Protocols and Trends in Maintaining the Stability of Orthodontic Treatment Outcomes in Croatia over 10 Years: A Repeated Cross - Sectional Study.

Objectives: The aim was to analyze current orthodontic retention protocols in Croatia and their trend over a 10-year period. Subjects and Methods: In a repeated cross-sectional survey, questionnaires were distributed to 150 orthodontists in Croatia in 2013 and 185 of them in 2023 (representing 69% and 85% of practicing orthodontists with response rates of 61% and 75%). Results: Significant changes in retainer types across different malocclusions and treatment protocols were observed over a 10-year period. There was an increase in the use of VFR and a decrease in acrylic retention plates in both jaws (p≤0.001). Over the decade, the use of only fixed retention in the mandible declined from 20% to 7% (p=0.007), and the combination of fixed and removable retention in the maxilla dropped from 29% to 17% (p≤0.033). Increased use of removable retainers was noted in cases involving rotations, open bites, and extractions. Conversely, fixed-removable retainers were more frequently used in spacing cases (p≤0.001). There was a trend toward fewer check-ups (p=0.001) and toward increased patient self-monitoring (p=0.021). Personal experience as the primary reason for choosing a retention protocol increased from 39% to 62% (p<0.001). Additionally, the use of written information on retention rose from 39% to 69% (p<0.001). Conclusion: Retention practices in Croatia have evolved over the past decade, characterized by increased use of VFRs, more frequent implementation of dual retention in the mandible, and greater provision of written retention information. Additionally, follow-up protocols have shifted toward fewer scheduled visits, with increased emphasis on patient self-monitoring.