Survey Based Study of the Most Common Retention Protocols

Objective: To use a pilot-tested survey instrument to identify the most popular orthodontic retention protocols used in the US as reported by active members of the American Association of Orthodontists. Methods: 2000 active members of the American Association of Orthodontists, stratified by region they practice in, were randomly selected for the study. Information gathered included, but was not limited to, the type of retainers prescribed in both dental arches, duration of full-time and part-time wear, use of fixed retainers, appliances fabricated in-office versus commercial labs, the number of debonds per year, and retention appointment schedules. In all, the survey consisted of 20 questions and data were gathered on a categorical scale and analyzed using SPSS. Results: 658 responses were received during a 12 week period. Maxillary Hawley retainers (58.2%) and mandibular fixed lingual retainers (40.2%) are the most commonly used. Most orthodontists prescribe less than 9 months of full-time wear of removable retainers and thereafter typically advise part-time, lifetime wear. Most orthodontists do not instruct patients to have the fixed lingual retainers removed at a specific time (75.9%). A greater percentage of orthodontists who prescribe Hawley retainers recommend a longer duration of full-time wear as compared to clear thermoplastic retainers. The timing of scheduled retention appointments is variable among clinicians and is dependent on the number of years in practice, volume of patients debonded, and the type of prescribed retainer. The only regional difference associated with retainer design was the Northeast region utilizing mandibular fixed lingual retainers less frequently. Statistical significance was predetermined at P < 0.05 for all comparisons. Conclusions: Maxillary Hawley retainers and mandibular fixed lingual retainers are the most commonly used retainers. This study is the first to describe retention protocols in the US, as reported by active members of the AAO.