3. RETENTION
PRE-TREATMENT
POST-TREATMENT
RELAPSE UNPREDICTABLE

4. RELAPSE
RELAPSE
FUNCTIONAL OPEN BITE
SHORT UPPER LIP

5. RELAPSE
POST-TREAMENT
PRE-ORTHO AFTER SERIAL EXT.
POST-RETENTION

8. THE ETIOLOGY OF LATE LOWER ARCH CROWDING RICHARDSON, ME. AJODO 1994
CROWDING IN ORTHODONTICALLY TREATED PATIENTS OVER TIME
ARCH LENGTH AND ARCH DEPTH DECREASE AFTER ERUPTION OF SECOND MOLARS……. LEADING TO CROWDING
CROWDING IN UNTREATED SUBJECTS BETWEEN YEARS
NORMAL PHYSIOLOGIC PHENOMENON
(10 REFERENCES)

9. GROWTH MANDIBLE > MAXILLA LATE MANDIBULAR GROWTH
BASAL BONE > ALVEOLAR BONE
MANDIBULAR ARCH CONTAINED BY MAXILLARY ARCH
GROWTH DIRECTION CLOSING ROTATION: MESIAL PATH OF ERUPTION OF POST. TEETH
OPENING ROTATION: RETROCLINATION OF INCISORS

10. GROWTH MUSCLE FORCES LIPS, CHEEKS, TONGUE
MESIALLY DIRECTED FORCES -PHYSIOLOGIC MESIAL DRIFT -ANT. COMPONANT OF FORCES OF OCCLUSION -THIRD MOLAR DEVELOPMENT

11. RETENTION FEW YEARS POST-TREAMENT PRIOR TO RETENTION
LOWER THIRD MOLARS
HORIZONTAL IMPACTIONS
PRIOR TO RETENTION
THIRD MOLARS
NORMAL DEVELOPMENT

12. OBJECTIVES FOR RETENTION
Teeth tend to return toward pretreatment condition
Retain what has been achieved
Consider the three dimensions + ROTATIONS

13. MAXILLARY HAWLEY RETAINER
Palate = transverse+antero-posterior
Labial bow = overjet + alignment standard or circumferential
Anterior bite plane = overbite
Finger springs = rotations, spaces, lingual tipping
Clasps for retention of appliance -ball, Adams, interproximal, “C” clasp
Headgear for Class II to molar bands

14. RETAINERS MAXILLARY CIRCUMFERENTIAL MAXILLARY HAWLEY RETAINER
MANDIBULAR
MAXILLARY
HAWLEY RETAINER

15. UPPER HAWLEY
FINGER SPRINGS
POST-TREATMENT
SMALL LATERALS

16. MAXILLARY FRENUM
MIDLINE DIASTEMA
DEEP OVERBITE
CLASS I MALOCCLUSION

17. FULL FIXED APPLIANCES
POST-TREATMENT

18. ALLOWS FOR PHYSIOLOGIC MOVEMENT OF ADJACENT TEETH
SPLINTING/PERMANENT
RETENTION
0.022 SPIRAL WIRE
ALLOWS FOR PHYSIOLOGIC
MOVEMENT OF ADJACENT TEETH

19. SPLINTING LONG-TERM
CLASS III CASE
POST-TREATMENT RELAPSE
MIN. OVERJET+OVERBITE

20. labial bow=space closure +alignment
MANDIBULAR RETAINERS
HAWLEY RETAINER
labial bow=space closure +alignment
occlusal rests

21. MANDIBULAR RETAINERS FIXED BONDED LINGUAL 3-3 0.030 BLUE ELGILOY
OR 4-4 (OVERBITE/CURVE OF SPEE)
LONG-TERM
HOLD AGAINST GROWTH
INCISOR UPRIGHTING
INTERCANINE WIDTH
INCISOR MALALIGNMENT
THIRD MOLARS???
FIXED BONDED 3-3
BONDING TECHNIQUE

22. LOWER ESSIX RETAINER
UPPER ESSIX RETAINER

23. POST-TREATMENT
MISSING LATERALS
ESSIX RETAINERS
WITH ACRYLIC TEETH

24. IMPRESSIONS FOR
TOOTH POSITIONER
LAB SET-UP FOR
TOOTH POSITIONER

25. RUBBER TOOTH POSITIONER

26. PRE-TREATMENT
INCISOR ROTATION
CIRCUMFERENTIAL
SUPRA-CRESTAL
FIBEROTOMY

27. INTER-PROXIMAL
STRIPPING
KEYSTONING

28. LAB. SET-UP FOR
SPRING ALIGNER
PRE-TREATMENT
CROWDING AND ROTATIONS

29. SPRING ALIGNER
IDEAL SET-UP
INITIAL PLACEMENT

30. SCHEDULE MANAGEMENT DURING RETENTION
LETTERS TO PATIENTS AND PARENTS
LETTER TO DENTIST-explain plan and request help in monitoring fixed lingual retainer. L

31. SCHEDULE MANAGEMENT DURING RETENTION
PLACE RETAINERS
6-8 WEEK RECALL
4 MONTH FOLLOW-UP
6-8 MONTHS FOLLOW-UP
ONE YEAR LATER
AFTER 2 YEARS AS NEEDED
NO RECALLS-letter to patient and dentist
FEES ???

32. REMOVAL OF FIXED LINGUAL RETAINER CONSIDER LOWER HAWLEY/ESSIX WHILE
FIXED BONDED RETAINER
AFTER 8 YEARS
REMOVAL OF FIXED LINGUAL RETAINER
CONSIDER LOWER HAWLEY/ESSIX WHILE
SLEEPING
RELAPSE MAY NEED TO BE MANAGED
LONG-TERM

33. CLASS I MALOCCLUSION
INCREASED OVERBITE
SMALL UL LATERAL
CONGENITALLY ABSENT
UPPER RIGHT LATERAL

34. POST-TREATMENT

35. ACID ETCH BRIDGE UPPER RIGHT LATERAL
BONDING BUILD-UP LEFT LATERAL INCISOR