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Meta-Analysis
. 2023 Nov 30;45(6):645-661.
doi: 10.1093/ejo/cjad047.

The prevalence of the failure of fixed orthodontic bonded retainers: a systematic review and meta-analysis

Su Thae Aye  1 , Shiyao Liu  1 , Emer Byrne  2 , Ahmed El-Angbawi  1
Affiliations
Meta-Analysis

The prevalence of the failure of fixed orthodontic bonded retainers: a systematic review and meta-analysis

Su Thae Aye et al. Eur J Orthod. .

Erratum in

Abstract

Objectives: To systematically assess the scientific literature for the prevalence of failure rate of fixed orthodontic bonded retainer (FOBR).

Method: Randomized clinical trials (RCTs) and prospective non-RCTs involving participants who had FOBR fitted were included. The Cochrane Central Register of Controlled Trials, Web of science, MEDLINE, and EMBASE via OVID were searched from inception to January 2023. Risk of bias was assessed using the Cochrane RoB 2 and Newcastle-Ottawa tools. The main outcome was the failure rate of FOBRs. The secondary outcome was to identify factors that can influence the failure of FOBR. Meta-analyses and sensitivity analyses were undertaken using Revman, version5.4. A random-effects model was used. Quality assessment using Grading of Recommendations Assessment, Development, and Evaluation.

Results: Thirty-four studies (25 RCTs and 9 prospective clinical studies) (3484 participants) were included in this review. The overall failure rate of bonded retainers, after excluding high-risk studies, was 35.22% (95% confidence interval [CI] 27.46-42.98). The failure rate is increased with the duration of follow up; with short-term follow-up rate 24.18% (95% CI 20.16-28.21), medium-term follow up 40.09% (95% CI 30.92-49.26), and long-term follow up 53.85% (95% CI 40.31-67.39). There is a low level of evidence to suggest there is no statistically significant difference in the failure rate of fixed retainers using direct versus indirect bonding methods, using liquid resin versus without liquid resin, and fibre-reinforced composite retainers compared to multi-stranded stainless steel retainers.

Discussion: There is low-quality evidence to suggest that the failure rate of FOBR is relatively high. There is a need for high-quality, well-reported clinical studies to assess factors that can influence the failure rate of FOBR.

Registration: CRD42021190910.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Study flow chart.
Figure 2.
Figure 2.
Forest plot showing the failure rate with 95% CI of (A) all the included studies and (B) all the low or some concern RoB RCT studies.
Figure 3.
Figure 3.
Forest plot showing the failure rate of maxillary bonded retainer with 95% CI of (A) all the included studies and (B) all the low or some concern RoB RCT studies.
Figure 4.
Figure 4.
Forest plot showing the failure rate of mandibular bonded retainer with 95% CI of (A) all the included studies and (B) all the low or some concern RoB RCT studies.
Figure 5.
Figure 5.
Forest plot showing the failure rate of bonded retainer after short-term, medium-term, and long-term follow up with 95% CI reporting (A) overall failure rate, (B) maxillary bonded retainer failure rate, and (C) mandibular bonded retainer failure rate.
Figure 6:
Figure 6:
Forest plot showing the failure rate of bonded retainer after short-term, medium-term, and long-term follow up with 95% CI in low or some concern RoB studies reporting (A) overall failure rate, (B) maxillary bonded retainer failure rate, and (C) mandibular bonded retainer failure rate.
Figure 7:
Figure 7:
Comparison 1. Failure rate of bonded fixed retainer (direct bonding vs indirect bonding).
Figure 8:
Figure 8:
Comparison 2. Failure rate of bonded fixed retainer (liquid resin vs without liquid resin).
Figure 9:
Figure 9:
Comparison 3. Failure rate of bonded fixed retainer FRC versus MSW (A) used the retainer as a unit of assessment and (B) used tooth as a unit of assessment.
Figure 10.
Figure 10.
Risk of bias for RCTs.
See this image and copyright information in PMC

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