Title In an Orthodontic Patient, There is no Significant Difference in Tooth Movement When Using Either a Mandibular Fixed Retainer or a Removable Retainer
Clinical Question In an orthodontic patient, will a mandibular lingual fixed retainer be better option in preventing tooth movement in comparison to removable retainers?
Clinical Bottom Line Although tooth movement can be observed with both removable and fixed retainers, the amount of movement is not significantly different. This is based on randomized controlled trial done on 58 patients, 29 with fixed retainers and 29 with removable retainers. Therefore only considering prevention of tooth movement, both types of retainers will be effective.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
18004927Atack/2007Two groups of 29 patients were identified Randomized controlled trial
Key resultsUsing Little’s index to measure tooth movement there was significant changes in both patient groups (p=.0010), but there was no statistically significant difference in the amount of change in Little’s index between fixed and removable retainer groups. (p=.13)
Evidence Search fixed[All Fields] AND removable[All Fields] AND ("orthodontic retainers"[MeSH Terms] OR ("orthodontic"[All Fields] AND "retainers"[All Fields]) OR "orthodontic retainers"[All Fields])
Comments on
The Evidence
The study design published by Atack et. al., was a randomized controlled trial. All the groups were similar at the start and had over 80% completion rate. The groups were also double blinded, treated the same, had adequate follow up, and adequately complied. Recall bias was not applicable for this article and there was no statement provided regarding competing interests.
Applicability The subjects used for this study are very representative of patients you will encounter in your dental practice. A factor that would limit the applicability of this study is that they some patients will show difficulty in compliance when wearing their removable retainers. Other factors should be considered when choosing the retainer type, such as oral hygiene and periodontal health.
Specialty (Orthodontics)
Keywords Orthodontics, fixed retainers, removable retainers, tooth movement
ID# 2400
Date of submission 03/19/2013
E-mail delgadome@livemail.uthscsa.edu
Author Mellina Delgado
Co-author(s) e-mail
Faculty mentor Clarence C. Bryk, DDS, MS
Faculty mentor e-mail Brykc@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?)
None available
Comments and Evidence-Based Updates on the CAT
None available