A Review of the Literature A systematic review of orthodontic retention systems: The verdict
International Orthodontics
Available online 9 July 2018
Summary
Introduction
Retention
during both the active and passive phases of treatment has given rise
to numerous publications concerning its efficacy, the range of systems
available and its variability over time. There are currently many
different retention protocols regularly used by orthodontists;
however, their efficacy and duration are still subject to debate. There
is as yet no consensus as to which retention protocol is the most
effective or for how long the retention device needs to be worn. The aim
of this research was to perform a systematic review of the scientific
literature in order to evaluate the efficacy of the different retention
systems and clinical protocols among those most widely used, so as to
make recommendations beneficial to both patient and practitioner.
Materials and methods
A
search of the literature was performed in the following databases:
PubMed (MEDLINE), ScienceDirect and Cochrane Library. The search was
limited to publications in English and French during the period
2006–2016.
Results
Out
of 1952 references initially identified, 17 articles corresponded to
our inclusion criteria. The results show that: fixed retention is more
effective than removable retainers
for the maintenance of incisor alignment during the first six months of
retention; there is no significant difference in efficacy between the
different fixed retention systems; there is no significant difference in
efficacy between the vacuum-formed systems and the Hawley retainer;
part-time use of removable retainers (between 8–10 h/day) is
sufficient; the most widely used retention protocol combines a
vacuum-formed splint or Hawley retainer in the upper arch with
mandibular fixed retention.
Conclusion
Despite
the large number of studies devoted to orthodontic retention only a few
articles corresponded to the methodological criteria of bio statistical
analysis. Also, on account of the variations in experimental protocols,
the levels of proof relating to the efficacy of different systems are
very weak. Research into this topic should first seek to normalize
methods of analysis and then perform randomized controlled long-term
trials to shed light on this problem.
Comments