Choice of the Retention Method After an Orthodontic Treatment-Rewiev

  • Azra Jelešković School of Dentistry, University of Sarajevo
  • Lejla Redzepagic-Vrazalica Department of Orthodontics, School of Dental Medicine, University of Sarajevo
  • Vildana Dzemidzic Department of Orthodontics, School of Dental Medicine, University of Sarajevo
  • Alisa Tiro Department of Orthodontics, School of Dental Medicine, University of Sarajevo
  • Enita Nakas Department of Orthodontics, School of Dental Medicine, University of Sarajevo


Retention is a phase of orthodontic treatment devised to keep the teeth in a correct position once the orthodontic treatment has been completed. There are three main characteristics that each ideal retainer is required to have: to keep the teeth in the correct position after orthodontic therapy, to be long lasting and resistant to mechanical damage, and to have no adverse long-term effects on periodontal tissue.

Through a computer-based browsing through a number of databases (such as, e.g. PubMed and Google Scholar) we have found and analysed various articles used in this research. The inclusion criteria to be met were: an overall availability of a research paper, the requirement that these research papers are published in English, that these research papers were published in the period 2007-2019, the requirement that the research papers should involve clinically randomized studies and that their titles contain one of the predefined keywords.

The database browsing that is based on the said keywords and carried out within the above time frame has resulted in finding 165 relevant articles. A complete set of the inclusion criteria were met by 8 published research papers, but 7 articles were analysed in the end. The selected articles have compared different types of fixed and mobile retainers, different times of wearing the retainers, the impact that the retainers had on the periodontium, and the acceptability of different retention protocols for patients.

The conclusion of this research paper is that bonded retainers prove to be most effective in stabilising the position of the incisors, particularly the lower ones, but that their disadvantages include the reopening of the extraction space and the retention of plaque due to difficulties in maintaining oral hygiene. Vacuum-formed retainers appear to be more effective than Hawley retainers in retaining the position of the incisors, and patients have indicated that they are more acceptable to wear. Hawley retainers prove to be most effective in preserving a closed extraction space, but they do now show solid results with regard to other segments. Changes in the overbite, overjet, arch length, and anterior and posterior widths did not show any significant statistical differences in the different types of retainers.


Keywords: orthodontics, retention, stability, impact


Littlewood SJ, Millett DT, Doubleday B, Bearn DR , Worthington HV. Retention procedures for stabilising tooth position after treatment with orthodontic braces, The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd. (2016)

Melrose C, Millett DT. Toward a perspective on orthodontic retention? Am J Orthod Dentofac Orthop. 1998;113(5):507–14.

Sadowsky C, Schneider BJ, BeGole EA, Tahir E. Long-term stability after orthodontic treatment: nonextraction with prolonged retention. Am J Orthod Dentofacial Orthop. 1994;106:243-9.

Binda SK, Kuijpers-Jagtman AM, Maertens JK, van ‘t Hof MA. A long-term cephalometric evaluation of treated Class II division 2 malocclusions. Eur J Orthod.


Proffit WR, Fields HW Jr., Sarver DM. Contemporary Orthodontics, 6th edition, Mosby, (2018) 43-58.

Mai, W., He, J., Meng, H., Jiang, Y., Huang, C., Li, M., Yuan, K. and Kang, N. Comparison of vacuum-formed and Hawley retainers: a systematic review. Am J of Orthod and Dentofac Orthop, (2014)145, 720–727.

Hyun, P., Preston, C.B., Al-Jewair, T.S., Park-Hyun, E. and Tabbaa, S. Patient compliance with Hawley retainers fitted with the SMART(R) sensor: a prospective clinical pilot study. Angle Orthodontist (2015),85, 263–269.

Iliadi A ,Kloukos D ,Gkantidis K, Katsaros C, Pandis N. Failure of fixed orthodontic retainers: A systematic review. Journal of Dentistry (2015) 2464 1-21

Andriekute A, Vasiliauskas A, Sidlauskas A. A survey of protocols and trends in orthodontic retention; Progress in Orthodontics (2017) 18:31

Littlewood SJ, Millett DT, Doubleday B, et al. Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database Syst Rev 2004;1:CD002283.

Heidi Rowland, Lisa Hichens,b Alison Williams, Darren Hills,Norman Killingback,Paul Ewings,Steven Clark,Anthony J. Ireland and Jonathan R. Sandyi The effectiveness of Hawley and vacuumformed retainers: a single centar randomized controlled trial. Am J Orthod Dentofac Orthop 2007; 132:730-7

Ramazanzadeh B, Ahrari F, Hosseini ZS.The retention characteristics of Hawley and vacuum-formed retainers with different retention protocols. J Clin Exp Dent. 2018;10(3):224-31

Barlin S, Smith R, Reed R, Sandy J, Ireland AJ. A retrospective randomized double- blind comparison study of the effectiveness of Hawley vs vacuum-formed retainers. Angle Orthod. 2011; 81:404-9.

Ledvinka J. Vacuum-formed retainers more effective than Hawley retainers. Evid Based Dent. 2009; 10:47.

Kalha AS. Hawley or vacuum-formed retainers following orthodontic treatment? Evid Based Dent. 2014; 15:110-1.

Sheridan JJ, LeDoux W, McMinn R. Essix retainers: fabrication and supervision for permanent retention. J Clin Orthod. 1993; 27:37-45.

Saleh M, Hajeer MY , Muessig D. Acceptability comparison between Hawley retainers and vacuum-formed retainers in orthodontic adult patients: a single-centre, randomized controlled trial. Eur J of Orthod, 2017, 1–9

O'Rourke N, Albeedh H, Sharma P, Johal A. Effectiveness of bonded and vacuum-formed retainers: A prospective randomized controlled clinical trial. American Journal of Orthodontics and Dentofacial Orthopedics. September 2016; 150:3

Johal A, Sharma NR, McLaughlin K, Zou LF. The reliability of thermoform retainers: a laboratory-based comparative study. Eur J Orthod 2015; 37:503-7.

Renkema AM, Renkema A, Bronkhorst E, Katsaros C. Long-term effectiveness of canine-to-canine bonded flexible spiral wire lingual retainers. Am J Orthod Dentofacial Orthop 2011; 139:614-21.

Tynelius EG, Bondemark L, Lilja-Karlander E. A randomized controlled trial of three orthodontic retention methods in Class I four premolar extraction cases—stability after 2 years in retention. Orthod Craniofac Res 2013; 16:105-15.

Storey M, Forde K, Littlewood S J,Scott P,Luther F, Kang J. Bonded versus vacuum-formed retainers: a randomized controlled trial. Part 2: periodontal health outcomes after 12 months; Eur J of Orthod, 2017, 1-10

Forde K, Storey M, Littlewood S J, Scott P, Luther K and Kang J. Bonded versus vacuum-formed retainers: a randomized controlled trial. Part 1: stability, retainer survival, and patient satisfaction outcomes after 12 months. Eur J of Orthod, 2017, 1–12

Tynelius G E, Petrén S, Bondemark, Lilja-Karlander E. Five-year postretention outcomes of three retention methods—a randomized controlled trial. Eur J of Orthod, 2014, 1–9