title: Long-term stability of orthodontic treatment and patient satisfaction. A systematic review.
abstract: OBJECTIVE
  To evaluate morphologic stability and patient satisfaction at least 5 years after orthodontic treatment.
  
  
  METHODS
  Published literature was searched through the PubMed and Cochrane Library electronic databases from 1966 to January 2005. The search was performed by an information specialist at the Swedish Council on Technology Assessment in Health Care. The inclusion criteria consisted of a follow-up period of at least 5 years postretention; randomized clinical trials, prospective or retrospective clinical controlled studies, and cohort studies; and orthodontic treatment including fixed or removable appliances, selective grinding, or extractions. Two reviewers extracted the data independently and also assessed the quality of the studies.
  
  
  RESULTS
  The search strategy resulted in 1004 abstracts or full-text articles, of which 38 met the inclusion criteria. Treatment of crowding resulted in successful dental alignment. However, the mandibular arch length and width gradually decreased, and crowding of the lower anterior teeth reoccurred postretention. This condition was unpredictable at the individual level (limited evidence). Treatment of Angle Class II division 1 malocclusion with Herbst appliance normalized the occlusion. Relapse occurred but could not be predicted at the individual level (limited evidence). The scientific evidence was insufficient for conclusions on treatment of cross-bite, Angle Class III, open bite, and various other malocclusions as well as on patient satisfaction in a long-term perspective.
  
  
  CONCLUSIONS
  This review has exposed the difficulties in drawing meaningful evidence-based conclusions often because of the inherent problems of retrospective and uncontrolled study design.
authors.affiliation: Faculty of Odontology, Malmoe University, Department of Orthodontics, Malmoe, Sweden. lars.bondemark@od.mah.se
authors.forename: L
authors.initials: L
authors.lastname: Bondemark
authors.forename: Anna-Karin
authors.initials: AK
authors.lastname: Holm
authors.forename: Ken
authors.initials: K
authors.lastname: Hansen
authors.forename: Susanna
authors.initials: S
authors.lastname: Axelsson
authors.forename: Bengt
authors.initials: B
authors.lastname: Mohlin
authors.forename: Viveka
authors.initials: V
authors.lastname: Brattstrom
authors.forename: Gunnar
authors.initials: G
authors.lastname: Paulin
authors.forename: Terttu
authors.initials: T
authors.lastname: Pietila
mesh_terms: D006801:Humans; D008310:Malocclusion / Q000628:therapy*; D008312:Malocclusion, Angle Class II / Q000628:therapy; D008313:Malocclusion, Angle Class III / Q000628:therapy; D024343:Open Bite / Q000628:therapy; D009971:Orthodontics, Corrective; D017060:Patient Satisfaction; D055502:Secondary Prevention; D016896:Treatment Outcome