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Journal of Pharmacy & Bioallied Sciences Jul 2023Long-term or even indefinite retention is routinely prescribed after orthodontic treatment as a preventive safeguard against post-treatment changes induced by tooth...
INTRODUCTION
Long-term or even indefinite retention is routinely prescribed after orthodontic treatment as a preventive safeguard against post-treatment changes induced by tooth movement, physiological healing, and the aging process. Though both fixed and removable versions of retainers may be equally effective in terms of results, sufficient research to support this assumption is missing at the moment.
OBJECTIVES
Long-term effects of fixed and removable retention on the periodontium, and the compliance level when used for an extended period of time.
METHODS
For 4 years participants were given a supply of canine-to-canine retainers and vacuum-formed canine-to-canine retainers. The inter-canine, as well as inter-molar widths, the length, and the extraction space opening of the mandibular anterior portion, were measured. Gingival inflammation, calculus, and plaque were observed, as well as the attachment of clinical and the case of bleeding during probing. 42 members had returned in the follow-up period, with 21 from each of the two groups. Measurements of the modified gingival index and plaque scoring were performed on the 10 intra-oral photographs that were taken at 4-week intervals in this study to investigate the intra-examiner reliability.
RESULTS
After controlling for confounding variables, there was a 1.64 mm (95% confidence interval [CI], 0.30, 2.98 mm) median between-groups difference among patients who utilized vacuum-formed retainers (VFRs). The treatment groups did not vary in inter-canine and intermolar widths ( = 0.52; 95% CI, -1.07, 1.05), arch length ( = 0.99; 95% CI, -1.15, 1.14), or opening of extraction spaces ( = 0.84).
CONCLUSION
A long-term study demonstrates that fixed retention can preserve the alignment of the mandibular anterior over time for the first time. Gingival discomfort and higher plaque scores were reported in both types of retainers.
PubMed: 37654327
DOI: 10.4103/jpbs.jpbs_587_22 -
Korean Journal of Orthodontics Nov 2023: To investigate the potential correlation between fixed orthodontic retention failure and several patient- and treatment-related factors.
OBJECTIVE
: To investigate the potential correlation between fixed orthodontic retention failure and several patient- and treatment-related factors.
METHODS
: Patients finishing treatment with fixed appliances between 2016 and 2017 were retrospectively included in this study. Those not showing fixed retention failure were considered as control group. Patients with fixed retention failure were considered as the experimental group. Additionally, patients with failure of fixed retainers in the period of June 2019 to March 2021 were prospectively identified and included in the experimental group. The location of the first retention failure, sex, pretreatment dental occlusion, facial characteristics, posttreatment dental occlusion, treatment approach and presence of oral habits were compared between groups before and after treatment separately by using a Fisher exact test and a Mann-Whitney test.
RESULTS
: 206 patients with fixed retention failure were included, 169 in the mandibular and 74 in the maxillary jaws. Significant correlations were observed between retention failure in the mandibular jaws and mandibular arch length discrepancy ( = 0.010), post-treatment growth pattern ( = 0.041), nail biting ( < 0.001) and abnormal tongue function ( = 0.002). Retention failure in the maxillary jaws was more frequent in patients with IPR in the mandibular jaws ( = 0.005) and abnormal tongue function ( = 0.021).
CONCLUSIONS
: This study suggests a correlation between fixed retention failure and parafunctional habits, such as nail biting and abnormal tongue function. Prospective studies with larger study populations could further confirm these results.
PubMed: 37649417
DOI: 10.4041/kjod23.012 -
Clinical Oral Investigations Oct 2023Since the introduction of miniplate osteosynthesis and the use of prophylactic antibiotics, the complication rate related to the teeth in the fracture gap has...
OBJECTIVES
Since the introduction of miniplate osteosynthesis and the use of prophylactic antibiotics, the complication rate related to the teeth in the fracture gap has significantly decreased. Currently, there are still no established guidelines for the management of such teeth in mandibular fracture lines. However, the long-term viability of these teeth within the fracture gap remains uncertain. Therefore, this study aimed to assess the survival rate of teeth located within the mandibular fracture line and evaluate related follow-up treatments over a minimum period of one year.
MATERIALS AND METHODS
This retrospective study examined 184 patients who underwent surgical treatment for mandibular fractures between January 2018 and December 2021. A total of 189 teeth located in the fracture line were analyzed. Clinical and radiological parameters were collected, including patient age and gender, fracture etiology and location, intraoperative tooth treatment, as well as complications related to both the fracture and the affected teeth in long term.
RESULTS
Most of the examined teeth remained uneventful, with postoperative tooth-related complications seen in 14 (7.4%) teeth. The most common complications were symptomatic apical periodontitis (n = 9, 4.8%) and increased tooth mobility (n = 3, 1.5%). A correlation was found between complications and trauma-related tooth luxation (p = 0.002, OR = 15.2), as well as prior teeth connected to retainers or orthodontic appliances (p = 0.001, OR = 10.32).
CONCLUSION
Tooth-related complications are rare when intact teeth are retained within the fracture gap. Therefore, unless there is a definitive intraoperative indication for extraction, it is recommended to preserve the teeth in the fracture line.
CLINICAL RELEVANCE
Intact teeth in the fracture line of the mandible should not be primarily extracted.
Topics: Humans; Retrospective Studies; Mandibular Fractures; Tooth Extraction; Tooth; Mandible; Postoperative Complications
PubMed: 37610459
DOI: 10.1007/s00784-023-05218-5 -
BMC Oral Health Aug 2023Retainer is a necessary procedure when orthodontic treatment complete to avoid relapse due to periodontal fiber elasticity and to allow for alveolar bone regeneration....
A comparative study of CAD/CAM fabricated polyether ether ketone and fiber-glass reinforcement composites versus metal lingual retainers under vertical load (an in vitro study).
BACKGROUND
Retainer is a necessary procedure when orthodontic treatment complete to avoid relapse due to periodontal fiber elasticity and to allow for alveolar bone regeneration. Compare the influence of vertical force on the failure of three fixed retainers: CAD/CAM polyether ether ketone (PEEK), CAD/CAM fiber glass reinforced composites (FRCs), and lingual retainer wire "Bond-A-Braid™".
MATERIALS AND METHODS
One hundred and eight maxillary first premolars teeth were randomly allocated to three groups: Group A (CAD/CAM PEEK), Group B (CAD/CAM FRC), and Group C (lingual retainer wire " Bond-A-Braid™"). These retainers were bonded using Assure Plus Bonding Resin and GO TO Paste. For each specimen, a loading cycling and thermocycling machine was used. The failure debonding forces were measured on the interproximal segments using a universal testing machine with a cross-head speed of 1 mm/min. The adhesive remnant index (ARI) was calculated after identifying types of failure with a stereomicroscope at (X 20) magnification.
RESULTS
Group B and group C showed the highest failure bonding forces, with a mean of 209.67 ± 16.15 and 86.81 ± 4.59 N, respectively. However, Group A had a statistically significant lower bond failure force, with a mean value of 45.73 ± 4.48 N. At baseline, there was a statistically significant difference in connector retainer displacement between the three studied groups (p < .001). The ARI score was not statistically significant (p < .001) between the three study groups; for groups A and B, the ARI was predominantly score 3, and group C showed a mixed score of 2 and 3. The failure mode of retainers was investigated using an optical stereomicroscope. In group B, there was a cohesive breakdown in the retainer, and groups A and C exhibited failures primarily in the adhesive at the retainer interface.
CONCLUSION
All groups differed significantly, with group A having the lowest debonding force and group B having the highest. Furthermore, there was not a substantial variation in ARI, but there was a significant difference in connector retainer displacement and the types of failure amongst the three groups.
Topics: Humans; Research Design; Benzophenones; Ketones; Ethers
PubMed: 37605187
DOI: 10.1186/s12903-023-03268-5 -
Dental and Medical Problems 2023This systematic review and meta-analysis aimed to summarize the effectiveness of bonded and removable retainers (the Hawley and Essix retainers) in terms of improving... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis aimed to summarize the effectiveness of bonded and removable retainers (the Hawley and Essix retainers) in terms of improving occlusal settling (occlusal contact points/areas) after orthodontic treatment. We searched the Cochrane Library, PubMed, CINAHL Plus, and Dental & Oral Sciences Source (DOSS), as well as SIGLE, Google Scholar and ClinicalTrials.gov for eligible studies. We included randomized and non-randomized controlled trials along with cohort studies. Studies that reported occlusal contacts/areas during retention with fixed bonded and removable retainers were included. To assess the quality of the randomized controlled trials (RCTs), the Cochrane Collaboration risk-of-bias (RoB) tool was utilized, whereas the Newcastle-Ottawa Scale (NOS) was used to assess the quality of cohort studies.We included 6 articles in our systematic review after scrutinizing 219 articles and eliminating the illegible ones based on duplication, titles, abstracts, and objectives. Bonded retainers (BRs) allowed faster and better posterior occlusal settling as compared to the Hawley retainer (HR). However, HR showed good occlusal settling in the anterior dental arch. The Essix retainer (ER) showed a decrease in occlusal contact during the retention phase. Meta-analysis showed no statistically significant difference between BRs and removable retainers. In conclusion, HR allowed better overall occlusal settling as compared to other retainers. However, BRs allowed faster settling in the posterior tooth region. The Essix retainer showed poor settling of occlusion. Overall, there is an insufficient number of high-quality RCTs to provide additional evidence, and further high-quality RCTs are needed.
Topics: Humans; Orthodontic Retainers; Tooth; Malocclusion
PubMed: 37458399
DOI: 10.17219/dmp/146194 -
Dental Materials Journal Sep 2023The use of fixed retainers in the lower arch is frequent; however, its presence increases the accumulation of biofilm and dental calculus. The objective of this research...
The use of fixed retainers in the lower arch is frequent; however, its presence increases the accumulation of biofilm and dental calculus. The objective of this research was to evaluate, in vitro, the accumulation of Streptococcus mutans (S. mutans) in 3 designs of fixed retainers. Nine models were reproduced in heat-cured acrylic resin and divided into groups: straight retainer (SR), retainer with vertical strap (RVS), retainer with horizontal strap (RHS). The accumulation of S. mutans was assessed using the MTT assay (3-4,5-dimethyl-thiazol-2-yl-2,5-diphenyltetrazolium bromide) and then measured using an automated reader. The RHS group showed less biofilm accumulation compared to the other groups (p<0.05). The distance between the tooth surface and the retainer showed a strong negative correlation with biofilm accumulation (rs=-0.79, p=0.00037). The RHS showed significantly less accumulation of S. mutans due to the distance between the retainer and the tooth surface. This research provides relevant data for a future randomized clinical trial.
Topics: Streptococcus mutans; Acrylic Resins; Orthodontic Appliances, Fixed; Orthodontic Appliance Design; Biofilms; Orthodontic Retainers
PubMed: 37423720
DOI: 10.4012/dmj.2023-003 -
Journal of Functional Biomaterials May 2023Three-dimensional printing has become incorporated into various aspects of everyday life, including dentistry. Novel materials are being introduced rapidly. One such...
Three-dimensional printing has become incorporated into various aspects of everyday life, including dentistry. Novel materials are being introduced rapidly. One such material is Dental LT Clear by Formlabs, a resin used for manufacturing occlusal splints, aligners, and orthodontic retainers. In this study, a total of 240 specimens, comprising two shapes (dumbbell and rectangular), were evaluated through compression and tensile tests. The compression tests revealed that the specimens were neither polished nor aged. However, after polishing, the compression modulus values decreased significantly. Specifically, the unpolished and nonaged specimens measured 0.87 ± 0.02, whereas the polished group measured 0.086 ± 0.03. The results were significantly affected by artificial aging. The polished group measured 0.73 ± 0.05, while the unpolished group measured 0.73 ± 0.03. In contrast, the tensile test proved that the specimens showed the highest resistance when the polishing was applied. The artificial aging influenced the tensile test and reduced the force needed to damage the specimens. The tensile modulus had the highest value when polishing was applied (3.00 ± 0.11). The conclusions drawn from these findings are as follows: 1. Polishing does not change the properties of the examined resin. 2. Artificial aging reduces resistance in both compression and tensile tests. 3. Polishing reduces the damage to the specimens in the aging process.
PubMed: 37367259
DOI: 10.3390/jfb14060295 -
Turkish Journal of Orthodontics Jun 2023Developments in computer-aided design and three-dimensional (3D) printing have revolutionized the workflow for orthodontic applications. The purpose of this review...
Developments in computer-aided design and three-dimensional (3D) printing have revolutionized the workflow for orthodontic applications. The purpose of this review article is to provide information about 3D printer history and types, appliances manufactured using 3D printers, and new designs that can be used in different cases. Articles published between January 2010 and November 2020 were reviewed on PubMed, MEDLINE, ScienceDirect, Elsevier, and Google academic resources, and 69 were identified as appropriate for the study. It was seen that bracket and archwires, nasoalveolar molding devices, orthognathic surgical splints, removable appliances, expansion appliances, clear aligner, retainers, auxiliary attachments, and working models can all be made with 3D printers. The 3D printer is now a technology that is easily accessible to orthodontists, increasing the production of different customizable appliances and promising a transition to a digital clinical workflow in the future.
PubMed: 37346463
DOI: 10.4274/TurkJOrthod.2022.2021.0074 -
The Angle Orthodontist Nov 2023To evaluate the force required to promote the failure of fixed orthodontic retainers with different adhesive (composite) coverage and to assess the presence and extent...
An assessment of the impact of adhesive coverage and wire type on fixed retainer failures and force propagation along two types of orthodontic retainer wires: an in vitro study.
OBJECTIVES
To evaluate the force required to promote the failure of fixed orthodontic retainers with different adhesive (composite) coverage and to assess the presence and extent of force propagation with two different orthodontic retainer wires.
MATERIALS AND METHODS
Ortho-FlexTech and Ortho-Care Perform (0.0175 inches), each of 15-cm length, were bonded on acrylic blocks with different adhesive surface diameters (2 mm, 3 mm, 4 mm, and 5 mm). The samples (n = 160) were subjected to a tensile pull-out test, and debonding force was recorded. Fixed retainers using two different wires and 4-mm adhesive diameter were bonded on acrylic bases resembling a maxillary dental arch (n = 72). The retainers were loaded occluso-apically until the first sign of failure while being video recorded. Individual frames of the recordings were extracted and compared. A force propagation scoring index was developed to quantify the extent of force transmission under load.
RESULTS
A 4-mm adhesive surface diameter required the highest debonding force for both retainer wires with significant differences compared with 2 mm (P < .001; 95% confidence interval [CI]: 8.69, 21.69) and 3 mm (P = .026; 95% CI: 0.60, 13.59). Force propagation scores were significantly higher for Ortho-Care Perform.
CONCLUSIONS
Based on this laboratory-based assessment, consideration should be given to the fabrication of maxillary fixed retainers using a minimum of 4-mm diameter composite coverage on each tooth. Force appeared to propagate more readily with Ortho-Care Perform than with a flexible chain alternative. This may risk stress accumulation at the terminal ends with potential for associated unwanted tooth movement in the presence of intact fixed retainers.
Topics: Dental Bonding; Orthodontic Retainers; Dental Cements; Orthodontic Wires; Orthodontic Appliances, Fixed; Orthodontic Appliance Design
PubMed: 37246952
DOI: 10.2319/110722-765.1 -
Scientific Reports May 2023Active audiovisual representation of instructions ensures vibrant knowledge acquisition and improves acquaintance needed for self-care with retainer wear. The aim of... (Randomized Controlled Trial)
Randomized Controlled Trial
Active audiovisual representation of instructions ensures vibrant knowledge acquisition and improves acquaintance needed for self-care with retainer wear. The aim of this trial is to assess the impact of audiovisual instructions with additional weekly electronic reminder messages on improving adherence to instructed wear time of Hawley retainer, periodontal outcomes, and participants' experiences. Fifty-two participants (mean age 26.1 y) planned for removable retention, were randomly assigned to two parallel groups to receive either (1) audiovisual instructions with an additional weekly reminder, or (2) verbal instructions alone. Each participant received a Hawley retainer equipped with a TheraMon microsensor and was instructed to wear it for 22 h daily. Participants were monitored for adherence to the wear time after 3 (T1) and 6 months (T2), and had their periodontal health and experiences assessed at T2. Overall, the mean objectively measured daily wear time at T1 was 14.9 (± 4.9 h), and 14.3 (± 5.4 h) at T2. After 3 months, no significant differences were found between the groups (p = 0.065), however, a significant difference favoring better compliance with wear instructions was observed in the audiovisual group after 6 months (p = 0.033). A non-significant difference was observed between both groups regarding the gingival (p = 0.165) and plaque index scores (p = 0.173). Participants' experiences were similar in both groups, except for satisfaction with the way of delivering instructions, being favorably reported in the audiovisual group. Audiovisual instructions with weekly reminders seem to have a significant effect on patient compliance in the longer term.Trial registration: TCTR20230220002.
Topics: Humans; Adult; Orthodontic Retainers; Orthodontic Appliance Design; Patient Compliance; Electronics
PubMed: 37237095
DOI: 10.1038/s41598-023-35686-4