acific Coast Society of Orthodontists Bulletin Summer 2018 - 31

Let's Talk About That
Special Section

RETENTION

Dr. Patrick K. Turley
Editor, Let's Talk About That
Manhattan Beach, CA

Dr. Patrick Turley Interviews
Dr. Michael Papademetriou
Since 2011, Dr. Michael Papademetriou has been
the clinical director at the Arizona School of Dentistry & Oral Health Postgraduate Orthodontic
Program at A.T. Still University. He also maintains a
part-time orthodontic practice in Phoenix. His special interests are orthognathic surgery, temporary
anchorage devices (TADs), and Wilckodontics.
Dr. Papademetriou is a graduate of the UCLA
Department of Orthodontics. After graduation,
he returned to his home country of Cyprus where
he practiced for 22 years. He was the first orthodontist in the country, and he contributed to the
recognition of the importance and value of orthodontics among the general population; he also significantly helped to upgrade the knowledge and
the clinical level of orthodontics. In this interview,
we discuss the various challenges and methods of
retention.
Patrick K. Turley (PT): What are your preferred
methods of retention and what are the indications for those various types?

Dr. Michael Papademetriou
Clinical Director
Postgraduate Orthodontic Program,
Arizona School of Dentistry
& Oral Health

Learn more about
Dr. Papademetriou

Dr. Michael Papademtriou (MP): As we all know,
the lack of long-term stability after orthodontic
treatment is a common problem. Each orthodontist determines which method of retention to
use based on his/her training, experience, type
of malocclusion, demographics, patient cooperation, popularity, and many other factors.1
My preferred retention is an upper removable
Essix and a lower fixed retainer, bonded individually from canine to canine with 0.0215", fivestranded stainless steel (SS) gold plated wire.*
Clear vacuum-formed and fixed retainers seem
to be more acceptable to patients these days, so
there is better cooperation with them. For maxillary spacing and large diastemas, I like to use
bonded 1-1 or 2-2 in addition to the vacuumformed retainers. For cases in which maxillary
expansion was done, I believe that a Hawley-type
retainer better maintains the results.
PT: What changes do you see in the use of
retention?

MP: For years, the traditional retainers were
upper/lower removable Hawleys. Recently, more
esthetic retainers (e.g., Essix) are being used and
compliance-free fixed lower retainers have
become more popular.
PT: Do you think the emphasis on non-extraction
therapy has influenced the way orthodontists
approach retention?
MP: Although the battle of extraction vs. nonextraction continues, several studies have shown
that relapse will occur whether we extract teeth
or not.2-4 Of course, with the current emphasis on
non-extraction and the tendency to over-expand
the arches and procline the incisors, I believe
there is a greater tendency to use fixed retainers.
PT: Long-term studies at the University of Washington on both treated and non-treated cases
have shown that increasing mandibular incisor
irregularity is the norm. However, some highly
regarded clinicians have argued that attention to
detail in finishing cases can result in most cases
being stable long-term. What is your feeling on
this?
MP: I agree with studies that say that over a person's lifetime, mandibular incisor irregularities
will continue to occur. I also agree that paying
attention to details in finishing the cases will
possibly reduce the tendency of mandibular incisor crowding, but it will not eliminate it. There
are so many factors affecting mandibular incisor
stability that orthodontists are still searching for
the right formula - considering factors such as
extraction vs. non-extraction, residual growth,
genetics, occlusion, incisor morphology, facial
divergence, and periodontal health to name just
a few.3
PT: Long-term studies have shown that lower
intercanine width returns to its pretreatment
dimension. Increasing the lower intercanine
width in an attempt to treat with non-extraction
now seems to be commonplace. How do you
reconcile this?

*Available from from Gold'n Braces, Palm Harbor, FL
Summer 2018  PCSO Bulletin

https://www.desertridgeorthodontics.com/meet-dr-michael-papademetriou https://www.desertridgeorthodontics.com/meet-dr-michael-papademetriou

Table of Contents for the Digital Edition of acific Coast Society of Orthodontists Bulletin Summer 2018