Comparison of Efficiency and Effectiveness of Two Types of Bonded Orthodontic Retainers: an RCT.

NCT ID: NCT05250765

Last Updated: 2023-12-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

114 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-01

Study Completion Date

2023-09-01

Brief Summary

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Comparson of efficiency and effectiveness of twisted/coaxial and linked retainers, placed under relative versus absolute isolation.

Detailed Description

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The domain of orthodontic retention is controversial. Orthodontic retention is the final step in an orthodontic procedure, and is performed after removal of the orthodontic appliance. Its goal is to prevent the relapse in occlusion or positioning of the teeth. Every patient will need some form of retention to maintain the ideal result. The bonded retainer is frequently used in the lower incisor region. It is capable to prevent relapse of orthodontic treatment but prevents tertiary crowding as well. Advantages of fixed retainers are in general no need for compliance and optimal aesthetics. The retention wire can stay in place for many years. Currently, there is a tendency towards lifelong retention. Disadvantages are more plaque and calculus accumulation, and possibly a poorer periodontal index.

Many types of bonded retainers with different properties could be bonded, each with different effects on periodontal health, potentially a different ability to maintain alignment, and different amounts of failure.

Different types of failure of fixed bonded retainers are possible. When the retainer does not stay in place and is debonded, this is is described as failure. It is also possible the retainer maintains bonded but shows unwanted tooth movement in the bonded teeth. This can also be described as a failure.

Bonding of the retention wire is a technique sensitive process. Correct and passive bonding could prevent debonding of the retainers. To eliminate moisture in the bonding process, it is possible to place a rubberdam before bonding the retainer.

One aim of this study is to compare two types of bonded retainer: the standard coaxial or twisted retainer. The other aim is to compare two bonding protocols with and without rubberdam isolation

Two general PICO questions can be formulated:

In an orthodontic patient (P), will fixed retention with a Ortho-flextech tm (Reliance orthodontic products, Itasca III, USA) (I) as compared to a 0.0195 in dead-soft coaxial wire (Respond; Ormco, Orange, Calif). (C) result in a more effective or efficient retention treatment (O)?

In an orthodontic patient (P), will placement of the retainer with rubber dam (I) result in less debonding (O) as compared to relative isolation with cotton rolls (C)?

Efficiency: is the procedure faster or cheaper than the alternative? Effectiveness: is the procedure better in maintaining the end result of treatment than the alternative? Are there less biomechanical or biological side effects?

Conditions

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Keywords

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Orthodontic retainers Isolation Bonding Twistflex retainer Coaxial retainer OrthoflexTech retainer Fixed retainer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

4 study groups are possible (2 types of retainers and 2 types of bonding protocol)
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Bonding with rubberdam

The retainer is bonded under rubber dam isolation

Group Type EXPERIMENTAL

Twistflex retainer

Intervention Type DEVICE

twisted 0.0195 dead-soft coaxial wire (Respond; Ormco, Orange, Calif)

Orthoflex retainer

Intervention Type DEVICE

Ortho-flextech (Reliance orthodontic products, Itasca III, USA)

Bonding under relative isolation

The retainer is bonded under relative isolation (hygrophormic suction, cotton pads)

Group Type ACTIVE_COMPARATOR

Twistflex retainer

Intervention Type DEVICE

twisted 0.0195 dead-soft coaxial wire (Respond; Ormco, Orange, Calif)

Orthoflex retainer

Intervention Type DEVICE

Ortho-flextech (Reliance orthodontic products, Itasca III, USA)

Interventions

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Twistflex retainer

twisted 0.0195 dead-soft coaxial wire (Respond; Ormco, Orange, Calif)

Intervention Type DEVICE

Orthoflex retainer

Ortho-flextech (Reliance orthodontic products, Itasca III, USA)

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Fixed orthodontic appliances upper and lower jaw
* Patient stays for 2 years in Belgium
* Parents consent
* Proper oral hygiene

Exclusion Criteria

* Orthognathic surgery
* Craniofacial disorders
* Cleft lip palate patients
* Orthodontic treatment without fixed appliances
* Extra retention other than bonded wire in the lower jaw
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University Hospital, Ghent

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Guy De Pauw, Prof

Role: STUDY_CHAIR

Head of orthodontics

Locations

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University of Ghent

Ghent, , Belgium

Site Status

Countries

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Belgium

References

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Stormann I, Ehmer U. A prospective randomized study of different retainer types. J Orofac Orthop. 2002 Jan;63(1):42-50. doi: 10.1007/s00056-002-0040-6. English, German.

Reference Type BACKGROUND
PMID: 11974451 (View on PubMed)

Engeler OG, Dalstra M, Arnold DT, Steineck M, Verna C. In vitro comparison of the torsional load transfer of various commercially available stainless-steel wires used for fixed retainers in orthodontics. J Orthod. 2021 Jun;48(2):118-126. doi: 10.1177/1465312520972402. Epub 2020 Nov 24.

Reference Type BACKGROUND
PMID: 33231109 (View on PubMed)

Ferreira LA, Sapata DM, Provenzano MGA, Hayacibara RM, Ramos AL. Periodontal parameters of two types of 3 x 3 orthodontic retainer: a longitudinal study. Dental Press J Orthod. 2019 Aug 1;24(3):64-70. doi: 10.1590/2177-6709.24.3.064-070.oar.

Reference Type BACKGROUND
PMID: 31390451 (View on PubMed)

Sifakakis I, Eliades T, Bourauel C. Residual stress analysis of fixed retainer wires after in vitro loading: can mastication-induced stresses produce an unfavorable effect? Biomed Tech (Berl). 2015 Dec;60(6):617-22. doi: 10.1515/bmt-2015-0013.

Reference Type BACKGROUND
PMID: 26057215 (View on PubMed)

Liebenberg WH. Extending the use of rubber dam isolation: alternative procedures. Part II. Quintessence Int. 1993 Jan;24(1):7-17.

Reference Type BACKGROUND
PMID: 8511260 (View on PubMed)

Arnold DT, Dalstra M, Verna C. Torque resistance of different stainless steel wires commonly used for fixed retainers in orthodontics. J Orthod. 2016 Jun;43(2):121-9. doi: 10.1080/14653125.2016.1155814. Epub 2016 Apr 22.

Reference Type BACKGROUND
PMID: 27104351 (View on PubMed)

Arnone R. Bonding orthodontic lower 3 to 3 retainers with a rubber dam: a second generation step-by-step procedure. Am J Orthod Dentofacial Orthop. 1999 Oct;116(4):432-4. doi: 10.1016/s0889-5406(99)70229-5.

Reference Type BACKGROUND
PMID: 10511672 (View on PubMed)

Aldrees AM, Al-Mutairi TK, Hakami ZW, Al-Malki MM. Bonded orthodontic retainers: a comparison of initial bond strength of different wire-and-composite combinations. J Orofac Orthop. 2010 Jul;71(4):290-9. doi: 10.1007/s00056-010-9947-5. Epub 2010 Jul 30. English, German.

Reference Type BACKGROUND
PMID: 20676816 (View on PubMed)

Other Identifiers

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BC-08508

Identifier Type: -

Identifier Source: org_study_id