Fixed mandibular retainers : a controlled 12-year follow-up

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Fixed mandibular retainers : a controlled 12-year follow-up

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Publication Licentiate Thesis
Licentiate Thesis, comprehensive summary
Title Fixed mandibular retainers : a controlled 12-year follow-up
Author Schütz-Fransson, Ulrike
Date 2018
English abstract
Fixed retainer after orthodontic treatment is an increasing retention appliance. For the mandibular incisors there are two different fixed retainers that are commonly used, either a canine-to-canine retainer bonded only to the canines or a twistflex retainer bonded to each of the mandibular incisors and canines. Increased mandibular incisor irregularity seems to be a continuous process throughout life even in untreated patients. The natural physiological changes during aging causes changes like those that occur after orthodontic treatment and the removal of retainers. There are few long-term studies that have compared patients who have had a mandibular fixed retainer with patients without retention appliance after treatment, and then compared the treated patients with untreated subjects. The overall aim of this thesis was to compare and evaluate two different mandibular fixed retainers and also to compare orthodontically treated cases with untreated long-term. This thesis is based on two studies and a PAR Index evaluation was presented in the frame story: Paper I is a retrospective longitudinal study done on dental casts and lateral head radiographs from patients who had received either a canine-to-canine retainer or a twistflex retainer after treatment. Different variables were measured, were Little’s Irregularity Index was the main outcome measure. The measurements were done at four different occasions, were the last registration was 12 years after treatment, i.e. 9 years after removal of retainer. Paper II is also a retrospective longitudinal study with three different groups, one group received a fixed mandibular retainer, one group did not receive any retention appliance after treatment and the third group was untreated subjects. Measurements were done on dental casts and lateral head radiographs at four different occasions to analyze dental and skeletal changes 12 years after treatment. Also here Little’s Irregularity Index was the main outcome measure. PAR Index evaluation is done to evaluate the stability of orthodontic treatment outcome after treatment and long-term for two different retainer groups and one non-retention group. The following conclusions were drawn: Paper I • Both the canine-to-canine retainer and the twistflex retainer can be recommended since both are equally effective during retention period. • None of the retention types prevent long-term changes of mandibular incisor irregularity or available space for the mandibular incisors after removal of the retainers. • No differences in bonding failures between the two retainers were found. Paper II • There were no differences found 12 years after treatment in Little’s Irregularity Index for the mandibular incisors between the group that had a retainer and the group that had no retainer after treatment • In the untreated group, Little’s Irregularity Index was increased over time but not to the same extent as in the treated groups. • The crowding before treatment did not explain the crowding at the last registration. • The use of mandibular retainers for two to three years does not appear to prevent long-term relapse. • If the patient wants to constrain the changes that come with natural development, then lifelong retention is needed. • The overjet and overbite were stable long-term. PAR Index evaluation • Twelve years after treatment the mean reduction in PAR score was over 70 per cent only for the groups who had a mandibular retainer after treatment. However, the non-retention group had a PAR score of 66 per cent. • There were more cases in the retention groups that were ”greatly improved and/or improved” 12 years after treatment compared to the non-retention group. After treatment between 16 and 23.3 per cent of all the cases were ”worse or not improved”. Twelve years after treatment between 36 and 43.6 per cent of the total cases were ”worse or not improved”.
DOI https://doi.org/10.2319/031716-227.1 (link to publisher's fulltext.)
Publisher Faculty of Odontology, Malmö University
ISSN 1650-6065
ISBN 9789171049353
9789171049360
Pages 86
Language eng (iso)
Subject Irregularity Index
Long-term stability
Relapse
Orthodontic retainers
Medicine
Adolescent
Child
Device Removal
Female
Follow-Up Studies
Humans
Incisor
Male
Malocclusion
Mandible
Orthodontic Retainers
Recurrence
Risk Factors
Treatment Outcome
Research Subject Categories::ODONTOLOGY
Included papers
  1. I. Schütz-Fransson U, Lindsten R, Bjerklin K, Bondemark L. Twelveyear follow-up of mandibular incisor stability: Comparison between two different bonded lingual orthodontic retainers. Angle Orthod. 2017; 87:200-208.

  2. II. Schütz-Fransson U, Lindsten R, Bjerklin K, Bondemark L. Mandibular incisor alignment in untreated subjects compared with long-term changes after orthodontic treatment with or without retainers. Accepted for publication by Am J Orthod Dentofacial Orthop. March 2018.

Handle http://hdl.handle.net/2043/25665 Permalink to this page
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