• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Doctoral Thesis
DOI
https://doi.org/10.11606/T.25.2022.tde-08062022-101711
Document
Author
Full name
Sílvio Augusto Bellini Pereira
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2022
Supervisor
Committee
Henriques, Jose Fernando Castanha (President)
Carreira, Daniela Gamba Garib
Castillo, Arón Aliaga Del
Freitas, Karina Maria Salvatore de
Title in English
Treatment stability with bonded versus vacuum-formed retainers after 12 months: a systematic review and randomized clinical trial
Keywords in English
Orthodontic retainers
Orthodontics
Randomized clinical trial
Systematic review
Abstract in English
Introduction: This systematic review (SR) and randomized clinical trial (RCT) aimed to compare the clinical effectiveness of bonded versus vacuum-formed retainers (VFRs) regarding their capacity to maintain treatment stability, periodontal effects, and failure rates. Methods: For the SR, ten databases were systematically searched up to August 2021. RCTs comparing both retainers were included. The Risk of Bias (RoB) evaluation was performed with the Cochrane RoB tool 2.0. All steps of the review were performed independently by two reviewers. The GRADE was used to evaluate the certainty of the evidence. For the RCT, patients finishing orthodontic treatment were recruited and randomly allocated into two experimental groups. The bonded retainer (BR) group received upper and lower V-bend BRs bonded in the lingual surfaces of the anterior teeth. The VFR group received upper and lower VFRs right after fixed appliances removal. The patients were evaluated in four time-points: at fixed appliances removal (T0), after 3 months (T1), 6 months (T2), and 12 months (T3). Treatment stability based on occlusal outcomes and retainers survival rates were the primary and secondary outcomes, respectively. Intergroup comparisons regarding stability outcomes were performed using Mann-Whitney U-tests (P < 0.05). The Kaplan-Meier survival plot and the log-rank test were employed to assess the retainers survival. Results: Initial search yielded 923 studies. After full-text assessment, five RCTs remained. On a short-term (3-6 months) and long-term (4 years) basis, BRs were more effective to maintain stability than VFRs in the lower arch. From 12 to 24 months both retainers presented the same efficacy. In the upper arch, the retainers were equally effective. BRs were associated with greater plaque and calculus accumulation than VFRs after 12 months. The retainers failure rates were similar in the upper arch on the first year of retention. Contrarily, BRs presented greater failure rates in the lower arch than VFRs. In the RCT, both groups included 25 patients. The groups were comparable regarding their baseline characteristics. Up to 6 months both retainers were equally effective; however, after 12 months, BRs were more effective in to maintain the incisors alignment in the maxilla (P < 0.001) and in the mandible (P < 0.006) compared to the VFRs. No differences were noticed in the intercanine and intermolar widths, overjet and overbite. There were also no differences in the retainers survival rates in the maxillary and mandibular arches. Conclusion: The SR concluded that in the lower arch BRs were more effective than VFRs to maintain stability in the initial 6 months of retention and in the long term. In the upper arch, both retention protocols are equally effective. The RCT concluded that BRs were more effective to maintain the incisors alignment in the maxilla and mandible compared to VFRs after 12 months. Moreover, both retainers present the same survival rates in the maxillary and mandibular arches after the same period. Registration: This SR was registered in PROSPERO CRD42020199392. This trial was registered at ClinicalTrials.gov (NCT04847323). Funding: Coordination for the Improvement of Higher Education Personnel - Brazil (CAPES), Finance Code 001.
Title in Portuguese
Estabilidade de tratamento com contenções fixas versus removíveis após 12 meses: uma revisão sistemática e ensaio clínico randomizado
Keywords in Portuguese
Contenções ortodônticas
Ensaio clínico randomizado
Ortodontia
Revisão sistemática
Abstract in Portuguese
Introdução: Esta revisão sistemática (RS) e ensaio clínico randomizado (RCT) teve como objetivo comparar a efetividade clínica de contenções fixas versus termoplásticas (VFR) em relação a sua capacidade de manter a estabilidade do tratamento, efeitos periodontais e taxas de falha. Métodos: Para a RS, dez bases de dados foram pesquisadas até agosto de 2021. RCTs comparando ambas contenções foram incluídos. A avaliação do risco de viés (RoB) foi realizada com a ferramenta Cochrane RoB 2.0. Todas as etapas da revisão foram realizadas independentemente por dois revisores. O GRADE foi usado para avaliar a certeza da evidência. Para o RCT, pacientes finalizando o tratamento ortodôntico foram recrutados e alocados em dois grupos experimentais. O grupo contenção fixa (BR) recebeu BRs superiores e inferiores com V-bends na lingual dos dentes anteriores. O grupo VFR recebeu VFRs nos arcos superior e inferior. Os pacientes foram avaliados em quatro momentos: Na remoção do aparelho fixo (T0), após 3 meses (T1), 6 meses (T2) e 12 meses (T3). A estabilidade do tratamento com base em variáveis oclusais e as taxas de sobrevivência das contenções foram os resultados primários e secundários, respectivamente. As comparações intergrupo foram feitas pelo teste U de Mann-Whitney (P < 0,05). O gráfico de sobrevivência de Kaplan-Meier e o teste Log-rank foram empregados para avaliar a sobrevivência das contenções. Resultados: A busca rendeu 923 estudos. Após a avaliação, 5 RCTs permaneceram. Em curto prazo (3-6 meses) e longo prazo (4 anos), os BRs foram mais efetivos em manter a estabilidade no arco inferior. De 12 a 24 meses ambas as contenções apresentaram a mesma efetividade. Na arcada superior, as contenções foram igualmente efetivas. BRs foram associados ao maior acúmulo de placa e cálculo do que VFRs após 12 meses. As taxas de falha das contenções foram semelhantes na arcada superior. Os BRs apresentaram maiores taxas de falha na arcada inferior. No RCT, ambos os grupos incluíram 25 pacientes. Os grupos foram comparáveis em relação às suas características no baseline. Até 6 meses, ambas as contenções foram igualmente efetivas; no entanto, após 12 meses, os BRs foram mais efetivos em manter o alinhamento dos incisivos na maxila (P < 0,001) e na mandíbula (P < 0,006) em comparação as VFRs. Não foram observadas diferenças nas larguras intercaninos e intermolares, sobressalência e sobremordida. Não houve diferenças nas taxas de sobrevivência das contenções nos arcos maxilar e mandibular. Conclusão: A RS concluiu que no arco inferior os BRs foram mais efetivos que os VFRs em manter a estabilidade nos 6 meses iniciais de contenção e a longo prazo. Na arcada superior, ambos os protocolos de contenção foram igualmente eficazes. O RCT concluiu que os BRs foram mais efetivos em manter o alinhamento dos incisivos na maxila e mandíbula em comparação aos VFRs após 12 meses. Além disso, ambas as contenções apresentaram as mesmas taxas de sobrevivência. Registro: Esta RS foi registrada no PROSPERO CRD42020199392. Este estudo foi registrado em ClinicalTrials.gov (NCT04847323). Financiamento: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES), Código 001.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2022-06-09
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2024. All rights reserved.