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Purpose <p>The objective of the present systematic review (SR) was to compare available retainers to determine which one has the highest probability of maintaining a&#xa0;stable post-orthodontic outcome.</p> Methods <p>Electronic platforms were searched up to 20&#xa0;January 2024 to identify randomized controlled trials (RCTs) comparing the efficacy of different retainers in stabilizing post-orthodontic tooth position (PROSPERO no. CRD42023399604). The Cochrane checklist was used for risk of bias assessment. Network meta-analyses (NMA) were conducted for the Little irregularity index (LII), intercanine width (ICW), and intermolar width (IMW) to identify metric ranking markers (highest probability of being the best [PBB], surface under the cumulative ranking curves [SUCRA], and mean ranking [MR]) for the different retention protocols.</p> Results <p>Eighteen RCTs were included in the SR, and&#xa0;15 in the NMA. Seven studies were at high risk of bias, 7&#xa0;at moderate, and 4&#xa0;at low risk of bias. The retainers were categorized into 14&#xa0;groups for analyzing LII, 13&#xa0;for ICW, and&#xa0;8 for IMW. The NMA on LII indicated that computer-aided design/computer-aided manufacturing (CAD/CAM) multistrand stainless steel (SS), followed by laboratory round multistrand SS and rectangular flex SS retainers had the highest PBB in maintaining a&#xa0;low LII. The NMA on ICW suggested that CAD/CAM multistrand SS followed by CAD/CAM NiTi and spring hard SS retainers have the highest PBB in maintaining ICW. Very limited evidence showed a&#xa0;low PBB for removable retainers related to LII and ICW. No difference between groups was observed for IMW.</p> Conclusion <p>There is moderate-to-low quality evidence that CAD/CAM and laboratory-bent multistrand SS followed by rectangular flex SS retainers might be the most effective retention protocol for maintaining a&#xa0;low LII over a&#xa0;short-to-mid-term follow-up, whereas CAD/CAM multistrand SS, CAD/CAM NiTi, and spring-hard wire retainers might be most effective in maintaining ICW. Intermolar width tends to decrease, but this does not seem to be influenced by the type of retention.</p>

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Which orthodontic retainer provides the best stabilization?

  • 期刊论文

  • 发表日期：

    2025年12月2日

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  • Zamira Kalemaj,
  • Elisa Boccalari,
  • Marco Tremolati,
  • Gianluca Martino Tartaglia,
  • Alberto Caprioglio

摘要

Purpose

The objective of the present systematic review (SR) was to compare available retainers to determine which one has the highest probability of maintaining a stable post-orthodontic outcome.

Methods

Electronic platforms were searched up to 20 January 2024 to identify randomized controlled trials (RCTs) comparing the efficacy of different retainers in stabilizing post-orthodontic tooth position (PROSPERO no. CRD42023399604). The Cochrane checklist was used for risk of bias assessment. Network meta-analyses (NMA) were conducted for the Little irregularity index (LII), intercanine width (ICW), and intermolar width (IMW) to identify metric ranking markers (highest probability of being the best [PBB], surface under the cumulative ranking curves [SUCRA], and mean ranking [MR]) for the different retention protocols.

Results

Eighteen RCTs were included in the SR, and 15 in the NMA. Seven studies were at high risk of bias, 7 at moderate, and 4 at low risk of bias. The retainers were categorized into 14 groups for analyzing LII, 13 for ICW, and 8 for IMW. The NMA on LII indicated that computer-aided design/computer-aided manufacturing (CAD/CAM) multistrand stainless steel (SS), followed by laboratory round multistrand SS and rectangular flex SS retainers had the highest PBB in maintaining a low LII. The NMA on ICW suggested that CAD/CAM multistrand SS followed by CAD/CAM NiTi and spring hard SS retainers have the highest PBB in maintaining ICW. Very limited evidence showed a low PBB for removable retainers related to LII and ICW. No difference between groups was observed for IMW.

Conclusion

There is moderate-to-low quality evidence that CAD/CAM and laboratory-bent multistrand SS followed by rectangular flex SS retainers might be the most effective retention protocol for maintaining a low LII over a short-to-mid-term follow-up, whereas CAD/CAM multistrand SS, CAD/CAM NiTi, and spring-hard wire retainers might be most effective in maintaining ICW. Intermolar width tends to decrease, but this does not seem to be influenced by the type of retention.