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Mandibular incisor alignment in untreated subjects compared with long-term changes after orthodontic treatment with or without retainers
Malmö University, Faculty of Odontology (OD). County Orthodontic Clinic Uddevalla, Västra Götalands Regionen, Uddevalla, Sweden.
Department of Orthodontics, Institute for Postgraduate Dental Education, Jönköping, Sweden.
Malmö University, Faculty of Odontology (OD).
Malmö University, Faculty of Odontology (OD).
2019 (English)In: American Journal of Orthodontics and Dentofacial Orthopedics, ISSN 0889-5406, E-ISSN 1097-6752, Vol. 155, no 2, p. 234-242Article in journal (Refereed) Published
Abstract [en]

Introduction: The aim of this work was to analyze the dental and skeletal changes in patients treated with fixedorthodontic appliances with or without retention appliances, and to compare the changes with untreated sub- jects. Specifically, mandibular incisor irregularity was analyzed. Methods: A total of 105 children who had undergone orthodontic treatment with fixed appliances in both jaws were examined in 2 groups: 64 had a lingual mandibular retainer and 41 had no retainer. Retention time was 2.7 +/- 1.5 years. The untreated group consisted of 25 subjects. Measurements were done on study casts and lateral head radiographs before and after treatment and 6 and 12 years after treatment. The Little irregularity index (LII) was the most important variable. Results: No differences were found in LII 12 years after treatment between the group that had a retainer and the group without a retainer after treatment. In the untreated group, LII was increased over time, but not to the same extent as in the treated groups. Correction of overjet and overbite was stable long-term. At the last examination, the amount of overjet was almost the same in all 3 groups. Conclusions: The routine use of mandibular retainers for 2 to 3 years does not appear to prevent long-term relapse. If the patient wants to constrain natural development and changes, lifelong retainers are needed.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 155, no 2, p. 234-242
Keywords [en]
Dentistry, Oral Surgery & Medicine
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-6348DOI: 10.1016/j.ajodo.2018.03.025ISI: 000457242700016PubMedID: 30712695Scopus ID: 2-s2.0-85060768967Local ID: 29899OAI: oai:DiVA.org:mau-6348DiVA, id: diva2:1403290
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-06-17Bibliographically approved
In thesis
1. Fixed mandibular retainers: a controlled 12-year follow-up
Open this publication in new window or tab >>Fixed mandibular retainers: a controlled 12-year follow-up
2018 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Fixed retainer after orthodontic treatment is an increasing retention appliance. For the mandibular incisors there are two different fixed retainers that are commonly used, either a canine-to-canine retainer bonded only to the canines or a twistflex retainer bonded to each of the mandibular incisors and canines. Increased mandibular incisor irregularity seems to be a continuous process throughout life even in untreated patients. The natural physiological changes during aging causes changes like those that occur after orthodontic treatment and the removal of retainers. There are few long-term studies that have compared patients who have had a mandibular fixed retainer with patients without retention appliance after treatment, and then compared the treated patients with untreated subjects.The overall aim of this thesis was to compare and evaluate two different mandibular fixed retainers and also to compare orthodontically treated cases with untreated long-term. This thesis is based on two studies and a PAR Index evaluation was presented in the frame story:Paper I is a retrospective longitudinal study done on dental casts and lateral head radiographs from patients who had received either a canine-to-canine retainer or a twistflex retainer after treatment. Different variables were measured, were Little’s Irregularity Index was the main outcome measure. The measurements were done at four different occasions, were the last registration was 12 years after treatment, i.e. 9 years after removal of retainer. Paper II is also a retrospective longitudinal study with three different groups, one group received a fixed mandibular retainer, one group did not receive any retention appliance after treatment and the third group was untreated subjects. Measurements were done on dental casts and lateral head radiographs at four different occasions to analyze dental and skeletal changes 12 years after treatment. Also here Little’s Irregularity Index was the main outcome measure. PAR Index evaluation is done to evaluate the stability of orthodontic treatment outcome after treatment and long-term for two different retainer groups and one non-retention group. The following conclusions were drawn: Paper I•Both the canine-to-canine retainer and the twistflex retainer can be recommended since both are equally effective during retention period.•None of the retention types prevent long-term changes of mandibular incisor irregularity or available space for the mandibular incisors after removal of the retainers.•No differences in bonding failures between the two retainers were found. Paper II•There were no differences found 12 years after treatment in Little’s Irregularity Index for the mandibular incisors between the group that had a retainer and the group that had no retainer after treatment•In the untreated group, Little’s Irregularity Index was increased over time but not to the same extent as in the treated groups. •The crowding before treatment did not explain the crowding at the last registration.•The use of mandibular retainers for two to three years does not appear to prevent long-term relapse. •If the patient wants to constrain the changes that come with natural development, then lifelong retention is needed.•The overjet and overbite were stable long-term.PAR Index evaluation•Twelve years after treatment the mean reduction in PAR score was over 70 per cent only for the groups who had a mandibular retainer after treatment. However, the non-retention group had a PAR score of 66 per cent.•There were more cases in the retention groups that were ”greatly improved and/or improved” 12 years after treatment compared to the non-retention group. After treatment between 16 and 23.3 per cent of all the cases were ”worse or not improved”. Twelve years after treatment between 36 and 43.6 per cent of the total cases were ”worse or not improved”.

Place, publisher, year, edition, pages
Malmö University, Faculty of Odontology, 2018. p. 86
Series
Malmö University Odontological Dissertations, ISSN 1650-6065
Keywords
Irregularity Index, Long-term stability, Relapse, Orthodontic retainers, Adolescent, Child, Device Removal, Female, Follow-Up Studies, Humans, Incisor, Male, Malocclusion, Mandible, Orthodontic Retainers, Recurrence, Risk Factors, Treatment Outcome
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-7756 (URN)25665 (Local ID)9789171049353 (ISBN)9789171049360 (ISBN)25665 (Archive number)25665 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-19Bibliographically approved

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Schütz-Fransson, UlrikeBjerklin, KristerBondemark, Lars

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