Retainer preferences and retention protocols of orthodontists: A scoping review

Insight into relevant orthodontist preferences and opinions regarding orthodontic retention and retainers is a key component of relevant evidence-based healthcare. The aim of this review was to collate and synthesize the evidence related to orthodontist preferences regarding orthodontic retainers and retention protocols. The review methodology aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Systematic searching of four databases and independent screening of publications by two reviewers resulted in 30 cross-sectional questionnaire studies for inclusion. A total of 8258 orthodontists in at least 23 countries were surveyed. The number and nature of questions within each study varied considerably. The clear plastic retainer (n=11; 36.7%) was reportedly the most prescribed retainer in the maxilla followed by the Hawley Retainer (n=7; 23.3%). The bonded retainer was the most preferred retainer in the mandible in 18 studies (60%) followed by the clear plastic retainer in five (16.7%) studies. Indefinite retainer wear was recommended by between 5.4-100% of respondents. There was wide variance in preferred clear plastic retainer and bonded retainer wear full-time and part-time wear protocols, material, design and fabrication characteristics reported by orthodontists. Adjunctive procedures appeared to be infrequently employed, and the pre-treatment malocclusion was the factor that most influenced orthodontists' choice of retainer. Future investigations should consider qualitative research methodologies to help provide insights and deeper understanding into orthodontists' retainer and retention preferences.