Retention & Relapse

Retention

Maintaining newly moved teeth in position long enough

to aid in stabilizing their correction
 why
Retention is required due to the following reasons
1) Gingival and periodontal tissues are affected by
orthodontic tooth movement
2) Teeth may be inherently unstable position after
treatment
3) Growth
 Alveolar bone is laid down in one month

1) Periodontal ligament fibres require at least 232 days or 3

to 4 moths to re-organize
2) Collagenous fiber network reorganize in 4 to six months

3) Elastic supra-crestal fibers need 1 year to remodel

4) Growth
 Categorization of cases on the basis of
retention required
1) NO RETENTION REQUIRED

• Corrected anterior cross bites where there is an

adequate OB
• Corrected posterior cross bites with good inter-
digitation
• Cases requiring drifto-dontics
2) SEMI-PERMANENT RETENTION
REQUIRED

• De-rotation
• Deep Over Bite
• Sk. Discrepancies
• Expansion cases
• PERMANENT RETENTION REQUIRED

• Severely Spaced Cases

• Diastema

• Multiple or severely rotated cases

• Neutral zone violation

 Timing for retention

• Full time for 3 to 4 months

• Part time 12 months
• Part time if growth is remaining
 Type of retainer

Removable retainer
Hawley retainers
Removable wraparound retainer
Clear ( vacuum former )retainer
Fixed retainer
Active retainer
Hawley's retainer ESSIX RETAINER

Lingual bonded retainer

 RELAPSE

Loss of any correction achieved by orthodontic

treatment
THEOREMS OF RETENTION
& RELAPSE
• Theorem 1
Teeth that have been moved tend to return to their
former position e.g. De-rotation, Diastema Closure

• Theorem 2
Elimination of the cause of malocclusion will
prevent relapse
• Theorem 3
Malocclusion should be overcorrected as a safety factor

• Theorem 4
Proper occlusion & inter-digitation prevents relapse

• Theorem 5
Bone and adjacent tissues must be allowed time to
reorganize around newly positioned teeth
• Theorem 6
If the lower incisors are placed upright over basal bone they
are more likely to remain in good alignment

• Theorem 7
Corrections carried out during periods of growth are less
likely to relapse
• Theorem 8
The farther the teeth have been moved, the less is the
likelihood of relapse
• Theorem 9

Arch form, particularly the mandibular arch, cannot be

altered permanently by appliance therapy

• Theorem 10
Many treated cases require permanent retaining devices
RELAPSE CAN BE MINIMIZED BY

1) Maintain existing arch form

2) Maintain inter-canine width
3) Do not alter the AP position of the Lowers
4) Correct rotations early in treatment
5) Overcorrect rotations
6. Consider inter-proximal enamel reduction
for triangular teeth to increase area of
inter-proximal contact
7. Active retention for SK discrepancies
throughout growth
8. Labial frenectomy (minimizes diastema
re-opening)
9. Maximize inter-digitation
10. Move upper incisors to within lip control