Clinical comparisons of different fixed orthodontic retainers

GÜNEŞ, Recep Onur; SAYAR, Gülşilay; TOYGAR, Hilal

doi:10.1590/2177-6709.27.6.e222154.oar

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Dental Press Journal of Orthodontics

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ORIGINAL ARTICLE • Dental Press J. Orthod. 27 (6) • 2022 • https://doi.org/10.1590/2177-6709.27.6.e222154.oar copy

Clinical comparisons of different fixed orthodontic retainers

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

The aim of this prospective clinical study was to compare the clinical outcomes of three different fixed lingual retainers, in terms of effects on periodontal health and success rate.

Methods:

Forty five patients aged 13 to 25 years were randomly assigned into three groups, using bonded upper and lower lingual retainers. The study groups were as follows: Group 1- Bond-A-Braid®, Group 2- everStick® ORTHO, Group 3- Super-Splint. The follow-up appointments were performed two weeks (Baseline=T0), one month (T1), three months (T2), and six months (T3) after the application of retainers. Plaque Index (PI), Gingival Index (GI), Probing Depth (PD), Bleeding in Probing (BOP) and Retainer Failure were assessed at each appointment.

Results:

The everStick Ortho group showed significantly lower PI values on the upper-lower lingual side after three (p=0.008) and six (p=0.001) months. The everStick Ortho group had significantly lower upper lingual (GI) levels after six months, and lower lingual side levels after one month. The Super-Splint group showed significantly lower PD values on the upper lingual side after six months. The everStick Ortho group presented significantly lower BOP levels after six months on the upper lingual side. No significant differences between the groups (p>0.05) in terms of retainer failure were found.

Conclusions:

The everStick Ortho group presented better results in terms of periodontal health. The failure rates of the retainers were similar.

Keywords:
Retention; Fixed retainer; Stability; Bonded retainer; Orthodontics

	BOND-A-BRAID		EVERSTICK ORTHO		SUPER-SPLINT		p-value
Gender	n	%	n	%	n	%	0.316
Female	13	86.7	11	73.3	11	73.3
Male	2	13.3	4	26.7	4	26.7
Age (years)	Min-Max	Mean±SD	Min-Max	Mean±SD	Min-Max	Mean±SD	0.701
	13.00-23.4	17.81±3.62	13.08-23.0	18.11±2.37	14.50-25.5	18.76±3.27	0.701

Plaque index		BOND-A-BRAID		EVERSTICK ORTHO		SUPER-SPLINT		p¹	Dunn’s multiple comparisons test
Plaque index		Min-Max	Mean±SD (median)	Min-Max	Mean±SD (median)	Min-Max	Mean±SD (median)		BOND A BRAID/ EVERSTICK ORTHO	BOND A BRAID/ SUPER-SPLINT	EVERSTICK ORTHO/ SUPER-SPLINT
Upper buccal	Baseline	0-2.5	0.62±0.69 (0.3)	0-1.22	0.22±0.41 (0)	0.11-1.94	0.72±0.55 (0.5)	0.002*	0.041*	1	0.002*
	First (1st) month	0-2	0.51±0.62 (0.2)	0-0.89	0.17±0.3 (0)	0.11-1.78	0.66±0.51 (0.7)	0.002*	0.068	0.787	0.002*
	Third (3rd) month	0-1.39	0.48±0.47 (0.2)	0-1	0.14±0.31 (0)	0.11-1.72	0.62±0.42 (0.6)	0.001*	0.020*	0.893	0.001*
	Sixth (6th) month	0-2.11	0.5±0.61 (0.2)	0-0.89	0.15±0.29 (0)	0.17-1.5	0.56±0.39 (0.5)	0.001*	0.056	0.56	0.001*
	p²		0.948		0.031*		0.170
	Baseline-1st month p³		-		0.176		-
	Baseline-3rd month p³		-		0.040*		-
	Baseline-6th month p³		-		0.123		-
	1st month- 3rd month p³		-		0.206		-
	1st month - 6th month p³		-		0.343		-
	3rd month- 6th month p³		-		0.461		-
Upper lingual	Baseline	0-2.5	0.86±0.68 (0.8)	0-1.5	0.44±0.49 (0.3)	0-2	0.78±0.62 (0.7)	0.129	-	-	-
	1st month	0-2	0.77±0.55 (0.8)	0-1	0.42±0.39 (0.3)	0-1.67	0.76±0.5 (1)	0.076	-	-	-
	3rd month	0-1.5	0.64±0.51 (0.5)	0-1	0.24±0.32 (0.2)	0-2	0.78±0.52 (1)	0.008*	0.064	1	0.009*
	6th month	0-2	0.67±0.48 (0.7)	0-1.33	0.22±0.37 (0)	0-2	0.72±0.49 (0.8)	0.001*	0.009*	1	0.003*
	p²		0.422		0.134		0.909
Lower buccal	Baseline	0-2.5	0.86±0.77 (0.7)	0-2.17	0.64±0.7 (0.3)	0.11-2.11	1.18±0.6 (1.2)	0.073	-	-	-
	1st month	0-2	0.77±0.65 (0.8)	0-1.67	0.41±0.51 (0.2)	0-2	0.86±0.69 (0.7)	0.084	-	-	-
	3rd month	0-1.55	0.52±0.53 (0.2)	0-1.72	0.36±0.54 (0.1)	0-2	0.84±0.59 (0.8)	0.034*	0.847	0.389	0.029*
	6th month	0-2.38	0.75±0.75 (0.5)	0-1	0.24±0.39 (0)	0-2	0.83±0.56 (1)	0.003*	0.023*	1	0.004*
	p²		0.549		0.006*		0.041*
	Baseline-1st month p³		-		0.198		0.043*
	Baseline-3rd month p³		-		0.059		0.014*
	Baseline-6th month p³		-		0.003*		0.014*
	1st month-3rd month p³		-		0.476		0.861
	1st month-6th month p³		-		0.016*		0.889
	3rd month-6th month p³		-		0.075		0.637
Lower lingual	Baseline	0-2	0.97±0.62 (1)	0-3.17	0.94±0.88 (0.8)	0-2.5	1.01±0.86 (1)	0.931	-	-	-
	1st month	0-2.33	0.75±0.73 (1)	0-2	0.81±0.71 (1)	0-2	1.11±0.62 (1)	0.434	-	-	-
	3rd month	0-2	0.81±0.55 (1)	0-2	0.49±0.6 (0.2)	0-2	1.13±0.7 (1)	0.027*	0.387	0.743	0.022*
	6th month	0-3	1.06±0.8 (1)	0-1.33	0.47±0.51 (0.2)	0.17-2	1.06±0.65 (1)	0.017*	0.052	1	0.034*
	p²		0.247		0.175		0.777

Gingival index		BOND-A-BRAID		EVERSTICK ORTHO		SUPER-SPLINT		p¹	Dunn’s multiple comparisons test
Gingival index		Min-Max	Mean±SD (median)	Min-Max	Mean±SD (median)	Min-Max	Mean±SD (median)		BOND A BRAID/ EVERSTICK ORTHO	BOND A BRAID/ SUPER-SPLINT	EVERSTICK ORTHO/ SUPER-SPLINT
Upper buccal	Baseline	0-2	0.93±0.46 (1)	0-1.78	0.87±0.53 (1)	0.44-1.56	1.04±0.31 (1)	0.658	-	-	-
	1st month	0-2	0.98±0.47 (1)	0-1.67	0.71±0.48 (0.7)	0.44-1.5	1.03±0.27 (1)	0.096	-	-	-
	3rd month	0.17-2	1±0.4 (1)	0-1.22	0.7±0.4 (0.9)	0.33-1.44	1.02±0.25 (1)	0.036*	0.030*	1	0.022*
	6th month	0.22-2	1.04±0.41 (1)	0-1.17	0.71±0.41 (1)	0.5-1.44	1.04±0.2 (1)	0.030*	0.027*	1	0.018*
	p²		0.671		0.121		0.904
Upper lingual	Baseline	0-1.83	0.94±0.47 (1)	0-1.83	0.71±0.6 (1)	0-1	0.62±0.42 (0.8)	0.253	-	-	-
	1st month	0-2	0.89±0.44 (1)	0-1.5	0.74±0.41 (0.7)	0.17-1.33	0.97±0.25 (1)	0.278	-	-	-
	3rd month	0.33-2	0.99±0.34 (1)	0-1.5	0.73±0.44 (1)	0.17-1	0.93±0.22 (1)	0.242	-	-	-
	6th month	0.5-2	1.08±0.34 (1)	0-1	0.76±0.35 (1)	0.33-1	0.96±0.17 (1)	0.010*	0.008*	0.818	0.173
	p²		0.100		0.425		0.002*
	Baseline- 1st month p³		-		-		0.008*
	Baseline- 3rd month p³		-		-		0.020*
	Baseline- 6th month p³		-		-		0.012*
	1st month- 3rd month p³		-		-		0.397
	1st month- 6th month p³		-		-		0.497
	3rd month- 6th month p³		-		-		0.180
Lower buccal	Baseline	0-2	1.04±0.55 (1.1)	0-1.83	1.14±0.51 (1.2)	0.44-1.78	1.13±0.43 (1.2)	0.761	-	-	-
	1st month	0-2	1.02±0.52 (1)	0-1.67	0.76±0.44 (0.6)	0.28-1.67	1.05±0.36 (1)	0.189	-	-	-
	3rd month	0.5-2	1.03±0.35 (1)	0-1.61	0.87±0.38 (1)	0.56-1.56	1.01±0.22 (1)	0.421	-	-	-
	6th month	0.33-2	0.99±0.5 (1)	0-1.06	0.76±0.35 (1)	0.5-1.22	0.99±0.19 (1)	0.208	-	-	-
	p²		0.889		0.004*		0.603
	Baseline- 1st month p³		-		0.008*		-
	Baseline- 3rd month p³		-		0.064		-
	Baseline- 6th month p³		-		0.015*		-
	1st month- 3rd month p³		-		0.373		-
	1st month- 6th month p³		-		0.789		-
	3rd month- 6th month p³		-		0.293		-
Lower lingual	Baseline	0-2	1.02±0.46 (1)	0-2	1.09±0.51 (1)	0.17-1.5	0.96±0.35 (1)	0.540	-	-	-
	1st month	0-2	0.89±0.44 (1)	0-1.5	0.84±0.4 (1)	01/01/1967	1.1±0.22 (1)	0.039*	1	0.041*	0.019*
	3rd month	0.33-2	1.03±0.35 (1)	0-1.5	0.86±0.36 (1)	01/01/2017	1.02±0.06 (1)	0.133	-	-	-
	6th month	0.67-2	1.14±0.41 (1)	0-1	0.86±0.3 (1)	01/01/1933	1.02±0.09 (1)	0.113	-	-	-
	p²		0.080		0.092		0.324

Probing Depth		BOND A BRAID		EVERSTICK ORTHO		SUPER-SPLINT		p¹	Dunn’s multiple comparisons test
Probing Depth		Min-Max	Mean±SD (median)	Min-Max	Mean±SD (median)	Min-Max	Mean±SD (median)		BOND A BRAID/ EVERSTICK ORTHO	BOND A BRAID/ HAGER WERKEN	EVERSTICK ORTHO/ HAGER WERKEN
Upper buccal	Baseline	0.61-2.5	1.61±0.64 (1.6)	1-2.17	1.73±0.38 (1.9)	1.11-2.22	1.68±0.33 (1.7)	0.861	-	-	-
	1st month	0.83-2.11	1.46±0.46 (1.3)	1-2	1.54±0.36 (1.6)	0.72-2	1.49±0.34 (1.4)	0.871	-	-	-
	3rd month	1-2.06	1.51±0.4 (1.4)	1-1.83	1.45±0.33 (1.5)	1-2	1.54±0.31 (1.5)	0.798	-	-	-
	6th month	0.89-2	1.39±0.32 (1.4)	1-1.67	1.38±0.25 (1.3)	1-2	1.43±0.29 (1.4)	0.800	-	-	-
	p²		0.350		0.001*		0.002*
	Baseline- 1st month p³		-		0.012*		0.026*
	Baseline- 3rd month p³		-		0.001*		0.008*
	Baseline- 6th month p³		-		0.003*		0.001*
	1st month- 3rd month p³		-		0.040*		0.401
	1st month- 6th month p³		-		0.028*		0.111
	3rd month- 6th month p³		-		0.161		0.088
Upper lingual	Baseline	0.72-2.67	1.29±0.51 (1.2)	0.17-2.33	1.4±0.59 (1.2)	0.5-1.67	1.01±0.31 (1)	0.062	-	-	-
	1st month	1-2	1.2±0.35 (1)	1-2	1.32±0.34 (1.2)	1-1.5	1.12±0.16 (1)	0.297	-	-	-
	3rd month	0.78-2	1.24±0.37 (1)	1-2	1.23±0.3 (1)	0.83-1.33	1.03±0.14 (1)	0.071	-	-	-
	6th month	0.83-1.83	1.08±0.24 (1)	1-2	1.29±0.33 (1.2)	0.78-1.33	1±0.11 (1)	0.004*	0.108	0.756	0.004*
	p		0.059		0.197		0.061
Lower buccal	Baseline	0.78-2.89	1.66±0.63 (1.7)	1-2.22	1.66±0.32 (1.7)	1.06-2.33	1.73±0.33 (1.8)	0.871	-	-	-
	1st month	0.72-2.44	1.46±0.53 (1.3)	0.89-2.22	1.48±0.38 (1.5)	0.78-2	1.35±0.32 (1.3)	0.720	-	-	-
	3rd month	0.83-2.38	1.44±0.45 (1.4)	1-2	1.5±0.35 (1.4)	1-1.83	1.39±0.26 (1.4)	0.678	-	-	-
	6th month	0.78-2.38	1.44±0.49 (1.3)	1-2	1.5±0.39 (1.4)	1-2	1.42±0.32 (1.4)	0.824	-	-	-
	p²		0.327		0.237		0.000*
	Baseline- 1st month p³		-		-		0.004*
	Baseline- 3rd month p³		-		-		0.001*
	Baseline- 6th month p³		-		-		0.006*
	1st month- 3rd month p³		-		-		0.506
	1st month- 6th month p³		-		-		0.308
	3rd month- 6th month p³		-		-		0.530
Lower lingual	Baseline	0.89-7	1.57±1.54 (1.2)	1-2	1.23±0.29 (1.2)	0.17-2	1.01±0.45 (1)	0.139	-	-	-
	1st month	1-2.33	1.25±0.46 (1)	0.06-1.67	1.11±0.38 (1)	0.83-2	1.1±0.27 (1)	0.651	-	-	-
	3rd month	1-2	1.17±0.28 (1)	1-1.67	1.23±0.27 (1.2)	1-1.67	1.12±0.2 (1)	0.408	-	-	-
	6th month	1-1.67	1.12±0.2 (1)	1-2	1.26±0.37 (1.2)	1-1.5	1.08±0.15 (1)	0.215	-	-	-
	p²		0.516		0.839		0.823

BOP		BOND A BRAID		EVERSTICK ORTHO		SUPER-SPLINT		p¹	Dunn’s multiple comparisons test
BOP		Min-Max	Mean±SD (median)	Min-Max	Mean±SD (median)	Min-Max	Mean±SD (median)		BOND A BRAID/ EVERSTICK ORTHO	BOND A BRAID/ HAGER WERKEN	EVERSTICK ORTHO/ HAGER WERKEN
Upper buccal	Baseline	0-0.56	0.23±0.18 (0.2)	0-0.61	0.15±0.18 (0.1)	0-0.67	0.32±0.2 (0.3)	0.023*	0.371	0.686	0.018*
	1st month	0-0.89	0.24±0.24 (0.2)	0-0.56	0.2±0.16 (0.2)	0-0.5	0.23±0.17 (0.2)	0.890	-	-	-
	3rd month	0-.5	0.19±0.15 (0.2)	0-0.22	0.08±0.08 (0.1)	0.06-0.56	0.26±0.16 (0.2)	0.002*	0.021	0.711	0.001*
	6th month	0-1	0.26±0.26 (0.2)	0-0.5	0.11±0.15 (0.1)	0.11-0.61	0.25±0.13 (0.2)	0.003*	0.027*	0.755	0.001*
	p²		0.897		0.018*		0.560
	Baseline- 1st month p³		-		0.098		-
	Baseline- 3rd month p³		-		0.206		-
	Baseline- 6th month p³		-		0.069		-
	1st month- 3rd month p³		-		0.012*		-
	1st month- 6th month p³		-		0.012*		-
	3rd month- 6th month p³		-		0.754		-
Upper lingual	Baseline	0-0.5	0.13±0.17 (0)	0-0.5	0.11±0.16 (0)	0-0.5	0.13±0.16 (0.2)	0.832	-	-	-
	1st month	0-1	0.21±0.27 (0.2)	0-0.5	0.12±0.17 (0)	0-0.5	0.21±0.2 (0.2)	0.334	-	-	-
	3rd month	0-0.33	0.17±0.14 (0.2)	0-0.5	0.11±0.14 (0.2)	0-0.5	0.23±0.2 (0.3)	0.225	-	-	-
	6th month	0-1	0.21±0.27 (0.2)	0-0.67	0.1±0.18 (0)	0-0.33	0.2±0.11 (0.2)	0.023*	0.276	0.899	0.019*
	p²		0.934		0.937		0.363
Lower buccal	Baseline	0-1	0.32±0.28 (0.2)	0-0.72	0.22±0.22 (0.1)	0.17-0.89	0.43±0.23 (0.3)	0.020*	0.791	0.289	0.016*
	1st month	0.06-0.72	0.27±0.22 (0.2)	0-0.67	0.23±0.22 (0.1)	0.11-0.83	0.4±0.22 (0.3)	0.039*	1	0.212	0.041*
	3rd month	0..11-0..67	0.29±0.15 (0.2)	0-0.56	0.17±0.14 (0.1)	0-0.56	0.29±0.16 (0.3)	0.019*	0.011*	1	0.021*
	6th month	0-1	0.32±0.29 (0.2)	0-0.56	0.14±0.15 (0.1)	0.06-0.5	0.27±0.13 (0.2)	0.033*	0.036*	1	0.016*
	p²		0.521		0.207		0.004*
	Baseline- 1st month p³		-		-		0.572
	Baseline- 3rd month p³		-		-		0.017*
	Baseline- 6th month p³		-		-		0.017*
	1st month- 3rd month p³		-		-		0.164
	1st month- 6th month p³		-		-		0.003*
	3rd month- 6th month p³		-		-		0.143
Lingual inferior	Baseline	0-0.5	0.24±0.2 (0.2)	0-0.83	0.29±0.26 (0.2)	0-0.83	0.28±0.25 (0.2)	0.970	-	-	-
	1st month	0-1	0.27±0.26 (0.2)	0-1	0.28±0.29 (0.2)	0-1	0.28±0.35 (0.2)	0.908	-	-	-
	3rd month	0-0.67	0.2±0.19 (0.2)	0-0.67	0.28±0.22 (0.2)	0-0.83	0.34±0.29 (0.3)	0.417	-	-	-
	6th month	0-1	0.3±0.31 (0.2)	0-0.67	0.24±0.22 (0.2)	0.17-0.67	0.32±0.16 (0.3)	0.247	-	-	-
	p²		0.922		0.621		0.808

Failure	BOND A BRAID		EVERSTICK ORTHO		SUPER-SPLINT		p¹
Failure	(n=30)		(n=30)		(n=30)		p¹
	n	%	n	%	n	%
Yes	4	13.3	3	10	4	13.3	1.000
No	26	86.7	27	90	26	86.7	1.000

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