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. 2023 May 22;2023(5):CD002283. doi: 10.1002/14651858.CD002283.pub5

Comparison 1. Removable versus fixed retainers.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1.1 Stability: Irregularity Index 6   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.1.1 Upper removable clear plastic part‐time vs fixed multistrand at 12 months 1 56 Mean Difference (IV, Fixed, 95% CI) ‐0.34 [‐0.95, 0.27]
1.1.2 Upper removable clear plastic part‐time vs fixed multistrand (13‐23) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) 0.70 [0.09, 1.31]
1.1.3 Upper removable clear plastic part‐time vs fixed multistrand (12‐22) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) 0.40 [‐0.21, 1.01]
1.1.4 Lower removable clear plastic full‐time vs fixed multistrand/coaxial at 6 months 2 103 Mean Difference (IV, Fixed, 95% CI) 0.05 [‐0.00, 0.10]
1.1.5 Lower removable clear plastic full‐time vs fixed single strand titanium at 6 months  1 29 Mean Difference (IV, Fixed, 95% CI) ‐0.10 [‐0.70, 0.50]
1.1.6 Lower removable clear plastic full‐time vs CAD‐CAM nitinol at 6 months 1 30 Mean Difference (IV, Fixed, 95% CI) ‐0.06 [‐0.62, 0.50]
1.1.7 Lower removable clear plastic full‐time vs fixed multistrand at 12 months 1 84 Mean Difference (IV, Fixed, 95% CI) 0.60 [0.17, 1.03]
1.1.8 Lower removable clear plastic part‐time vs fixed multistrand at 12 months 1 56 Mean Difference (IV, Fixed, 95% CI) 0.92 [0.23, 1.61]
1.1.9 Lower removable partial clear plastic part‐time vs thick plain canine to canine at 18 months 1 95 Mean Difference (IV, Fixed, 95% CI) 0.07 [‐0.20, 0.34]
1.1.10 Lower removable clear plastic part‐time vs fixed coaxial at 48 months 1 42 Mean Difference (IV, Fixed, 95% CI) 1.52 [0.75, 2.29]
1.2 Stability: intercanine width 5   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.2.1 Upper removable clear plastic part‐time vs fixed multistrand at 12 months 1 56 Mean Difference (IV, Fixed, 95% CI) ‐0.06 [‐0.48, 0.36]
1.2.2 Upper removable clear plastic part‐time vs fixed multistrand (13‐23) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) 0.50 [0.23, 0.77]
1.2.3 Upper removable clear plastic part‐time vs fixed multistrand (12‐22) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) 0.20 [‐0.23, 0.63]
1.2.4 Lower removable clear plastic full‐time vs fixed multistrand/coaxial at 6 months 2 103 Mean Difference (IV, Fixed, 95% CI) 0.11 [0.05, 0.17]
1.2.5 Lower removable clear plastic full‐time vs fixed single strand titanium at 6 months 1 29 Mean Difference (IV, Fixed, 95% CI) 0.06 [‐0.48, 0.60]
1.2.6 Lower removable clear plastic full‐time vs fixed CAD‐CAM nitinol at 6 months 1 30 Mean Difference (IV, Fixed, 95% CI) 0.10 [‐0.12, 0.32]
1.2.7 Lower removable clear plastic part‐time vs fixed multistrand at 12 months 1 56 Mean Difference (IV, Fixed, 95% CI) ‐0.19 [‐0.53, 0.15]
1.2.8 Lower removable partial clear plastic part‐time vs thick plain (33 and 43) at 18 months 1 95 Mean Difference (IV, Fixed, 95% CI) ‐0.08 [‐0.29, 0.13]
1.2.9 Lower removable clear plastic part‐time vs fixed coaxial at 48 months 1 42 Mean Difference (IV, Fixed, 95% CI) ‐0.24 [‐0.87, 0.39]
1.3 Stability: intermolar width 5   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.3.1 Upper removable clear plastic part‐time vs fixed multistrand at 12 months 1 56 Mean Difference (IV, Fixed, 95% CI) 0.18 [‐0.56, 0.92]
1.3.2 Upper removable clear plastic part‐time vs fixed multistrand (13‐23) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) ‐0.10 [‐0.53, 0.33]
1.3.3 Upper removable clear plastic part‐time vs fixed multistrand (12‐22) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) 0.00 [‐0.43, 0.43]
1.3.4 Lower removable clear plastic full‐time vs fixed multistrand/coaxial at 6 months 2 103 Mean Difference (IV, Fixed, 95% CI) ‐0.10 [‐0.23, 0.03]
1.3.5 Lower removable clear plastic full‐time vs fixed single strand titanium at 6 months 1 29 Mean Difference (IV, Fixed, 95% CI) 0.03 [‐0.84, 0.90]
1.3.6 Lower removable clear plastic full‐time vs fixed CAD‐CAM nitinol at 6 months 1 30 Mean Difference (IV, Fixed, 95% CI) ‐0.25 [‐1.19, 0.69]
1.3.7 Lower removable clear plastic part‐time vs fixed multistrand at 12 months 1 56 Mean Difference (IV, Fixed, 95% CI) 0.43 [‐0.30, 1.16]
1.3.8 Lower removable partial clear plastic part‐time vs thick plain (33 and 43) at 18 months 1 95 Mean Difference (IV, Fixed, 95% CI) 0.24 [‐0.15, 0.63]
1.3.9 Lower removable clear plastic part‐time vs fixed coaxial at 48 months 1 42 Mean Difference (IV, Fixed, 95% CI) 0.57 [‐0.36, 1.50]
1.4 Stability: arch length 5   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.4.1 Upper removable clear plastic part‐time vs fixed multistrand at 12 months 1 56 Mean Difference (IV, Fixed, 95% CI) 0.46 [‐0.16, 1.08]
1.4.2 Upper removable clear plastic part‐time vs fixed multistrand (13‐23) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) ‐0.10 [‐0.37, 0.17]
1.4.3 Upper removable clear plastic part‐time vs fixed multistrand (12‐22) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) 0.10 [‐0.17, 0.37]
1.4.4 Lower removable clear plastic full‐time vs fixed multistrand/coaxial at 6 months 2 103 Mean Difference (IV, Fixed, 95% CI) 0.02 [‐0.11, 0.14]
1.4.5 Lower removable clear plastic full‐time vs fixed single strand titanium at 6 months 1 29 Mean Difference (IV, Fixed, 95% CI) ‐0.31 [‐0.84, 0.22]
1.4.6 Lower removable clear plastic full‐time vs fixed CAD‐CAM nitinol at 6 months 1 30 Mean Difference (IV, Fixed, 95% CI) ‐0.15 [‐0.73, 0.43]
1.4.7 Lower removable clear plastic part‐time vs fixed multistrand at 12 months 1 56 Mean Difference (IV, Fixed, 95% CI) ‐0.80 [‐1.28, ‐0.32]
1.4.8 Lower removable partial clear plastic part‐time vs thick plain (33 and 43) at 18 months 1 95 Mean Difference (IV, Fixed, 95% CI) 0.19 [‐0.12, 0.50]
1.4.9 Lower removable clear plastic part‐time vs fixed multistrand at 48 months 1 42 Mean Difference (IV, Fixed, 95% CI) ‐0.15 [‐0.84, 0.54]
1.5 Stability: overjet 3   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.5.1 Upper and lower removable clear plastic part‐time vs fixed multistrand at 12 months 1 56 Mean Difference (IV, Fixed, 95% CI) 0.21 [‐0.07, 0.49]
1.5.2 Lower removable partial clear plastic part‐time vs thick plain (33 and 43) at 18 months 1 95 Mean Difference (IV, Fixed, 95% CI) 0.08 [‐0.19, 0.35]
1.5.3 Upper removable clear plastic part‐time vs fixed multistrand (13‐23) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) ‐0.10 [‐0.53, 0.33]
1.5.4 Upper removable clear plastic part‐time vs fixed multistrand (12‐22) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) ‐0.10 [‐0.64, 0.44]
1.6 Stability: overbite 3   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.6.1 Upper and lower removable clear plastic part‐time vs fixed multistrand at 12 months 1 56 Mean Difference (IV, Fixed, 95% CI) ‐0.15 [‐0.45, 0.15]
1.6.2 Lower removable partial clear plastic part‐time vs thick plain (33 and 43) at 18 months 1 95 Mean Difference (IV, Fixed, 95% CI) 0.15 [‐0.09, 0.39]
1.6.3 Upper removable clear plastic part‐time vs fixed multistrand (13‐23) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) 0.10 [‐0.33, 0.53]
1.6.4 Upper removable clear plastic part‐time vs fixed multistrand (12‐22) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) 0.00 [‐0.43, 0.43]
1.7 Stability: maximum rotation 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.7.1 Upper removable clear plastic part‐time vs fixed multistrand (13‐23) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) 3.70 [0.87, 6.53]
1.7.2 Upper removable clear plastic part‐time vs fixed multistrand (12‐22) at 24 months 1 60 Mean Difference (IV, Fixed, 95% CI) 1.40 [‐1.36, 4.16]
1.8 Failure of retainers 5   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.8.1 Upper removable clear plastic part‐time vs fixed multistrand at 12 months 1 57 Risk Ratio (M‐H, Fixed, 95% CI) 0.81 [0.38, 1.71]
1.8.2 Lower removable clear plastic part‐time vs fixed multistrand at 12 months 1 57 Risk Ratio (M‐H, Fixed, 95% CI) 0.44 [0.20, 0.98]
1.8.3 Lower removable clear plastic full‐time vs fixed multistrand at 12 months 1 77 Risk Ratio (M‐H, Fixed, 95% CI) 3.42 [1.38, 8.47]
1.8.4 Lower removable partial clear plastic part‐time vs thick plain canine to canine at 18 months 1 104 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.21, 4.73]
1.8.5 Lower removable (acrylic & wire) vs thick plain canine to canine at 36 months 1 25 Risk Ratio (M‐H, Fixed, 95% CI) 1.57 [0.16, 15.16]
1.8.6 Lower removable (acrylic & wire) vs thick spiral canine to canine at 36 months 1 27 Risk Ratio (M‐H, Fixed, 95% CI) 0.46 [0.10, 2.12]
1.8.7 Lower removable (acrylic & wire) vs thin spiral wire (incisors and canines) at 36 months 1 25 Risk Ratio (M‐H, Fixed, 95% CI) 0.52 [0.11, 2.61]
1.8.8 Lower removable part‐time clear plastic vs fixed coaxial at 48 months 1 42 Risk Ratio (M‐H, Fixed, 95% CI) 3.00 [1.33, 6.75]
1.9 Mean survival time (days) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.9.1 Upper removable clear plastic part‐time vs fixed multistrand at 12 months 1 60 Mean Difference (IV, Fixed, 95% CI) 38.80 [‐15.80, 93.40]
1.9.2 Lower removable clear plastic part‐time vs fixed multistrand at 12 months 1 60 Mean Difference (IV, Fixed, 95% CI) 85.60 [31.44, 139.76]
1.10 Patient satisfaction: acceptance 2   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.10.1 Lower removable clear plastic full‐time vs fixed multistrand at 12 months (specifically, "How acceptable was the retainer to wear?") 1 81 Mean Difference (IV, Fixed, 95% CI) ‐12.84 [‐18.60, ‐7.09]
1.10.2 Lower removable partial clear plastic part‐time vs thick plain canine to canine at 18 months (specifically, "Have you gotten used to retainers?") 1 95 Mean Difference (IV, Fixed, 95% CI) ‐7.50 [‐11.54, ‐3.46]
1.11 Patient satisfaction: acceptance (dichotomous) 1   Risk Difference (M‐H, Fixed, 95% CI) Subtotals only
1.11.1 Upper and lower removable clear plastic part‐time vs fixed multistrand at 12 months (specifically, "Are you embarrassed to wear your retainer?" (dichotomised)) 1 57 Risk Difference (M‐H, Fixed, 95% CI) 0.07 [‐0.04, 0.19]
1.11.2 Upper and lower removable clear plastic part‐time vs fixed multistrand at 12 months (specifically, "How have you found wearing your retainer in comparison to your fixed appliances?" (dichotomised)) 1 56 Risk Difference (M‐H, Fixed, 95% CI) 0.15 [0.00, 0.29]
1.12 Patient satisfaction: compliance (dichotomous) 1   Risk Difference (M‐H, Fixed, 95% CI) Subtotals only
1.12.1 Upper and lower removable clear plastic part‐time vs fixed multistrand at 12 months (specifically, "Do you wear your retainers as instructed?" (dichotomised)) 1 57 Risk Difference (M‐H, Fixed, 95% CI) 0.22 [0.06, 0.38]
1.13 Patient satisfaction: efficiency 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.13.1 Lower removable partial clear plastic part‐time vs thick plain canine to canine at 18 months (specifically, "Are the retainers working well?") 1 95 Mean Difference (IV, Fixed, 95% CI) 2.00 [‐2.75, 6.75]
1.13.2 Lower removable partial clear plastic part‐time vs thick plain canine to canine at 18 months (specifically, "Noticed any change in tooth position?") 1 95 Mean Difference (IV, Fixed, 95% CI) 2.00 [‐2.66, 6.66]
1.14 Patient satisfaction: cleaning/hygiene (continuous) 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.14.1 Lower removable clear plastic full‐time vs fixed multistrand at 12 months (specifically, "How easy was it to keep the retainer clean?") 1 81 Mean Difference (IV, Fixed, 95% CI) ‐10.31 [‐20.05, ‐0.58]
1.15 Patient satisfaction: cleaning/hygiene (dichotomous) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.15.1 Upper and lower removable clear plastic part‐time vs fixed multistrand at 12 months (specifically, "How have you found easy cleaning your retainers?") 1 57 Risk Ratio (M‐H, Fixed, 95% CI) 1.39 [1.06, 1.83]
1.16 Patient satisfaction: discomfort/pain 1   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.16.1 Lower removable partial clear plastic part‐time vs thick plain canine to canine at 18 months (specifically, "discomfort/pain") 1 95 Mean Difference (IV, Fixed, 95% CI) 5.00 [‐2.21, 12.21]
1.16.2 Lower removable partial clear plastic part‐time vs thick plain canine to canine at 18 months (specifically, "soreness") 1 95 Mean Difference (IV, Fixed, 95% CI) 2.00 [0.72, 3.28]
1.16.3 Lower removable partial clear plastic part‐time vs thick plain canine to canine at 18 months (specifically, "tension in your teeth") 1 95 Mean Difference (IV, Fixed, 95% CI) 8.50 [2.53, 14.47]
1.17 Patient satisfaction: discomfort/pain (dichotomous) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.17.1 Upper and lower removable clear plastic part‐time vs fixed multistrand at 12 months 1 57 Risk Ratio (M‐H, Fixed, 95% CI) 12.22 [1.69, 88.52]
1.18 Patient satisfaction: speech (dichotomous) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.18.1 Upper and lower removable clear plastic part‐time vs fixed multistrand at 12 months (specifically, "Has your retainer affected your speech?") 1 57 Risk Ratio (M‐H, Fixed, 95% CI) 3.89 [1.46, 10.38]
1.19 Oral health: evidence of caries (dichotomous) 1   Risk Difference (M‐H, Fixed, 95% CI) Subtotals only
1.19.1 Lower removable full‐time clear plastic vs fixed multistrand at 12 months 1 84 Risk Difference (M‐H, Fixed, 95% CI) 0.00 [‐0.05, 0.05]
1.20 Oral health: Plaque Index 4   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.20.1 Upper removable clear plastic part‐time vs fixed multistrand at 12 months 1 59 Mean Difference (IV, Fixed, 95% CI) ‐0.17 [‐0.29, ‐0.05]
1.20.2 Lower removable clear plastic  part‐time vs fixed multistrand at 12 months 1 59 Mean Difference (IV, Fixed, 95% CI) ‐0.15 [‐0.32, 0.02]
1.20.3  Lower removable clear plastic full‐time vs fixed multistrand at 6 months 1 29 Mean Difference (IV, Fixed, 95% CI) ‐0.21 [‐0.51, 0.10]
1.20.4  Lower removable clear plastic full‐time vs fixed single strand titanium at 6 months 1 29 Mean Difference (IV, Fixed, 95% CI) ‐0.28 [‐0.74, 0.18]
1.20.5  Lower removable clear plastic full‐time vs CAD/CAM nitinol at 6 months 1 30 Mean Difference (IV, Fixed, 95% CI) 0.04 [‐0.27, 0.35]
1.20.6 Lower removable clear plastic part‐time vs fixed coaxial at 48 months 1 42 Mean Difference (IV, Fixed, 95% CI) ‐0.50 [‐1.21, 0.21]
1.20.7 Upper & lower removable Hawley full‐time vs fixed multistrand at 3 months 1 30 Mean Difference (IV, Fixed, 95% CI) ‐0.02 [‐0.06, 0.02]
1.20.8 Upper & lower removable clear plastic full‐time vs fixed multistrand at 3 months 1 30 Mean Difference (IV, Fixed, 95% CI) 0.05 [‐0.04, 0.14]
1.21 Oral health: Gingival Index 4   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.21.1 Upper removable clear plastic part‐time vs fixed multistrand at 12 months 1 59 Mean Difference (IV, Fixed, 95% CI) ‐0.33 [‐0.67, 0.01]
1.21.2 Lower removable clear plastic part‐time vs fixed multistrand at 12 months 1 59 Mean Difference (IV, Fixed, 95% CI) ‐0.34 [‐0.66, ‐0.02]
1.21.3  Lower removable clear plastic full‐time vs fixed multistrand at 6 months 1 29 Mean Difference (IV, Fixed, 95% CI) ‐0.12 [‐0.50, 0.26]
1.21.4  Lower removable clear plastic full‐time vs fixed single strand titanium at 6 months 1 29 Mean Difference (IV, Fixed, 95% CI) 0.06 [‐0.39, 0.50]
1.21.5  Lower removable clear plastic full‐time vs fixed CAD/CAM nitinol at 6 months 1 30 Mean Difference (IV, Fixed, 95% CI) 0.12 [‐0.25, 0.49]
1.21.6 Lower removable clear plastic part‐time vs fixed coaxial at 48 months 1 42 Mean Difference (IV, Fixed, 95% CI) 0.50 [‐0.84, 1.84]
1.21.7 Upper & lower removable Hawley full‐time vs fixed multistrand at 3 months 1 30 Mean Difference (IV, Fixed, 95% CI) ‐0.05 [‐0.15, 0.05]
1.21.8 Upper & lower removable clear plastic full‐time vs fixed multistrand at 3 months 1 30 Mean Difference (IV, Fixed, 95% CI) 0.04 [‐0.16, 0.24]
1.22 Oral health: Calculus Index 2   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.22.1 Upper removable clear plastic part‐time vs fixed multistrand at 12 months 1 0 Mean Difference (IV, Fixed, 95% CI) Not estimable
1.22.2 Lower removable clear plastic part‐time vs fixed multistrand at 12 months 1 59 Mean Difference (IV, Fixed, 95% CI) ‐0.15 [‐0.29, ‐0.01]
1.22.3 Lower removable clear plastic part‐time vs fixed coaxial at 48 months 1 42 Mean Difference (IV, Fixed, 95% CI) 0.00 [‐0.45, 0.45]
1.23 Oral health: probing depth 2   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.23.1 Lower removable clear plastic full‐time vs fixed multistrand at 6 months 1 29 Mean Difference (IV, Fixed, 95% CI) ‐0.09 [‐0.32, 0.14]
1.23.2 Lower removable clear plastic full‐time vs fixed single strand titanium at 6 months 1 29 Mean Difference (IV, Fixed, 95% CI) ‐0.06 [‐0.28, 0.16]
1.23.3 Lower removable clear plastic full‐time vs CAD/CAM nitinol at 6 months 1 30 Mean Difference (IV, Fixed, 95% CI) ‐0.10 [‐0.32, 0.12]
1.23.4 Upper & lower removable Hawley full‐time vs fixed multistrand at 3 months 1 30 Mean Difference (IV, Fixed, 95% CI) ‐0.13 [‐0.37, 0.11]
1.23.5 Upper & lower removable clear plastic full‐time vs fixed multistrand at 3 months 1 30 Mean Difference (IV, Fixed, 95% CI) ‐0.07 [‐0.27, 0.13]
1.24 Oral health: periodontal pocketing (dichotomous) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.24.1 Lower removable clear full‐time plastic vs fixed multistrand at 12 months 1 84 Risk Ratio (M‐H, Fixed, 95% CI) 0.32 [0.12, 0.87]
1.25 Oral health: bleeding on probing 2   Mean Difference (IV, Fixed, 95% CI) Subtotals only
1.25.1 Lower removable clear plastic full‐time vs fixed multistrand at 6 months 1 29 Mean Difference (IV, Fixed, 95% CI) 0.01 [‐0.13, 0.15]
1.25.2 Lower removable clear plastic full‐time vs fixed single strand titanium at 6 months 1 29 Mean Difference (IV, Fixed, 95% CI) ‐0.03 [‐0.18, 0.12]
1.25.3 Lower removable clear plastic full‐time vs CAD/CAM nitinol at 6 months 1 30 Mean Difference (IV, Fixed, 95% CI) 0.12 [0.00, 0.24]
1.25.4 Upper & lower removable Hawley full‐time vs fixed multistrand at 3 months 1 30 Mean Difference (IV, Fixed, 95% CI) 0.03 [0.00, 0.06]
1.25.5 Upper & lower removable clear plastic full‐time vs fixed multistrand at 3 months 1 30 Mean Difference (IV, Fixed, 95% CI) 0.01 [‐0.02, 0.04]
1.26 Oral health: gingival bleeding (dichotomous) 1   Risk Ratio (M‐H, Fixed, 95% CI) Subtotals only
1.26.1 Lower removable clear plastic full‐time vs fixed multistrand at 12 months 1 84 Risk Ratio (M‐H, Fixed, 95% CI) 0.53 [0.31, 0.88]