontic retainers AND failure AND wire"). The framework of this systematic review according to PICO was: Population: orthodontic patients; Intervention: fixed orthodontic retainer bonding; Comparison: Different protocols of fixed orthodontic retention applied; Outcomes: failure rate, survival rate. Three different specific scales from the Cochrane Collaboration Handbook were used, according to each study type. Additionally, a meta-analysis was conducted to compare the effectiveness of retention using fiber reinforced composite and multistranded steel wire.
RESULTS
The search identified 177 potential articles: 114 from PubMed, 41 from Scopus, 20 from Web of Science and 2 from Embase. After excluding studies inconsistent with selection criteria, 21 studies were included and subjected to qualitative analysis. The main outcome investigated was failure rate. This systematic review has some potential limitations due to the heterogeneity of design between included studies.
CONCLUSIONS
No retainer is proved to guarantee a perfect stability of dental alignment. The retainer should be bonded to all adherent teeth, preferably with additional use of bonding resin. No wire or fiber splint present superior characteristics concerning failure rate. Fiber reinforced composite retention is more sensitive to operator skills, and with imperfect bonding technique, failure rate is much higher. During the first 6 months after bonding retainer the patient should be under frequent control. The study protocol was registered in PROSPERO database with the number CRD42021233406.
Topics: Dental Bonding; Humans; Orthodontic Appliance Design; Orthodontic Retainers; Orthodontic Wires
PubMed: 34301280
DOI: 10.1186/s13005-021-00281-3 -
Head & Face Medicine Nov 2020The Multiloop Edgewise Archwire (MEAW) appliance is an orthodontic treatment method suitable for the therapy of severe types of malocclusions such as open bites or... (Review)
Review
BACKGROUND
The Multiloop Edgewise Archwire (MEAW) appliance is an orthodontic treatment method suitable for the therapy of severe types of malocclusions such as open bites or anterior crossbites. The cephalometric Denture Frame Analysis (DFA) provides a supportive diagnostic tool for patient-specific treatment planning concerning the rearrangement of occlusion within the "denture frame". The objective of this study is to give a comprehensive overview of the national and international scientific literature about MEAW and DFA regarding the general therapeutic effects, advantages and limitations.
METHODS AND MATERIALS
A computerized literature search was performed using four principal medical databases (PubMed/Medline, Google Scholar, Web of Science and Cochrane Central Register of Controlled Trials) and supplemented by manual searching of the references listed in the retrieved articles. The results were screened and assessed following the PRISMA guidelines.
RESULTS
Six hundred seventy-seven full articles were assessed for eligibility. A number of 134 articles went through qualitative analysis and 3 studies were finally involved in comparative synopsis. The findings reveal advantageous characteristics of the MEAW technique such as a high degree of three-dimensional individual tooth control and a comparatively low load deflection rate, causing mostly dentoalveolar changes without significantly influencing the skeletal structures.
CONCLUSION
Based on current literature, the MEAW technique appears to have several therapeutic benefits and serves as a sufficient alternative treatment method for dentoalveolar compensation, when measures of orthognathic surgery are rejected. Concerning the deficient data basis of available literature and the low level of scientific evidence, further studies are required in order to expand on the knowledge in this subject area. Several aspects like the effectiveness or the long-term stability have to be evaluated more extensively. Moreover, the transferability of the DFA to ethnic groups other than the Asian ethnicity should be examined further.
Topics: Cephalometry; Dentures; Humans; Malocclusion; Orthodontic Wires; Tooth Movement Techniques
PubMed: 33243257
DOI: 10.1186/s13005-020-00247-x