No randomised controlled trial evidence on effective methods to treat relapse of lower front teeth following orthodontic treatment


The tendency for teeth to return to their pre-treatment following orthodontic treatment (relapse) is more common for the lower front teeth.  Ten years after orthodontic treatment between 30-50% of patients no longer have the initial post-treatment alignment and after 20 years only 10% maintain that alignment. The aim of this review was to assess the effects of interventions used to manage relapse of the lower front teeth after first fixed orthodontic treatment.

The Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, and Embase databases were searched with no restrictions. Handsearching of the American Journal of Orthodontics and Dentofacial Orthopedics, Angle Orthodontist European Journal of Orthodontics (Journal of Orthodontics, Chinese Journal of Stomatology, West China Journal of Stomatology, Chinese Journal of Dental Materials and Devices and Chinese Journal of Orthodontics was also conducted.  Searches were conducted to identify randomised controlled trials (RCTs) comparing fixed or removable retention options.

  • No RCTs were identified.

The authors concluded

This review has revealed that there was no evidence from RCTs to show that one intervention was superior to another to manage the relapse of the alignment of lower front teeth using any method or index, aesthetic assessment by participants and practitioners, treatment time, patient’s discomfort, quality of life, cost-benefit considerations, stability of the correction, and side effects including pain, gingivitis, enamel decalcification and root resorption. There is an urgent need for RCTs in this area to identify the most effective and safe method for managing the relapse of alignment of the lower front teeth.


A previous Cochrane review by Littlewood et al in 2009 looked at retention procedures and identified 5 RCTs  but found insufficient information on which to base retention in clinical practice . More recently (Dental Elf 22nd Jan) I highlighted a trial which looked at 3 different retention approaches and found that they were equally effective.


Yu Y, Sun J, Lai W, Wu T, Koshy S, Shi Z. Interventions for managing relapse of the lower front teeth after orthodontic treatment. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD008734. DOI: 10.1002/14651858.CD008734.pub2.

Littlewood SJ, Millett DT, Doubleday B, Bearn DR, Worthington HV. Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD002283. DOI: 10.1002/14651858.CD002283.pub3.

Dental Elf Jan 22nd – Trial found little difference between three post-orthodontic retention methods

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