Ìåäèöèíà/7. Êëèíè÷åñêàÿ ìåäèöèíà
PhD
Kobtseva O.A.
Donetsk National Medical University named after M.
Gorky, Liman, Ukraine
The efficiency of usage of the main types of
retention devices used in orthodontic practice
Introduction. The retention
of orthodontic treatment is a set of therapeutic measures
aimed at preserving of the achieved results [1]. Considered that the probability of pathology
relapse may be caused by three factors: the lack of time
to complete the reorganization of the gingival and periodontal tissues, the
influence of a constant pressure from the soft tissue, the response to changes
associated with the development of the patient, for example, with the growth of
jaw bones. After completion of the period of active orthodontic treatment must
be prevented the relapses of anomalies of the teeth, forms of dental arches and
malocclusion with applying of the retention devices [2].
Aim. To compare the frequency of pathology
relapse and complaints of patients using three types of retention devices used
in orthodontic practice.
Material
and methods. The research material is 60 patients aged 16-22 years old who had
completed active fixed orthodontic treatment and were in the retention period
of treatment. In the first study group (20
patients) the retention removable plastic aligners «Essix»
were used. In the second group (20 patients) were used the removable retention
plates «Hawley», consisting of palatal basis, clasps on the molars and the vestibular
arch with loops. For retention of treatment results
in the third group (20 patients) were used the non-removable wire retainers
which were fixed to the composite material on the oral surface of the frontal
six teeth. In each group by clinical examination at 6 months after the
beginning of the retention device worn the incidence of
orthodontic pathology relapse and patients' complaints were evaluated. The
analysis of the study results was performed using statistical methods.
Results
and discussion. The incidence of relapse of
orthodontic pathology prevalent in group 1 and 2 and was 30,0 ± 10,2% and 35,0 ± 10,6% of cases, respectively. In
group 3, which were used the removable retention devices, the relapse rate was
10,0 ± 6,7% of cases. The obtained data indicate about an
abuse prescribed clock wearing of the removable retention devices. This in turn
led to such the high incidence of complications of treatment as relapse of
abnormality. Complaints of patients while
wearing the retention devices are presented in Table 1.
Table 1.
The complaints
of patients (%, M ± m)
Complaints while wearing the retention devices |
Group
1 (n=20) |
Group
2 (n=20) |
Group
3 (n=20) |
The visibility of device for associates |
15,0±7,9 |
50,0±11,1 |
0 |
A bad adaptation to the device |
10,0±6,7 |
30,0±10,2 |
5,0±4,8 |
Damage to the device |
35,0±10,6 |
20,0±8,9 |
5,0±4,8 |
The impossibility of good oral
hygiene |
0 |
0 |
25,0±9,6 |
High
percentage of the complaints on the visibility of the device in group 2, in our
opinion, can be explained by the presence of vestibular steel arch in the
appliance design. Poor adaptation to the plate apparently caused by
plastic palatal basis, which made it difficult to clear
pronunciation of sounds and sometimes causes an increase in the
vomiting reflex. Durability of the device design was higher in non-removable
retainers, the plastic aligners and retention plates often were subjected to everyday breakdowns. As can
be seen from the data, only the 3 group patients noted the
impossibility of good oral hygiene because the retention device had non-removable
fixation, making it difficult to use floss in the fixed retainer areas.
Conclusions. These results indicate that each of widely applied orthodontic retention
devices have its own advantages and disadvantages. The individual approach is necessary in choosing of stabilizing
device for patients.
In
our opinion, the use of fixed retainers has more advantages in their
application, both
for patients and for doctors. The application of the removable retention devices is permissible in
disciplined patients, at the low risk of anomalies' relapse and in patients' poor oral hygiene skills.
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