Retention protocols and relapse management strategies used by orthodontists in Türkiye: A national cross-sectional survey

Abstract

Background: Orthodontic relapse is a common clinical challenge following orthodontic treatment and may occur due to biological factors such as periodontal reorganization, soft-tissue pressures, and craniofacial growth changes. Although various retention protocols are widely used, there is still no universal consensus regarding the most effective retention strategy. Aim: The aim of this study was to investigate the retention protocols and relapse management strategies preferred by orthodontists in Türkiye following orthodontic treatment. Materials and Methods: A national cross-sectional survey consisting of 33 multiple-choice questions was distributed electronically to members of the Turkish Orthodontic Society using an online survey platform. A total of 100 orthodontists responded, corresponding to a 10% response rate. Statistical analyses were performed using Chi-square and Fisher’s exact tests to evaluate differences according to professional experience. Results: Retention protocols were applied to all patients by 94% of orthodontists, and 74% recommended lifelong retention. Vacuum-formed retainers and bonded retainers were the most commonly used appliances in maxillary and mandibular arches, respectively. Less experienced orthodontists showed a significantly higher tendency to prefer removable retainers in non-extraction Class I crowding cases (p = 0.015). Overall, 87% of orthodontists reported encountering relapse in their clinical practice, most frequently in tooth rotation and anterior open-bite cases (p = 0.006, p = 0.034, respectively). Retreatment was reported in ≤25% of patients in 73% of relapse cases. Conclusions: Orthodontists in Türkiye widely recognize the importance of retention; however, substantial variability exists in retention protocols and relapse management strategies. Professional experience appears to influence certain clinical decisions, highlighting the need for standardized evidence-based retention guidelines.