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References

Durbin DD Relapse and the need for permanent fixed retention. J Clin Orthod. 2001; 35:723-727
Dimond HD A nickel titanium space regainer-retainer. J Clin Orthod. 2001; 35:767-768

Active lingual retainer

From Volume 41, Issue 5, June 2014 | Page 473

Authors

Surendra Lodha

Postgraduate Student, Department of Orthodontics and Dentofacial Orthopaedics, Manipal College of Dental Sciences, Manipal, India

Articles by Surendra Lodha

Santosh KumarKumar

Assistant Professor

Articles by Santosh KumarKumar

Siddharth Mehta

Assistant Professor, Department of Orthodontics and Dentofacial Orthopedics, Manipal College of Dental Sciences, Manipal, India

Articles by Siddharth Mehta

Article

It is believed that, because dental arch length decreases and lower anterior crowding increases throughout life, the only way to maintain ideal alignment after orthodontic treatment is by means of some form of permanent retention. Bonded lingual retainers are often placed after fixed orthodontic treatment and can serve in-mouth for decades.1

Accidental breakage of the bonded lingual retainer may be encountered during the post retention phase of the orthodontic treatment and failure to get this repaired may lead to relapse of anterior crowding, which may need removable appliances or a tooth positioner for realignment.

The replacement of the permanent bonded retainer will be needed after the alignment.

With technological advances in archwires, there are many creative new ways to treat classic orthodontic problems.2 The authors used a simple technique to correct minor crowding that developed as a result of relapse with the help of a bonded lingual retainer made with 0.014” Nickel Titanium archwire.

Procedure

  • Lower archwire should be selected according to patient's arch form and sectioned into the required length;
  • Bonding of the retainer should be started from the canine and continued towards the contralateral side;
  • Proper adaptation of the archwire on the tooth surface is important for correction. An explorer/wire tucker can be used to adapt the archwire to the crowded tooth.

    • Moisture control and isolation should be maintained throughout the procedure.

    In the present case, mild lower anterior crowding was noted following the accidental breakage of the bonded lingual retainer (Figure 1). A 0.014” Ni-Ti archwire was selected and bonded to the lower anterior as described above.

    Figure 1. Lower anterior crowding due to relapse

    The crowding was relieved in one month and the same retainer was left in the mouth to serve as a passive bonded retainer (Figure 2).

    Figure 2. Correction of crowding after one month.

    Advantages

  • The technique enhances patient compliance as there is no need to use a ‘tooth positioner’ or any other ‘removable appliance’ to correct crowding;
  • There is an aesthetic value;
  • The flexibility of the wire reduces the concentration of stress within the bonded composite, thus minimizing the probability of subsequent failure;
  • The same retainer can be continued as a passive retainer once the crowding is relieved.

    • Disadvantages

  • Severe crowding cannot be corrected;
  • If patient is allergic to nickel then this technique cannot be used.