EFFECTS OF FIXED VS REMOVABLE ORTHODONTIC RETAINERS ON PERIODONTAL HEALTH
Main Article Content
Abstract
Objective: To assess the effects of fixed and removable orthodontic retainers in a mandibular arch on periodontal health.
Methodology: This study was carried out at AFID from November 2018 to November 2020. Sixty-four patients, 42 females (65%) and 22 males (34%) with a mean age of 19.46±2.01years were selected and given either vacuum formed retainer (VFR) or bonded retainer wire (BRW) in mandibular arch and divided into two equal groups. Only the mandibular arch was used to measure two clinical variables (Gingival index and calculus index) at four different time intervals, immediately after de-bonding (T0), at 6 months (T1), at 12 months (T2) and at 24 months(T3) to assess the effects of two retainer groups on Periodontal health.
Results: No significant difference was found between gingival index and calculus index scores at T0 among VFR group and BRW group (p>0.05) while statistically significant differences were found in gingival index scores at T1 (p=0.025) and calculus index scores at T1 and T3 (p=0.015, p=0.048 respectively) among the two retainer groups.
Conclusion: Fixed bonded retainer wire is capable of causing gingival inflammation and calculus aggregation, indicated by mild increase in gingival and calculus scores, in comparison to vacuum formed retainer. Although no adverse effects were observed on overall periodontal health with both retainers. This does not guarantee future disease progression, so careful monitoring of oral hygiene on follow-up visits should be a prime concern of orthodontists.
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References
Al-Moghrabi D, Johal A, O'Rourke N, Donos N, Pandis N, Gonzales-Marin C, et al. Effects of fixed vs remov¬able orthodontic retainers on stability and periodontal health: 4-year fol¬low-up of a randomized controlled trial. Am J Orthod Dentofacial Or¬thop. 2018;154(2):167-174.1. DOI:10.1016/j.ajodo.2018.01.007.
Arn ML, Dritsas K, Pandis N, Kloukos D. The effects of fixed orthodontic re¬tainers on periodontal health: A sys¬tematic review. Am J Orthod Dentofa¬cial Orthop. 2020;157(2):156-164.17. DOI:10.1016/j.ajodo.2019.10.010.
Molyneaux C, Sandy JR, Ireland AJ. Or¬thodontic retention and the role of the general dental practitioner. Br Dent J. 2021;230(11):753-7. DOI:10.1038/ s41415-021-2875-5.
Littlewood SJ, Kandasamy S, Huang G. Retention and relapse in clinical prac¬tice. Aust Dent J. 2017;62 Suppl 1:51- 7. DOI:10.1111/adj.12475.
Karmacharya A, Kafle D, Adhikari RB, Malla N. A study on orthodontic reten¬tion practices in Nepal. Orthod J Nepal. 2021;11(1):29-33.
Kartal Y, Kaya B. Fixed Orthodontic Retainers: A Review. Turk J Orthod. 2019;32(2):110-114. DOI:10.5152/ TurkJOrthod.2019.18080.
Littlewood SJ, Dalci O, Dolce C, Holli¬day LS, Naraghi S. Orthodontic reten¬tion: what's on the horizon? Br Dent J. 202;230(11):760-764. DOI:10.1038/ s41415-021-2937-8.
Storey M, Forde K, Littlewood SJ, Scott P, Luther F, Kang J. Bonded versus vacuum-formed retainers: a random¬ized controlled trial. Part 2: periodon¬tal health outcomes after 12 months. Eur J Orthod. 2018;40(4):399-408. DOI:10.1093/ejo/cjx059.
Heier EE, De Smit AA, Wijgaerts IA, Adriaens PA. Periodontal implications of bonded versus removable retain¬ers. Am J Orthod Dentofacial Orthop. 1997;112(6):607-16. DOI:10.1016/ s0889-5406(97)70225-7.
Al-Moghrabi D, Johal A, O'Rourke N, Donos N, Pandis N, Gonzales-Marin C, Fleming PS. Effects of fixed vs re¬movable orthodontic retainers on sta¬bility and periodontal health: 4-year follow-up of a randomized controlled trial. Am J Orthod Dentofacial Or¬thop. 2018;154(2):167-174.e1. DOI:10.1016/j.ajodo.2018.01.007.
Gunay F, Oz AA. Clinical effectiveness of 2 orthodontic retainer wires on mandib¬ular arch retention. Am J Orthod Den¬tofacial Orthop. 2018;153(2):232-238. DOI:10.1016/j.ajodo.2017.06.019.
Löe H. The Gingival Index, the Plaque Index and the Retention Index Systems. J Periodontol. 1967;38(6): 610-6. DOI:10.1902/jop.1967.38.6.610.
Greene JC, Vermillion JR. The oral hy¬giene index: a method for classifying oral hygiene status. J Am Dent Assoc. 1960;61(2):172-9.
Pandis N, Vlahopoulos K, Madianos P, Eliades T. Long-term periodontal status of patients with mandibular lingual fixed retention. Eur J Orthod. 2007;29(5):471-6. DOI10.1093/ejo/ cjm042.
Knaup I, Wagner Y, Wego J, Fritz U, Jäger A, Wolf M. Potential impact of lingual retainers on oral health: com¬parison between conventional twist¬flex retainers and CAD/CAM fabri¬cated nitinol retainers : A clinical in vitro and in vivo investigation. J Orofac Orthop. 2019;80(2):88-96. English. DOI:10.1007/s00056-019-00169-7.
White DJ. Dental calculus: recent in¬sights into occurrence, formation, pre¬vention, removal and oral health effects of supragingival and subgingival depos¬its. Eur J Oral Sci. 1997;105(5 Pt 2):508- 22. DOI:10.1111/j.1600-0722.1997. tb00238.x.
Rody WJ Jr, Elmaraghy S, McNeight AM, Chamberlain CA, Antal D, Dolce C, et al. Effects of different orthodontic retention protocols on the periodontal health of mandibular incisors. Orthod Craniofac Res. 2016;19(4):198-208. DOI:10.1111/ocr.12129.
Xu XC, Li RM, Tang GH. Clinical eval¬uation of lingual fixed retainer com¬bined with Hawley retainer and vac¬uum-formed retainer. Shanghai Kou Qiang Yi Xue. 2011;20(6):623-6.
Millett DT, McDermott P, Field D, Er¬fia I, Doubleday B, Vandenheuvel A, et al. Dental and periodontal health with bonded or vacuum-formed retainer. In: IADR Conference Abstract; 2008: (Vol. 3168).
Booth FA, Edelman JM, Proffit WR. Twenty-year follow-up of patients with permanently bonded mandibular ca¬nine-to-canine retainers. Am J Orthod Dentofacial Orthop. 2008;133(1):70-6. DOI:10.1016/j.ajodo.2006.10.023. .
Al-Moghrabi D, Johal A, O'Rourke N, Donos N, Pandis N, Gonzales-Marin C, Fleming PS. Effects of fixed vs re¬movable orthodontic retainers on sta¬bility and periodontal health: 4-year follow-up of a randomized controlled trial. Am J Orthod Dentofacial Or¬thop. 2018;154(2):167-174.e1. DOI:10.1016/j.ajodo.2018.01.007. .
Cerny R, Cockrell D, Lloyd D. Long-term results of permanent bonded retention. J Clin Orthod. 2010;44(10):611-6.
Rody WJ Jr, Akhlaghi H, Akyalcin S, Wiltshire WA, Wijegunasinghe M, Filho GN. Impact of orthodontic retainers on periodontal health status assessed by biomarkers in gingival crevicular flu¬id. Angle Orthod. 2011;81(6):1083-9. DOI:10.2319/011011-15.1.
Artun J. Caries and periodontal reac¬tions associated with long-term use of different types of bonded lingual retain¬ers. Am J Orthod. 1984;86(2):112-8. DOI:10.1016/0002-9416(84)90302-6.
Artun J, Spadafora AT, Shapiro PA, McNeill RW, Chapko MK. Hygiene sta¬tus associated with different types of bonded, orthodontic canine-to-ca¬nine retainers. A clinical trial. J Clin Periodontol. 1987;14(2):89-94. DOI:10.1111/j.1600-051x.1987. tb00948.x.
Artun J, Spadafora AT, Shapiro PA. A 3-year follow-up study of various types of orthodontic canine-to-canine retain¬ers. Eur J Orthod. 1997;19(5):501-9. DOI:10.1093/ejo/19.5.501.
Gökçe B, Kaya B. Periodontal effects and survival rates of different mandibular retainers: comparison of bonding tech¬nique and wire thickness. Eur J Erthod. 2019;41(6):591-600. DOI:10.1093/ ejo/cjz060.
Levin L, Samorodnitzky-Naveh GR, Machtei E. The association of or¬thodontic treatment and fixed re-tainers with gingival health. J Peri¬odentol. 2008;79(11):2087-2092. DOI:10.1902/jop.2008.080128.
César Neto JB, Régio MRS, Mar¬tos J, Spautz F, Moraes GB. Analysis of the periodontal status of patients with mandibular-bonded retainers. 2010;25:132-136.