, FISID
• Retention The last phase of
orthodontic treatment and one of the
most important, where teeth are held in
an esthetic and functional position.
• Any Treatment is a failure unless the
treatment result can be retained.
• The term “Retention” has been define
d as : “The holding of teeth in idealisti
c and functional position”.
(Joondeph and Riedel, 1985)
The need for retention is important to
maintain the stability of the occlusion
achieved by the orthodontist and
patient.
Without stability, the esthetic and
functional result may relapse.
What is Relapse?
“loss of any correction achieved by any
orthodontic treatment” RELAPSE
• Teeth are in a stable position because of the
equilibrium of forces of chewing, swallowing,
tongue, and cheek movements.
• There is a balance between the internal and
external oral musculature.
Causes of Relapse
Causes of Relapse
Other causes:
• Periodontal ligament traction
• Relapse due to growth related changes
• Bone adaptation
• Muscular factors
• Failure to eliminate the original cause
• Role of third molars
• Role of occlusion
Causes of Relapse
The most basic of them all is the
persistence of the etiology.
If the underlying etiology is not
removed, the treatment is destined to
Relapse.
The removal of the etiologic factor
before finishing is mandatory.
Causes of Relapse
THEOREM 5
THEOREM 4 THEOREM 6
“Bone and adjacent
“Occlusion is an “Lower incisors must be
tissues must be allowed to
important factor in placed upright over the
reorganize around of
retention.” basal bone”.
newly positioned teeth .“
THEOREM 9
THEOREM 7 THEOREM 8 “Arch form, particularly in
“Corrections carried out “The further teeth have the mandibular arch,
during period of growth been moved, the less the cannot be permanently
are less likely to relapse.” likelihood of relapse.” altered by appliance
therapy.”
RALEIGH Williams’ 6 KEYS OF RETENTION
Incisal edges of the lower incisors should be placed on the A‐P line or 1mm in front of it.
All four lower incisors apices must be in the same labiolingual plane
Lower cuspid root apex must be positioned slightly buccal to the crown apex
Deep bites
Early corrections of rotated teeth to their normal position before root completion
Single arrowhead
partial wraparounds
retainer
Removable Retainer
Osamu’s invisible
upper and lower
retainers
Kesling’s tooth
positioner
Hawley Retainer
Advantages Disadvantages
Lingual 3 to 3
retainers: Commercially available bonded
Bonded wire banded/ bonded retainer with mesh throughout
retainer with the length of the retainer
mesh on canine
• Advantages of bonded over banded extra-coronal
retainers:
– 1. Completely invisible from the front
– 2. Reduced caries risk, as complete adhesion to the
tooth surface
– 3. Reduced need for long-term patient cooperation
– 4. No time gap between removal of fixed appliance and
bonding of retainer (can even be placed before
debonding of brackets)
– 5. Can be bonded directly/indirectly
• Disadvantages of banded type extra-coronal
retainers:
– 1. Lack of esthetics, the metallic bands are visible
– 2. Build up of debris and plaque around bands
and the connecting wire
– 3. More susceptible to caries in the cement
washout areas
– 4. Not always effective against the return of
flaring, spacing or incisor torque changes
• Flexible Spiral Wire Retainer:
– Thick Wire (0.032’’)
– Thin Wire (0.02’’)