Cochrane · intervention · CD002283

Retention procedures for stabilising tooth position after treatment with orthodontic braces

Martin, C, Littlewood, SJ, Millett, DT, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library

Oral Health Orthodontics5 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 11 · 33.3%Ungraded 5 · 15.2%Very low 15 · 45.5%Low 2 · 6.1%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Children and adults who have had retainers fitted or adjunctive procedures undertaken following treatment with orthodontic braces. There was no restriction for the presenting malocclusion or type of active orthodontic treatment undertaken. The participants had to be followed up at least three months after completing their orthodontic treatment. Excluded: people who had surgical correction of the jaws; people with a cleft lip or palate, or both, or other craniofacial syndrome; people who had orthodontic treatment based on extractions alone or the fitting of a passive space maintainer, or both	Forty-seven studies were identified that fulfilled the criteria of the review. All studies were parallel randomised controlled trials. Forty-seven studies were parallel-design studies and one was a cross-over clinical study. Thirty-eight studies were two-arm studies, seven were three-arm studies, and three were four-arm studies
Intervention	Retainers or adjunctive procedures, or both, after treatment with orthodontic braces. We included only studies where the full course of definitive orthodontic treatment was completed - we excluded data on retention strategies at the end of an initial phase of removable or functional appliance treatment. We excluded studies comparing techniques (not materials) for placing the bonded retainers. We did not include studies on aligners in this review	Circumferential supracrestal fiberotomy and removable retainer (n=2); Three types of fixed retainers and removable retainer (n=1); Hawley removable retainer (n=1); Multistrand wire versus direct-bonded polyethylene ribbon-reinforced resin composite for lingual retention (n=1); Modified thermoplastic retainer versus full coverage thermoplastic retainer (n=1); Part-time versus full-time wear of thermoplastic retainers (n=2); Begg retainers versus thermoplastic retainers (n=1); Hawley retainers versus thermoplastic retainers (n=10); Part-time versus full-time wear of Hawley retainers (n=1); Different types of fixed retainers (n=25); Lower multistrand stainless steel versus lower thermoplastic (n=2); Upper removable and lower fixed retainer versus upper removable retainer and lower adjunctive procedure (n=1); Upper removable and lower fixed retainer versus positioner (n=1)
Comparison	Fixed retainers/Removable retainers/No retainers/Hard tissue adjunctive procedures/Soft tissue adjunctive procedures	Removable retainer full time (n=2); Removable retainer nights only (n=1); Clear overlay removable retainer (n=1); Direct-bonded polyethylene ribbon-reinforced resin composite (n=1); Full coverage thermoplastic retainer (n=1); Full-time wear of thermoplastic retainers (n=2); Thermoplastic retainers (n=1); Hawley retainers (n=10); Full-time wear of Hawley retainers (n=1); Multistrand bonded retainers (n=25); Lower thermoplastic (n=2); Upper removable retainer and lower adjunctive procedure (n=1); Positioner (n=1)
Outcomes	Assessment of how well the teeth were stabilised using index of tooth irregularity (e.g. Little's index) or how the teeth meet together using index such as PAR index at least 3 months after fitting of retainer; Survival of the retainers assessed by how long they lasted without breaking (in months) or how many times they needed to be replaced or repaired during wear; Quality of life assessed in terms of patient's satisfaction; Adverse effects on health of teeth (decay assessed using indices of demineralisation) and surrounding structures (gums and other supporting structures assessed using periodontal indices or other markers of periodontal disease)	Assessment of stability (n=27); Survival of retainers (n=27); Patient satisfaction (n=14); Adverse effects on oral health (n=15)
Study designs	Randomised controlled trials	NR
Timing	At least 3 months after the fitting of the retainer and/or after adjunctive procedure was carried out	At 1 year after debond (n=1); After 3 months (n=1); Over 3 years (n=1); Over 6 months (n=1); Over 2 years (n=1); Three months (n=17); Six months (n=25); Nine months (n=5); One year (n=20); 18 months (n=4); Two years (n=8); Three years (n=1); Four years (n=1); Five years (n=1); Six years (n=1)

Search date: April 2022. Databases: Cochrane Oral Health Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid; OpenGrey