Assessing the Impact of Removable Orthodontic Retainers on Oral Health Related Quality of Life: Non-Randomized Clinical Trial
Abstract
Objectives: This study aimed to compare the oral health-related quality of life (OHRQoL) and self-perceived satisfaction of patients wearing Hawley (HR) or Essix retainer (ER) using the Oral Health Impact Profile (OHIP-14) questionnaire.
Materials and Methods: Sixty patients who had recently completed orthodontic treatment and received either an HR or ER were recruited. Participants completed the OHIP-14 questionnaire one week (T1) and two months (T2) after receiving their retainers. Self-perceived satisfaction with the retainers was also recorded.
Results: The ER group showed significantly lower overall OHIP-14 scores than the HR group at both T1 and T2. In 14 OHIP items, HR scored higher in all except “sense of taste” (T1 and T2), “unsatisfactory diet” (T1), and “uncomfortable eating” (T2). From T1 to T2, overall OHIP-14 scores decreased significantly in both groups, with reductions in 10 items for ER and 8 items for HR. The mean satisfaction score (out of 3) was higher for ER (2.5±0.5) than for HR (1.23±0.43), and satisfaction increased significantly in both groups over time.
Conclusion: ER had less negative impact on OHRQoL than HR. After two months, most OHIP-14 dimensions showed improvement in both groups, indicating patient adaptation to retainers and reduced discomfort over time. Adaptation was slightly greater with ER, and overall satisfaction was higher compared to HR.
1. Li B, Xu Y, Lu C, Wei Z, Li Y, Zhang J. Assessment of the effect of vacuum-formed retainers and Hawley retainers on periodontal health: A systematic review and meta-analysis. PLoS One 2021;16:e0253968.
2. Steinnes J, Johnsen G, Kerosuo H. Stability of orthodontic treatment outcome in relation to retention status: An 8-year follow-up. Am J Orthod Dentofac Orthop 2017;151:1027-33.
3. Al-Moghrabi D, Pandis N, Fleming PS. The effects of fixed and removable orthodontic retainers: a systematic review. Prog Orthod 2016;17:24.
4. Lyros I, Tsolakis IA, Maroulakos MP, Fora E, Lykogeorgos T, Dalampira M, et al. Orthodontic Retainers—A Critical Review. Children 2023;10:230.
5. Johnston CD, Littlewood SJ. Retention in orthodontics. Br Dent J 2015;218:119-22.
6. Wong PM, Freer TJ. A comprehensive survey of retention procedures in Australia and New Zealand. Aust Orthod J 2004;20:99-106.
7. Saleh M, Hajeer MY, Muessig D. Acceptability comparison between Hawley retainers and vacuum-formed retainers in orthodontic adult patients: a single-centre, randomized controlled trial. Eur J Orthod 2017;39:453-61.
8. Barlin S, Smith R, Reed R, Sandy J, Ireland AJ. A retrospective randomized double-blind comparison study of the effectiveness of Hawley vs vacuum-formed retainers. Angle Orthod 2011;81:404-9.
9. Gardner GD, Dunn WJ, Taloumis L. Wear comparison of thermoplastic materials used for orthodontic retainers. Am J Orthod Dentofac Orthop 2003;124:294-7.
10. Rowland H, Hichens L, Williams A, Hills D, Killingback N, Ewings P, et al. The effectiveness of Hawley and vacuum-formed retainers: A single-center randomized controlled trial. Am J Orthod Dentofac Orthop 2007;132:730-7.
11. Blake M, Garvey MT. Rationale for retention following orthodontic treatment. J Can Dent Assoc 1998;64:640-4.
12. Mai W, He J, Meng H, Jiang Y, Huang C, Li M, et al. Comparison of vacuum-formed and Hawley retainers: A systematic review. Am J Orthod Dentofac Orthop 2014;145:720-7.
13. Geramy A, Retrouvey JM, Sobuti F, Salehi H. Anterior Teeth Splinting After Orthodontic Treatment: 3D Analysis Using Finite Element Method. J Dent (Tehran) 2012;9:90.
14. Alzoubi E, Hariri R, Mulligan K, Attard N. An evaluation of oral health-related quality of life in orthodontic patients treated with fixed and twin blocks appliances. J Orthod Sci 2017;6:65-70.
15. Alzarea BK. Assessment and evaluation of quality of life (OHRQOL) of patients with dental implants using the oral health impact profile (OHIP-14) - A clinical study. J Clin Diagnostic Res 2016;10:ZC57.
16. Locker D, Quiñonez C. To what extent do oral disorders compromise the quality of life? Community Dent Oral Epidemiol 2011;39:3-11.
17. Atik E, Esen Aydınlı F, Kulak Kayıkçı ME, Ciğer S. Comparing the effects of Essix and Hawley retainers on the acoustics of speech. Eur J Orthod 2016;39:440-5.
18. Najjar HE, Alzaid SA, Alasmari AM, Alrashdi SA, Alqahtani AM, Alrhile SM, et al. Impact of orthodontic treatment on speech and phonetics: a review. Int J Community Med Public Heal 2023;10:2995.
19. Shueb SS, Nixdorf DR, John MT, Alonso BF, Durham J. What is the impact of acute and chronic orofacial pain on quality of life? J Dent 2015;43:1203-10.
20. Brennan DS, Spencer AJ. Dimensions of oral health related quality of life measured by EQ-5D+ and OHIP-14. Health Qual Life Outcomes 2004;2:35.
21. Ravaghi V, Farrahi-Avval N, Locker D, Underwood M. Validation of the Persian short version of the Oral Health Impact Profile (OHIP-14). Oral Heal Prev Dent 2010;8:229-35.
22. Proffit WR, Fields HW, Larson BE, Sarver DM. Contemporary orthodontics 6th edition William proffit. 2019;6:579-85.
23. Barkokebas A, Silva IHM, de Andrade SC, Carvalho AAT, Gueiros LAM, Paiva SM, et al. Impact of oral mucositis on oral-health-related quality of life of patients diagnosed with cancer. J Oral Pathol Med 2015;44:746-51.
24. De Oliveira CM, Sheiham A. Orthodontic treatment and its impact on oral health-related quality of life in Brazilian adolescents. J Orthod 2004;31:20-7.
25. Feu D, Miguel JAM, Celeste RK, Oliveira BH. Effect of orthodontic treatment on oral health-related quality of life. Angle Orthod 2013;83:892-8.
26. Silvola AS, Rusanen J, Tolvanen M, Pirttiniemi P, Lahti S. Occlusal characteristics and quality of life before and after treatment of severe malocclusion. Eur J Orthod 2012;34:704-9.
27. Chen M, Wang DW, Wu LP. Fixed orthodontic appliance therapy and its impact on oral health-related quality of life in Chinese patients. Angle Orthod 2010;80:49-53.
28. Kettle JE, Hyde AC, Frawley T, Granger C, Longstaff SJ, Benson PE. Managing orthodontic appliances in everyday life: A qualitative study of young people’s experiences with removable functional appliances, fixed appliances and retainers. J Orthod 2020;47:47-54.
29. Quinzi V, Carli E, Mummolo A, De Benedictis F, Salvati SE, Mampieri G. Fixed and removable orthodontic retainers, effects on periodontal health compared: A systematic review. J Oral Biol Craniofacial Res 2023;13:337-46.
30. Lyros I, Tsolakis IA, Maroulakos MP, Fora E, Lykogeorgos T, Dalampira M, Tsolakis AI. Orthodontic retainers—a critical review. Children. 2023;10:230.
31. Medina MCG, dos Santos CCO, Lima BO, Ferreira MB, Normando D. Impact of fixed orthodontic retainers on oral health-related quality of life: a longitudinal prospective study. Dental Press J Orthod 2024;29:e242317.
32. Westerlund A. Stability and Side Effects of Orthodontic Retainers - A Systematic Review. Dentistry 2014;04:1.
33. Alghamdi MA, Farsi NJ, Hassan AH. Comparison of oral health-related quality of life of patients treated by palatal expanders with patients treated by fixed orthodontic appliances. Patient Prefer Adherence 2017;11:699-705.
34. Bibi K, Jan A, Hameed M, Afgan N, Alamzeb H, Malik S. Comparative Assessment of Patient’s Acceptability between Hawley and Vacuum-Formed Retainer in Patients Treated with Fixed Orthodontics Appliance. Pakistan Armed Forces Med J 2023;73:682.
35. Devi S, Jain RK, Balasubramaniam A. Comparative evaluation of patient satisfaction following the use of two different orthodontic removable retainers: A prospective randomized controlled trial. J Int Oral Heal 2022;14:370-6.
36. Zheng DH, Wang XX, Su YR, Zhao SY, Xu C, Kong C, et al. Assessing changes in quality of life using the Oral Health Impact Profile (OHIP) in patients with different classifications of malocclusion during comprehensive orthodontic treatment. BMC Oral Health 2015;15:148.
37. Vinita Mary A, Mahendra J, John J, Moses J, Rajesh Ebenezar A V., Kesavan R. Assessing quality of life using the oral health impact profile (OHIP-14) in subjects with and without orthodontic treatment need in Chennai, Tamil Nadu, India. J Clin Diagnostic Res 2017;11:ZC78.
38. Cunningham SJ, Hunt NP. Quality of life and its importance in orthodontics. J Orthod 2001;28:152-8.
39. Hichens L, Rowland H, Williams A, Hollinghurst S, Ewings P, Clark S, et al. Cost-effectiveness and patient satisfaction: Hawley and vacuum-formed retainers. Eur J Orthod 2007;29:372-8.
40. Pratt MC, Kluemper GT, Lindstrom AF. Patient compliance with orthodontic retainers in the postretention phase. Am J Orthod Dentofac Orthop 2011;140:196-201.
41. Chen J, Wan J, You L. Speech and orthodontic appliances: A systematic literature review. Eur J Orthod 2018;40:29-36.
42. Haydar B, Karabulut G, Ozkan S, Aksoy AU, Ciger S. Effects of retainers on the articulation of speech. Am J Orthod Dentofacial Orthop 1996;110:535-40.
43. Wan J, Wang T, Pei X, Wan Q, Feng W, Chen J. Speech effects of Hawley and vacuum-formed retainers by acoustic analysis: A single-center randomized controlled trial. Angle Orthod 2017;87:286-92.
44. Kayikci MEK, Akan S, Ciger S, Ozkan S. Effects of Hawley retainers on consonants and formant frequencies of vowels. Angle Orthod 2012;82:14-21.
45. Kacer KA, Valiathan M, Narendran S, Hans MG. Retainer wear and compliance in the first 2 years after active orthodontic treatment. Am J Orthod Dentofac Orthop 2010;138:592-8.
46. Bartsch A, Witt E, Sahm G, Schneider S. Correlates of objective patient compliance with removable appliance wear. Am J Orthod Dentofac Orthop 1993;104:378-86.
47. Freitas LRP, Oliveira DD. Orthodontic retreatment: Positive effects on the patient’s self-esteem and quality of life. Dental Press J Orthod 2021;26:e21bbo5.
2. Steinnes J, Johnsen G, Kerosuo H. Stability of orthodontic treatment outcome in relation to retention status: An 8-year follow-up. Am J Orthod Dentofac Orthop 2017;151:1027-33.
3. Al-Moghrabi D, Pandis N, Fleming PS. The effects of fixed and removable orthodontic retainers: a systematic review. Prog Orthod 2016;17:24.
4. Lyros I, Tsolakis IA, Maroulakos MP, Fora E, Lykogeorgos T, Dalampira M, et al. Orthodontic Retainers—A Critical Review. Children 2023;10:230.
5. Johnston CD, Littlewood SJ. Retention in orthodontics. Br Dent J 2015;218:119-22.
6. Wong PM, Freer TJ. A comprehensive survey of retention procedures in Australia and New Zealand. Aust Orthod J 2004;20:99-106.
7. Saleh M, Hajeer MY, Muessig D. Acceptability comparison between Hawley retainers and vacuum-formed retainers in orthodontic adult patients: a single-centre, randomized controlled trial. Eur J Orthod 2017;39:453-61.
8. Barlin S, Smith R, Reed R, Sandy J, Ireland AJ. A retrospective randomized double-blind comparison study of the effectiveness of Hawley vs vacuum-formed retainers. Angle Orthod 2011;81:404-9.
9. Gardner GD, Dunn WJ, Taloumis L. Wear comparison of thermoplastic materials used for orthodontic retainers. Am J Orthod Dentofac Orthop 2003;124:294-7.
10. Rowland H, Hichens L, Williams A, Hills D, Killingback N, Ewings P, et al. The effectiveness of Hawley and vacuum-formed retainers: A single-center randomized controlled trial. Am J Orthod Dentofac Orthop 2007;132:730-7.
11. Blake M, Garvey MT. Rationale for retention following orthodontic treatment. J Can Dent Assoc 1998;64:640-4.
12. Mai W, He J, Meng H, Jiang Y, Huang C, Li M, et al. Comparison of vacuum-formed and Hawley retainers: A systematic review. Am J Orthod Dentofac Orthop 2014;145:720-7.
13. Geramy A, Retrouvey JM, Sobuti F, Salehi H. Anterior Teeth Splinting After Orthodontic Treatment: 3D Analysis Using Finite Element Method. J Dent (Tehran) 2012;9:90.
14. Alzoubi E, Hariri R, Mulligan K, Attard N. An evaluation of oral health-related quality of life in orthodontic patients treated with fixed and twin blocks appliances. J Orthod Sci 2017;6:65-70.
15. Alzarea BK. Assessment and evaluation of quality of life (OHRQOL) of patients with dental implants using the oral health impact profile (OHIP-14) - A clinical study. J Clin Diagnostic Res 2016;10:ZC57.
16. Locker D, Quiñonez C. To what extent do oral disorders compromise the quality of life? Community Dent Oral Epidemiol 2011;39:3-11.
17. Atik E, Esen Aydınlı F, Kulak Kayıkçı ME, Ciğer S. Comparing the effects of Essix and Hawley retainers on the acoustics of speech. Eur J Orthod 2016;39:440-5.
18. Najjar HE, Alzaid SA, Alasmari AM, Alrashdi SA, Alqahtani AM, Alrhile SM, et al. Impact of orthodontic treatment on speech and phonetics: a review. Int J Community Med Public Heal 2023;10:2995.
19. Shueb SS, Nixdorf DR, John MT, Alonso BF, Durham J. What is the impact of acute and chronic orofacial pain on quality of life? J Dent 2015;43:1203-10.
20. Brennan DS, Spencer AJ. Dimensions of oral health related quality of life measured by EQ-5D+ and OHIP-14. Health Qual Life Outcomes 2004;2:35.
21. Ravaghi V, Farrahi-Avval N, Locker D, Underwood M. Validation of the Persian short version of the Oral Health Impact Profile (OHIP-14). Oral Heal Prev Dent 2010;8:229-35.
22. Proffit WR, Fields HW, Larson BE, Sarver DM. Contemporary orthodontics 6th edition William proffit. 2019;6:579-85.
23. Barkokebas A, Silva IHM, de Andrade SC, Carvalho AAT, Gueiros LAM, Paiva SM, et al. Impact of oral mucositis on oral-health-related quality of life of patients diagnosed with cancer. J Oral Pathol Med 2015;44:746-51.
24. De Oliveira CM, Sheiham A. Orthodontic treatment and its impact on oral health-related quality of life in Brazilian adolescents. J Orthod 2004;31:20-7.
25. Feu D, Miguel JAM, Celeste RK, Oliveira BH. Effect of orthodontic treatment on oral health-related quality of life. Angle Orthod 2013;83:892-8.
26. Silvola AS, Rusanen J, Tolvanen M, Pirttiniemi P, Lahti S. Occlusal characteristics and quality of life before and after treatment of severe malocclusion. Eur J Orthod 2012;34:704-9.
27. Chen M, Wang DW, Wu LP. Fixed orthodontic appliance therapy and its impact on oral health-related quality of life in Chinese patients. Angle Orthod 2010;80:49-53.
28. Kettle JE, Hyde AC, Frawley T, Granger C, Longstaff SJ, Benson PE. Managing orthodontic appliances in everyday life: A qualitative study of young people’s experiences with removable functional appliances, fixed appliances and retainers. J Orthod 2020;47:47-54.
29. Quinzi V, Carli E, Mummolo A, De Benedictis F, Salvati SE, Mampieri G. Fixed and removable orthodontic retainers, effects on periodontal health compared: A systematic review. J Oral Biol Craniofacial Res 2023;13:337-46.
30. Lyros I, Tsolakis IA, Maroulakos MP, Fora E, Lykogeorgos T, Dalampira M, Tsolakis AI. Orthodontic retainers—a critical review. Children. 2023;10:230.
31. Medina MCG, dos Santos CCO, Lima BO, Ferreira MB, Normando D. Impact of fixed orthodontic retainers on oral health-related quality of life: a longitudinal prospective study. Dental Press J Orthod 2024;29:e242317.
32. Westerlund A. Stability and Side Effects of Orthodontic Retainers - A Systematic Review. Dentistry 2014;04:1.
33. Alghamdi MA, Farsi NJ, Hassan AH. Comparison of oral health-related quality of life of patients treated by palatal expanders with patients treated by fixed orthodontic appliances. Patient Prefer Adherence 2017;11:699-705.
34. Bibi K, Jan A, Hameed M, Afgan N, Alamzeb H, Malik S. Comparative Assessment of Patient’s Acceptability between Hawley and Vacuum-Formed Retainer in Patients Treated with Fixed Orthodontics Appliance. Pakistan Armed Forces Med J 2023;73:682.
35. Devi S, Jain RK, Balasubramaniam A. Comparative evaluation of patient satisfaction following the use of two different orthodontic removable retainers: A prospective randomized controlled trial. J Int Oral Heal 2022;14:370-6.
36. Zheng DH, Wang XX, Su YR, Zhao SY, Xu C, Kong C, et al. Assessing changes in quality of life using the Oral Health Impact Profile (OHIP) in patients with different classifications of malocclusion during comprehensive orthodontic treatment. BMC Oral Health 2015;15:148.
37. Vinita Mary A, Mahendra J, John J, Moses J, Rajesh Ebenezar A V., Kesavan R. Assessing quality of life using the oral health impact profile (OHIP-14) in subjects with and without orthodontic treatment need in Chennai, Tamil Nadu, India. J Clin Diagnostic Res 2017;11:ZC78.
38. Cunningham SJ, Hunt NP. Quality of life and its importance in orthodontics. J Orthod 2001;28:152-8.
39. Hichens L, Rowland H, Williams A, Hollinghurst S, Ewings P, Clark S, et al. Cost-effectiveness and patient satisfaction: Hawley and vacuum-formed retainers. Eur J Orthod 2007;29:372-8.
40. Pratt MC, Kluemper GT, Lindstrom AF. Patient compliance with orthodontic retainers in the postretention phase. Am J Orthod Dentofac Orthop 2011;140:196-201.
41. Chen J, Wan J, You L. Speech and orthodontic appliances: A systematic literature review. Eur J Orthod 2018;40:29-36.
42. Haydar B, Karabulut G, Ozkan S, Aksoy AU, Ciger S. Effects of retainers on the articulation of speech. Am J Orthod Dentofacial Orthop 1996;110:535-40.
43. Wan J, Wang T, Pei X, Wan Q, Feng W, Chen J. Speech effects of Hawley and vacuum-formed retainers by acoustic analysis: A single-center randomized controlled trial. Angle Orthod 2017;87:286-92.
44. Kayikci MEK, Akan S, Ciger S, Ozkan S. Effects of Hawley retainers on consonants and formant frequencies of vowels. Angle Orthod 2012;82:14-21.
45. Kacer KA, Valiathan M, Narendran S, Hans MG. Retainer wear and compliance in the first 2 years after active orthodontic treatment. Am J Orthod Dentofac Orthop 2010;138:592-8.
46. Bartsch A, Witt E, Sahm G, Schneider S. Correlates of objective patient compliance with removable appliance wear. Am J Orthod Dentofac Orthop 1993;104:378-86.
47. Freitas LRP, Oliveira DD. Orthodontic retreatment: Positive effects on the patient’s self-esteem and quality of life. Dental Press J Orthod 2021;26:e21bbo5.
| Issue | Vol 22 (Continuously Published Article-Based) | |
| Section | Original Article | |
| Keywords | ||
| Appliance Removable Orthodontic orthodontic retainer Quality of life Questionnaire | ||
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How to Cite
1.
Saffar Shahroudi A, Bahrami R. Assessing the Impact of Removable Orthodontic Retainers on Oral Health Related Quality of Life: Non-Randomized Clinical Trial. Front Dent. 2025;22.
