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Am J Orthod Dentofacial Orthop. 2013 Oct;144(4):533-40. doi: 10.1016/j.ajodo.2013.04.020.

Quantification of patient compliance with Hawley retainers and removable functional appliances during the retention phase.

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Assistant professor, Department of Orthodontics and Orofacial Orthopedics, Eberhard Karls University, Tübingen, Germany. Electronic address:



The success of retention with removable retainers is highly dependent on efficient patient compliance. The aim of this study was to quantify patient compliance with removable retainers using microelectronic wear-time documentation during the retention phase.


One hundred patients, between 13 and 20 years of age, were retained with removable Hawley retainers and functional appliance retainers after successful multibracket treatment at the University Hospital of Tübingen, Germany, and in 4 private practices in Germany. Microsensors were incorporated into the orthodontic retainers by polymerization, and daily wear time was documented in 15-minute intervals during the retention phase for up to 15 months. Patient compliance was quantified with wear-time documentation. Additionally, the influences of age, sex, place of treatment, device type, and health insurance status on compliance were determined and statistically evaluated.


Most study participants complied with the prescribed wear time of 8 hours or more per day. Combined patient data indicated a median wear time of 7.0 hours per day over the evaluation period. Wear-time documentation showed either regular or irregular patterns of compliance. Initial compliance did not usually alter over the retention phase. Compliance was not influenced by device type, but age, sex, place of treatment, and insurance status produced changes in the median wear time of up to 50%.


Electronic wear-time documentation of patients' compliance is an easily comprehensible measurement that allows orthodontists to examine the patient's contribution to the success of retention and personalize treatment accordingly. Place of treatment and health insurance status are more closely associated with compliance than are basic patient demographics.

[Indexed for MEDLINE]

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