PERSONALISED RETENTION PLANS: TAILORING RETAINERS THROUGH ADVANCED DIAGNOSTIC METHODS
Main Article Content
Keywords
personalized retention, orthodontic relapse, retainer customization, diagnostics, treatment planning.
Abstract
Orthodontic relapse is a prevalent issue, and it is frequently caused by uniform retention prescriptions that disregard individual risk factors. Despite the advancement of computerized diagnostics, individualization of retainer form and wearing duration is not widely used. This research evaluates a new diagnostic-directed strategy for tailoring retention regimens based on patient-specific anatomic and biomechanical risk factors. To compare the efficacy of individually created retention plans based on sophisticated diagnostics to typical retainer plans in maintaining post-treatment orthodontic stability. 80 patients aged 14-30 years who had completed fixed appliance treatment were randomly assigned to either the tailored or standard retention groups. To stratify the risk of recurrence, the customized group had digital intraoral scanning, Cone-Beam Computed Tomography imaging (CBCT), and 3D cephalometric analysis. Retention plans (type retainer and wear schedule) were also tailored. The control group received a conventional Hawley or Vacuum Formed Retainer (VFR) with the same wear orders. Little's Irregularity Index (LII), cephalometric changes, compliance, and satisfaction were all measured at 6 and 12 months. The personalized group had significantly reduced LII at both time intervals (T1: 1.12 +/- 0.38 mm; T2: 1.36 +/- 0.42 mm) compared to the control group (T1: 1.84 +/- 0.61 mm; T2: 2.24 +/- 0.73 mm; p < 0.001). There were also higher compliance and satisfaction ratings. The risk of relapse model demonstrated strong predictive validity (AUC = 0.87). Using diagnostics to customize orthodontic retention improves post-treatment stability, compliance, and recurrence. This procedure is clinically feasible and should be regarded as a future standard for orthodontic retention treatments.
References
2. Al Rahma, W. J., Kaklamanos, E. G., & Athanasiou, A. E. (2018). Performance of Hawley-type retainers: a systematic review of randomized clinical trials. European Journal of Orthodontics, 40(2), 115-125.
3. Alqerban, A., Willems, G., Bernaerts, C., Vangastel, J., Politis, C., & Jacobs, R. (2014). Orthodontic treatment planning for impacted maxillary canines using conventional records versus 3D CBCT. European journal of orthodontics, 36(6), 698-707.
4. Aragón, M. L., Pontes, L. F., Bichara, L. M., Flores-Mir, C., & Normando, D. (2016). Validity and reliability of intraoral scanners compared to conventional gypsum models measurements: a systematic review. European journal of orthodontics, 38(4), 429-434.
5. Bellini-Pereira, S. A., Aliaga-Del Castillo, A., Dos Santos, C. C. O., Henriques, J. F. C., Janson, G., & Normando, D. (2022). Treatment stability with bonded versus vacuum-formed retainers: a systematic review of randomized clinical trials. European Journal of Orthodontics, 44(2), 187-196.
6. Bianchi, J., Mendonca, G., Gillot, M., Oh, H., Park, J., Al Turkestani, N., ... & Cevidanes, L. (2022). Three-dimensional digital applications for implant space planning in orthodontics: A narrative review. Journal of the World federation of orthodontists, 11(6), 207-215.
7. Bichu, Y. M., Hansa, I., Bichu, A. Y., Premjani, P., Flores-Mir, C., & Vaid, N. R. (2021). Applications of artificial intelligence and machine learning in orthodontics: a scoping review. Progress in orthodontics, 22, 1-11.
8. Demir, A., Babacan, H., Nalcacı, R., & Topcuoglu, T. (2012). Comparison of retention characteristics of Essix and Hawley retainers. The Korean Journal of Orthodontics, 42(5), 255-262.
9. Edman Tynelius, G., Bondemark, L., & Lilja-Karlander, E. (2010). Evaluation of orthodontic treatment after 1 year of retention—a randomized controlled trial. The European Journal of Orthodontics, 32(5), 542-547.
10. Fleming, P. S., & Pandis, N. (2024). Orthodontic retention: Rationale and periodontal implications. Periodontology 2000.
11. Forde, K., Storey, M., Littlewood, S. J., Scott, P., Luther, F., & Kang, J. (2018). Bonded versus vacuum-formed retainers: a randomized controlled trial. Part 1: stability, retainer survival, and patient satisfaction outcomes after 12 months. European Journal of Orthodontics, 40(4), 387-398.
12. Gelin, E., Seidel, L., Bruwier, A., Albert, A., & Charavet, C. (2020). Innovative customized CAD/CAM nickel-titanium lingual retainer versus standard stainless-steel lingual retainer: a randomized controlled trial. Korean Journal of Orthodontics, 50(6), 373-382.
13. Goracci, C., Franchi, L., Vichi, A., & Ferrari, M. (2016). Accuracy, reliability, and efficiency of intraoral scanners for full-arch impressions: a systematic review of the clinical evidence. European journal of orthodontics, 38(4), 422-428.
14. Hussain, U., Kunwar, S. S., Khan, U. W., Alnazeh, A. A., Kamran, M. A., Alam, S., ... & Campobasso, A. (2024). Can vacuum-formed retainers maintain arch dimensions and alignment compared to Hawley and fixed bonded retainers after treatment with fixed appliances? A systematic review and meta-analysis. European journal of orthodontics, 46(5), cjae040.
15. Joda, T., Balmer, M., Jung, R. E., & Ioannidis, A. (2024). Clinical use of digital applications for diagnostic and treatment planning in prosthodontics: A scoping review. Clinical Oral Implants Research, 35(8), 782-792.
16. Kazimierczak, N., Kazimierczak, W., Serafin, Z., Nowicki, P., Nożewski, J., & Janiszewska-Olszowska, J. (2024). AI in orthodontics: Revolutionizing diagnostics and treatment planning—A comprehensive review. Journal of Clinical Medicine, 13(2), 344.
17. Khanagar, S. B., Al-Ehaideb, A., Vishwanathaiah, S., Maganur, P. C., Patil, S., Naik, S., ... & Sarode, S. S. (2021). Scope and performance of artificial intelligence technology in orthodontic diagnosis, treatment planning, and clinical decision-making systematic review. Journal of dental sciences, 16(1), 482-492.
18. Krämer, A., Sjöström, M., Hallman, M., & Feldmann, I. (2020). 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. European Journal of Orthodontics, 42(5), 551-558.
19. Li, B., Xu, Y., Lu, C., Wei, Z., Li, Y., & Zhang, J. (2021). Assessment of the effect of vacuum-formed retainers and Hawley retainers on periodontal health: A systematic review and meta-analysis. PLoS One, 16(7), e0253968.
20. Lippold, C., Kirschneck, C., Schreiber, K., Abukiress, S., Tahvildari, A., Moiseenko, T., & Danesh, G. (2015). Methodological accuracy of digital and manual model analysis in orthodontics–A retrospective clinical study. Computers in biology and medicine, 62, 103-109.
21. Naraghi, S., Ganzer, N., Bondemark, L., & Sonesson, M. (2021). Stability of maxillary anterior teeth after 2 years of retention in adolescents: a randomized controlled trial comparing two bonded and a vacuum-formed retainer. European Journal of Orthodontics, 43(2), 152-158.
22. Qi, J., Kitaura, H., Shen, W. R., Kishikawa, A., Ogawa, S., Ohori, F., ... & Mizoguchi, I. (2019). Establishment of an orthodontic retention mouse model and the effect of anti-c-Fms antibody on orthodontic relapse. PLoS One, 14(6), e0214260.
23. Raucci, G., Elyasi, M., Pachêco-Pereira, C., Grassia, V., d’Apuzzo, F., Flores-Mir, C., & Perillo, L. (2015). Predictors of long-term stability of maxillary dental arch dimensions in patients treated with a transpalatal arch followed by fixed appliances. Progress in Orthodontics, 16, 1-6.
24. Saleh, M., Hajeer, M. Y., & Muessig, D. (2017). Acceptability comparison between Hawley retainers and vacuum-formed retainers in orthodontic adult patients: a single-centre, randomized controlled trial. European Journal of Orthodontics, 39(4), 453-461.
25. Samandara, A., Papageorgiou, S. N., Ioannidou-Marathiotou, I., Kavvadia-Tsatala, S., & Papadopoulos, M. A. (2019). Evaluation of orthodontically induced external root resorption following orthodontic treatment using cone beam computed tomography (CBCT): a systematic review and meta-analysis. European journal of orthodontics, 41(1), 67-79.
26. Sangalli, L., Savoldi, F., Dalessandri, D., Visconti, L., Massetti, F., & Bonetti, S. (2022). Remote digital monitoring during the retention phase of orthodontic treatment: A prospective feasibility study. Korean Journal of Orthodontics, 52(2), 123-130.
27. Shaheen, E., Shujaat, S., Saeed, T., Jacobs, R., & Politis, C. (2019). Three-dimensional planning accuracy and follow-up protocol in orthognathic surgery: a validation study. International journal of oral and maxillofacial surgery, 48(1), 71-76.
28. Steinnes, J., Johnsen, G., & Kerosuo, H. (2017). Stability of orthodontic treatment outcome concerning retention status: an 8-year follow-up. American Journal of Orthodontics and Dentofacial Orthopedics, 151(6), 1027-1033.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Abhishek Sinha
Reader, Department of Orthodontics and Dentofacial Orthopedics, Dr B R Ambedkar Institute of Dental Sciences and Hospital, Patna, Magadh University, Bodh Gaya