A survey of retention and retainer practices of orthodontists in Australia
Published Online: Jul 20, 2021
Page range: 174 - 183
Received: Jun 01, 2019
Accepted: Aug 01, 2019
DOI: https://doi.org/10.21307/aoj-2020-047
© 2019 Maurice J. Meade et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Objective
To survey retention and retainer practices of orthodontists in Australia.
Methods
A pilot-tested e-survey was distributed to 502 eligible members of the Australian Society of Orthodontists (ASO). The questions addressed participant background information, preferred retainer and retention practices, retainer characteristics and factors influencing retainer choice. Statistical analyses were performed using PASWH version 18.
Results
The response rate was 58%. Thermoplastic retainers (TRs) were the most commonly chosen retainer in the maxilla (39.4%) and bonded retainers (BRs) were most commonly chosen in the mandible (38.5%). An initial period of full-time wear of removable retainers (RRs) was prescribed by 37.7–48.3%. ‘Night/sleeping with reducing frequency over time’ was the most commonly prescribed part-time RR wear practice (28.1-33.5%).
Indefinite retainer wear was recommended by 85.3-87.4% of orthodontists. Indefinite retainer checks were carried out by 19.1-19.8% of orthodontists while 28.9-43.6% were ‘not happy’ for general dental practitioners (GDPs) to continue retention checks. Adjunctive retention practices were used by 25.6-72.8%. Pre-fabrication TR sheet thickness of 1.0 mm (68%) and polypropylene co-polymer/ethylene material type (55.8%) were most commonly used. Vacuum-forming was the preferred mode of TR fabrication by 48.4%. ‘Stainless steel single strand round’ was the most commonly used BR material type (33.4%). BR bonded to 12-22 (bonded to four teeth) was the most common BR design in the maxilla (48.8%) and 33-43 (bonded to six teeth) was most commonly chosen for the mandible (81.5%). Inadvertent tooth movement associated with BRs was observed by 62%. The orthodontist factor that most influenced retainer choice was the nature of the pretreatment malocclusion (88%).
Conclusion
Although there is agreement that retention is indefinite, orthodontic retention practices and retainer characteristics vary considerably between orthodontists in Australia. Greater communication between orthodontists and GDPs is required to effectively manage retention over the long term.