Key Points
-
Describes the factors that influence stability following orthodontic treatment.
-
Explains the rationale and evidence for orthodontic retention and the various types of orthodontic retainers.
-
Outlines how general dental practitioners can support their patients wearing orthodontic retainers.
Abstract
Retention is necessary following orthodontic treatment to prevent relapse of the final occlusal outcome. Relapse can occur as a result of forces from the periodontal fibres around the teeth which tend to pull the teeth back towards their pre-treatment positions, and also from deflecting occlusal contacts if the final occlusion is less than ideal. Age changes, in the form of ongoing dentofacial growth, as well as changes in the surrounding soft tissues, can also affect the stability of the orthodontic outcome. It is therefore essential that orthodontists, patients and their general dental practitioners understand the importance of wearing retainers after orthodontic treatment. This article will update the reader on the different types of removable and fixed retainers, including their indications, duration of wear, and how they should be managed in order to minimise any unwanted effects on oral health and orthodontic outcomes. The key roles that the general dental practitioner can play in supporting their patients wearing orthodontic retainers are also emphasised.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Richter D D, Nanda R S, Sinha P K, Smith D W, Currier G F . Effect of behavior modification on patient compliance in orthodontics. Angle Orthod 1998; 68: 123–132.
Lyotard N, Hans M, Nelson S, Valiathan M . Short-term postorthodontic changes in the absence of retention. Angle Orthod 2010; 80: 1045–1050.
Harris E F, Vaden J L . Posttreatment stability in adult and adolescent orthodontic patients: a cast analysis. Int J Adult Orthodon Orthognath Surg 1994; 9: 19–29.
Harris E F, Vaden J L, Dunn K L, Behrents R G . Effects of patient age on postorthodontic stability in Class II, division 1 malocclusions. Am J Orthod 1994; 105: 25–34.
Kaplan H . The logic of modern retention procedures. Am J Orthod Dentofacial Orthop 1988; 93: 325–340.
Meade M J, Millett D . Retention protocols and use of vacuum-formed retainers among specialist orthodontists. J Orthod 2013; 40: 318–325.
Pratt M C, Kluemper G T, Hartsfield J K Jr, Fardo D, Nash D A . Evaluation of retention protocols among members of the American Association of Orthodontists in the United States. Am J Orthod Dentofacial Orthop 2011; 140: 520–526.
Hichens L, Rowland H, Williams A et al. Cost-effectiveness and patient satisfaction: Hawley and vacuum-formed retainers. Eur J Orthod 2007; 29: 372–378.
Singh P, Grammati S, Kirschen R . Orthodontic retention patterns in the United Kingdom. J Orthod 2009; 36: 115–121.
Mollov N D, Lindauer S J, Best A M, Shroff B, Tufekci E . Patient attitudes toward retention and perceptions of treatment success. Angle Orthod 2010; 80: 468–473.
Kumar A G, Bansal A . Effectiveness and acceptability of Essix and Begg retainers: a prospective study. Aust Orthod J 2011; 27: 52–56.
Rowland H, Hichens L, Williams A et al. The effectiveness of Hawley and vacuum-formed retainers: a single-center randomized controlled trial. Am J Orthod Dentofacial Orthop 2007; 132: 730–737.
Chate R A, Falconer D T . Dental appliances with inadequate occlusal coverage: a case report. Br Dent J 2011; 210: 109–110.
Sauget E, Covell D A, Boero R P, Lieber W S . Comparison of occlusal contacts with use of Hawley and clear overlay retainers. Angle Orthod 1997; 67: 223–230.
Scheibe K, Ruf S . Lower bonded retainers: survival and failure rates particularly considering operator experience. J Orofac Orthop 2010; 71: 300–307.
Heier E E, De Smit, A A, Wijgaerts I A, Adriaens P A . Periodontal implications of bonded versus removable retainers. Am J Orthod Dentofacial Orthop 1997; 112: 607–616.
Sadowsky C, Schneider B J, BeGole E A, Tahir E . Long-term stability after orthodontic treatment: nonextraction with prolonged retention. Am J Orthod Dentofacial Orthop 1994; 106: 243–249.
van Westing K, Algera T J, Kleverlaan C J . Rebond strength of bonded lingual wire retainers. Eur J Orthod 2012; 34: 345–349.
Littlewood S J, Millett D T, Doubleday B, Bearn D R, Worthington H V . Orthodontic retention: a systematic review. J Orthod 2006; 33: 205–212.
Clark J D, Kerr W J, Davis M H . CASESclinical audit; scenarios for evaluation and study. Br Dent J 1997; 183: 108–111.
Reitan K . Clinical and histologic observations on tooth movement during and after orthodontic treatment. Am J Orthod 1967; 53: 721–745.
Edwards J G . A study of the periodontium during orthodontic rotation of teeth. Am J Orthod 1968; 54: 441–461.
Little R M, Riedel R A, Artun J . An evaluation of changes in mandibular anterior alignment from 10 to 20 years postretention. Am J Orthod Dentofacial Orthop 1988; 93: 423–428.
Little R M . Stability and relapse of dental arch alignment. Br J Orthod 1990; 17: 235–241.
Littlewood S J, Millett D T, Doubleday B, Bearn D R, Worthington H V . Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database Syst Rev 2006; 1: CD002283.
Gill D S, Naini F B, Jones A, Tredwin C J . Part-time versus full-time retainer wear following fixed appliance therapy: a randomized prospective controlled trial. World J Orthod 2007; 8: 300–306.
Thickett E, Power S . A randomized clinical trial of thermoplastic retainer wear. Eur J Ortho 2010; 32: 1–5.
Shawesh M, Bhatti B, Usmani T, Mandall N . Hawley retainers fullor part-time? A randomized clinical trial. Eur J Orthod 2010; 32: 165–170.
Richardson M E . Late lower arch crowding facial growth or forward drift? Eur J Orthod 1979; 1: 219–225.
Richardson M E . Lower incisor crowding in the young adult. Am J Orthod Dentofacial Orthop 1992; 101: 132–137.
Richardson M E, Gormley J S . Lower arch crowding in the third decade. Eur J Orthod 1998; 20: 597–607.
Mills J R E . The stability of the lower labial segment. A cephalometric survey. Dent Pract Dent Rec 1968; 18: 293–306.
Sharpe W, Reed B, Subtelny J D, Polson A . Orthodontic relapse, apical root resorption, and crestal alveolar bone levels. Am J Orthod Dentofacial Orthop 1987; 91: 252–258.
Zachrisson BU . Tooth movements in the periodontally compromised patient. In Lindhe J, Lang N P, Karring T (ed) Clinical periodontology and implant dentistry. 5th ed. pp 1241–1279. Oxford: Blackwell Munksgaard, 2008.
Joondelph D R . Stability, retention and relapse. In Graber L W, Vanarsdall R L, Vig KWL (ed) Orthodontics: current principles and techniques. 5th ed. pp 991–1020. Philadelphia: Elsevier Mosby, 2012.
Chate R A . Truth or consequences: the potential implications of short-term cosmetic orthodontics for general dental practitioners. Br Dent J 2013; 215: 551–553.
Edwards J G . A long-term prospective evaluation of the circumferential supracrestal fiberotomy in alleviating orthodontic relapse. Am J Orthod Dentofacial Orthop 1988; 93: 380–387.
Edman Tynelius G, Bondemark L, Lilja-Karlander E . Evaluation of orthodontic treatment after 1 year of retentiona randomized controlled trial. Eur J Orthod 2010; 32: 542–547.
Author information
Authors and Affiliations
Corresponding author
Additional information
Refereed Paper
Rights and permissions
About this article
Cite this article
Johnston, C., Littlewood, S. Retention in orthodontics. Br Dent J 218, 119–122 (2015). https://doi.org/10.1038/sj.bdj.2015.47
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.bdj.2015.47
This article is cited by
-
Mechanical properties of combined packable and high-filled flowable composite used for the fixed retainer: an in vitro study
BMC Oral Health (2024)
-
Knowledge, attitude and practice of patients towards orthodontic treatment
BMC Oral Health (2023)
-
Impact of occlusal contact pattern on dental stability and oromandibular system after orthodontic tooth movement in rats
Scientific Reports (2023)
-
Restorative dentistry clinical decision-making for hypodontia: peg and missing lateral incisor teeth
British Dental Journal (2023)
-
A survey of patient compliance with removable orthodontic retainer wear in Brunei Darussalam
BDJ Open (2023)


