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Retention and

Relapse in
orthodontics
*contents*
1_ Relapse : •
** definition
** problems
** causes
2_ Retention :
** definition
**importance of retention
** schools of retention
** theorem of retention
**types of retention
** retainers
Relapse

Defined as : •
Loss of any correction achieved by
orthodontic treatment
Problems of relapse :
1_ re_opening of closed spaces •
2_ re_crowding of decrowded
teeth
3_ recollapse of expanded arches
4_ re_rotation of derotated teeth
5_ increase of reduced overjet and
overbite
Causes of relapse
1_ periodontal ligament traction •
> teeth moved orthodontically >
stretching of periodontal principal
fibers and gingival fibers encircling
the teeth > fibers contract >
relapse
2_ due to growth related changes :
pt with skeletal problems class ꞁꞁ and
class ꞁꞁꞁ > continued abnormal
growth pattern after therapy >
relapse
3_ bone adaptation : •
teeth moved recently are
surrounded by lightly calcified
ostoeid bone > no adequate
stabilization of teeth > relapse
4_ muscular forces : •
teeth are encapsulated in all
directions by muscles > if muscular
imbalance occurs at the end of the
TTT > relapse
5_ persistent etiology : •
cause not eliminated > relapse

6_ role of third molar : •


eruption after the therapy >
pressure on teeth > relapse
Retention
Defined as :
{maintaining newly moved teeth
in position long enough to aid in
stabilizing their correction .
( said moyer )}
Why is retention important ?
1_ The gingival and periodontal tissues are •
affected by orthodontic tooth movement and
require time for recognization when
appliances are moved

2_ Teeth maybe inherently in unstable position


after TTT so that soft tissue pressure
constantly produce relapse tendency

3_ changes produced by growth may alter the


orthodontic TTT results after removal of
appliances .
Schools of retention
1_ Occlusal school •
2_ Apical base school
3_ Mandibular incisor school
4_ Musculature school
RIEDEL’S Theorems of
retetion
Theorem 1 •
teeth that have been moved tend •
to return to their former position
Theorem 2
elimination of the cause of
malocclusion will prevent relapse
Theorem3
malocclusion should be
overcorrected as safety factor
Theorem 4 •
proper occlusion is a potent factor in
holding teeth in their corrected
positions
Theorem 5
bone adjacent to tissues should be
allowed time to reorganize around
newly positioned teeth
Theorem 6
if the lower insicors are based upright
over basal bone they are more likely
to remain in good alignment
Theorem 7 •
correction carried out during
periods of growth are less likely to
relapse
Theorem 8
the farther the teeth have been
moved the lesser is the risk for
relapse
Theorem 9 •
arch form particularly in the
mandibular arch can not be
permenantly altered by appliance
therapy
Theorem 10
many treated malocclusions
require permenant retaining
devices
Classification of retention
1- According to Time : •
_ No retention
examples : ant cross bite _ serial
extractions _ post cross bite with
steep cusps
_ standard retention
6 months day and night followed by 3
months every night then 3 months
alternate night
_ prolonged period of retention
1 year full time is required in rotation
_ retention until growth
required in growing with skeletal
problems
_ permenant retention
in generalized spaces wth enlarged
tongue , compromised TTT and late teen
crowding
2- According to means of retention : •
_ mechanical retetion :
will be discussed
_ retetion by carrying teeth into
positions of soft tissue balance :
betn lips and cheek from one side
and tongue from other side
_ retention by carrying teeth into
positions of balanced occlusion
Removable retainers
1- Hawley’s appliance :
+ the most frequently used
+ clasps on molars and short labial
bow extending from canine to canine
having adjustment loops
2- begg’s retainer : •
+ labial wire extend till the last
erupted molar and curves around
it to get embedded in the acrylic
that spans the palate
_eliminate the risk of space
opening
3- Clip on retainer : •
+ wire pass labially over the
incisors and then passes betn
canine and premolar
+ correction of rotation
+ less comfortable than hawley’s
+ indicated in perio cases (
splinting)
4 – vacuum formed retainer : •
+ plastic removable appliance
+ esthetics
+ inexpensive
5- positioners : •
+ made of thermoplastic rubber
material that spans inter_occlusal
space
+ no activation needed
+ bulky difficult to wear
Fixed retainers
1_ Banded canine to canine : •
+lower ant region
2_ Bonded lingual retainer : •
3_ band and spur retainer : •
Active retainers
1_ •
2_Barrer appliance : •
3_ Headgear : •
Made by :
1 _ Rana Sayed Farghally
2_ Rana hany elhagry
3_ rehab shabaan
4_ esraa lotfy
5_ mohamed mostafa
6_ mohamed mourad
7_ amr ezz
8_ omar mahmoud