Vacuum-formed Retainer Versus Bonded Retainer to Prevent Relapse After Orthodontic Treatment

NCT ID: NCT03070444

Last Updated: 2022-08-09

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

104 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-11-12

Study Completion Date

2021-06-18

Brief Summary

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The purpose of this trial is to evaluate and compare stability after orthodontic treatment with an Essix retainer and a bonded cuspid-to-cuspid retainer (CTC), respectively in the mandibular arch and longitudinally follow these patients over time up to 5 years. The patients' perceptions of the two methods are also evaluated with questionnaires during the follow-up period.

A further aim of this study is to analyze the relationship between diagnosis, treatment outcome, treatment time, age at start of treatment and stability with an Essix retainer in the maxilla.

The null hypotheses are:

* that there is no difference in retention capacity between Essix retainer and cuspid-to-cuspid retainer
* that there is no difference in patients' perception between Essix retainer and cuspid-to-cuspid retainer
* that there is no difference in retention capacity for Essix retainer in the maxilla concerning diagnosis before treatment, treatment outcomes, treatment time and age at start of treatment

Detailed Description

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The study is conducted at the Orthodontic Clinic, Gävle, Sweden and consists of 104 patients. All patients are treated with fixed appliances in the upper and lower jaw (standard .022 straight wire), both with and without extractions. The patients are randomized into two groups with 52 patients in each group (Group A: cuspid-to-cuspid retainer, Group B: Essix retainer).

Dental cast are obtained at the debond appointment (T1) and at the follow-up controls after six months (T2), 18 months (T3) and 60 months (T4) for both groups.

At the visit two weeks in retention and at the follow-up visits after 6, 18 and 60 months the patients assess questionnaires in order to evaluate their experience of retention with the retention device.

Conditions

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Orthodontics Retention

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Group A: CTC retainer + Essix retainer

The CTC is bonded directly after debonding. The Essix retainer maxilla is handed out to the patient the same day after removal of fixed appliances.

Alginate impressions are taken at the follow-up visits. Questionnaires are completed at the follow-up visits.

Group Type EXPERIMENTAL

Questionnaire

Intervention Type OTHER

A questionnaire is completed at the follow-up visits.

CTC retainer

Intervention Type DEVICE

The CTC retainer consists of 0.8 hard Remanium® wire (Dentaurum, Germany) and is bonded with Tetric Flow (Ivoclar Vivadent, Liechtenstein) to the lower canines directly after debonding.

Essix retainer maxilla

Intervention Type DEVICE

The Essix retainer is made of 1 mm Essix C+® Plastic (Dentsply, USA) and is handed out to the patient the same day after removal of fixed appliances.

Alginate impression

Intervention Type PROCEDURE

Alginate impressions are taken to made the cuspid-to-cuspid and Essix retainers, respectively. Dental casts are obtained at the debond appointment and at the follow-up visits after 6, 18 and 60 months.

Group B: Essix retainer + Essix retainer

The Essix retainer maxilla and Essix retainer mandible are handed out to the patient the same day after removal of fixed appliances.

Alginate impressions are taken at the follow-up visits. Questionnaires are completed at the follow-up visits.

Group Type ACTIVE_COMPARATOR

Questionnaire

Intervention Type OTHER

A questionnaire is completed at the follow-up visits.

Essix retainer maxilla

Intervention Type DEVICE

The Essix retainer is made of 1 mm Essix C+® Plastic (Dentsply, USA) and is handed out to the patient the same day after removal of fixed appliances.

Essix retainer mandible

Intervention Type DEVICE

The Essix retainer is made of 1 mm Essix C+® Plastic (Dentsply, USA) and is handed out to the patient the same day after removal of fixed appliances.

Alginate impression

Intervention Type PROCEDURE

Alginate impressions are taken to made the cuspid-to-cuspid and Essix retainers, respectively. Dental casts are obtained at the debond appointment and at the follow-up visits after 6, 18 and 60 months.

Interventions

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Questionnaire

A questionnaire is completed at the follow-up visits.

Intervention Type OTHER

CTC retainer

The CTC retainer consists of 0.8 hard Remanium® wire (Dentaurum, Germany) and is bonded with Tetric Flow (Ivoclar Vivadent, Liechtenstein) to the lower canines directly after debonding.

Intervention Type DEVICE

Essix retainer maxilla

The Essix retainer is made of 1 mm Essix C+® Plastic (Dentsply, USA) and is handed out to the patient the same day after removal of fixed appliances.

Intervention Type DEVICE

Essix retainer mandible

The Essix retainer is made of 1 mm Essix C+® Plastic (Dentsply, USA) and is handed out to the patient the same day after removal of fixed appliances.

Intervention Type DEVICE

Alginate impression

Alginate impressions are taken to made the cuspid-to-cuspid and Essix retainers, respectively. Dental casts are obtained at the debond appointment and at the follow-up visits after 6, 18 and 60 months.

Intervention Type PROCEDURE

Other Intervention Names

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Fixed retainer Bonded retainer Removable retainer Vacuum-formed retainer Removable retainer Vacuum-formed retainer

Eligibility Criteria

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Inclusion Criteria

* Patients treated with fixed appliances in both the maxilla and the mandible

Exclusion Criteria

* Rapid Maxillary Expansion (RME) for patients with severe transversal malocclusion
* Treatment with segmented appliances
* Patients with craniofacial anomalies and patients requiring orthognatic surgery
* Patients with missing mandibular incisor
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Umeå University

OTHER

Sponsor Role collaborator

Region Gävleborg

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anke Krämer, DDS

Role: PRINCIPAL_INVESTIGATOR

Folktandvården Gävleborg AB, Specialisttandvården ortdonti

References

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Atack N, Harradine N, Sandy JR, Ireland AJ. Which way forward? Fixed or removable lower retainers. Angle Orthod. 2007 Nov;77(6):954-9. doi: 10.2319/103106-449.1.

Reference Type BACKGROUND
PMID: 18004927 (View on PubMed)

Bennett ME, Tulloch JF. Understanding orthodontic treatment satisfaction from the patients' perspective: a qualitative approach. Clin Orthod Res. 1999 May;2(2):53-61. doi: 10.1111/ocr.1999.2.2.53.

Reference Type BACKGROUND
PMID: 10534980 (View on PubMed)

Feldmann I, List T, John MT, Bondemark L. Reliability of a questionnaire assessing experiences of adolescents in orthodontic treatment. Angle Orthod. 2007 Mar;77(2):311-7. doi: 10.2319/0003-3219(2007)077[0311:ROAQAE]2.0.CO;2.

Reference Type BACKGROUND
PMID: 17319767 (View on PubMed)

Feldmann I, List T, Bondemark L. Orthodontic anchoring techniques and its influence on pain, discomfort, and jaw function--a randomized controlled trial. Eur J Orthod. 2012 Feb;34(1):102-8. doi: 10.1093/ejo/cjq171. Epub 2011 Feb 7.

Reference Type BACKGROUND
PMID: 21300723 (View on PubMed)

Hichens L, Rowland H, Williams A, Hollinghurst S, Ewings P, Clark S, Ireland A, Sandy J. Cost-effectiveness and patient satisfaction: Hawley and vacuum-formed retainers. Eur J Orthod. 2007 Aug;29(4):372-8. doi: 10.1093/ejo/cjm039.

Reference Type BACKGROUND
PMID: 17702797 (View on PubMed)

Jaderberg S, Feldmann I, Engstrom C. Removable thermoplastic appliances as orthodontic retainers--a prospective study of different wear regimens. Eur J Orthod. 2012 Aug;34(4):475-9. doi: 10.1093/ejo/cjr040. Epub 2011 Apr 20.

Reference Type BACKGROUND
PMID: 21508267 (View on PubMed)

Lindauer SJ, Shoff RC. Comparison of Essix and Hawley retainers. J Clin Orthod. 1998 Feb;32(2):95-7. No abstract available.

Reference Type BACKGROUND
PMID: 9709631 (View on PubMed)

Littlewood SJ, Millett DT, Doubleday B, Bearn DR, Worthington HV. Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database Syst Rev. 2016 Jan 29;2016(1):CD002283. doi: 10.1002/14651858.CD002283.pub4.

Reference Type BACKGROUND
PMID: 26824885 (View on PubMed)

Kumar AG, Bansal A. Effectiveness and acceptability of Essix and Begg retainers: a prospective study. Aust Orthod J. 2011 May;27(1):52-6.

Reference Type BACKGROUND
PMID: 21696115 (View on PubMed)

Reitan K. Clinical and histologic observations on tooth movement during and after orthodontic treatment. Am J Orthod. 1967 Oct;53(10):721-45. doi: 10.1016/0002-9416(67)90118-2. No abstract available.

Reference Type BACKGROUND
PMID: 5233926 (View on PubMed)

Renkema AM, Al-Assad S, Bronkhorst E, Weindel S, Katsaros C, Lisson JA. Effectiveness of lingual retainers bonded to the canines in preventing mandibular incisor relapse. Am J Orthod Dentofacial Orthop. 2008 Aug;134(2):179e1-8. doi: 10.1016/j.ajodo.2008.06.003.

Reference Type BACKGROUND
PMID: 18675196 (View on PubMed)

Rowland H, Hichens L, Williams A, Hills D, Killingback N, Ewings P, Clark S, Ireland AJ, Sandy JR. The effectiveness of Hawley and vacuum-formed retainers: a single-center randomized controlled trial. Am J Orthod Dentofacial Orthop. 2007 Dec;132(6):730-7. doi: 10.1016/j.ajodo.2006.06.019.

Reference Type BACKGROUND
PMID: 18068589 (View on PubMed)

Sheridan JJ, LeDoux W, McMinn R. Essix retainers: fabrication and supervision for permanent retention. J Clin Orthod. 1993 Jan;27(1):37-45. No abstract available.

Reference Type BACKGROUND
PMID: 8478438 (View on PubMed)

Thickett E, Power S. A randomized clinical trial of thermoplastic retainer wear. Eur J Orthod. 2010 Feb;32(1):1-5. doi: 10.1093/ejo/cjp061. Epub 2009 Oct 14.

Reference Type BACKGROUND
PMID: 19828592 (View on PubMed)

Yu Y, Sun J, Lai W, Wu T, Koshy S, Shi Z. Interventions for managing relapse of the lower front teeth after orthodontic treatment. Cochrane Database Syst Rev. 2013 Sep 6;2013(9):CD008734. doi: 10.1002/14651858.CD008734.pub2.

Reference Type BACKGROUND
PMID: 24014170 (View on PubMed)

Steegmans PAJ, Cavagnetto D, Reynders RAM. Which orthodontic retention protocol should I implement? A critical assessment of a randomised controlled trial. Evid Based Dent. 2022 Dec;23(4):162-165. doi: 10.1038/s41432-022-0845-7. Epub 2022 Dec 16.

Reference Type DERIVED
PMID: 36526846 (View on PubMed)

Kramer A, Sjostrom M, Apelthun C, Hallman M, Feldmann I. Post-treatment stability after 5 years of retention with vacuum-formed and bonded retainers-a randomized controlled trial. Eur J Orthod. 2023 Feb 10;45(1):68-78. doi: 10.1093/ejo/cjac043.

Reference Type DERIVED
PMID: 35968668 (View on PubMed)

Kramer A, Sjostrom M, Hallman M, Feldmann I. Vacuum-formed retainers and bonded retainers for dental stabilization-a randomized controlled trial. Part II: patients' perceptions 6 and 18 months after orthodontic treatment. Eur J Orthod. 2021 Apr 3;43(2):136-143. doi: 10.1093/ejo/cjaa039.

Reference Type DERIVED
PMID: 32613244 (View on PubMed)

Kramer A, Sjostrom M, Hallman M, Feldmann I. Vacuum-formed retainer versus bonded retainer for dental stabilization in the mandible-a randomized controlled trial. Part I: retentive capacity 6 and 18 months after orthodontic treatment. Eur J Orthod. 2020 Nov 3;42(5):551-558. doi: 10.1093/ejo/cjz072.

Reference Type DERIVED
PMID: 31665279 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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CFUG-557411

Identifier Type: -

Identifier Source: org_study_id

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