Retention1 /certified fixed orthodontic courses by Indian dental academy

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


RETENTION
• TEETH TEND TO RETURN TO
FORMER POSITIONS
• ELIMINATE ETIOLOGY
• CORRECTIONS DURING GROWTH
• GROWTH EFFECTS
• MAINTAIN ARCH FORM
PARTICULARLY LOWER

RETENTION
• OVERCORRECTION
• IDEAL STATIC AND FUNCTIONAL
OCCLUSION
• TEETH UPRIGHT OVER BASAL BONE
• LOWER INCISOR UPRIGHTING
• ALLOW TISSUES TIME TO REORGANIZE/ADAPT

RETENTION

PRE-TREATMENT


POST-TREATMENT

RELAPSE UNPREDICTABLE

RELAPSE

RELAPSE
FUNCTIONAL OPEN BITE

SHORT UPPER LIP


RELAPSE

PRE-ORTHO AFTER SERIAL EXT.

POST-TREAMENT


POST-RETENTION

THE ETIOLOGY OF LATE LOWER
ARCH CROWDING
RICHARDSON, ME. AJODO 1994
 CROWDING IN ORTHODONTICALLY
TREATED PATIENTS OVER TIME
 ARCH LENGTH AND ARCH DEPTH
DECREASE AFTER ERUPTION OF
SECOND MOLARS……. LEADING TO
CROWDING
 CROWDING IN UNTREATED SUBJECTS
BETWEEN 12-18-30 YEARS
 NORMAL PHYSIOLOGIC PHENOMENON
• (10 REFERENCES)

GROWTH
 MANDIBLE > MAXILLA
LATE MANDIBULAR GROWTH
 BASAL BONE > ALVEOLAR BONE
 MANDIBULAR ARCH CONTAINED BY
MAXILLARY ARCH
 GROWTH DIRECTION
CLOSING ROTATION: MESIAL PATH OF
ERUPTION OF POST. TEETH
OPENING ROTATION: RETROCLINATION
OF INCISORSwww.indiandentalacademy.com

GROWTH
 MUSCLE FORCES
LIPS, CHEEKS, TONGUE

 MESIALLY DIRECTED FORCES
-PHYSIOLOGIC MESIAL DRIFT
-ANT. COMPONANT OF FORCES OF
OCCLUSION
-THIRD MOLAR DEVELOPMENT


RETENTION

FEW YEARS POST-TREAMENT
PRIOR TO RETENTION
LOWER THIRD MOLARS
THIRD MOLARS
NORMAL DEVELOPMENT HORIZONTAL IMPACTIONS

OBJECTIVES FOR RETENTION
Teeth tend to return toward pretreatment
condition
Retain what has been achieved
Consider the three dimensions +
ROTATIONS


MAXILLARY HAWLEY RETAINER
Palate = transverse+antero-posterior
Labial bow = overjet + alignment
standard or circumferential
Anterior bite plane = overbite
Finger springs = rotations, spaces,
lingual tipping
Clasps for retention of appliance
-ball, Adams, interproximal, “C” clasp
Headgear for www.indiandentalacademy.com bands
Class II to molar

RETAINERS

MAXILLARY
HAWLEY RETAINER

MAXILLARY
CIRCUMFERENTIAL
HAWLEY RETAINER
MANDIBULAR
HAWLEY RETAINER

UPPER HAWLEY
FINGER SPRINGS

POST-TREATMENT
SMALL LATERALS


MAXILLARY FRENUM
MIDLINE DIASTEMA
DEEP OVERBITE

CLASS I MALOCCLUSION


FULL FIXED APPLIANCES

POST-TREATMENT


SPLINTING/PERMANENT
RETENTION
0.022 SPIRAL WIRE
ALLOWS FOR PHYSIOLOGIC
MOVEMENT OF ADJACENT TEETH


SPLINTING LONG-TERM

CLASS III CASE
POST-TREATMENT RELAPSE
MIN. OVERJET+OVERBITE


MANDIBULAR RETAINERS
HAWLEY RETAINER
labial bow=space closure +alignment
occlusal rests


MANDIBULAR RETAINERS
FIXED BONDED LINGUAL
3-3 0.030 BLUE ELGILOY
OR 4-4 (OVERBITE/CURVE OF SPEE)
LONG-TERM
HOLD AGAINST GROWTH
INCISOR UPRIGHTING

INTERCANINE WIDTH
INCISOR MALALIGNMENT
THIRD MOLARS???

FIXED BONDED 3-3

BONDING TECHNIQUE

LOWER ESSIX RETAINER

UPPER ESSIX RETAINER


POST-TREATMENT
ESSIX RETAINERS
MISSING LATERALS
WITH ACRYLIC TEETH

IMPRESSIONS FOR
TOOTH POSITIONER

LAB SET-UP FOR
TOOTH POSITIONER


RUBBER TOOTH POSITIONER

PRE-TREATMENT
INCISOR ROTATION

CIRCUMFERENTIAL
SUPRA-CRESTAL
FIBEROTOMY


KEYSTONING

INTER-PROXIMAL
STRIPPING


PRE-TREATMENT
CROWDING AND ROTATIONS

LAB. SET-UP FOR
SPRING ALIGNER


SPRING ALIGNER
IDEAL SET-UP

INITIAL PLACEMENT


SCHEDULE MANAGEMENT
DURING RETENTION
• LETTERS TO PATIENTS AND
PARENTS
• LETTER TO DENTIST-explain plan
and request help in monitoring fixed
lingual retainer.
• L


SCHEDULE MANAGEMENT
DURING RETENTION
•
•
•
•
•
•
•

PLACE RETAINERS
6-8 WEEK RECALL
4 MONTH FOLLOW-UP
6-8 MONTHS FOLLOW-UP
ONE YEAR LATER
AFTER 2 YEARS AS NEEDED
NO RECALLS-letter to patient and dentist
FEES ???

FIXED BONDED RETAINER
AFTER 8 YEARS

REMOVAL OF FIXED LINGUAL RETAINER
CONSIDER LOWER HAWLEY/ESSIX WHILE
SLEEPING
RELAPSE MAY NEED TO BE MANAGED
LONG-TERM

CLASS I MALOCCLUSION
INCREASED OVERBITE
SMALL UL LATERAL

CONGENITALLY ABSENT
UPPER RIGHT LATERAL


POST-TREATMENT


ACID ETCH BRIDGE UPPER RIGHT LATERAL
BONDING BUILD-UP LEFT LATERAL INCISOR


Thank you
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Retention1 /certified fixed orthodontic courses by Indian dental academy

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