ORTHODONTICS

Lec 23 Dr. Ali Radhi B.D.S, M. Sc.(orthodontics)

4th stage

Retention and Relapse 2

 Three types:
1. Removable Retainers
2. Fixed Retainers
3. Active Retainers
 Fixed Retainers:
Utilized in cases where stability is questionable and prolonged
retention is planned
 Four main indications:
1. Maintaining lower incisor position.
2. Diastema maintenance.
3. Implant or pontic space maintenance.
4. Retaining closed extraction spaces.

1. Maintaining lower incisor position during late mandibular growth:

a. Even mild mandibular growth between the ages of 16-20 can cause
lower incisor relapse.
b. A fixed lingual bar bonded only to canines can prevent distal tipping
of lower incisors.
c. A heavy wire, 28 or 30 mil, should be used due to long span
d. Studies indicate that placing retention loops on canines will
decrease breakage.
f. If proper flossing is maintained, fixed retainers can remain indefinitely.

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2. Holding diastema closed:

a. Utilize lighter wire (17.5 or 19.5 mil twist).

b. Bond above cingulum – out of occlusion.

c. Can prevent bite deepening if lower incisors erupt.

3. Implant or pontic space maintance:

a. Reduces mobility of teeth making it easier to place bridge.

b. Holds space if prolonged periodontal treatment is required post-

orthodontic treatment, prior to placement of restoration.

c. Implants should be placed as soon as orthodontic treatment is

completed so it can be included in initial stages of retention.

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4. Retaining closed extractions spaces:

a. Placed on facial surfaces of posterior teeth.

b. Mainly used in adults, as they tolerate this better than removable

retainers.

c. More reliable than removable retainer.

 Types of Fixed Retainers:

1. Banded Canine to Canine Retainer:
a. Commonly used in lower anterior region
b. Canines are banded and a thick wire is contoured over the
lingual aspects and soldered to the canine bands
c. The bands predispose to poor oral hygiene and are
unaesthetic.

2. Bonded Lingual Retainers

a. Retainers bonded on the lingual aspect
b. S.S wire is adapted lingually to follow the anterior curvature.
c. Ends are curved over the canines where its bonded.
d. Various pre-fabricated lingual retainers also are available that
can be bonded on the teeth
e. Recently use of spiral wire is recommended that can be
bonded to each tooth individually.

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 3. Band and Spur Retainers
a. Used in cases where single tooth has been orthodontically
treated for rotation correction or labio lingual displacement.
b. The tooth that has been moved is banded and spurs are
soldered on to the bands so as to overlap the adjacent teeth.

 Advantages of Fixed Retainers:

a. Reduced need for patient corporation
b. Can be used when conventional retainers cannot provide same
degree of stability.
c. Bonded retainers are more esthetic
d. No tissue irritation unlike what may been seen in tissue bearing
areas of Hawley’s retainer
e. Can be used for permanent and semi-permanent retention.
f. Do not effect speech.

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 Disadvantages of Fixed Retainers:
a. More cumbersome to insert
b. Increased chair side time
c. More expensive
d. Banded variety may interfere with oral
e. hygiene maintenance
f. More prone to breakages
g. Loss of healthy tooth material
h. Tend to discolor

The End