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Orthodontic
retainers
types
orthodontic
      retainers types
• REMOVABLE APPLIANCES AS RETAINERS

• FIXED RETAINERS
Removable appliances can
serve effectively for
retention against intra-arch
instability and are also
useful as retainers (ex:
headgear) in patients with
growth problems.

If permanent retention is needed, a fixed
retainer should be used in most Instances.
• The most common removable retainer
• Designed in the    as active removable
  appliance.

                              adjustment
                              loops
  clasps on molar




   labial bow
1. Close band spaces between the incisors.
2. keep the extraction space closed When first
   premolars have been extracted.

• which the standard design
  of the Hawley retainer
  cannot do!!
So
common modification of
the Hawley retainer for
use in extraction cases
is:

 a bow soldered to the
buccal section o f Adams
clasps so that the action
of the bow helps hold
the extraction site
closed.
Clasp locations for a Hawley retainer most be selected
carefully, since It   can disturb rather than
retain the tooth relationships established during
treatment. So circumferential clasps on the terminal
molar may be preferred over the more effective Adams
clasp if the occlusion is tight.
Advantages:
 1-Can be used in most cases.
 2-Hygiene not an issue.
 3-can be modified.


Disadvantages:
1-Requires patient compliance.
2-Visible labial bow.
3-interproximal wire may cause opening of spaces.
4-High incidence of breakage and loss.
• The 2nd major type of R.O.R.
• Consists of wire that passes along the labial as well
  as lingual surfaces of all erupted teeth which is
  embedded in a strip of acrylic.
 Not routinely used because:
 1. Its often Less comfortable than
    Hawley retainer.
 2. May not be effective in
    maintaining overbite
    correction.
BUT:
A full-arch wraparound retainer is indicated primarily when
periodontal breakdown requires splinting the teeth together.
-What’s tooth positioners?
a resilient rubbery and plastic removable appliance fitted over the
occlusal surfaces of the teeth to obtain limited tooth movement and
stabilization, usually at the end of orthodontic treatment.


-Positioners as Retainers?
A tooth positioners also can be
used as Retainer, either fabricated
for this purpose alone or more
commonly, continued as a retainer
after serving initially as a finishing
device.
This type Needs no activation at regular
intervals and it is durable.


But The major problem are:
1. its bulk, patients often have difficulty wearing a positioner
   full-time or nearly.
2. Positioners do not retain incisor irregularities and rotations
   as well as standard retainers.
3. Over bite tends to increase while a positioner is being worn.
These all are probably relates in large
part to fact that its worn only a
small percentage of time .
Use in the situation where “intra arch
instability” is anticipated and “prolonged
retention” is planned especially the
mandibular incisor area.
1-does not require patient compliance.

2- Reduced need for patient cooperation.

3- Can be used when removable retainers. cannot
provide same degree of stability.

4-Permanent retention.
1-Difficult to maintain hygiene.

2-Poor patient acceptance.

3-more cumbersome to insert

4-Increased chair-side time and more expensive
potential for becoming de-bonded.
1. Maintenance of lower incisor position during late
  growth of mandible (age 16-20) . Especially if the
  lower incisors have previously been irregular. A
  relapse into crowding is almost always accompanied
  by lingual tipping of the central and lateral incisors
  in response to the pattern of mandibular growth.
An excellent retainer to hold these teeth in alignment
 is a fixed lingual bar, attached only to canines (or to
 canines and 1st premolars) and resting against the flat
 lingual surface of the lower incisors above the
 cingulum.
Its also possible to bond a fixed lingual retainer to one
 or more of incisor teeth, the major indication for this
 variation is a tooth or teeth that had been
  severely rotated.
2. Diastema maintenance. A second indication for a
   fixed retainer is a situation were teeth most be
   permanently or semi-permanently bonded together
   to maintain the closure of a space between them.
   The best retainer for this purpose is a bonded
   lingual section of Flexible wire as shown in the
   figure.
A removable retainer is not a good choice for
 prolonged retention of central Diastema. In trouble
 some cases, the Diastema is closed when the
 retainer is removed but opens up quickly. The tooth
 movement that accompanies this back and fourth
 closure is potentially damaging over a long period.
3. Maintain of Pontic or Implant Space. Using a fixed
   retainer for a few months reduces mobility of teeth
   and often makes it easer to place the fixed bridge that
   will serve among other functions as a permanent
   orthodontic retainer.

  -Use a heavy intracoronal
  wire and bonded it to the
  adjacent teeth. Obviously,
  the longer span the heaver
  the wire should be.
4. Keeping Extraction Spaces Closed in Adults. A
  fixed retainer is both more reliable and better tolerated
  than a full-time removable retainer, and spaces re-open
  unless a retainer is worn consistently.


  -Bringing the wire down out
  of occlusion decrease the
  chance that it will displaced
  by occlusal forces.
Is a contradiction in term !
Since the device can not be actively moving
teeth and serving as a retainer at the same time.

this usually accomplished with a removable
appliance that continues as a retainers after it
has repositioned the teeth.

           Hence the name
The term usually reserved for two specific
situations:

1) Realignment of irregular incisors with spring
   retainers.
2) Management of class II or class III relapse
   tendencies with modified functional
   appliance.
 Spring Retainers
 Its a variation type from Removable Wraparound
  Retainer knows also as clip-on retainer
 The major indication for this retainer is re-crowding of
  the lower incisors which is usually caused by late
  mandibular growth.
 if late crowding has
 developed, it often necessary
 to reduce the interproximal
 width of lower incisors so that
 the crown do not tip labially
 into an obviously unstable
 position.
 Its not indicated as a routine procedure.
 just 0.25mm on each.
 interproximal enamel can be removed with
 abrasive strips or thin flame-shaped diamond
 stone.
 Modified Functional Appliance as
             Active Retainers
  When functional appliance
   used as retainer it known as
   Modified F.A.
  EX: The Bionator which is a 1
   piece removable appliance
   designed to produce a forward
   positioning of the mandible
   correcting a skeletal Class II
   relationship.
 A typical use for bionator as an active retainer would
  be a male adolescent who had slipped back 2 to 3 mm
  toward a Class II relationship after early correction.
 functional appliance as an active retainer can
  be used in teenagers but is of no value in adults!!

 This is because differential anterioposerior
  growth is not necessary to correct a small
  occlusal discrepancy (because tooth movement
  is adequate) but some vertical growth is required
  to prevent downward and backward rotation of
  the mandible.
The use of a functional appliance as an active retainer
            from its use as a pure retainer.




  Expected                       The object is to control
  primarily                      growth, and tooth
  to move teeth                  movement is largely
  no significant skeletal        an undesirable side
  change is expected.            effect.

The correction
is achieved by restraining the eruption of maxillary teeth
posteriorly and directing the erupting mandibular teeth
anteriorly.
 Retention and Relapse ..  AAA

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Retention and Relapse .. AAA

  • 2. orthodontic retainers types • REMOVABLE APPLIANCES AS RETAINERS • FIXED RETAINERS
  • 3. Removable appliances can serve effectively for retention against intra-arch instability and are also useful as retainers (ex: headgear) in patients with growth problems. If permanent retention is needed, a fixed retainer should be used in most Instances.
  • 4. • The most common removable retainer • Designed in the as active removable appliance. adjustment loops clasps on molar labial bow
  • 5. 1. Close band spaces between the incisors. 2. keep the extraction space closed When first premolars have been extracted. • which the standard design of the Hawley retainer cannot do!!
  • 6. So common modification of the Hawley retainer for use in extraction cases is: a bow soldered to the buccal section o f Adams clasps so that the action of the bow helps hold the extraction site closed.
  • 7. Clasp locations for a Hawley retainer most be selected carefully, since It can disturb rather than retain the tooth relationships established during treatment. So circumferential clasps on the terminal molar may be preferred over the more effective Adams clasp if the occlusion is tight.
  • 8. Advantages: 1-Can be used in most cases. 2-Hygiene not an issue. 3-can be modified. Disadvantages: 1-Requires patient compliance. 2-Visible labial bow. 3-interproximal wire may cause opening of spaces. 4-High incidence of breakage and loss.
  • 9. • The 2nd major type of R.O.R. • Consists of wire that passes along the labial as well as lingual surfaces of all erupted teeth which is embedded in a strip of acrylic. Not routinely used because: 1. Its often Less comfortable than Hawley retainer. 2. May not be effective in maintaining overbite correction. BUT: A full-arch wraparound retainer is indicated primarily when periodontal breakdown requires splinting the teeth together.
  • 10. -What’s tooth positioners? a resilient rubbery and plastic removable appliance fitted over the occlusal surfaces of the teeth to obtain limited tooth movement and stabilization, usually at the end of orthodontic treatment. -Positioners as Retainers? A tooth positioners also can be used as Retainer, either fabricated for this purpose alone or more commonly, continued as a retainer after serving initially as a finishing device.
  • 11. This type Needs no activation at regular intervals and it is durable. But The major problem are: 1. its bulk, patients often have difficulty wearing a positioner full-time or nearly. 2. Positioners do not retain incisor irregularities and rotations as well as standard retainers. 3. Over bite tends to increase while a positioner is being worn.
  • 12. These all are probably relates in large part to fact that its worn only a small percentage of time .
  • 13. Use in the situation where “intra arch instability” is anticipated and “prolonged retention” is planned especially the mandibular incisor area.
  • 14. 1-does not require patient compliance. 2- Reduced need for patient cooperation. 3- Can be used when removable retainers. cannot provide same degree of stability. 4-Permanent retention.
  • 15. 1-Difficult to maintain hygiene. 2-Poor patient acceptance. 3-more cumbersome to insert 4-Increased chair-side time and more expensive potential for becoming de-bonded.
  • 16. 1. Maintenance of lower incisor position during late growth of mandible (age 16-20) . Especially if the lower incisors have previously been irregular. A relapse into crowding is almost always accompanied by lingual tipping of the central and lateral incisors in response to the pattern of mandibular growth.
  • 17. An excellent retainer to hold these teeth in alignment is a fixed lingual bar, attached only to canines (or to canines and 1st premolars) and resting against the flat lingual surface of the lower incisors above the cingulum.
  • 18. Its also possible to bond a fixed lingual retainer to one or more of incisor teeth, the major indication for this variation is a tooth or teeth that had been severely rotated.
  • 19. 2. Diastema maintenance. A second indication for a fixed retainer is a situation were teeth most be permanently or semi-permanently bonded together to maintain the closure of a space between them. The best retainer for this purpose is a bonded lingual section of Flexible wire as shown in the figure.
  • 20. A removable retainer is not a good choice for prolonged retention of central Diastema. In trouble some cases, the Diastema is closed when the retainer is removed but opens up quickly. The tooth movement that accompanies this back and fourth closure is potentially damaging over a long period.
  • 21. 3. Maintain of Pontic or Implant Space. Using a fixed retainer for a few months reduces mobility of teeth and often makes it easer to place the fixed bridge that will serve among other functions as a permanent orthodontic retainer. -Use a heavy intracoronal wire and bonded it to the adjacent teeth. Obviously, the longer span the heaver the wire should be.
  • 22. 4. Keeping Extraction Spaces Closed in Adults. A fixed retainer is both more reliable and better tolerated than a full-time removable retainer, and spaces re-open unless a retainer is worn consistently. -Bringing the wire down out of occlusion decrease the chance that it will displaced by occlusal forces.
  • 23. Is a contradiction in term ! Since the device can not be actively moving teeth and serving as a retainer at the same time. this usually accomplished with a removable appliance that continues as a retainers after it has repositioned the teeth. Hence the name
  • 24. The term usually reserved for two specific situations: 1) Realignment of irregular incisors with spring retainers. 2) Management of class II or class III relapse tendencies with modified functional appliance.
  • 25.  Spring Retainers  Its a variation type from Removable Wraparound Retainer knows also as clip-on retainer  The major indication for this retainer is re-crowding of the lower incisors which is usually caused by late mandibular growth. if late crowding has developed, it often necessary to reduce the interproximal width of lower incisors so that the crown do not tip labially into an obviously unstable position.
  • 26.  Its not indicated as a routine procedure.  just 0.25mm on each.  interproximal enamel can be removed with abrasive strips or thin flame-shaped diamond stone.
  • 27.  Modified Functional Appliance as Active Retainers  When functional appliance used as retainer it known as Modified F.A.  EX: The Bionator which is a 1 piece removable appliance designed to produce a forward positioning of the mandible correcting a skeletal Class II relationship.  A typical use for bionator as an active retainer would be a male adolescent who had slipped back 2 to 3 mm toward a Class II relationship after early correction.
  • 28.  functional appliance as an active retainer can be used in teenagers but is of no value in adults!!  This is because differential anterioposerior growth is not necessary to correct a small occlusal discrepancy (because tooth movement is adequate) but some vertical growth is required to prevent downward and backward rotation of the mandible.
  • 29. The use of a functional appliance as an active retainer from its use as a pure retainer. Expected The object is to control primarily growth, and tooth to move teeth movement is largely no significant skeletal an undesirable side change is expected. effect. The correction is achieved by restraining the eruption of maxillary teeth posteriorly and directing the erupting mandibular teeth anteriorly.