Am J Orthod Dentofacial Orthop. 2022 Aug 26:S0889-5406(22)00432-2. doi: 10.1016/j.ajodo.2022.07.003. Online ahead of print.
ABSTRACT
INTRODUCTION: Orthodontic fixed retainers are preferred as they depend less on patient compliance. Recently, researchers tried to use fiber-reinforced composite (FRC) to replace the multistranded stainless-steel wire (MSW) of the fixed retainers to enhance the mechanical properties and esthetics. This systematic review aimed to analyze the effectiveness of the FRC retainers.
METHODS: We searched the electronic databases (May 1, 2021), including Medline, the Cochrane Library, EMBASE, PubMed, Web of Science, and CINAHL. We applied no language or date restrictions in the searches of the databases. Only randomized controlled trials (RCTs) and prospective clinical controlled trials were included. The revised Cochrane risk of bias tool for randomized trials and risk of bias in nonrandomized studies of interventions were used to evaluate the risk of bias in RCTs and non-RCTs, respectively. The outcomes were pooled using Review Manager 5.4. The primary outcome of this review was teeth relapse, and the secondary outcomes were bonded retainer failure rate, adverse effect on oral health, and patient’s satisfaction.
RESULTS: Eleven out of 99 studies, which included 873 participants, were used in this review, with the follow-up ranging from 6 months to 6 years. Ten studies compared the FRC retainers with MSW retainers, and 1 study compared FRC retainers with a different fiber material. Ten studies were RCT, and 1 was non-RCT. There was 0.39 less relapse with the FRC retainers than with MSW retainers (mean difference, -0.39; 95% confidence interval [CI], -0.41 to -0.37; P <0.00001). There was no statistically significant difference in the failure rate between the FRC and MSW with the whole retainer as an outcome unit risk ratio of 1.72 (95% CI, 0.57-5.14; P = 0.33) or with the teeth an as outcome unit risk ratio of 0.85 (95% CI, 0.47-1.52; P = 0.58). There was insufficient evidence to conduct the meta-analysis of the adverse effect on oral health and patient satisfaction.
CONCLUSIONS: Low-quality evidence is available to suggest that the effectiveness of the FRC is comparable to the MSW with no significant difference in the failure rate. However, we have very low certainty on these results. It is worth conducting future robust clinical studies to assess the effectiveness of FRC retainers with long follow-up.
PMID:36031511 | DOI:10.1016/j.ajodo.2022.07.003
