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Review
. 2019 May;22(2):69-80.
doi: 10.1111/ocr.12302. Epub 2019 Mar 18.

Development of a clinical practice guideline for orthodontic retention

Cleo Wouters  1 , Toon A Lamberts  2 , Anne Marie Kuijpers-Jagtman  1 , Anne Marie Renkema  1
Affiliations
Review

Development of a clinical practice guideline for orthodontic retention

Cleo Wouters et al. Orthod Craniofac Res. 2019 May.

Abstract

Objectives: To develop a clinical practice guideline (CPG) for orthodontic retention (OR).

Materials and methods: The CPG was developed according to the AGREE II instrument and EBRO (Dutch methodology for evidence-based guideline development). Reporting was done according the RIGHT statement. A Task Force developed clinical questions regarding OR. To answer these questions, a systematic literature search in PubMed and EMBASE was performed. Two independent researchers identified and selected studies, assessed risk of bias using Cochrane RoB tool and rated quality of evidence using GRADE. The Task Force formulated considerations and recommendations after discussing the evidence. The concept CPG was sent for commentary to all relevant stakeholders.

Result: One systematic review-with 15 studies-met the inclusion criteria. In case of low evidence and lack of outcome measures, expert-based considerations were developed. Over four meetings, the Task Force reached consensus on considerations and recommendations, after which the concept CPG was ready for the commentary phase. After processing the comments, the CPG was presented to the Dutch Association of Orthodontists, whereafter authorization followed.

Limitations: The paucity of evidence-based studies concerning OR and the reporting of measurable patient outcomes.

Conclusion: This CPG offers practitioner recommendations for best practice regarding OR, may reduce variation between practices and assists with patient aftercare. A carefully chosen retention procedure for individual patients, combined with clear information and communication between orthodontist, dentist and patient will contribute to long-term maintenance of orthodontic treatment results.

Keywords: clinical practice guideline; orthodontic; retention.

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Conflict of interest statement

According to the “Code for the prevention of improper influence due to conflicts of interest” (http://www.haring.nl/download/tools/en/Code_for_the_prevention_of_improper_ influence_due_to_conflicts_of_interest.pdf) drawn up by a number of Dutch health authorities, all members of the Task Force were required to disclose potential conflicts of interest of the last three years regarding financial (relationship to commercial companies, personal financial interests, research funding) and indirect interests (personal relations, reputation management, knowledge valorization). None of the members of the Task Force declared any conflicts that would influence the development of the CPG for orthodontic retention.

Figures

Figure 1
Figure 1
PRISMA flow chart [Colour figure can be viewed at http://wileyonlinelibrary.com]
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