Non-Cochrane · intervention · PM41788127
Effect of Direct Versus Indirect Bonding Techniques on Fixed Retainer Failure Rates: A Systematic Review and Meta-Analysis.
Marei Mohamed A, Failakawi Lujain E, Alhouti Fatemah Y, et al. · Cureus · 2026 · PubMed · doi:10.7759/cureus.102821
Findings
Population Patients who completed orthodontic treatment and received a bonded fixed retainer
3 findings
| Indirect bonding of fixed retainer (laboratory based, including CAD/CAM) | Direct (chairside) bonding of fixed retainer | Failure of maxillary fixed retainer Follow-up 6 to 60 months · Orthodontic retention clinics · Maxillary arch | HR 1.30 [0.89, 1.90] GRADE not reported 4 studies |
| Indirect bonding of fixed retainer (laboratory based, including CAD/CAM) | Direct (chairside) bonding of fixed retainer | Failure of mandibular fixed retainer Follow-up 6 to 60 months · Orthodontic retention clinics · Mandibular arch | HR 1.41 [1.12, 1.79] GRADE not reported 15 studies · 1481 participants |
| Indirect bonding of fixed retainer (laboratory based, including CAD/CAM) | Direct (chairside) bonding of fixed retainer | Failure of maxillary fixed retainer Follow-up 6 to 60 months · Orthodontic retention clinics · Maxillary arch (value as stated in Abstract; differs from Figure 3) | HR 1.30 [0.89, 1.90] GRADE not reported 4 studies |
Included primary studies 15
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Gelin 2020 Innovative customized CAD/CAM nickel-titanium lingual retainer versus standard stainless-steel lingual retainer: A randomized controlled… PMID:33144526 | 2020 | 1 other review | Failure of mandibular fixed retainer | not extracted yet |
| Bovali 2014 Indirect vs direct bonding of mandibular fixed retainers in orthodontic patients: A single-center randomized controlled trial comparing… DOI:10.1016/j.ajodo.2014.08.015 | 2014 | this review only | Failure of mandibular fixed retainer | not extracted yet |
| Cokakoglu 2023 Comparison of periodontal status and failure rates with different retainer bonding methods and adhesives: a randomized clinical trial DOI:10.2319/031622-224.1 | 2023 | this review only | Failure of mandibular fixed retainer | not extracted yet |
| Cornelis 2022 Indirect vs direct bonding of mandibular fixed retainers in orthodontic patients: Comparison of retainer failures and posttreatment… DOI:10.1016/j.ajodo.2022.03.014 | 2022 | this review only | Failure of mandibular fixed retainer | not extracted yet |
| Egli 2017 Indirect vs direct bonding of mandibular fixed retainers in orthodontic patients: Comparison of retainer failures and posttreatment… DOI:10.1016/j.ajodo.2016.09.009 | 2017 | this review only | Failure of mandibular fixed retainer | not extracted yet |
| Gera 2023 Stability, survival, and patient satisfaction with CAD/CAM versus conventional multistranded fixed retainers in orthodontic patients: a… DOI:10.1093/ejo/cjac042 | 2022 | this review only | Failure of mandibular fixed retainer; Failure of maxillary fixed retainer | not extracted yet |
| Gunay 2018 Clinical effectiveness of 2 orthodontic retainer wires on mandibular arch retention DOI:10.1016/j.ajodo.2017.06.019 | 2018 | this review only | Failure of mandibular fixed retainer | not extracted yet |
| Johal 2025 A comparison of survival rates using 3 methods of mandibular fixed retainer fabrication: A randomized clinical trial DOI:10.1016/j.ajodo.2025.08.005 | 2025 | this review only | Failure of mandibular fixed retainer | not extracted yet |
| Jowett 2023 CAD/CAM nitinol bonded retainer versus a chairside rectangular-chain bonded retainer: A multicentre randomised controlled trial DOI:10.1177/14653125221118935 | 2022 | this review only | Failure of mandibular fixed retainer; Failure of maxillary fixed retainer | not extracted yet |
| Kartal 2021 Comparative evaluation of periodontal effects and survival rates of Memotain and five-stranded bonded retainers DOI:10.1007/s00056-020-00243-5 | 2020 | this review only | Failure of mandibular fixed retainer | not extracted yet |
| Murugaiyan 2024 Post-treatment stability, survival time and periodontal health associated with vacuum-formed, bonded and rapid prototype retainers: A… DOI:10.1177/14653125241255702 | 2024 | this review only | Failure of mandibular fixed retainer; Failure of maxillary fixed retainer | not extracted yet |
| Pullisaar 2024 Stability, survival, patient satisfaction, and cost-minimization of CAD/CAM versus conventional multistranded fixed retainers in… DOI:10.1093/ejo/cjae006 | 2024 | this review only | Failure of mandibular fixed retainer; Failure of maxillary fixed retainer | not extracted yet |
| Shim 2022 Comparative assessment of relapse and failure between CAD/CAM stainless steel and standard stainless steel fixed retainers in orthodontic… DOI:10.2319/121720-1015.1 | 2022 | this review only | Failure of mandibular fixed retainer | not extracted yet |
| Taner 2011 A prospective clinical evaluation of mandibular lingual retainer survival DOI:10.1093/ejo/cjr038 | 2011 | this review only | Failure of mandibular fixed retainer | not extracted yet |
| Tran 2024 Relapse and failure rates between CAD/CAM and conventional fixed retainers: a 2-year follow-up of a randomized controlled clinical trial DOI:10.1093/ejo/cjad079 | 2024 | this review only | Failure of mandibular fixed retainer | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Effects of different orthodontic retainers on dental arch stability and periodontal health: a systematic review with pairwise… (2026) | 1 | 0.03 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients who completed orthodontic treatment and received a fixed retainer | Orthodontic retention patients with fixed retainers (n=1481) |
| Intervention | Indirect bonding technique (including CAD/CAM) | Indirect bonding (laboratory-based or CAD/CAM) (n=15 studies) |
| Comparison | Direct bonding technique | Direct chairside bonding |
| Outcomes | Failure rate of the fixed retainer | Retainer failure, mandibular arch (15 studies) and maxillary arch (4 studies); hazard ratio |
| Study designs | RCTs and prospective or retrospective cohort studies | 13 RCTs and 2 prospective cohort studies |
| Timing | Not specified | 6 to 60 months follow-up |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Partial Yes | NRSI: Partial Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: No · RCT: Yes | RCT: Yes · NRSI: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |