ReviewCureus2026
Effect of Direct Versus Indirect Bonding Techniques on Fixed Retainer Failure Rates: A Systematic Review and Meta-Analysis.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Bonded fixed orthodontic retainers frequently fail, yet it remains uncertain whether laboratory-based indirect bonding, including computer-aided design and computer-aided manufacturing (CAD/CAM)-assisted techniques, reduces failure rates compared with conventional chair-side direct bonding. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Dentistry & Oral Science Source, Google Scholar, ClinicalTrials.gov, and other trial registers were searched from inception to November 2025. Randomized controlled trials (RCTs) and prospective or retrospective cohort studies comparing indirect with direct bonding and reporting retainer failure were eligible. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Revised Cochrane Risk of Bias tool for randomized trials (RoB 2) for randomized trials and the Newcastle-Ottawa Scale (NOS) for cohort studies. Hazard ratios (HRs) for first failure were pooled using a random-effects model, and heterogeneity was quantified with the I² statistic. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD420251003540). Fifteen studies, including 13 RCTs and two cohort studies involving 1,481 patients, were included. The pooled analysis for mandibular retainers demonstrated a significantly higher failure risk in the direct bonding group (HR = 1.41, 95% CI 1.12-1.79, p = 0.004), with low heterogeneity (I² = 14%). For maxillary retainers, no statistically significant difference was observed between bonding techniques (HR = 1.28, 95% CI 0.90-1.84, p = 0.17). Overall risk of bias was low to moderate, with inadequate blinding being the most common limitation. Updated evidence indicates a significantly higher failure risk for directly bonded mandibular retainers compared with indirect bonding, while outcomes for maxillary retainers appear comparable between techniques. Indirect bonding may therefore offer improved mandibular retainer survival, although further well-controlled trials are required to confirm this effect.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.