Storey Madeleine, Forde Katherine, Littlewood Simon J, Scott Paul, Luther Friedy, Kang Jing
Department of Orthodontics, Leeds Dental Institute, Clarendon Way, UK.
Holywell House Orthodontics, Hinckley, Leicestershire, UK.
Eur J Orthod. 2018 Jul 27;40(4):399-408. doi: 10.1093/ejo/cjx059.
Retainer have the potential to compromise periodontal health.
Evaluate the periodontal health implications of upper and lower bonded retainers (BRs) versus upper and lower vacuum-formed retainers (VFRs) over 12 months.
Two-arm parallel group multicentre randomized controlled clinical trial.
Sixty consecutive patients completing upper and lower fixed appliance therapy and requiring retainers were recruited from three hospital orthodontic departments. They were randomly allocated to either upper and lower labial segment BRs (n = 30) or upper and lower full-arch VFRs (n = 30). Periodontal health was assessed using the plaque and gingival indices of Silness and Loe, and the calculus index of Greene and Vermillion. Data were collected at debond and placement of the retainers (T0), 3 months (T1), 6 months (T2), and 12 months (T3). A random sequence of treatment allocation was computer-generated and implemented by sealing in sequentially numbered opaque sealed envelopes independently prepared in advance. Patients, operators, and outcome could not be blinded due to the nature of the intervention.
Thirty patients received BRs (median age 16 years, interquartile range [IQR] = 2, 50% female, 50% male) and 30 received VFRs (median age 17 years, IQR = 4, 60% female, 40% male). Gingival inflammation decreased from baseline for both types of retainer. There was significantly less plaque and calculus accumulation and better gingival health with VFRs than BRs over the evaluated 12 months. No serious harm was observed.
It is not known how much the patients chose to wear their removable retainers. The results reported are after 1 year only.
After 1 year, BRs were associated with greater accumulation of plaque and calculus than VFRs and minimally worse gingival inflammation than VFRs, but this did not appear to produce any clinically significant, adverse periodontal health problems.
This trial was not registered.
There was no funding.
保持器有可能损害牙周健康。
评估上下颌粘结式保持器(BRs)与上下颌真空成型保持器(VFRs)在12个月内对牙周健康的影响。
双臂平行组多中心随机对照临床试验。
从三个医院正畸科招募了60名连续完成上下颌固定矫治器治疗并需要保持器的患者。他们被随机分配到上下唇侧段BRs组(n = 30)或上下全牙弓VFRs组(n = 30)。使用Silness和Loe的菌斑和牙龈指数以及Greene和Vermillion的牙石指数评估牙周健康状况。在去除矫治器和佩戴保持器时(T0)、3个月(T1)、6个月(T2)和12个月(T3)收集数据。治疗分配的随机序列由计算机生成,并通过密封预先独立准备的顺序编号的不透明密封信封来实施。由于干预的性质,患者、操作者和结果无法设盲。
30名患者接受了BRs(中位年龄16岁,四分位间距[IQR]=2,50%为女性,50%为男性),30名患者接受了VFRs(中位年龄17岁,IQR = 4,60%为女性,40%为男性)。两种类型的保持器牙龈炎症均较基线水平降低。在评估的12个月内,VFRs的菌斑和牙石堆积明显少于BRs,牙龈健康状况更好。未观察到严重危害。
不知道患者佩戴可摘保持器的时间有多长。报告的结果仅为1年后的情况。
1年后,BRs比VFRs的菌斑和牙石堆积更多,牙龈炎症比VFRs略差,但这似乎并未产生任何具有临床意义的不良牙周健康问题。
本试验未注册。
无资金支持。