Retention is normally required after active orthodontic tooth movement in order to maintain tooth position and minimize the effects of age-related changes to the dentition. The aim of this article is to define stability, retention and relapse with reference to the literature and to review the evidence with regards to clinical effectiveness of different types of fixed and removable retainers and wear regimens, with emphasis on systematic reviews and Randomized Controlled Trials (RCTs). Furthermore, to discuss the general dental practitioner's role and responsibility in managing patients after active orthodontic treatment.
CPD/Clinical Relevance: It is common practice for orthodontists to review patients for one year after active orthodontic treatment. Beyond this period, monitoring of the patient's long-term retention is often carried out in general dental practice. This paper provides an overview of orthodontic retention, including retainer types, wear regimens and a discussion of the common problems associated with retainers and advice on management.
Article
Orthodontic relapse can be disheartening for both patient and clinician alike; it is therefore common practice to provide retainers to maintain tooth position after active orthodontic treatment. Relapse was defined by the British Standards Institute (BSI) in 1983 as ‘The return, following correction, of the original features of the malocclusion’. A more contemporary definition states that ‘it is unfavourable change(s) from the final tooth position at the end of orthodontic treatment’.1 This latter definition encompasses the notion of positional changes of the dentition that are seen to occur with advancing age.2 Orthodontic retention can be defined as ‘the phase of orthodontic treatment following completion of the desired tooth movement, focused solely on maintaining the finished treatment result and preventing relapse’.3
Retainers can be either removable or fixed. In practice a combination of the two is often utilized. Although many variations of retainers are available, the Hawley retainer (HR) and the vacuum-formed retainer (VFR)/thermoplastic retainer are two of the most commonly used removable retainers.
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