Affiliation:
1. Department of Orthodontics, Faculty of Odontology, Malmö University, Sweden
2. Orthodontic Clinic, Public Dental Health, Växjö, Sweden
Abstract
Summary
Background
There has been an increased interest in conducting healthcare economic evaluations. Also, orthodontic treatments have gathered focus from an economic point of view, however orthodontic research seldom examines both clinical and economic outcomes.
Objective
To evaluate and compare the costs of three retention methods: a bonded retainer to the maxillary four incisors, a bonded retainer to the maxillary four incisors and canines, and a removable vacuum-formed retainer (VFR) in the maxilla. The null hypothesis was that there was no difference in costs for the three types of retention methods.
Trial design
Three-arm, parallel group, single-centre, randomized controlled trial.
Materials and methods
Ninety adolescent patients, 54 girls and 36 boys, treated with fixed or removable retainers in the maxilla, were recruited to the study. The patients were randomized in blocks of 30, by an independent person, to one of three groups: bonded multistranded PentaOne (Masel Orthodontics) retainer 13-23, bonded multistranded PentaOne (Masel Orthodontics) retainer 12-22, and removable VFR. A cost analysis was made regarding chair time costs based on the costs per hour for the specialist in orthodontics, and material costs plus any eventual costs for repairs of the appliance. Changes in Little’s irregularity index and in single contact point discrepancies (CPDs) were measured on digitalized three-dimensional study casts. Data were evaluated on an intention-to-treat basis. The analysis was performed at 2 years of retention.
Results
No statistically significant difference in costs between the maxillary fixed retainers and the VFRs was found, however, the material and emergency costs were significantly higher for the VFR compared with the bonded retainers. All three retention methods showed equally effective retention capacity, and no statistically significant differences in irregularity or CPDs of the maxillary anterior teeth in the three groups was detected.
Limitations
It was a single-centre trial, and hence less generalizable. Costs depended on local factors, and consequently, cannot be directly transferred to other settings.
Conclusions
All three retention methods can be recommended when considering costs and retention capacity.
Trial registration
NCT04616755.
Funder
Public Dental Health, Region Kronoberg
Department of Research and Development, Region Kronoberg
Faculty of Odontology, Malmö, Sweden
Publisher
Oxford University Press (OUP)
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