RESUMO
ABSTRACT Introduction: Fixed orthodontic retainers are very important for treatment stability; however, adverse effects on the health of periodontium can be caused as a result of deposition of plaque and calculus. Objectives: To compare and determine the effects of two mandibular fixed lingual retainers on the periodontal status, and to test the null hypothesis that there would be no significant difference on the periodontium health between the patients using fiber-reinforced composite (FRC) or multistranded wire (MSW) fixed retainers. Methods: A total of 60 subjects were recruited, out of which 6 were excluded and 2 dropped out during the study. Hence, 52 subjects with mean age of 21.5 ± 3.6 years were included in the study. The sample was composed by 8 males (15.4%) and 44 females (84.6%). The participants were randomly divided into two groups: Group 1 received fiber-reinforced composite retainer, while Group 2 received multistranded wire retainer. After insertion, plaque index, calculus index, gingival index and bleeding on probing were compared, after three months (T1), six months (T2), nine months (T3) and twelve months (T4), using Mann-Whitney test with p-value ≤ 0.05 as significant. Results: It could be seen that the health of periodontium deteriorated with the passage of time from T1 to T4 in both group of retainers. However, no statistically significant differences were found between the two groups (p> 0.05). Conclusion: The results of the study indicate that there was no significant difference on the health of periodontium between the patients with FRC and MSW fixed retainers, hence, the null hypothesis was accepted.
RESUMO Introdução: As contenções ortodônticas fixas são muito importantes para a estabilidade do tratamento; no entanto, elas podem causar efeitos adversos na saúde do periodonto, como resultado da deposição de placa e cálculo. Objetivos: Comparar e determinar os efeitos na saúde periodontal de duas contenções inferiores coladas por lingual, e testar a hipótese nula de que não haveria diferença significativa na saúde periodontal entre os pacientes usando contenções fixas de compósito reforçado com fibra (FRC) ou de fio multitrançado (MSW). Métodos: No total, 60 indivíduos foram recrutados, dos quais 6 foram excluídos e 2 desistiram durante o estudo. Assim, foram incluídos no estudo 52 indivíduos com média de idade de 21,5 ± 3,6 anos. A amostra foi composta por 8 homens (15,4%) e 44 mulheres (84,6%). Os participantes foram divididos aleatoriamente em dois grupos: O Grupo 1 recebeu contenção de compósito reforçado com fibra, enquanto o Grupo 2 recebeu contenção de fio multitrançado. Após três meses (T1), seis meses (T2), nove meses (T3) e doze meses (T4) da colagem, foram comparados os índices de placa e de cálculo, índice gengival e sangramento à sondagem, usando o teste de Mann-Whitney com p ≤ 0,05 como significativo. Resultados: Pôde-se observar que a saúde periodontal piorou com o passar do tempo, de T1 a T4, em ambos os grupos de contenções. No entanto, não foram encontradas diferenças estatisticamente significativas entre os dois grupos (p> 0,05). Conclusão: Os resultados do estudo indicam que não houve diferença significativa na saúde periodontal entre os pacientes com contenções fixas FRC e MSW; portanto, a hipótese nula foi aceita.
RESUMO
Orthodontists must fully inform patients about the implications of orthodontic treatment and the subsequent need for retention. This review provides an update on relapse, unwanted movements and different factors that can cause loss of stability following orthodontic treatment. Since it is difficult to predict which patients will present some degree of loss of stability after treatment, it is important that they be treated as if they have a high potential for relapse. The present review included a bibliographic search in the main sources of scientific review including Medline via PubMed, Scopus and the Cochrane library. The search strategy was carried out until May 5, 2022. Only 34 studies fulfilling the selection criteria. Our results showed that maintaining teeth in the correct position following orthodontic treatment is a great challenge for orthodontists. The etiology of relapse is complex and not yet clearly established. Its origin is attributed to factors such as the time of gingival and periodontal tissue reorganization and changes produced by growth, compromising the stability of the results achieved with orthodontic treatment. The retention phase is necessary after orthodontic treatment to avoid relapse or loss of the occlusion results obtained. However, fixed retainers may induce unwanted tooth movement that may occur despite these retainers being attached and intact. There is currently no consensus among orthodontists regarding the ideal type of wire for fixed containment. We concluded that post-orthodontic treatment relapse is the result of a regression towards the original malocclusion. However, changes in the position of the teeth can also occur, which are considered as unwanted movements and have a multifactorial origin.
Los ortodoncistas deben informar completamente a los pacientes sobre las implicaciones del tratamiento de ortodoncia y la subsiguiente necesidad de retención. Esta revisión brinda una actualización sobre las recidivas, los movimientos no deseados y los diferentes factores que pueden causar la pérdida de estabilidad después del tratamiento de ortodoncia. Dado que es difícil predecir qué pacientes presentarán algún grado de pérdida de estabilidad después del tratamiento, es importante que sean tratados como si tuvieran un alto potencial de recaída. La presente revisión incluyó una búsqueda bibliográfica en las principales fuentes de revisión científica, incluyendo Medline vía PubMed, Scopus y la biblioteca Cochrane. La estrategia de búsqueda se llevó a cabo hasta el 5 de mayo de 2022. Solo 34 estudios cumplieron con los criterios de selección. Nuestros resultados mostraron que mantener los dientes en la posición correcta después del tratamiento de ortodoncia es un gran desafío para los ortodoncistas. La etiología de la recaída es compleja y aún no está claramente establecida. Su origen se atribuye a factores como el tiempo de reorganización del tejido gingival y periodontal, y a los cambios producidos por el crecimiento, comprometiendo la estabilidad de los resultados alcanzados con el tratamiento de ortodoncia. La fase de retención es necesaria después del tratamiento de ortodoncia para evitar la recaída o la pérdida de los resultados de oclusión obtenidos. Sin embargo, los retenedores fijos pueden inducir un movimiento dental no deseado que puede ocurrir a pesar de que estos retenedores estén colocados e intactos. Actualmente, no hay consenso entre los ortodoncistas con respecto al tipo de alambre ideal para la contención fija. Concluimos que la recidiva postratamiento de ortodoncia es el resultado de una regresión hacia la maloclusión original. Sin embargo, también pueden ocurrir cambios en la posición de los dientes que se consideran movimientos no deseados y tienen un origen multifactorial.