American Journal of Orthodontics and Dentofacial Orthopedics
Retention and stability: A review of the literature☆,☆☆,★,★★
Section snippets
NORMAL DEVELOPMENT
Posttreatment changes in the dentition may be affected by physiologic dentoalveolar adaptation. During normal development a moderate increase in arch width is seen until permanent cuspid eruption,3, 4 followed by a reduction of intercanine width.5, 6, 7 The intermolar width remains stable from 13 to 20 years,1, 3, 4, 6, 7and there is a reduction in the AP dimension of the mandibular arch with time.3, 6, 7, 8, 9, 10, 11 Incisor irregularity increases during the teenage years and is more
FACTORS THAT AFFECT POSTTREATMENT STABILITY
Although numerous factors have been reported to play a role in posttreatment crowding, no definite conclusions regarding the relative contribution of these factors have been reached. Some areas of investigation are discussed in the following section.
TREATMENT MODALITIES
Several long-term retention studies evaluating the stability of different treatment modalities have been reported. The main center for much of this research is the University of Washington. Most of the research is centered on the mandibular arch with the assumption that alignment of the lower arch serves as a template around which the upper arch develops and functions.
Most of the studies report on the Irregularity index,10 arch length, and intercanine width. It is important to note that the
SUMMARY OF POSTTREATMENT CHANGES
Similar long-term alterations in arch form are seen in most of the treatment groups studied. Arch length reduction is evident to some extent after orthodontic treatment. Variables such as Angles classification, length of retention, patient's age, gender, pretreatment overbite, overjet, arch width, or arch length cannot be used to predict these posttreatment arch changes. A lingual displacement of the anterior mandibular segment relative to the body of the mandible is seen.102 This has also been
CONCLUSION
Permanent retention is cited by several authors87, 96, 103 as the only way to ensure long-term posttreatment stability. However, as trained orthodontists it is incumbent on us to take a more proactive approach in dealing with the factors associated with relapse. We should aim to remove the primary burden of preventing relapse from our patients and would be well advised to maintain as treatment goals the following well documented basic principles:
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The patient's pretreatment lower arch form should
References (103)
Dental arch depth and width studies longitudinally 12 years of age to adulthood
Am J Orthod
(1972)- et al.
Growth studies of the dentition: a review
Am J Orthod
(1969) - et al.
Maturation of untreated normal occlusions
Am J Orthod Dentofacial Orthop
(1983) - et al.
Dentofacial maturation of untreated normals
Am J Orthod Dentofacial Orthop
(1985) The irregularity index: a quantitative score of mandibular anterior alignment
Am J Orthod
(1975)- et al.
Facial development and tooth eruption: an implant study at the age of puberty
Am J Orthod
(1972) The cuspid and its function in retention
Am J Orthod
(1944)Mandibular dental arch form and dimension: treatment and postretention changes
Am J Orthod
(1974)- et al.
Stability and relapse of mandibular anterior alignment: first premolar extraction cases treated by traditional edgewise orthodontics
Am J Orthod
(1981) - et al.
Expansion of the lower arch concurrent with rapid maxillary expansion
Am J Orthod Dentofacial Orthop
(1988)
Long-term stability of rapid palatal expander treatment and edgewise mechanotherapy
Am J Orthod Dentofacial Orthop
A study of the periodontium during orthodontic rotation of teeth
Am J Orthod
Surgical operations on the alveolar ridge to correct occlusal abnormalities
Oral Surg Oral Med Oral Pathol
Increased stability of orthodontically rotated teeth following gingivectomy in Macaca nemestrina
Am J Orthod
The effect of surgical transsection of the free gingival fibres on the regression of orthodontically rotated teeth in the dog
Am J Orthod
A surgical procedure to eliminate rotational relapse
Am J Orthod
A long-term prospective evaluation of the circumferential supra- crestal fiberotomy in alleviating orthodontic relapse
Am J Orthod Dentofac Orthop
Comparison of electrosurgery with conventional fiberotomies on rotational relapse and gingival tissue in the dog
Am J Orthod Dentofacial Orthop
The response of supraalveolar gingival collagen to orthodontic rotation movement in dogs
Am J Orthod Dentofac Orthop
Mandibular incisor dimensions and crowding
Am J Orthod
Incisor shape and incisor crowding; a re-evaluation of the Peck and Peck ratio
Am J Orthod
Tooth morphology and lower incisor alignment many years after orthodontic therapy
Am J Orthod
Principles of retention and avoidance of posttreatment relapse
Am J Orthod
Stability and relapse of mandibular anterior alignment: a cephalometric appraisal of first premolar extraction cases treated by traditional edgewise orthodontics
Am J Orthod
Considerations of dentofacial growth in long-term retention and stability: is active retention needed
Am J Orthod Dentofac Orthop
Posttreatment craniofacial growth; its implications in orthodontic treatment
Am J Orthod
Incisor uprighting: mechanism for late secondary crowding in the anterior segments of the dental arches
Am J Orthod
Third molars in relation to malocclusion
Int J Orthod
Extraction of third molars in cases of anticipated crowding in the lower jaw
Am J Orthod
Mandibular third molars and postretention crowding
Am J Orthod
A long-term study of the relationship of third molars to mandibular dental arch changes
Am J Orthod Dentofacial Orthoped
Changes in overbite: a 10 year postretention study
Am J Orthod
Mandibular bicanine width relative to overbite
Am J Orthod
Anterior open-bite malocclusion: a longitudinal 10 year. postretention evaluation of orthodontically treated patients
Am J Orthod
Long term stability of Class II Division I nonextraction cervical face-bow therapy: 1. model analysis
Am J Orthod Dentofacial Orthop
Factors that affect the alignment of the mandibular incisors; a longitudinal study
Am J Orthod
Årtun J. An evaluation of changes in mandibular anterior alignment from 10-20 years post-retention
Am J Orthod
Mandibular arch length increase during the mixed dentition: postretention evaluation of stability and relapse
Am J Orthod Dentofacial Orthop
Long-term stability of rapid palatal expander treatment and edgewise mechanotherapy
Am J Orthod Dentofacial Orthop
Long-term stability after orthodontic treatment: nonextraction with prolonged retention
Am J Orthod Dentofac Orthop
Post-retention evaluation of stability and relapse: mandibular arches with generalized spacing
Am J Orthod
Handbook of orthodontics for the student and general practitioner
The dentition of the growing child
A longitudinal study of mandibular arch perimeter
Angle Orthod
Normal mandibular arch changes between the ages of 9 and 16
CDA J
Stability and relapse of maxillary anterior alignment: a postretention study of premolar extraction cases treated by traditional edgewise orthodontics [Masters Thesis]
Behaviour of the axes of human teeth during growth
Angle Orthod
Long-term stability of the mandibular arch following differential management of arch length deficiencies [MSD Thesis]
A review of the retention problem
Angle Orthod
Cited by (0)
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aLecturer Consultant, Department of Child Dental Health, Dublin Dental Hospital.
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bIn private practice.
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Reprint requests to: Marielle Blake, BDent Sc, FDS(Orth), MOrth, MRCDC, Lecturer Consultant, Department of Child Dental Health, Dublin Dental Hospital, Lincoln Place, Dublin 2, Ireland.
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8/1/85459