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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie

Open Access 28-06-2023 | Computer Aided Manufacturing | Original Article

Comparison of six different CAD/CAM retainers vs. the stainless steel twistflex retainer: an in vitro investigation of survival rate and stability

Authors: Christoph J. Roser, Carolien Bauer, Lutz Hodecker, Andreas Zenthöfer, Christopher J. Lux, Stefan Rues

Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie

Abstract

Purpose

To compare failure rates and maximum load capacity (F_max) of six different computer-aided design/computer-aided manufacturing (CAD/CAM) retainers with those of the hand-bent five-stranded stainless steel twistflex retainer.

Materials and methods

Six groups (n = 8 per group) of commercially available CAD/CAM retainers (cobalt–chromium [CoCr], titanium grade 5 [Ti5], nickel–titanium [NiTi], zirconia [ZrO₂], polyetheretherketone [PEEK], and gold) and twistflex retainers were tested for long-term sufficiency and for F_max using a self-developed in vitro model. All retainer models underwent a simulated ageing process of about 15 years (1,200,000 chewing cycles with a force magnitude of 65 N at 45° followed by storage in water at 37 °C for 30 days). If retainers did not debond or break during ageing, their F_max was determined in a universal testing machine. Data were statistically analysed using Kruskal–Wallis and Mann–Whitney U‑tests.

Results

Twistflex retainers did not fail (0/8) during ageing and had the highest F_max (445 N ± 51 N). Ti5 retainers were the only CAD/CAM retainers that also did not fail (0/8) and had similar F_max values (374 N ± 62 N). All other CAD/CAM retainers had higher failure rates during ageing and significantly lower F_max values (p < 0.01; ZrO₂: 1/8, 168 N ± 52 N; gold: 3/8, 130 N ± 52 N; NiTi: 5/8, 162 N ± 132 N; CoCr: 6/8, 122 N ± 100 N; PEEK: 8/8, 65 ± 0 N). Failure was due to breakage in the NiTi retainers and debonding in all other retainers.

Conclusion

Twistflex retainers remain the gold standard regarding biomechanical properties and long-term sufficiency. Of the CAD/CAM retainers tested, Ti5 retainers seem to be the most suitable alternative. In contrast, all other CAD/CAM retainers investigated in this study showed high failure rates and had significantly lower F_max values.

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Title: Comparison of six different CAD/CAM retainers vs. the stainless steel twistflex retainer: an in vitro investigation of survival rate and stability
Authors: Christoph J. Roser
Carolien Bauer
Lutz Hodecker
Andreas Zenthöfer
Christopher J. Lux
Stefan Rues
Publication date: 28-06-2023
Publisher: Springer Medizin
Keywords: Computer Aided Manufacturing
Computer Aided Design
Published in: Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie
Print ISSN: 1434-5293
Electronic ISSN: 1615-6714
DOI: https://doi.org/10.1007/s00056-023-00486-y

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Comparison of six different CAD/CAM retainers vs. the stainless steel twistflex retainer: an in vitro investigation of survival rate and stability

Abstract

Purpose

Materials and methods

Results

Conclusion

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Abstract

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