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Orthodontic RetentionNCT05968625

3D-Printed Vs Thermoformed Retainers: Comparison of Post-Treatment Stability, Changes in Mechanical Properties and Patients' OHRQoL

A study testing Thermoformed retainers and 3D-printed retainers in people with Orthodontic Retention, run by University of Malaya at 1 site in Malaysia.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Following completion of orthodontic treatment, prolonged retention with either part-time or full-time wear of retainers is crucial in preventing relapse. Clear thermoformed retainers (TFR) are easy to fabricate and popular among orthodontic patients. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Orthodontic Retention
What is being tested?
Thermoformed retainers and 3D-printed retainers
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteMalaysia
Study dates
28 Mar 2023to Oct 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Fixed appliance treatment in both arches and indicated for VFR in the retention phase as part of their original treatment plan.
  • No intention to relocate within the study period; able to attend the three-monthly review appointments for half a year.

Who cannot join

  • Single-arch or sectional fixed appliances.
  • Space dentition.
  • Hypodontia requiring tooth replacement on the retainer as a temporary measure.
  • Previous treatment with maxillary expansion.
  • Indicated for fixed retainer or double retention regime (such as VFRs fitted over fixed retainers).
  • Premature debond from the original fixed appliances course.
  • Cleft lip and/or palate; or orthognathic cases.
  • Learning difficulties and inability to read written instructions/ questionnaire in English or Malay

Trial locations and contacts

1 site in 1 country.

Dr. Boo Hui Shan contact

+60102705306

17080312@siswa.um.edu.my

Associate Professor Dr. Saritha Sivarajan contact

+6037967 4802 ext. 4562

saritha@um.edu.my

Malaysia1 site, 1 recruiting
  • Orthodontic Postgraduate Clinic, Faculty of Dentistry, Universiti Malaya.

    Kuala Lumpur, Kuala Lumpur, 50603

    Dr. Boo Hui Shan, +60102705306, 17080312@siswa.um.edu.my

    Associate Professor Dr. Saritha Sivarajan, +60379674802 ext. 4562, saritha@um.edu.my

    Recruiting

Other trials in Malaysia

About this study

Official title: Post-Treatment Stability, Changes in Mechanical Properties and Patients' OHRQoL Of Direct 3D-Printed Retainers Versus Thermoformed Retainers: An Open-label Randomized Controlled Trial

Following completion of orthodontic treatment, prolonged retention with either part-time or full-time wear of retainers is crucial in preventing relapse. Clear thermoformed retainers (TFR) are easy to fabricate and popular among orthodontic patients. With the advent of digital orthodontics and the development of biocompatible photopolymerizable resin, it is now possible to fabricate direct 3D-printed retainers.

The aim of this study is to determine and compare the post-treatment stability of dentition, changes in thickness and mechanical properties of the retainers, and oral health-related quality of life (OHRQoL) of patients wearing direct 3D-printed retainers and conventional thermoformed retainers over a retention period of 6 months.

Read the detailed description

Primary Objective:

  1. To determine and compare the post-treatment stability for direct 3D printed retainers (3DPR) and conventional TFR (TFR) at baseline (T0), 3 months (T1) and 6 months (T2).

Secondary Objectives:

  1. To determine and compare the thickness and mechanical properties for 3DPR and TFR after 6 months of usage.
  2. To determine and compare the OHRQoL of patients wearing 3DPR and TFR at T0, T1 and T2.

Sample size calculation:

Sample size calculation is based on the study done by Kumar \& Bansal (2011) which compared the effectiveness of two different removable retainers on stability. With an effect size of 1.127, α = 0.05, and power = 0.80. Using G*Power version 3.1.9.7 software, the total number of samples is n = 22 (11 subject per group). This number is increased by 30% to account for the dropout rate to produce the final sample size, n = 30 (15 subjects per group).

Methodology:

Subjects who have completed their orthodontic treatment (fulfil the inclusion and exclusion criteria) and are ready for debond, will be invited to participate in the research and consecutively recruited, between April 2023 until September 2023, in the Postgraduate Orthodontic Clinic, Dental Specialists and Research Tower, Faculty of Dentistry, Universiti Malaya, Malaysia. Patient information sheets and consent forms will be issued to the subjects that fulfil the criteria. Only consented respondents will be recruited.

All 30 subjects will be randomly allocated (simple randomization with 1:1 allocation) to either the TFR group or the 3DPR group by using number generated list provided by www.random.org . The randomization will be performed by the main supervisor, who is not involve in the treatment, data collection and data analysis of the research. The operator will be concealed from the group allocation. The allocation will be revealed to the operator on the day of debond appointment with a opaque white envelope.

All the subjects will undergo the same standard debond process. and receive a post debond thermoformed retainers within 24 hours which they are required to part-time for every night (8-12 hours).

The subjects will be reviewed after 1 week (T0) for scanning of teeth with Trios 3 intraoral scanner. The interventional retainers (TFR or 3DPR) will be issued after 2 weeks. The subjects are instructed to wear the retainers part-time (8-12 hours) for every nights. A pamphlet that contains detailed information on the care of retainers will also be provided to every subject. All the subjects will be reviewed after 3 months (T1) and at 6 months (T2) after wearing the interventional retainers.

The primary outcome is to assess the post-treatment stability after part time wear of the retainers for a period of 6 months. The subject's upper and lower dentition will be scanned by using intraoral scanner at T0, T1, and T2. The measurements will be performed digitally using 3Shape orthodontic analyzer software. Overjet, overbite, intermolar width, and little irregularity index will be measured.

OHIP-14 questionnaire will be given to the participants to answer during T0, T1 and T2. All the retainers will be retrieved at T2 to undergo mechanical test.

Statistical Analysis:

The data collected will be entered into SPSS software (version 26.0). i. Chi-square tests will be used to compare baseline characteristics between the 2 groups.

ii. Repeated measures ANOVA or paired t-test will be used to determine the mean differences in post treatment stability, thickness of retainers, mechanical properties of retainers and OHIP-14 scores at different time intervals. The p-value will be set to less than 0.05.

iii. Two samples independent t test will be used to compare the post-treatment stability, changes in thickness, mechanical properties, and OHIP-14 scores between TFR and 3DPR group. The p-value will be set to less than 0.05.

iv. Shapiro-Wilk tests will be referred, and non-parametric tests will be performed for skewed data.

Data will be analyzed following the intention-to-treat analysis.

Being tested
Thermoformed retainers, 3D-printed retainers
Keywords
Thermoformed retainers, 3D-printed retainers, vacuum-formed retainers, Post-treatment stability, Orthodontics

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Thermoformed retainersDevice

    conventional thermoformed retainers fabricated on stone models.

  • 3D-printed retainersDevice

    3D-printed retainers fabricated directly by DLP printer.

Study groups in NCT05968625
Study groupRoleWhat they receive
Thermoformed retainers (TFR)ExperimentalThermoformed retainers are constructed from an Erkodur blank (ERKODENT® Erich Kopp GmbH, Pfalzgrafenweiler, Germany) with 1.0 mm in thickness, following the manufacturer's instructions.
Receives: Device: Thermoformed retainers
Direct 3-D printed retainers (3DPR)ExperimentalPrivate dental laboratories directly print the retainers using a NextDent 3D printer and NextDent ortho Flex resin. Thickness of 0.80mm
Receives: Device: 3D-printed retainers

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Post-treatment stability

    The subject's upper and lower dentition will be scanned by using intraoral scanner at T0, T1, and T2. The measurements will be performed digitally using 3Shape orthodontic Analyzer software (3Shape A/S, Copenhagen, Denmark). Measurements: Overjet (mm), Overbite (mm), Intermolar width (mm), and little irregularity index (mm). All the measurements are in millimetres.

    Measured: 6 months

Secondary outcomes (3)
  1. Changes in thickness of retainers

    Measurements of changes in thickness (mm) will be performed by the principal investigator by using an electronic digital thickness gauge with a resolution of 0.01 mm and accuracy of ±0.02 mm, which will be calibrated before each use.

    Measured: 6 months

  2. Changes in hardness of retainers

    The extra sets of retainers (5 sets from each group) at T0 and the retrieved retainers (5 sets from each group) at T2 of each group will be tested. The hardness that will be determined is Vickers hardness in Megapascal (MPa). A universal hardness testing machine (DUH-211S, Shimadzu, Kyoto Japan) will be used to determine the hardness.

    Measured: 6 months

  3. Oral Health Impact Profile -14 (OHIP-14)

    This research will use the validated Modified short version of the OHIP-14 for Malaysian adults with questions that are relevant to subjects wearing removable retainers. Responses to each item will be scored on a five-point Likert scale measuring from never (score 0) to very often (score 4). The OHIP-14 questionnaire will be given to the participants to answer during T0, T1 and T2.

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Aug 2023
  2. Study start28 Mar 2023
  3. Primary completionMay 2024 (estimated)
  4. Study completionOct 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Screening
Allocation
Randomised
Intervention model
Parallel groups
Model description
Direct 3D-printed retainers
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05968625
Sponsor's protocol ID
UNIVERSITI MALAYA
Other IDs
UMG013E-2023
Status last verified
Sep 2023
First submitted
17 Jul 2023
Last updated
8 Sep 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Williams A, Bencharit S, Yang IH, Stilianoudakis SC, Carrico CK, Tufekci E. Effect of print angulation on the accuracy and precision of 3D-printed orthodontic retainers. Am J Orthod Dentofacial Orthop. 2022 Jan;161(1):133-139. doi: 10.1016/j.ajodo.2021.01.020.

    PubMed 35012743
  • Rowland H, Hichens L, Williams A, Hills D, Killingback N, Ewings P, Clark S, Ireland AJ, Sandy JR. The effectiveness of Hawley and vacuum-formed retainers: a single-center randomized controlled trial. Am J Orthod Dentofacial Orthop. 2007 Dec;132(6):730-7. doi: 10.1016/j.ajodo.2006.06.019.

    PubMed 18068589
  • Naeem OA, Bencharit S, Yang IH, Stilianoudakis SC, Carrico C, Tufekci E. Comparison of 3-dimensional printing technologies on the precision, trueness, and accuracy of printed retainers. Am J Orthod Dentofacial Orthop. 2022 Apr;161(4):582-591. doi: 10.1016/j.ajodo.2021.03.016.

    PubMed 35337648
  • Kumar AG, Bansal A. Effectiveness and acceptability of Essix and Begg retainers: a prospective study. Aust Orthod J. 2011 May;27(1):52-6.

    PubMed 21696115
  • Kessler A, Hickel R, Reymus M. 3D Printing in Dentistry-State of the Art. Oper Dent. 2020 Jan/Feb;45(1):30-40. doi: 10.2341/18-229-L. Epub 2019 Jun 7.

    PubMed 31172871
  • Jindal P, Juneja M, Siena FL, Bajaj D, Breedon P. Mechanical and geometric properties of thermoformed and 3D printed clear dental aligners. Am J Orthod Dentofacial Orthop. 2019 Nov;156(5):694-701. doi: 10.1016/j.ajodo.2019.05.012.

    PubMed 31677678
  • Etemad-Shahidi Y, Qallandar OB, Evenden J, Alifui-Segbaya F, Ahmed KE. Accuracy of 3-Dimensionally Printed Full-Arch Dental Models: A Systematic Review. J Clin Med. 2020 Oct 20;9(10):3357. doi: 10.3390/jcm9103357.

    PubMed 33092047
  • Cousley RR. Introducing 3D printing in your orthodontic practice. J Orthod. 2020 Sep;47(3):265-272. doi: 10.1177/1465312520936704. Epub 2020 Jul 6.

    PubMed 32627658
  • Cole D, Bencharit S, Carrico CK, Arias A, Tufekci E. Evaluation of fit for 3D-printed retainers compared with thermoform retainers. Am J Orthod Dentofacial Orthop. 2019 Apr;155(4):592-599. doi: 10.1016/j.ajodo.2018.09.011.

    PubMed 30935614
  • Can E, Panayi N, Polychronis G, Papageorgiou SN, Zinelis S, Eliades G, Eliades T. In-house 3D-printed aligners: effect of in vivo ageing on mechanical properties. Eur J Orthod. 2022 Jan 25;44(1):51-55. doi: 10.1093/ejo/cjab022.

    PubMed 33950232
  • Al-Moghrabi D, Salazar FC, Pandis N, Fleming PS. Compliance with removable orthodontic appliances and adjuncts: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop. 2017 Jul;152(1):17-32. doi: 10.1016/j.ajodo.2017.03.019.

    PubMed 28651764
  • Al-Moghrabi D, Littlewood SJ, Fleming PS. Orthodontic retention protocols: an evidence-based overview. Br Dent J. 2021 Jun;230(11):770-776. doi: 10.1038/s41415-021-2954-7. Epub 2021 Jun 11.

    PubMed 34117437
  • Thickett E, Power S. A randomized clinical trial of thermoplastic retainer wear. Eur J Orthod. 2010 Feb;32(1):1-5. doi: 10.1093/ejo/cjp061. Epub 2009 Oct 14.

    PubMed 19828592
  • Saub R, Locker D, Allison P. Derivation and validation of the short version of the Malaysian Oral Health Impact Profile. Community Dent Oral Epidemiol. 2005 Oct;33(5):378-83. doi: 10.1111/j.1600-0528.2005.00242.x.

    PubMed 16128798
  • Mohd Tahir N, Wan Hassan WN, Saub R. Comparing retainers constructed on conventional stone models and on 3D printed models: a randomized crossover clinical study. Eur J Orthod. 2019 Aug 8;41(4):370-380. doi: 10.1093/ejo/cjy063.

    PubMed 30321319

Questions about this trial

What is this clinical trial studying?

A study testing Thermoformed retainers and 3D-printed retainers in people with Orthodontic Retention, run by University of Malaya at 1 site in Malaysia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 8 Sep 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Malaysia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Dr. Boo Hui Shan (+60102705306, 17080312@siswa.um.edu.my), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Post-treatment stability (time frame: 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05968625, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Sep 2023.

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