Retention & Relapse

Retention

Maintaining newly moved teeth in position

long enough to aid in stabilizing their
correction
 Retention is required due to the following
reasons

1) Alveolar bone is laid down in one month

2) Periodontal ligament fibres require at least 232 days to re-

organize

3) Elastic supra-crestal fibres need 1 year to remodel

4) Growth
 Categorization of cases on the basis of retention
required

1) No Retention Required

• Corrected anterior cross bites where there is an adequate OB

• Corrected posterior cross bites with good inter-digitation
• Cases requiring driftodontics

2) Semi-Permanent Retention 3) Permanent Retention Required

Required
• Expansion Cases (Few)
• De-rotation • Severely Spaced Cases
• Diastema
• Deep Over Bite • Multiple or severely rotated cases
• Sk. Discrepancies • Neutral zone violation
• Expansion cases
• Almost all cases
Retention can be achieved by

1) Removable Retainers
• Hawley's Retainer
• Barrer Retainer
• Essix Retainer

2) Bonded Retainers
• Lingual Bar
 Relapse

Loss of any correction achieved by

orthodontic treatment
Theorems of Retention & Relapse

• Theorem 1
Teeth that have been moved tend to return to their former
position e.g. De-rotation, Diastema Closure

• Theorem 2
Elimination of the cause of malocclusion will prevent relapse
• Theorem 3
Malocclusion should be overcorrected as a safety factor

• Theorem 4
Proper occlusion & inter-digitation prevents relapse

• Theorem 5
Bone and adjacent tissues must be allowed time to reorganize around
newly positioned teeth
• Theorem 6
If the lower incisors are placed upright over basal bone they are
more likely to remain in good alignment

• Theorem 7
Corrections carried out during periods of growth are less likely
to relapse

• Theorem 8
The farther the teeth have been moved, the less is the
likelihood of relapse
• Theorem 9
Arch form, particularly the mandibular arch, cannot be altered
permanently by appliance therapy

• Theorem 10
Many treated cases require permanent retaining devices
Relapse can be minimized by
1) Maintain existing arch form
2) Maintain inter-canine width
3) Correct rotations early in treatment
4) Overcorrect rotations
5) Consider inter-proximal enamel reduction for triangular
teeth to increase area of inter-proximal contact
6) Labial frenectomy (minimizes diastema re-opening)
7) Maximize inter-digitation
8) Move upper incisors to within lower lip control