| 1. |
- Andrén, Anders, et al.
(författare)
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Pattern and Amount of Change after Orthodontic Correction of Upper Front Teeth 7 Years Postretention.
- 2010
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Ingår i: The Angle Orthodontists. - : The Angle Orthodontist (EH Angle Education & Research Foundation). - 0003-3219 .- 1945-7103. ; 80:4, s. 432-437
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the amount and pattern of changes of maxillary front teeth 7 years postretention, which previously were retained with a bonded retainer. Materials and Methods: The study group consisted of 27 patients. Study models before treatment (T1), at debonding (T2), 1 year after removal of the upper bonded retainer (T3), and 7 years postretention (T4) were present. The irregularity index (sum of contact point displacements) and the rotations of front teeth toward the raphe line were calculated. Results: The irregularity index of the maxillary front teeth changes very little or not at all during the first year postretention. Further change long term resulted in an irregularity index of mean 2.0 (range 0.0–5.8). The contact relationship between the laterals and centrals seems to be the most critical. Forty rotated teeth in 21 patients were corrected more than 20°. Mean relapse during the first year postretention was 6.7° (range 0.0°–14.7°). Mean changes during 7 years was 8.2° (range 0.0°–19.3°). Conclusions: Relapse of upper front teeth retained with a bonded retainer is minor in both the short and long term. If permanent retention is required after 3 years of retention, it is enough to retain the incisors.
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| 2. |
- Naraghi, Sasan, et al.
(författare)
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Comparison of post-treatment changes with and without retention in adolescents treated for maxillary impacted canines : a randomised controlled trial
- 2021
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Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 43:2, s. 121-127
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To evaluate whether retention is needed after orthodontic treatment of impacted maxillary canines.Trial design: Two-arm parallel group single-centre randomized controlled trial.Materials and methods: Sixty-three patients, 39 girls and 24 boys, were recruited to the study. The inclusion criteria were patients with at least one impacted or unerupted maxillary canine, and moderate irregularity of the maxillary six anterior teeth according to Little’s index (LI). After gaining informed consent from the patient and their custodians, the patients were randomized to one of two groups, i.e. to a non-retention group or a retention group. The randomization process was prepared and carried out by an independent person not involved in the trial and the randomization used blocks of 20 (10 + 10). Primary outcomes were changes in single contact point discrepancy, and LI measured on digitalized three-dimensional study casts 1-year post-treatment. The study casts were anonymized before assessment and the changes were blinded for the assessor. Data were evaluated on an intention-to-treat basis. Thus, all randomized patients were incorporated into the final analysis. In the non-retention group a 10-week interim period was used to detect patients who eventually have a relapse immediately after treatment. If so, the patient got the arch-wire reinserted. Most patients in the retention group received a vacuum-formed retainer and pretreatment spacing cases got a bonded retainer.Results: Mean irregularity change was 0.4 mm in the retention and 1.3 mm in the non-retention group (P < 0.001). Maximum change was 2.5 mm in the retention and 3.2 mm in the non-retention group (P < 0.001). Most changes in the non-retention group occurred during the 10-week interim period. In the non-retention group, one patient developed contact point discrepancy of >2 mm during the interim period and was realigned.HarmsOne patient met the stopping guideline criteria. This patient had the arch wire reinserted for 2 months. After realignment, the patient received a retention appliance.LimitationsThe trial was a single-centre study and short-term changes were evaluated.Conclusions: Changes between the retention and the non-retention group were statistically but not clinically significant. Since satisfactory clinical results 1-year post-treatment were found in the non-retention group, retention does not appear to be needed. The 10-week interim period was useful in detecting patients who might have a relapse immediately after treatment.Trial registration: The trial was not registered.
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| 3. |
- Naraghi, Sasan, et al.
(författare)
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Relapse tendency after orthodontic correction of upper front teeth retained with a bonded retainer.
- 2006
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Ingår i: The Angle orthodontist. - 0003-3219 .- 1945-7103. ; 76:4, s. 570-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the amount and pattern of relapse of maxillary front teeth previously retained with a bonded retainer. MATERIALS AND METHODS: The study group consisted of 135 study casts from 45 patients. Recordings from study models before treatment (T1), at debonding (T2), and 1 year after removal of the retainer (T3) were present. All patients had been treated with fixed edgewise appliances. The irregularity index (sum of contact point displacement [CPD]) and rotations of front teeth toward the raphe line were calculated at T1, T2, and T3. RESULTS: The mean irregularity index at T1 was 10.1 (range 3.0-29.9, SD 5.4). At T2 it was 0.7 (range 0.0-2.1, SD 0.7), and at T3 it was 1.4 (range 0.0-5.1, SD 1.2). Fifty-five teeth in 42 patients were corrected more than 20 degrees between T1 and T2 (mean correction 31.4 degrees range 20.0-61.7), and mean relapse in this group was 7.3 degrees (range 0.0-20.5). Regarding alignment of the maxillary front teeth, the contact relationship between the laterals and centrals seems to be the most critical. A significant positive correlation was found between the amount of correction of incisor rotation and the magnitude of relapse but not between the amount of correction of CPD and the magnitude of relapse. Eighty-four percent of the overcorrected CPDs returned to a desired position. CONCLUSIONS: Minor or no relapse was noted at the 1-year follow-up.
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| 4. |
- Naraghi, Sasan
(författare)
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Stability of aligned maxillary anterior teeth after orthodontic treatment : amount of changes with different retention methods and without retention
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Well-aligned anterior teeth are the major reason for the patients seeking orthodontic treatment, and keeping teeth aligned and stable afterwards is a goal for the orthodontist and the patient. Relapse after treatment is a common problem, and it is defined as when teeth go back to their previous positions. Removable or fixed retainers have been used to avoid relapse after treatment. It has been common practice to use removable retention to retain anterior teeth in the maxilla. However, in recent decades, it has become increasingly common to retain with bonded retainers.Almost all previous studies on retention devices in the maxilla were based on removable retainers. Consequently, there existed knowledge gaps and lack of short-term and long-term studies on the capability to maintain the stability of the maxillary anterior teeth with bonded retainers. Hence, the reason for the papers in this study. In addition, it is not known if retentionis needed in all orthodontic patients or if there are patients, based on their initial malocclusion and individual variations, who may not need retention after treatment.The research questions addressed in this thesis thus originate from knowledgegaps and clinical needs concerning retention strategies after orthodontic treatments. To provide strong clinical evidence, randomised controlled trials (RCT) as well as intention to treat (ITT) methodology has been assessed. The results are expected to be beneficial for the patients who will be offered the most effective retention strategy for maxillary anterior teeth based on patients’ preferences.In Paper I and II, 45 and 27 adolescents’ patients were collected from the Orthodontic Clinic in Mariestad, Sweden. At the time when Paper Iand II were conducted, there were no studies that had evaluated the longterm effect of bonded retainers in the maxilla. In two RCTs, Paper III and IV, 90 and 63 adolescents’ patients were collected from the Orthodontic Clinic in Växjö, Region Kronoberg, Sweden.Paper I: The aim was to investigate the amount and pattern of relapse of maxillary anterior teeth previously retained with a bonded retainer.Paper II: The aim was to investigate the amount and pattern of changes of maxillary anterior teeth seven years post-retention, which previously were retained with a bonded retainer.Paper III: The aim was to evaluate post-treatment changes in the irregularity of the maxillary six anterior teeth and single tooth Contact Point Discrepancy (CPD) of three different retention methods.Paper IV: The aim was to evaluate whether retention is needed after orthodontic treatment for impacted maxillary canines and with moderate pre-treatment irregularity in the maxilla.Key findings in Paper I• The contact relationship between the laterals and the centrals is the most unstable contact. Canines are the most stable teeth.• There was no difference in the relapse pattern between rotational displacements and labiolingual displacement.Key findings in Paper II• There was a strong correlation between irregularity at one- and seven-years post-retention. Stable cases one-year post-retention were stable and unstable cases deteriorated with time.Key findings in Paper III• All three retention methods showed equally effective retention capacity and all the changes found in the three groups were small and considered clinically insignificant. Thus, the null hypothesis was confirmed. All three methods can be recommended.Key findings in Paper IV• Changes between the retention and the non-retention group were statistically but not clinically significant. Since satisfactory clinical results one-year post-treatment were found in the non-retention group, retention does not appear always to be needed.• Most of the changes occur within the first 10-week period after treatment with no retention.Key conclusions and clinical implicationsBoth removable and bonded retainers are effective for holding teeth inposition and can be used for preventing the relapse. It can be enough toretain with bonded retainer 12-22 instead of 13-23. It might be possibleto avoid retention in selected cases in the short-term, but a longer evaluationperiod is needed.
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| 5. |
- Naraghi, Sasan, et al.
(författare)
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Stability of maxillary anterior teeth after two years of retention in adolescents : a randomised controlled trial comparing two bonded and a vacuum-formed retainer
- 2021
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Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 43:2, s. 152-158
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Tidskriftsartikel (refereegranskat)abstract
- Background: Retention of the maxillary anterior teeth is commonly recommended to maintain the teeth in their corrected positions. Both fixed and removable retention methods are used, but the certainty of evidence is low.Objective: To evaluate post-treatment changes in irregularity of the maxillary six anterior teeth and single tooth contact point discrepancy (CPD) of three different retention methods.Trial design: Three-arm parallel group single-centre randomized controlled trial.Materials and methods: Ninety patients, 54 girls and 36 boys, were recruited to the study. The inclusion criteria were adolescent patients treated with fixed appliances at least in the maxilla. After gaining informed consent from the patient and their custodians, the patients were randomized to one of three groups: bonded retainer 13–23, bonded retainer 12–22, and removable vacuum-formed retainer (VFR) covering the maxillary teeth including the second molars. The randomization, prepared by an independent person, used blocks of 30. The primary outcomes were changes in single CPD and Little’s irregularity index (LII) measured on digitalized three-dimensional study casts before and after 2-year retention. The study casts were anonymized before assessment and the changes were blinded for the assessor. Data were evaluated on an intention-to-treat basis. Thus, all randomized patients were incorporated into the final analysis.Results: The LII and CPDs increased slightly in all three groups without any statistically significant differences between the groups. The VFR group showed a small intercanine width increase and some more changes of canine rotations than in the other groups.Harms: No harm was observed in any subjects and none of the patients needed retreatment.Limitations: The trial was a single-centre study and short-term changes were evaluated.Conclusions: All three retention methods showed equally effective retention capacity and all the changes found in the three groups were small and considered clinically insignificant. Thus, the null hypothesis was confirmed. All three methods can be recommended.Trial registration: NCT04616755
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| 6. |
- Naraghi, Sasan, et al.
(författare)
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Stability of maxillary anterior teeth during retention and 1 year after removal of retention—an RCT on adolescents retained with two different bonded retainers and a vacuum-formed retainer
- 2023
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Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 45:6, s. 629-636
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Tidskriftsartikel (refereegranskat)abstract
- Background: Maxillary bonded and removable retainers maintain teeth in correct positions following orthodontic treatment. There is insufficient evidence regarding the capacity of the retention methods to stabilize the maxillary teeth both during and after retention.Objective: To evaluate retention capacity and 1-year post-retention changes in the irregularity of maxillary anterior teeth and single anterior tooth contact point discrepancy (CPD) of two bonded and one removable retention method.Trial design: Three-arm parallel group single-centre randomized controlled trial.Methods: Ninety adolescent patients treated with fixed orthodontic appliances were enrolled. After gaining informed consent, the patients were randomized in blocks of 30 by an independent person into one of three groups: A) bonded retainer 13-23; B) bonded retainer 12-22; and C) removable vacuum-formed retainer. The primary outcomes were changes in Little's irregularity index (LII) and single CPD measured on digitalized casts before retention (T1), after 2 years of retention (T2), and 1-year post-retention (T3).Blinding: The digital casts were blinded for the outcome assessor.Results: Data on all 90 patients were analysed according to intention-to-treat principles. Changes in LII during retention were 0.3 mm in group A, 0.6 mm in group B, and 1.0 mm in group C. No significant differences between the groups were seen (P > 0.05). Changes during post-retention were 1.1 mm in group A, 0.5 mm in group B, and 0.4 mm in group C. Group A showed more significant changes than groups B and C (P = 0.003). During the whole post-treatment period, no significant differences were shown between the groups (P > 0.05). CPD did not differ significantly between the groups at any point.Harms: Three patients showed changes of LII over 3 mm or CPD over 2 mm during the post-retention period, and two accepted to be realigned.Limitations: The trial was a single-centre study evaluating 1-year post-retention changes.Conclusions: The changes were clinically insignificant during and after the retention period. Thus, all three methods showed equal retention capacity.Trial registration: www.clinicaltrials.com (NCT04616755).
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| 7. |
- Sonesson, Mikael, et al.
(författare)
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Cost analysis of two types of fixed maxillary retainers and a removable vacuum-formed maxillary retainer : a randomized controlled trial
- 2022
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Ingår i: European Journal of Orthodontics. - : Oxford University Press. - 0141-5387 .- 1460-2210. ; 44:2, s. 197-202
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There has been an increased interest in conducting healthcare economic evaluations. Also, orthodontic treatments have gathered focus from an economic point of view, however orthodontic research seldom examines both clinical and economic outcomes.OBJECTIVE: To evaluate and compare the costs of three retention methods: a bonded retainer to the maxillary four incisors, a bonded retainer to the maxillary four incisors and canines, and a removable vacuum-formed retainer (VFR) in the maxilla. The null hypothesis was that there was no difference in costs for the three types of retention methods.TRIAL DESIGN: Three-arm, parallel group, single-centre, randomized controlled trial.MATERIALS AND METHODS: Ninety adolescent patients, 54 girls and 36 boys, treated with fixed or removable retainers in the maxilla, were recruited to the study. The patients were randomized in blocks of 30, by an independent person, to one of three groups: bonded multistranded PentaOne (Masel Orthodontics) retainer 13-23, bonded multistranded PentaOne (Masel Orthodontics) retainer 12-22, and removable VFR. A cost analysis was made regarding chair time costs based on the costs per hour for the specialist in orthodontics, and material costs plus any eventual costs for repairs of the appliance. Changes in Little's irregularity index and in single contact point discrepancies (CPDs) were measured on digitalized three-dimensional study casts. Data were evaluated on an intention-to-treat basis. The analysis was performed at 2 years of retention.RESULTS: No statistically significant difference in costs between the maxillary fixed retainers and the VFRs was found, however, the material and emergency costs were significantly higher for the VFR compared with the bonded retainers. All three retention methods showed equally effective retention capacity, and no statistically significant differences in irregularity or CPDs of the maxillary anterior teeth in the three groups was detected.LIMITATIONS: It was a single-centre trial, and hence less generalizable. Costs depended on local factors, and consequently, cannot be directly transferred to other settings.CONCLUSIONS: All three retention methods can be recommended when considering costs and retention capacity.TRIAL REGISTRATION: NCT04616755.
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