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The mystery of stability and relapse remains elusive after more than a century of concern. Why do some patients seem to tolerate or adapt to changes in arch dimension that others do not? Why is intercanine width increase apparently unstable, even when the method of treatment involves retraction into the first bicuspid extraction space? If soft tissue has the final say, why is its voice louder in some people than others? Until these and other fundamental questions on treatment stability can be answered, what should responsible orthodontists do? One suggestion is to personalize the retention phase to the treatment delivered. But do we do that in our retention protocols? Do American orthodontists devise retention modalities unique to each patient and reflective of the treatment or original diagnosis? This paper will review issues relevant to treatment stability and reflective of the retention protocols of practicing orthodontists in this country. Recent literature will be reviewed and interesting, unexpected findings will be shared.
Learning Objectives:
Common trends and retention protocols among U.S. orthodontists
Past, present and future perceptions and usages of fixed, Hawley and vacuum-formed retainers
Patients understanding and compliance in retention and post-retention phases
Retention and Stability: A Perspective
The purpose of this presentation is to refresh knowledge, provide guidance as to treatment considerations and give an outlook on future management of treated occlusions. Patients seek orthodontic treatment to correct dental and skeletal malrelationships, however, the complaint mostly noted by orthodontic patients is that of crowding or irregularity of their teeth. This is no surprise as research data in respect to the oral health in the U.S. show that almost 40% of untreated subjects between 15-50 years possess clinically unacceptable aligned lower incisors. It is thus an accepted fact that some change will occur following treatment; the extent dependent on the management of the treatment. Retention and stability are important phases of this management. The information presented should encourage each clinician who seeks excellence in their treatment to think long-term planning right from the initial appointment. The intention is to make the clinician aware of the changes expected in untreated and treated dentitions over time, thus enabling the clinician to enhance the treatment management.
Learning Objectives
Insight into long-term changes of untreated and treated dentitions