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Post-treatment stability after 5 years of retention with vacuum-formed and bonded retainers: a randomized controlled trial
Umeå University, Faculty of Medicine, Department of Odontology. Orthodontic Clinic, Public Dental Health, Region Gävleborg , Gävle , Sweden;Centre for Research and Development, Uppsala University/Region Gävleborg , Gävle , Sweden;Department of Odontology/Oral and Maxillofacial Surgery, Umeå University , Umeå , Sweden.ORCID iD: 0000-0001-6221-6729
Umeå University, Faculty of Medicine, Department of Odontology. Department of Odontology/Oral and Maxillofacial Surgery, Umeå University , Umeå , Sweden.
Centre for Research and Development, Uppsala University/Region Gävleborg , Gävle , Sweden.
Umeå University, Faculty of Medicine, Department of Odontology. Department of Odontology/Oral and Maxillofacial Surgery, Umeå University , Umeå , Sweden.
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2023 (English)In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 45, no 1, p. 68-78Article in journal (Refereed) Published
Abstract [en]

Background: Retention after orthodontic treatment is still a challenge and more evidence about post-treatment stability and patients’ perceptions of different retention strategies is needed.

Objectives: This trial compares removable vacuum-formed retainers (VFR) with bonded cuspid-to-cuspid retainers (CTC) after 5 years of retention.

Trial design: A single centre two-arm parallel-group randomized controlled trial.

Methods: This trial included 104 adolescent patients, randomized into two groups (computer-generated), using sequentially numbered, opaque, and sealed envelopes. All patients were treated with fixed appliances in both jaws with and without tooth extractions. Patients in the intervention group received a VFR in the mandible (n = 52), and patients in the active comparator group received a CTC (n = 52). Both groups had a VFR in the maxilla. Dental casts at debond (T1), after 6 months (T2), after 18 months (T3), and after 5 years (T4) were digitized and analysed regarding Little’s Irregularity Index (LII), overbite, overjet, arch length, and intercanine and intermolar width. The patients completed questionnaires at T1, T2, T3, and T4.

Results: Post-treatment changes between T1 and T4 in both jaws were overall small. In the maxilla, LII increased significantly (median difference: 0.3 mm), equally in both groups. In the mandible, LII increased significantly in the group VFR/VFR (median difference: 0.6 mm) compared to group VFR/CTC (median difference: 0.1 mm). In both groups, overjet was stable, overbite increased, and arch lengths decreased continuously. Intercanine widths and intermolar width in the mandible remained stable, but intermolar width in the maxilla decreased significantly. No differences were found between groups. Regardless of retention strategy, patients were very satisfied with the treatment outcome and their retention appliances after 5 years.

Limitations: It was not possible to perform blinded assessments of digital models at follow-up.

Conclusions: Post-treatment changes in both jaws were small. Anterior alignment in the mandible was more stable with a bonded CTC retainer compared to a removable VFR after 5 years of retention. Patients were equally satisfied with fixed and removable retention appliances.

Trial registration: ClinicalTrials.gov (NCT03070444).Issue

Section:Randomized Controlled Trial (RCT)

Place, publisher, year, edition, pages
Oxford University Press, 2023. Vol. 45, no 1, p. 68-78
National Category
Dentistry
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URN: urn:nbn:se:umu:diva-198630DOI: 10.1093/ejo/cjac043ISI: 000840414200001PubMedID: 35968668Scopus ID: 2-s2.0-85146463354OAI: oai:DiVA.org:umu-198630DiVA, id: diva2:1687403
Available from: 2022-08-15 Created: 2022-08-15 Last updated: 2023-07-13Bibliographically approved

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Krämer, AnkeSjöström, MatsHallman, Mats

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