EFFICACY OF TEMPORARY FIXED RETENTION FOLLOWING ...

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ACKNOWLEDGEMENTS There are several folks that I need to thank for their help, guidance and patience in completing this thesis project. First, I am forever thankful for an understanding wife, whose unwavering support and constant encouragement have never wavered throughout this endeavor, or our marriage. I am truly blessed to have three wonderful children, Mark, Luke, and Rhett. You’ll never know how much I look forward to coming home to you guys every day and playing baseball in the yard or wrestling on “momma’s bed.” I can’t thank Dr. Edward F. Harris enough for all of his hard work and assistance on this project. Though rarely recognized, Dr. Harris is such a valuable asset to this department and was integral in the composition and completion of this Master’s thesis. Without his constant help and encouragement, this project would not have been possible. I would also like to thank the members of my thesis committee, Dr. James L. Vaden and Dr. Jere L. Yates, for their unselfish donation of time and energy to my thesis project. Your guidance and advice were invaluable. Thank you to Dr. George S. Harris, Dr. James L. Ferguson, and Donna Niemczyk for the countless hours of collecting, measuring and digitizing the orthodontic records used in this research project. I am grateful for their assistance in interpreting the significance of such an impressive collection of research data. And finally, I am grateful to have been blessed with such admirable parents, Don and Carol Owens, who instilled in me a solid work ethic and sense of responsibility from an early age, and have always been available to offer help and guidance in every way throughout my life. iv
ABSTRACT Instability of the occlusion is a common problem following orthodontic treatment. The purpose of the present research was to evaluate posttreatment relapse at long-term recall (> 10 years) in cases (A) treated with temporary fixed mandibular retention plus Hawley retainers compared to (B) a similar group retained with just removable retention (standard Hawley type retainers alone). Fixed retainers were removed after having been in place for about 2.5 years. Following this period, use of removable retention was left up to the discretion of the patient in both groups. Data consisted of orthodontic records of 166 American whites, all of whom had received comprehensive orthodontic treatment, collected from multiple private practice orthodontists using conventional Edgewise mechanics. Records were analyzed at pretreatment, end of treatment, and at long-term posttreatment recall examination (mean = 16 years after treatment). The mandibular Incisor Irregularity index at recall averaged 1.9 mm in the fixed group and 2.5 mm in the Hawley-only group. This ½-mm difference is marginally significant statistically (P = 0.03), but seems trivially small clinically. A 1.0 mm change in Incisor Irregularity during treatment was shown to be associated with 0.13 mm of relapse long term. Mandibular intercanine width increased (mean = 1.2 mm) during treatment, but decreased by almost the same amount by the recall examination. Maxillary and mandibular arch widths became slightly narrower after treatment. Overbite and overjet both increased after treatment. Results of the present study seem more stable than those reported in most long-term studies; however, there is little clinical support for a fixed-retention phase given the modest (½-mm) difference in Incisor Irregularity. v
Page 1 and 2: EFFICACY OF TEMPORARY FIXED RETENTI
Page 3: DEDICATION This thesis is dedicated
Page 7 and 8: CHAPTER 5. DISCUSSION .............
Page 9 and 10: LIST OF FIGURES Figure 3-1. All cas
Page 11 and 12: Figure 4-14. Box plot of the distri
Page 13 and 14: Joondeph and Riedel (1994, p 908) d
Page 15 and 16: Strang (1952, p 794) claimed that
Page 17 and 18: malocclusion must be maintained if
Page 19 and 20: e aimed at maintaining, in most ins
Page 21 and 22: three time intervals: during treatm
Page 23 and 24: mechanical treatment does not neces
Page 25 and 26: elation, the masticatory system wil
Page 27 and 28: exerted on the denture from the buc
Page 29 and 30: In summary, the variance in tongue
Page 31 and 32: Sinclair and Little (1983, p 114) a
Page 33 and 34: Study and 43 orthodontically treate
Page 35 and 36: and Sakols 1982; Vaden et al. 1997;
Page 37 and 38: years postretention. Årtun et al.
Page 39 and 40: adjustment, if necessary. This abil
Page 41 and 42: Duration of Retention The premise i
Page 43 and 44: The reduction in tooth structure of
Page 45 and 46: 4. The most stable position of the
Page 47 and 48: CHAPTER 3. MATERIALS AND METHODS Sa
Page 49 and 50: The present sample consisted of the
Page 51 and 52: Figure 3-2. Illustration of how mol
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Figure 3-5. Illustration showing mi
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Figure 3-6. Illustration showing an
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Figure 3-8. Illustration showing in
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34. LR3 cusp tip point. 35. Right d
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Figure 3-10. Illustration showing o
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Figure 3-11. Illustration of Inciso
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3. Go, Gonion (anatomic): The most
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Figure 3-13. Depiction of the angle
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Figure 3-15. Illustration of the me
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Figure 3-17. Illustration of the me
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Figure 3-19. Illustration of the an
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Figure 3-21. Illustration of the up
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Figure 3-22. Illustration of the to
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Figure 3-24. Illustration of the po
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the “older” Tweed force system,
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The null hypothesis is: There was n
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Figure 4-1. Distribution of the 166
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occlusal issues are tolerated by bo
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40 35 30 FMA (degrees) 25 20 15 10
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Figure 4-4. Plot of the average val
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larger ANB at the recall examinatio
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21 19 Total Chin (mm) 17 15 13 11 9
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Figure 4-8. Box plot of the distrib
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which a Class I relationship was no
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Figure 4-11. Plot of mean Curve of
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Figure 4-13. Box plot of the distri
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Table A-4 addresses the question of
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Figure 4-16. Bar chart of the avera
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only sample changed significantly m
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3 2 1 0 Canonical Variate 2 -1 -2 R
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8 Anterior Discrepancy (ADisc) 6 4
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40 Incisor Aspect Ratio (IAR) 30 20
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1.5 Incisor Segment Depth (ISD) 1 0
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more stable (i.e., the mean change
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Molar Correction (MC) 10 8 6 4 2 0
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Anterior Segment Width (ASW) 1 0 -1
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final vertical positions. This phas
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decreased in both arches during the
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Figure 5-1. Plot of average Incisor
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Based on the present results, the u
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these variables indicate more anter
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and the hassle associated with plac
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Figure 5-2. Scatter-plot graph refl
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stability?” and “for how long?
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About two-thirds (64%) of the corre
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Baume LJ, Horowitz HS, Summers CJ,
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Case CS. Techniques and principles
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Glenn G, Sinclair PM, Alexander RG.
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Joondeph DR. Retention and relapse.
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Littlewood SJ, Millett DT, Doubleda
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Ormiston JP, Huang GJ, Little RM, D
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Rosenstein SW, Jacobson BN. Retenti
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Steadman SR. A philosophy and pract
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Zachrisson BU, Büyükyilmaz T. Bon
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Table A-1. Descriptive statistics a
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Table A-2. Descriptive statistics a
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Table A-3. Descriptive statistics f
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APPENDIX B. ANCOVA TESTS OF THE COM
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Table B-1. Continued. Sex Retention
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Table C-1. Results of ANCOVA tests
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Table D-1. Descriptive statistics,
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Table E-1. Two-way ANOVA tests eval
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VITA Mark Owens was born on January
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