ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title The Use Of Retention Devices To Decrease Relapse After Orthodontic Treatment
Clinical Question In a patient who has had his teeth moved using orthodontic treatment, would using a retention device decrease tooth movement compared to a patient not using any retention?
Clinical Bottom Line Orthodontic retention devices decrease relapse after large amounts of orthodontic tooth movement by decreasing the mean rate of relapse but not the duration of measurable relapse. After small amounts of orthodontic tooth movement, retention devices showed less or no benefit. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 12648262van Leeuwen/2003Young Adult Beagle Dogs (n=19)Animal Research
Key resultsRetention for 90 days had no effect on the duration of the relapse period thereafter (P = 0.93). It resulted, however, in a significant decrease in the amount of relapse(P < 0.01) and the total mean relapse rate (P < 0.01). As a consequence, relapse, also expressed as a percentage of the active tooth movement, decreased significantly (P < 0.01).A regression line was drawn for a graph of the relationship between active tooth movement and total relapse. The regression line between the non-retention data is steeper than the one through the retention data. This indicates that the effect of retention is higher if more active tooth movement has taken place, and indeed a significant correlation between the amount of active tooth movement and the difference between the two regression lines was found (r = 0.86, P < 0.001). However, if the active tooth movement was less than 2 mm, no significant effect of retention could be found.
Evidence Search Ovid: [orthodontic retainers] [AND] [Recurrence]
Comments on
The Evidence
There is no mention on how the subjects were assigned to each study group. This could be a potential source of bias, although bias seems unlikely in this experiment. Otherwise, the experimental structure was sound with both groups of dogs receiving the same treatment and follow up procedures.
Applicability This study has limited and unknown applicability to human patients.
Specialty/Discipline (Orthodontics)
Keywords Orthodontic Retainers, Recurrence
ID# 860
Date of submission: 04/04/2011spacer
E-mail chon@livemail.uthscsa.edu
Author David Chon
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ridley Ross, DDS
Faculty mentor/Co-author e-mail rossr@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Ryushiro Sugita & Carson Phillips (San Antonio, Texas) on 10/13/2014
A PubMed search on the use of retention devices to decrease relapse after orthodontic treatment was performed October 2014. More recent publications were found: Lassaire 2012, PubMed: 22516027 and Aszkle 2014, PubMed: 24485731. These retrospective comparative studies using 30 subjects each showed that anterior alignment and rotations became worse post-retention, specifically in patients without lower fixed retention device. However, the evidence related to this area is still limited. Further research concerning about several retention devices should be done.
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