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 INCISORS

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 what has been achieved

Retain

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 Class II to molar bands

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 MISSING LATERALS

ESSIX RETAINERS 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