A survey of protocols and trends in orthodontic retention

BACKGROUND The objectives of this study were to evaluate retention procedures and protocols which are used by the orthodontists in Lithuania and to identify commonly used types of dental retainers. METHODS One hundred seven questionnaires in total with 28 multiple-choice questions were sent to all members of the Lithuanian Orthodontic Society. The questionnaire was organized into eight sections representing specific information about socio-demographic status of the respondents, selection of a retention system, details of commonly used fixed and removable retainers, the duration of the retention period, supervision of the retainers, instructions for patients, and necessity of common retention guidelines. RESULTS The overall response rate was 75.7%. All of the respondents prescribed retainers after the orthodontic therapy. More than 40% of the respondents combined fixed and removable retainers in different clinical situations, but the first-choice option after an expansion of the maxillary dental arch was the removable retainer (54.3%); meanwhile, a fixed retainer was used after a correction of any rotations of the mandibular anterior teeth (49.4%). The Hawley retainer was preferred by 90.1% of the respondents for a maxillary dental arch, and 74.1% of them preferred it for a mandibular dental arch. The most preferable fixed retainer was the retainer bonded to all six anterior teeth (in the upper dental arch-by 71.6%; in the lower one-by 80.2%). There was no consensus on the duration of a retention period. Most of the orthodontists checked up retainers three times during the first year (fixed ones-by 42.0%; removable ones-by 30.0%) and once per year after the 1-year retention period (fixed ones-by 44.4%; removable ones-by 40.7%). All orthodontists gave instructions for taking care of an orthodontic retainer. It was observed that the orthodontists with less than 10 years of experience used a protocol based on the skills learned during their postgraduate studies, while orthodontists with more than 10 years of experience used retention procedures based on their orthodontic work practice (p < 0.05). CONCLUSIONS A combination of fixed and removable retainers was the most often used in an orthodontic retention. Evidence-based guidelines are desired for a common retention protocol.