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7/25/2019 Retention Lecture Color
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RETENTION RELAPSE
AND THEOCCURANCE OF MALOCCLUSION
From
Riolo, M. and Avery, J. Eds., Essentials for Orthodontic Practice,
EFOP Press of EFOP, LLC. Ann Arbor and Grand Haven,
Michigan, U.S.A., 2003.
By
Manish Valiathan and Mark G. Hans
CHAPTER 21
PAGES 594-616
Retention is the final phase of active orthodontic
treatment where teeth are maintained in a healthy,
functional, and esthetic position.
The method of retention to be employed is best
selected at the outset of treatment and incorporated in
the treatment plan for each individual case.
RETENTION
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General Factors affecting stability
Among the many suggested factors mentioned
that influence stability, three deserve further
elaboration:
(i) the involvement of the periodontal ligament
fibers and gingival fibers
(ii) late mandibular growth and,
(iii) physiologic imbalance of local extrinsicforces acting on the corrected dentition.
restoration and reorganization of arrangement of the PDL
fibers and calcification of the lamina dura takes 3 to 4 months
periodontal ligament fibers and gingival fibers
unorganized gingival and PDL fibers lead to an increased
susceptibility to tooth movement
collaginous fibers reorganize structurally in 4 to 6 months
supracrestal elastic fibers of the gingiva take up to 1 year
to structurally adapt to the new position of the teeth
rotational relapse might be caused by the elastic fibersof the gingival tissue
fiberotomy
Life time retention
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late mandibular growth
Remodeling of the craniofacial skeletal and soft
tissue structures continuous into adult life, leading
to changes in dental alignment
physiologic imbalance of local extrinsic forces
the rebound effect
- occlusion
- tongue musculature
- cheek musculature
- gingival fibers
- fibers of the PDL
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Retention of Anterioposterior Corrections
- Retention of Class II Corrections
- Retention of Class III Corrections
PHASE I TREATMENT WITH TWIN BLOCK APPLIANCE
(FUNCTIONAL APPLIANCE)
Class II Corrections
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RETENTION AFTER PHASE I TREATMENT
WITH TWIN BLOCK APPLIANCE (FUNCTIONAL)
Retention of Class II Corrections
Retention of Vertical Corrections
-Retention after Deep Bite Corrections
-Retention after Anterior Open Bite
Corrections
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UPPER HAWLEY TYPE RETAINER WITH ANTERIOR BITE PLANE
Retention after Deep Bite Corrections
PASSIVE ANTERIOR BITE PLANE
TONQUE CRIB
POSTERIOR BITE BLOCK
Retention after Anterior Open Bite Corrections
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Retention of Arch Form and Arch Alignment
Effects of Extraction and Non extraction
Treatment on Arch Stability
-intermolar width
-Intercanine width
-interpremolar width
-dental arch length-dental arch form
-mandibular incisors
Palatal Expansion and Stability
Minimum time of Retention
3 to 6 months
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Third Molars and Relapse
?
Extraction of third molars for the purpose of
preventing lower incisor relapse is not justified
Appliances designs and Retention
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HAWLEY TYPE REMOVABLE RETAINERS
WITH ARROW CLASPS WITH ADAMS CLASPS
LOWER HAWLEY TYPE RETAINERS
WITH BALL CLASPS WITH MOLAR RESTS
AND CANINE ATTACHMENTS
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WRAP-AROUND RETAINER
AVOIDS OCCLUSAL INTERFERENCE
RETAINER WITH PONTIC
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BONDED RETAINERS
BONDED RETAINER-SPACE MAINTAINER
HAWLEY TYPE RETAINERS WITH FINGER SPRINGS FOR LATERAL INCISORS
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HAWLEY TYPE RETAINERS WITH FINGER SPRINGS FOR LATERAL INCISORS
MODIFIED HAWLEY TYPE RETAINER
FOLLOWING
EXTRACTION OF FIRST PREMOLARS
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MODIFIED HAWLEY TYPE RETAINER
FOLLOWING
EXTRACTION OF FIRST PREMOLARS
Modified lingual clasp
Eye claspLong modified Adams clasp
Adams clasp L clasp C clasp
Ball claspModified Adams clasps
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SPRING ALIGNER
TRU-TAIN RETAINER
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POSITIONER