Poly-ether-ether-ketone (PEEK) versus dead-soft coaxial bonded retainers: a randomized clinical trial. Part 1. Stability, retainer failure, and participant satisfaction

Abstract Background Poly-ether-ether-ketone (PEEK) was introduced in dentistry as an alternative to metal alloys. Objective To assess the effectiveness of PEEK-fixed retainers in preserving the stability of mandibular anterior and participant satisfaction as compared to the Dead-soft coaxial fixed retainer (DSC). Trial design A single-centre, two-arm parallel groups randomized clinical trial. Methods The patients treated with pre-adjusted orthodontic appliances who have a Little’s Irregularity Index (LII) ≤ 0.5 mm have been enrolled in the trial. PEEK retainers were prepared to round 0.8 mm wire by computer-aided design and manufacturing, and the DSC wire was carefully adapted to the lingual surface of the lower anterior teeth. The primary outcome was the stability of lower anterior teeth as assessed by LII, while the secondary outcomes were changes in occlusal parameters, retainer failure, and patient satisfaction. The data were collected at the debonding stage (T0), 1 month (T1), 3 months (T3), and 6 months (T6) after starting the trial, except for patient’s satisfaction, which was recorded using an electronic form at T1 and T6. Blinding Single blinding of participants. Results A total of 46 participants with an age range of 12–28 years old were randomly allocated to the two groups (n = 23 in each). Only one participant dropped out; therefore, 45 participants were analysed. The DSC group showed a significant increase in LII at T3. Both retainer groups had comparable occlusal measurements, failure frequency, and survival time, with no significant difference. The patients in the DSC group reported a statistically significant perception of change in the position of their teeth compared to those in the PEEK group. Harms No harmful effects have been reported. Limitations Limited follow-up duration and the inability to blind the operator due to the nature of the intervention. Conclusions After 6-month retention, the PEEK retainer was equally effective to DSC retainers in maintaining the teeth alignment, with no significant differences regarding the failure frequency, survival rate, and general patient satisfaction. Trial registration https://register.clinicaltrials.gov. (NCT05557136).