Abstract
Implementing retention at end of orthodontic treatment is not straightforward: it may induce harmful side-effects on occlusion, muscles, joints and posture.To foresee and prevent such risks, exhaustive clinical examination should be performed ahead of the retention phase: history taking, intra- and extra-oral examination, and static and dynamic analysis. The choice of type of retention appliance will result from this appraisal:The practitioner should be rigorous in producing the device (form and choice of material), fitting it (fixity, stabilization), adjusting it (balance), and above all in follow-up.Whatever the selected retention system, regular clinical follow-up is mandatory, to monitor ongoing adaptive balance: teeth, joints, muscles, etc.
Highlights
Temporary removable retention is implemented at the end of orthodontic treatment, to fix, maintain and stabilize inter-dental relations so as to limit relapse and secondary migration[7]
The literature on periodontal ligament fiber reorganization is rich[14,30] and dental units certainly need to be blocked; but other factors need to be taken into account, such as inter-dental relations in occlusion and during functional mandibular movement[28], soft tissue pressure on the arcades and respiratory pressure on the nasal cavities
Muscles are liable to be strained by parafunctional activity such as bruxism, and the strain may be symmetrical or asymmetrical, inducing short- to longterm orodental and possibly postural forces and tension that may lead to severe imbalance[4]
Summary
Temporary removable retention is implemented at the end of orthodontic treatment, to fix, maintain and stabilize inter-dental relations so as to limit relapse and secondary migration[7]. Whatever the type of device, fitting needs to respect the various components of the masticatory (dental, osteoarticular and neuromuscular) system If any of these fail, progressive imbalance ensues; this is known as dysfunction, and may lead to relapse and/or postural imbalance. Implementing temporary retention is a phase of treatment in itself, determining overall success or failure[3]. It is essential, before proceeding to retention, to perform thorough clinical examination, enabling global diagnosis that goes beyond the presenting dysmorphism
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