Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients: a retrospective study

  • Han, Ji-Young (Division of Periodontology, Department of Dentistry, Hanyang University College of Medicine) ;
  • Park, Seo Hee (Division of Periodontology, Department of Dentistry, Hanyang University Medical Center) ;
  • Kim, Joohyung (Division of Orthodontics, Department of Dentistry, Hanyang University Medical Center) ;
  • Hwang, Kyung-Gyun (Division of Oral & Maxillofacial Surgery, Department of Dentistry, Hanyang University College of Medicine) ;
  • Park, Chang-Joo (Division of Oral & Maxillofacial Surgery, Department of Dentistry, Hanyang University College of Medicine)
  • Received : 2020.05.11
  • Accepted : 2021.03.22
  • Published : 2021.06.30
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Abstract

Purpose: The aim of this study was to evaluate clinical factors affecting the longevity of fixed retainers and the influence of fixed retainers on periodontal health in periodontitis patients. Methods: In total, 52 patients with at least 2 years of follow-up after periodontal and orthodontic treatment were included in this study. After scaling and root planing, orthodontic treatment with fixed appliances or clear aligners was performed. Fixed retainers with twist-flex stainless steel wires were bonded to the palatal or lingual sides of anterior teeth. Changes in clinical parameters, including the plaque index, gingival index, calculus index (CI), probing pocket depth, and radiographic bone levels, were evaluated before bonding of fixed retainers and at a 12-month follow-up. Cumulative survival rates (CSRs) for retainer failure were evaluated according to sex, site, CI, stage of periodontitis, and the severity of the irregularity with the log-rank test and hazard ratios (HRs). Results: Twelve months after bonding of fixed retainers, improvements were observed in all clinical parameters except CI and radiographic bone gain. The overall CSR of the retainers with a CI <1 at the 12-month follow-up after bonding of fixed retainers was significantly higher than that of the retainers with a CI ≥1 at the 12-month follow-up (log-rank test; P<0.001). Patients with stage III (grade B or C) periodontitis had a higher multivariate HR for retainer failure (5.4; 95% confidence interval, 1.22-23.91; P=0.026) than patients with stage I (grade A or B) periodontitis. Conclusions: Although fixed retainers were bonded in periodontitis patients, periodontal health was well maintained if supportive periodontal treatment with repeated oral hygiene education was provided. Nonetheless, fixed retainer failure occurred more frequently in patients who had stage III (grade B or C) periodontitis or a CI ≥1 at 12-month follow-up after bonding of fixed retainers.

Keywords

Acknowledgement

We would like to thank Prof. En-Woo Nam of the Biostatistical Consulting and Research Lab, Hanyang University for assistance with statistical analysis and Seong-Jin Ahn of Hanyang Medical Center for radiographic assistance.

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