# Retrospective Study Regarding Orthodontic Retention Complications in Clinical Practice
###### Abstract  
At the end of any orthodontic treatment, retention is a necessary phase. Unfortunately, the current retention devices and the lack of proper oral hygiene on the part of patients lead to the accumulation of dental plaque, periodontal inflammation, and gingival retraction. Our retrospective study included 116 adult patients wearing various types of orthodontic retainers. To quantitatively determine the accumulation of dental plaque, we used the Quigley-Hein plaque index modified by [PERSON] and the Navy plaque index modified by [PERSON]. Another studied parameter was related to the gingival recession associated with retention devices. We had investigated the correctness of patients' dental hygiene, their preferences for auxiliary means of oral hygiene, the consistency with which they wear the mobile retainers, and respect the orthodontis's instructions; we also investigated the inconveniences and the accidents that may occur during the retention period. Statistical analysis showed that plaque accumulation is significantly lower in the case of mobile retainer than fixed retainer wearers; the exception was the Hawley plate, where the interidental plaque was more than in all the other studied retainers. Periodontal recessions were more frequent in the case of fixed retainer wearing. Flossing was the most commonly used auxiliary mean for oral hygiene. The compliance of women in wearing vacuum-formed retainers was better than that of men. Patients with a class III history had more plaque accumulation, and class II/1 had the most problems related to detachment/damage of fixed retainers. Mobile retainers proved better results for oral hygiene, but fixed retainers cannot be waved. Orthodontic retainer; oral hygiene; gingival recession; patient compliance +
Footnote †: journal: Medical Medicine  
1 Faculty of Medicine, Dimitrie Cantemir University, 3-5 Bodoni Sandor Str., 540545 Targu Mures, Romania; [EMAIL_ADDRESS]  
2 Faculty of Engineering and Information Technology, [PERSON] University of Medicine, Pharmacy, Science and Technology, 38 Gheorghe Marinescu Str., 540139 Targu Mures, Romania; [EMAIL_ADDRESS]  
3 Faculty of Dental Medicine, [PERSON] University of Medicine, Pharmacy, Science and Technology, 38 GheorgIn literature, there are controversial opinions on the effect of orthodontic retainers on the periodontium. Some authors found no significant difference between stainless steel fixed retainers bonded to the anterior teeth and canines only in terms of periodontal outcomes, at 12-month and 3-year follow-ups [6,7]. Periodontal damages caused by mandibular Hawley retainers comparatively with mandibular stainless steel fixed retainers proved no significant difference in a 3-year follow-up [7]. No significant difference in the survival rate of multistrand stainless steel fixed retainers and esthetic retainers made of polyethylene woven ribbon or polyethylene fiber-reinforced resin composite was found [8]. Orthodontic fixed retainers seem to be compatible with periodontal health or at least not related to severe detrimental effects on the periodontium. Other authors [8] found increased plaque accumulation, gingival recession, increase in periodontal pockets' depth, marginal gingival recession, and calculus accumulation in fixed retainers wearers. The adherent microorganisms of the biofilm are different from the free planktonic bacteria because they could not be affected by antibiotics, disinfectants, and the body's defense agents [9]. Other aggressive factors for periodontal tissues are tartar, incorrectly adapted fillings, inadequate prosthetic works, orthodontic braces, rings, and retainers [10,11,12]. Gingival recession is the movement of the free gingival margin in the apical direction from the enamel-cement junction. The etiology is multifactorial still, periodontal disease and mechanical trauma are causes for gingival recessions. Orthodontic treatment can help develop gingival recession [11].