acific Coast Society of Orthodontists Bulletin Summer 2018 - 33

Special Section

Let's Talk About That

RETENTION

Summer 2018  PCSO Bulletin

PT: Several articles have discussed the sometimes
serious problem of tooth movement that can
occur using a multi-strand retainer bonded to
individual teeth. The most recent issue of the
American Journal of Orthodontics and Dentofacial
Orthopedics shows a case in which severe periodontal support on a lower canine occurred due
to a bonded retainer. Have you not seen this with
the bonded retainer you are currently using?
Are certain types more prone to allowing tooth
movement than others? Do you inform patients
that there is a chance this will happen?

References

MP: In my practice in Cyprus, I had the opportunity to see many transfer patients from different
countries; over the years I have seen minor to
moderate tooth movement with fixed retainer
variations of braided and solid wires. There are
many reasons why these movements occur: bond
failure, the wire being active during bonding,
inadvertent bending (and therefore, activation of
the wire), and others. In reference to the article
by J. Padmos in the most recent AJO-DO,12 this is
the most extreme case I have ever seen. Obviously, the wrong technique is being used, and an
improperly formed, active wire is being bonded; it
is not necessarily the fault of the type of retainer.
I have seen severely displaced canines with
improperly fitting and activated removable Hawley retainers. Personally, since I started using Dr.
Zachrisson's6 multi-stranded 0.0215" SS wire over
15 years ago, I haven't seen anything extreme,
nothing beyond the usual bond failure and minor
tooth movement. You see movements with all
retainers; unfortunately they all have their pros
and cons! In my opinion, fixed retainers are technique-sensitive; therefore the orthodontist
should be more involved and careful during the
fitting and bonding of the retainer. But it is also
as important to give and emphasize verbal and
written instructions to patients that if they
notice or feel any change in the wire or their
teeth, they should contact the office immediately. Patients should be given a thorough explanation of the pros and cons of the type of
retainer that is to be used. 

4. Heiser W, Richter M, Niederwanger A, Neunteufel N,
Kulmer S. Association of the canine guidance angle
with maxillary and mandibular intercanine widths and
anterior alignment relapse: Extraction vs nonextraction
treatment. Am J Orthod Dentofacial Orthop
2008;133:669-680.

1. Edman Tynelius G, Bondemark L, Lilja-Karlander E. A
randomized controlled trial of three orthodontic retention models in Class I four premolar extraction cases-
stability after 2 years in retention. Orthod Craniofac Res
2013;16:105-115.
2. Francisconi MF, Janson G, Freitas KM, et al. Overjet,
overbite, and anterior crowding relapses in extraction
and nonextraction patients and their correlations. Am J
Orthod Dentofacial Orthop 2014;146:67-72.
3. Ben Mohimd H, Bahije L, Zaoui F, Halimi A, Benyahia
H. Is systematic mandibular retention mandatory?
A systematic review. Int Orthod 2018;16:114-132.

5. Burke SP, Silveira AM, Goldsmith LJ, Yancey JM, Van
Stewart A, Scarfe WC. A meta-analysis of mandibular
intercanine width in treatment and postretention.
Angle Orthod 1998;68:53-60.
6. Zachrisson BU. Multistranded wire bonded retainers: from start to success.Am J Orthod Dentofacial
Orthop 2015;148:724-727.
7. Rowland H, Hichens I, 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.
8. Gill DS, Naini FB, Jones A, Tredwin CJ. Part-time versus full-time wear following fixed appliance therapy: a
randomized prospective controlled trial. World J Orthod
2007;8:300-306.
9. O'Rourke N, Albeedh H, Sharma P, Johal A. Effectiveness of bonded and vacuum-formed retainers: A
prospective randomized controlled clinical trial. Am J
Orthod Dentofacial Orthop 2016;150:406-415.
10. Littlewood SJ, Kandasamy S, Huang G. Retention
and relapse in clinical practice. Aust Dent J
2017:62:51-57.
11. Oppenheim A. The crisis in orthodontia. Tissue
changes during retention. Int J Orthod 1934;6:639-644.
12. Padmos J, Fudalej P, Renkema AM. Epidemiologic
study of orthodontic retention procedures. Am J Orthod
Dentofacial Orthop 2018;153:496-504.

33


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