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Orthodontic retention protocols: an evidence-based overview


In view of the diversity of orthodontic presentations, a single optimal retention protocol does not exist, with approaches tailored based on pre-treatment characteristics, treatment-induced changes and general patient characteristics. However, orthodontic practitioners should be responsive to the best available evidence to formulate optimal retention protocols in terms of appliance type, design and regimen, in particular. Based on a comprehensive search strategy, we discuss fundamental aspects concerning orthodontic retention of particular interest both to orthodontists and general dentists. These include stability and periodontal outcomes, cost-effectiveness, patient experiences, survival and failure rates of retainers, and the duration of retention.

Key points

  • Prescription of prolonged retention following orthodontics is essentially routine, with part-time wear of removable retainers as effective as full-time wear.

  • Little or no detrimental change to the periodontal health is observed with orthodontic retainers in the short-term or the long-term, except in rare circumstances where inherent activity in the bonded retainer in situ can lead to unwanted tooth movement.

  • Fixed and removable retainers show similar effectiveness in maintaining stability outcomes in the short term; however, superior preservation of alignment may be observed with the former in the longer term.

  • The combined use of both fixed and removable retainers is widely prescribed; however, little is known about the additional benefit over the use of either type in isolation.

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This research was funded by the Deanship of Scientific Research at Princess Nourah bint Abdulrahman University through the Fast-track Research Funding Program.

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Correspondence to Dalya Al-Moghrabi.

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Al-Moghrabi, D., Littlewood, S. & Fleming, P. Orthodontic retention protocols: an evidence-based overview. Br Dent J 230, 770–776 (2021).

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