Poly-ether-ether-ketone versus dead-soft coaxial bonded retainers: a randomized clinical trial. Part 2: periodontal health and microbial biofilm assessment

Abstract Background Retainers have the potential to detrimentally impact periodontal health and contribute to tooth decay. Objectives To investigate periodontal health and bacterial biofilm related to Poly-ether-ether-ketone (PEEK) fixed retainers as compared to Dead-soft coaxial fixed retainer (DSC). Trial design A two-arm parallel groups single-centre randomized clinical trial. Methods The trial included patients whose orthodontic treatment was completed and required retainers. Participants were randomly assigned into two retainer groups: PEEK retainers, prepared by computer-aided design and manufacturing into 0.8 mm wire form, and DSC retainers. The objectives included assessing periodontal health through plaque accumulation index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD), gingival index (GI), calculus index (CI), and alveolar bone height (ABH) assessment. Biofilm assessment involved bacteriological screening of aerobic, facultative anaerobic, mutans streptococci, and lactobacilli. The periodontal indices and microbiological screening as well as were assessed at the debonding stage (T0), 1-month (T1), 3-month (T3), and 6-month (T6) after the commencement of the trial, except for the ABH, which was recorded using periapical radiograph at T0 and T6. Blinding Single blinding of participants in addition to the bacteriological specialist. Results Initially, the trial enrolled 46 participants, aged between 12 and 28 years, and were randomly assigned to two groups, with 23 participants in each group. Subsequently, one participant withdrew from the trial, resulting in a total of 45 participants whose data were analysed. Assessment of the periodontal indices, excluding the CI (P = .480), revealed statistically but not clinically significant differences between groups after 6-month of retention (P = .016 of PI, P = .020 of BOP, P = .05 of PPD, and P = .01 of GI). There was slight plaque accumulation, normal PPD (approximately 1 mm), healthy to mild gingivitis with a GI of less than 1 and BOP was around 10%. Concerning the ABH, there was a noticeable reduction in its score after 6 months, particularly in the PEEK group, although the difference was not statistically significant (P = .102). Furthermore, the bacteriological viable count did not show any significant difference between the groups during the recall visits. Harms There have been no reported negative consequences. Limitations Blinding the assessor of periodontal indices was not feasible due to the nature of the intervention. The trial follow-up duration was limited. Conclusions Both the PEEK and DSC retainers have comparable impacts on periodontal health and bacterial accumulation and composition during the retention period. Trial registration NCT05557136.