Effect of Bonded and Removable Retainers on Occlusal Settling after Orthodontic Treatment: A Systematic Review and Meta-analysis
Objectives: This systematic review and meta-analysis aimed to summarize the effectiveness of bonded and removable retainers (Hawley and Essix retainer) in terms of improvement in occlusal settling (occlusal contact points/areas) after orthodontic treatment.
Methods: We searched the Cochrane Library, CINAHL Plus, PubMed, Web of Science, Orthodontic journals, and Google scholar for eligible studies. We included randomized control trial (RCT) along with Cohort studies. Studies that reported occlusal contacts/areas during retention with fixed bonded and removable retainers were included. To assess the quality of the RCTs Cochrane risk of bias tool was utilized, whereas Newcastle-Ottawa Scale was used for assessing the quality of cohort studies.
Results: We included 6 articles in our systematic review after scrutinizing 219 articles and eliminating them based on duplication, titles and objectives. We found significant differences between fixed and removable retainers in terms of occlusal settling within the included studies. Bonded retainer (BR) allowed faster and better posterior tooth settling as compared to Hawley retainer (HR). However, HR showed good occlusal settling in the anterior dental arch. Essix retainer showed a decrease in occlusal contact during the retention phase. Meta-analysis showed no statistically significant difference between BR and removable retainers.
Conclusions: HR allowed better overall occlusal settling as compared to other retainers in comparison. However, BR allowed faster settling in the posterior teeth region. Overall, there are insufficient high-quality RCTs to provide additional evidence, and further high-quality RCTs research is needed.