PMID- 29059289
OWN - NLM
STAT- MEDLINE
DCOM- 20190128
LR  - 20190128
IS  - 1460-2210 (Electronic)
IS  - 0141-5387 (Linking)
VI  - 40
IP  - 4
DP  - 2018 Jul 27
TI  - Bonded versus vacuum-formed retainers: a randomized controlled trial. Part 1: 
      stability, retainer survival, and patient satisfaction outcomes after 12 months.
PG  - 387-398
LID - 10.1093/ejo/cjx058 [doi]
AB  - BACKGROUND: There is a shortage of evidence on the best type of retainer. 
      OBJECTIVES: Evaluate upper and lower bonded retainers (BRs) versus upper and 
      lower vacuum-formed retainers (VFRs) over 12 months, in terms of stability, 
      retainer survival, and patient satisfaction. TRIAL DESIGN: Two-arm parallel group 
      multi-centre randomized controlled clinical trial. METHODS: Sixty consecutive 
      patients completing fixed appliance therapy and requiring retainers were 
      recruited from 3 hospital departments. They were randomly allocated to either 
      upper and lower labial segment BRs (n = 30) or upper and lower full-arch VFRs (n 
      = 30). Primary outcome was stability. Secondary outcomes were retainer survival 
      and patient satisfaction. A random sequence of treatment allocation was 
      computer-generated and implemented by sealing in sequentially numbered opaque 
      sealed envelopes independently prepared in advance. Patients, operators and 
      outcome could not be blinded due to the nature of the intervention. RESULTS: 
      Thirty patients received BRs (median [Mdn] age 16 years, inter-quartile range 
      [IQR] = 2) and 30 received VFRs (Mdn age 17 years, IQR = 4). Baseline 
      characteristics were similar between groups. At 12 months, there were no 
      statistically significant inter-group differences in post-treatment change of 
      maxillary labial segment alignment (BR = 1.1 mm, IQR = 1.56, VFR = 0.76 mm, IQR = 
      1.55, P = 0.61); however, there was greater post-treatment change in the 
      mandibular VFR group (BR = 0.77 mm, IQR = 1.46, VFR = 1.69mm, IQR = 2.00, P = 
      0.008). The difference in maxillary retainer survival rates were statistically 
      non-significant, P = 0.34 (BR = 63.6%, 239.3 days, 95% confidence interval [CI] = 
      191.1-287.5, VFR = 73.3%, 311.1 days, 95% CI = 278.3-344.29). The mandibular BR 
      had a lower survival rate (P = 0.01) at 12 months (BR = 50%, 239.3 days 95% CI = 
      191.1-287.5, VFR = 80%, 324.9 days 95% CI = 295.4-354.4). More subjects with VFRs 
      reported discomfort (P = 0.002) and speech difficulties (P = 0.004) but found 
      them easier to clean than those with BRs (P = 0.001). LIMITATIONS: Results are 
      after 1 year and we do not know how much the removable retainers were worn. 
      CONCLUSIONS: After 1 year, there is no evidence of a significant difference in 
      stability or retainer survival in the maxilla. In the mandible, BRs are more 
      effective at maintaining mandibular labial segment alignment, but have a higher 
      failure rate. In comparison with patients wearing VFRs, patients wearing BRs 
      reported that they caused less interference with speech, required less compliance 
      to wear them, and were more comfortable to wear than VFRs. Patients found the BRs 
      harder to keep clean. TRIAL REGISTRATION: The trail was not registered.
FAU - Forde, Katherine
AU  - Forde K
AD  - Holywell House Orthodontics, Hinckley, Leicestershire, UK.
FAU - Storey, Madeleine
AU  - Storey M
AD  - Department of Orthodontics, Leeds Dental Institute, Clarendon Way, UK.
FAU - Littlewood, Simon J
AU  - Littlewood SJ
AD  - Department of Orthodontics, St Luke's Hospital, Bradford, UK.
FAU - Scott, Paul
AU  - Scott P
AD  - Department of Orthodontics, Montagu Hospital, Mexborough, Doncaster and Bassetlaw 
      NHS Trust, UK.
FAU - Luther, Friedy
AU  - Luther F
AD  - Sheffield Teaching Hospitals NHS Foundation Trust, Department of Orthodontics, 
      The Charles Clifford Dental Hospital, Sheffield, UK.
FAU - Kang, Jing
AU  - Kang J
AD  - Department of Biostatistics, School of Dentistry, University of Leeds, UK.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - England
TA  - Eur J Orthod
JT  - European journal of orthodontics
JID - 7909010
SB  - IM
CIN - J Am Dent Assoc. 2018 Apr;149(4):e71. PMID: 29395006
CIN - J Orthod. 2019 Mar;46(1):80-84. PMID: 31056061
MH  - Adolescent
MH  - Dental Occlusion
MH  - Female
MH  - Humans
MH  - Male
MH  - Malocclusion/*therapy
MH  - Mandible
MH  - Maxilla
MH  - Orthodontic Appliance Design
MH  - Orthodontic Appliances, Fixed
MH  - *Orthodontic Retainers
MH  - Orthodontics, Corrective/*instrumentation
MH  - Patient Compliance
MH  - Patient Satisfaction
MH  - Vacuum
MH  - Young Adult
EDAT- 2017/10/24 06:00
MHDA- 2019/01/29 06:00
CRDT- 2017/10/24 06:00
PHST- 2017/10/24 06:00 [pubmed]
PHST- 2019/01/29 06:00 [medline]
PHST- 2017/10/24 06:00 [entrez]
AID - 4558723 [pii]
AID - 10.1093/ejo/cjx058 [doi]
PST - ppublish
SO  - Eur J Orthod. 2018 Jul 27;40(4):387-398. doi: 10.1093/ejo/cjx058.