Медицина/7. Клиническая медицина

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.

REFERENCES

1. Хамитова Н.Х. Характер течения ретенционного периода у подростков после ортодонтического лечения в зависимости от состояния вегетативной нервной системы / Н.Х. Хамитова, Д.Р. Сингатуллина // Казанский медицинский журнал. – 2012. – Т.93, № 4. - С. 651-653.

2. Картон Е.А. Ретенция и рецидивы / Е.А. Картон, Ж.А. Ленденгольц, Л.С. Персин. - М., 2006. – 36 с.