Retention, What Should We Do Now?

Join me for a update on retention, I explore a review of currentliterature and what the changes are recommended to our retention protocols,research of stability,  critical look of retainerfailures and factors to consider in design and location of fixedretainers, as well as monitoring recommendations based on Clinical PracticeGuidelines. This podcast is based on recent literature as well as two excellentlectures from this year’s British Orthodontic Conference by Marie Cornelis(Australia) and Simon Littlewood (UK).

Recommendations for the maxilla:

·     Low risk of relapse = Removable retainer (polyethyleneor polyurethane)

·     High risk of relapse = Dual retention with fixedand removable retainers

·     Fixed retainer

o  3-3 if occlusion allows, most likely 2-2 designunless high risk of canine relapse

o  Location slightly gingival due to occlusalforces and account for Increase in overbite with age (Littlewood)

Recommendations for the mandible

Lower arch

o  Low risk of relapse = fixed retainers

o  High risk of relapse = dual arch

o  Fixed retainer 3-3

§ Position slightly incisal Mandible: slightlymore incisal, greater cleanability, less gingival inflammation  – Petsos 2023

Monitoring regime

·     1 month – fixed retainer (greatest timepoint offailure)

·     3 month – removable retainer (motivation ofcompliance)

·     Every 3-4 months Wouters 2018

·     1 year retention necessary  Wouters 2018

·     Annual check-up Wouters 2018

o  Greater likelihood of compliance if annualcheck-up

o  General dentist

Improve compliance

·     2/3rds stop wearing after 4 years,All-Moghrabi 2018

·     Visual photo of relapse to patient and parentsincreased compliance Vs patient only or instructions only Lin 2015 (1.5Hrsgreater wear)

Clinical PracticeGuideline For Orthodontic Retention Wouters 2019 (open access paper)