Fixed retainers are often preferred over removable retainers when permanent retention is needed. Common types of fixed retainers include lingual bars bonded to the lingual surfaces of teeth. Removable retainers like Hawley retainers require patient compliance but can be modified as needed. Retainers help prevent relapse of the teeth into their original malformed positions and help stabilize dental arches after orthodontic treatment.
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.