Microbial adherence on vacuum-formed retainers with different surface roughness as constructed from conventional stone models and 3D printed models: a randomized controlled clinical trial

Abstract

Objective: This single center parallel, randomized controlled trial aimed to determine the propensity of microbial adherence on vacuum-formed retainers (VFRs) with different surface roughness imprints.

Materials and methods: Thirty-six patients debonded from fixed appliances at a teaching institution were allocated by block randomization stratified for gender to three groups [VFRs fabricated on conventional, fused deposition modeling (FDM) or stereolithography apparatus (SLA) working models]. Participants wore the VFRs for three months full-time followed by three months part-time. VFRs were collected after each follow-up for Streptococcus and yeast counts. Surface roughness was measured indirectly on the working models using a 3D optical surface texture analyzer. Blinding was not feasible due to appliance appearance. The trial was registered [NCT03844425 ( ClinicalTrials.gov )] and funded by the Universiti Malaya Dental Postgraduate Research Grant (DPRG/14/19).

Results: Thirty participants (eleven conventional, ten FDM, and nine SLA) were analyzed after six dropped out. No harms were reported. Microbial counts between the groups were not significantly different. There were more microbes in the lower VFRs than upper VFRs (total count: p<0.05; effect size, 0.5 during full-time wear and 0.4 during part-time wear). SLA had significantly (p<0.05) smoother surface than FDM (effect size, 0.3) and conventional models (effect size, 0.5). Microbial adherence was not associated with working model surface roughness.

Conclusion: Microbial adherence on VFRs was not influenced by degree of surface roughness imprints from working models.

Clinical relevance: 3D printed models can be used to make VFRs. Lower VFRs tended to accumulate oral microbes, potentially increasing the oral health risk in the lower arch.

Keywords: Candida; Fused deposition modeling; Stereolithography apparatus; Streptococcus; Surface roughness; Vacuum-formed retainers.