Retention in orthodontics. Part 1: Removable retainers – a literature review
Journal Title: Forum Ortodontyczne - Year 2014, Vol 10, Issue 4
Abstract
Termination of an active treatment with fixed thin-wire arch braces is not the end of the fight for preservation of normal occlusion status and a beautiful smile. It is so because after the braces are removed, the soft tissues surrounding the teeth continue to undergo restructuring. Additionally, the occlusion status resulting from such treatment may be disturbed by variable forces exerted by the muscles of the tongue, lips, and cheeks. The treatment outcomes are also affected by an active body growth stage following the conclusion of the treatment, as well as by the habits, ageing processes and natural anterior movement of the teeth that leads to the shortening of dental arches. In order to provide optimal position of the teeth as far as their function and aesthetics are concerned, fixed and removable retainers are used. [b]Aim.[/b] A review of literature referring to removable retainers, systematization of the knowledge on retention and an attempt to answer the question of what type of removable retainer best fulfils its task from the point of view of an orthodontist and is tolerated well by the patient. [b]Material and methods[/b]. The key phrase (‘removable retainers’) was searched in the following data bases: Scopus (Elsevier), Medline (NLM), OneFile (GALE), and SciVerse Science Direct (Elsevier). Out of 247 papers, to the next stage of the study were included only those written after year 2000 – on the assumption that the date represented the timeline of contemporary methods of retention treatment and the application of retention protocols. In order to reduce the number of analysed papers, some appropriate inclusion and exclusion criteria were employed. [b]Results[/b]. Advantages of Hawley retainers include resistance to mechanical damage and improved occlusion achieved during their use, whereas disadvantages comprise a high cost of their manufacture in a laboratory and the visibility of the retainer in the oral cavity. Thermoplastic retainers are beneficial due to a better aesthetics and a higher patient satisfaction index reported during the first two years of use. After two years, patients’ unwillingness to use clear aligners resulted from frequent failures and pigment absorption on the surface of the retainer. [b]Discussion.[/b] In view of thecommon objective of the patient and the doctor, which is to preserve treatment effects and encourage the patient to a long-term use of effect-sustaining devices, a dual retention pattern should be applied, namely a thermoplastic retainer to be worn during the first two years and to be subsequently replaced with a Hawley retainer. (Podobas-Muderrisoglu B, Krasny M, Zadurska M. Retention in orthodontics. Part 1: Removable retainers – a literature review. Orthod Forum 2014; 10: 287-94). Recived: 16.10.2014 Accepted: 8.12.2014
Authors and Affiliations
Barbara Podobas-Muderrisoglu, Marta Krasny, Małgorzata Zadurska
Keywords
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