Interventions to improve adherence to removable orthodontic appliances retainers among adolescents

Adherence to removable orthodontic retainers is essential for maintaining treatment outcomes, yet compliance among adolescents remains suboptimal. This systematic review evaluates the effectiveness of these interventions in enhancing compliance with removable orthodontic appliances (ROAs) retainers among adolescents. A systematic search of PubMed, Scopus, Embase, and Cochrane Library was conducted using relevant keywords. Observational and experimental studies assessing the impact of interventions on retainer adherence were included. The primary outcome was wear time, with secondary outcomes related to patient satisfaction and orthodontic stability. Data extraction was performed using a structured spreadsheet. Nine studies met the inclusion criteria, comprising 8,229 participants. Monitoring and feedback interventions, such as microsensors, consistently improved adherence. Digital interventions, including mobile applications and electronic reminders, produced mixed results, with some studies reporting a positive effect while others found no significant impact. Behavioral reinforcement strategies, including parental involvement and incentives, showed inconsistent effectiveness. Monitoring and feedback interventions appear to be the most effective interventions for improving adherence to ROA and retainers. Digital and behavioral approaches show variable effectiveness, suggesting that a multimodal strategy may be beneficial.