Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea.
BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea.
Orthod Craniofac Res. 2024 Dec;27(6):928-937. doi: 10.1111/ocr.12837. Epub 2024 Jul 23.
The aim of this study was to evaluate retention efficacy by assessing retention stability and patient perspectives according to type of circumferential retainer: the wrap-around circumferential retainer (WCR) and customized clear retainer (CCR).
This cohort follow-up study involved 52 patients aged 18-62 who underwent fixed-appliance orthodontic treatment without extractions or orthognathic surgery. Following screening consenting participants were divided into WCR and CCR groups. All participants before follow-up received fixed retainers for the upper and lower anteriors and respective removable retainers within 2 weeks post-debond. Intraoral scans and lateral cephalograms were taken immediately after debonding (T0) and again 12 months later. Dentoalveolar changes in several measurements were compared to evaluate retention efficacy. Surveys were conducted at 1 month (T1) and 12 months (T2) post-debonding to assess changes in patient experiences. Outcome assessments were blinded. Paired T-tests and independent T-tests were used for intragroup and intergroup comparisons of dentoalveolar measurements, respectively. Survey responses were analysed using the Pearson Chi-Square test.
The final assessment included 32 participants. Model analysis revealed no significant differences between the groups, except for maxillary intermolar width (p = .033). In the WCR group, the cephalometric analysis indicated a significant increase in the incisor mandibular plane angle (p = .002) and a decrease in the interincisal angle (p = .014), while changes in the CCR group were statistically non-significant. Patient attitude evaluation showed similar trends for wear time and overall satisfaction. However, a higher percentage of respondents in the WCR group reported irritation when wearing the retainers (p = .037) at T1 and discomfort related to speech (p = .038) at T2.
CCR showed better retention efficacy in terms of lower incisor inclination. Patients experienced relatively less irritation and speech discomfort with CCRs.
本研究旨在通过评估保留稳定性和患者观点来评估保留效果，根据环形保持器的类型进行评估：环绕式环形保持器（WCR）和定制透明保持器（CCR）。
这是一项队列随访研究，涉及 52 名年龄在 18-62 岁之间的患者，他们接受了固定矫治器正畸治疗，没有拔牙或正颌手术。经过筛选并同意后，参与者被分为 WCR 和 CCR 组。所有参与者在随访前都在上前牙和相应的可摘保持器上佩戴固定保持器，在去粘接后 2 周内。在去粘接时（T0）立即进行口腔内扫描和侧位头颅侧位片拍摄，并在 12 个月后再次拍摄。比较了几个测量值的牙牙槽变化，以评估保留效果。在去粘接后 1 个月（T1）和 12 个月（T2）进行调查，以评估患者体验的变化。结果评估是盲法的。分别使用配对 T 检验和独立 T 检验对内组和外组的牙牙槽测量值进行比较。使用 Pearson 卡方检验分析调查响应。
最终评估包括 32 名参与者。模型分析显示，除上颌尖牙间宽度（p=0.033）外，两组之间无显著差异。在 WCR 组中，头影测量分析显示切牙下颌平面角显著增加（p=0.002），切牙间角减小（p=0.014），而 CCR 组的变化无统计学意义。患者态度评估显示，佩戴时间和整体满意度的趋势相似。然而，WCR 组在佩戴保持器时出现刺激的受访者比例较高（p=0.037），在 T1 时出现与言语相关的不适（p=0.038）。
CCR 在下前牙倾斜方面表现出更好的保留效果。患者佩戴 CCR 时相对较少出现刺激和言语不适。
