Fixed Orthodontic Retentions from Orthodontists’ Perspectives (A Qualitative Study)

Volume 12 , Issue 1 , April 2025 , Pages 43-50

Authors

Adham Abdulrahman 1

1 Department of Orthodontics, College of Dentistry, University of Sulaimani, Sulaimani, Iraq.

DOI logo 10.17656/sdj.10204

Keywords

Abstract

Objective: This study aimed to investigate orthodontists' perspectives and experiences with fixed orthodontic retention, emphasizing its effectiveness, challenges, and recommended practices. It aimed to uncover the factors that influence the selection and management of fixed retainers and their impact on patient care.

Methods: To select experienced orthodontists, a qualitative study design with purposive sampling was employed. Structured interviews were conducted with 15 participants, and verbal responses were recorded using phone sound recorders. The recordings were transcribed verbatim and analyzed through thematic analysis. Data collection and analysis were carried out simultaneously to ensure data saturation, which was reached after 15 interviews.

Results: Thematic analysis identified eight key themes: perceptions of fixed retainers, patient compliance and education, technological and practical considerations, long-term outcomes and follow-up, treated malocclusion types, professional development and continuing education, multidisciplinary collaboration, and patient-centered care. Fixed retainers are generally regarded as effective for maintaining alignment, particularly in cases where patient compliance is less critical, making them preferable to removable retainers in specific scenarios. However, concerns were noted regarding potential drawbacks, such as maintenance challenges, increased plaque accumulation, and difficulties achieving long-term success. Enhancing compliance and retainer effectiveness requires educational initiatives and technological advancements. The type of malocclusion significantly influences the choice of fixed retainers, especially in cases involving generalized spacing or severe rotations. Ongoing professional development, multidisciplinary collaboration, and patient-centered strategies are essential for providing tailored treatment plans and improving patient satisfaction.

Conclusions: This study highlights the complex dynamics of fixed orthodontic retention and introduces Structured-Self-Reply (SSR) interviews as a novel qualitative data collection method. Successful retention strategies necessitate integrating advanced technology, patient education, consideration of malocclusion types, and multidisciplinary collaboration. Addressing these elements can lead to improved patient outcomes and greater overall effectiveness of orthodontic treatment. Future research should explore cost-effective retention methods, long-term outcomes, and approaches to enhance patient adherence to retention protocols.

References

  1. Inchingolo F, Inchingolo AM, Ceci S, Carpentiere V, Garibaldi M, Riccaldo L, et al. Orthodontic relapse after fixed or removable retention devices: a systematic review. Appl Sci. 2023;13(20):11442.
  2. Hotchandani KD, Thangadurai J, Parate AS, Nixon JZ, Kamble RH, Meghalapriya P. The effects of fixed versus removable orthodontic retainers on stability and periodontal health: 4-year follow-up of a randomized controlled trial. J Pharm Bioallied Sci. 2023;15(Suppl 1):S502-7.
  3. Di Giovanni T, Vogiatzi T, Koretsi V, Walsh T. Effect of orthodontic extraction of mandibular premolars on third molar angulation after treatment with fixed appliances: A cross-sectional study. J Orofac Orthop. 2024;85(6):392-403.
  4. Gera A, Pullisaar H, Cattaneo PM, Gera S, Vandevska-Radunovic V, Cornelis MA. Stability, survival, and patient satisfaction with CAD/CAM versus conventional multistranded fixed retainers in orthodontic patients: a 6-month follow-up of a two-centre randomized controlled clinical trial. Eur J Orthod. 2022;45(1):58-67.
  5. Bondemark L, Holm AK, Hansen K, Axelsson S, Mohlin B, Brattstrom V, et al. Long-term stability of orthodontic treatment and patient satisfaction: a systematic review. Angle Orthod. 2007;77(1):181-91.
  6. Booth FA, Edelman JM, Proffit WR. Twenty-year follow-up of patients with permanently bonded mandibular canine-to-canine retainers. Am J Orthod Dentofacial Orthop. 2008;133(1):70-6.
  7. Kocher KE, Gebistorf MC, Pandis N, Fudalej P, Katsaros C. Long-term effectiveness of maxillary and mandibular bonded orthodontic retainers. Oral Health Prev Dent. 2020;18(3):633-41.
  8. 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(1):94-5.
  9. Creswell JW, Poth CN. Qualitative inquiry and research design: Choosing among five approaches. 4th ed. Sage Publ. 2018.
  10. Braun V, Clarke V. To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qual Res Sport Exerc Health. 2021;13(2):201-16.
  11. Peters HC. A-methodological saturation: A grounded theory analysis. Couns Psychol. 2023;51(3):289-315.
  12. Braun V, Clarke V. One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qual Res Psychol. 2021;18(3):328-52.
  13. Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis: Striving to meet the trustworthiness criteria. Int J Qual Methods. 2017;16(1):1609406917733847.
  14. Lasance SJ, Papageorgiou SN, Eliades T, Patcas R. Post-orthodontic retention: how much do people deciding on a future orthodontic treatment know and what do they expect? A questionnaire-based survey. Eur J Orthod. 2019;42(1):86-92.
  15. Jedliński M, Grocholewicz K, Mazur M, Janiszewska-Olszowska J, Rafta A, Janiszewska-Olszowska J, et al. What causes failure of fixed orthodontic retention?–systematic review and meta-analysis of clinical studies. Head Face Med. 2021;17(1):1-22.
  16. Habegger M, Renkema A-M, Bronkhorst E, Fudalej PS, Katsaros C. A survey of general dentists regarding orthodontic retention procedures. Eur J Orthod. 2017;39(1):69-75.
  17. Iliadi A, Kloukos D, Gkantidis N, Katsaros C, Pandis N. Failure of fixed orthodontic retainers: a systematic review. J Dent. 2015;43(8):876-896.
  18. Kang DO, Yu HS, Choi SH, Kim ST, Jung HD, Lee KJ. Stability of vertical dimension following total arch intrusion. BMC Oral Health. 2023;23(1):2842.
  19. Zachrisson BU. Multistranded wire bonded retainers: from start to success. Am J Orthod Dentofacial Orthop. 2015;148(5):724-7.
  20. Al-Moghrabi D, Pandis N, Fleming PS. The effects of fixed and removable orthodontic retainers: a systematic review. Prog Orthod. 2016;17:1-22.
  21. Littlewood SJ, Millett DT, Doubleday B, Bearn DR, Worthington HV. Orthodontic retention: a systematic review. J Orthod. 2006;33(3):205-12.
  22. Wolf M, Niederau C, Pollak TL, Knaup I. Evaluation of digital construction, production, and intraoral position accuracy of novel 3D CAD/CAM titanium retainers. J Orofac Orthop. 2023;84(2):132-41.
  23. Shim H, Foley P, Bankhead B, Kim KB. Comparative assessment of relapse and failure between CAD/CAM stainless steel and standard stainless steel fixed retainers in orthodontic retention patients: A randomized controlled trial. Angle Orthod. 2022;92(1):87-94.
  24. Gorbunkova A, Pagni G, Brizhak A, Farronato G, Rasperini G. Impact of orthodontic treatment on periodontal tissues: a narrative review of multidisciplinary literature. Int J Dent. 2016;2016(1):4723589.
  25. Checherita LE, Antohe ME, Costin LI, Văscu MB, Ioan BG, Postelnicu C. Research regarding dental mobility phenomena in the clinical recognition diagnosis of temporomandibular disorders. Diagnostics. 2023;13(4):598.
  26. Martin C, Littlewood SJ, Millett DT, Griffin A, Seo P, Harrison J. Retention procedures for stabilizing tooth position after treatment with orthodontic braces. Cochrane Database Syst Rev. 2023;(5):CD002283.
  27. Jepsen S, Tietmann C, Heibrok H, Adam K, Hoffmann T, Jentsch HF, et al. Long-term stability of regenerative periodontal surgery and orthodontic tooth movement in stage IV periodontitis: 10-year data of a retrospective study. J Periodontol. 2023;94(10):1176-86.
  28. Rauf AM, Rashid TA, Fatah AO, Kareem FA, Mohammad NO. Assessment of oral hygiene in a sample of orthodontically treated patients using different bracket materials with different motivational techniques in Sulaimani city. Sulaimani Dent J. 2014;1(1):15-20.
  29. Böhme Kristensen C, Asimakopoulou K, Scambler S. Enhancing patient-centred care in dentistry: a narrative review. Br Med Bull. 2023;148(1):79-88.
Statistics
  • Article view1134
  • Downloads18
  • Published at1 April 2025

  • RIS
  • BibTeX
  • EndNote
  • Mendeley
  • APA (7th edition)
  • MLA (9th edition)
  • Chicago
  • Harvard
  • IEEE
  • Vancouver