Retainers
Creating a new smile is a substantial time investment, which makes maintaining orthodontic improvements even more important.
While orthodontic treatments such as braces are a great way to initially straighten and align teeth, there is a risk they will relapse once the braces are removed. This can happen for many reasons, including the periodontal ligament moving back into its original position or the continuous development of the jaw.
Fortunately, there is a way to diminish the risk. A retainer is a wearable device that helps to maintain your new smile. It is worn after your braces are removed to keep the teeth from moving back into their original, misaligned position.
Gentle pressure is maintained, allowing the periodontal ligament to reshape and adjust to the changes, minimising the possibility of any further movement.
Types of Retainers
A retainer is not a one-size-fits-all device. Each one is custom-made to suit the patient wearing it. There are two common types of retainers, as well as two primary materials used to make them.
Retainers are either fixed or removable and are made from either clear plastic or wires. Each option has its advantages and disadvantages.
Removable retainers are generally only worn at night or for a portion of the day. However, if not worn properly according to the orthodontist’s recommendation, it is possible the teeth will shift back into their original position.
A fixed retainer is secured to the teeth and won’t be removed until it is no longer needed. Using a fixed retainer eliminates the possibility of a patient forgetting to use their retainer, helping to maintain the progress they’ve made.
There is no conclusive evidence as to whether one type of retainer is better than the other, although there is evidence to support that both types are effective. The unique needs of each patient will determine the type of retainer Pedro recommends.
Removable Retainers
A removable retainer allows for the freedom to remove the device. Some patients like being able to use a retainer at home and remove it when in social situations. The retainer is still effective, provided it is used for the requisite number of hours per day.
When patients first start using a retainer, they may notice an excess of saliva. This is entirely normal, as the feeling of the retainer stimulates the salivary glands.
Users may also find it difficult to speak with the retainer at first, but this should become easier after the initial adjustment period. A removable retainer comes with a container to keep it clean and safe when it is not being worn.
Vacuum Formed
A vacuum formed retainer (VFR) is made from a clear plastic material that is both quick to make and cost-effective. The form is typically 0.2” to 0.3” thick, making it comfortable yet durable.
The retainer is produced from a mould of the teeth and can be made to fit from canine to canine or over the entire arch, depending on the patient’s specific needs.
The clear material makes a VFR virtually invisible when worn. It is removed during eating and drinking so that particles can’t become trapped between the retainer and the teeth, which can lead to decalcification and enamel loss.
VFRs aren’t recommended for all patients. For individuals with disorders such as bruxism (clenching and grinding of the teeth), a VFR may deteriorate or break.
Hawley
A Hawley removable retainer is a metal wire that keeps the six anterior (frontal) teeth in place. The wire is anchored to an acrylic base plate that rests snugly against the roof of the mouth. The device is also anchored to the teeth using two loops that are slipped around the neighbouring molars.
The molar loops can be tightened at regular intervals throughout the treatment to make minor adjustments to the anterior teeth if necessary.
A Hawley retainer is strong, rigid and easy to make. A transparent wire option is also available. Another benefit of this model is that an orthodontist can bond prosthetic teeth to the retainer to replace any missing anterior teeth.
Two potential disadvantages of this model include speech interference and risk of tooth fracture. There also tends to be poorer retention of the lower incisors when compared to vacuum-formed retainers.
Invisalign® Vivera
The Invisalign® Vivera retainer is popular because it is comfortable, durable and easy to use. The fit is guaranteed to be accurate because the form is based on an impression or scan of the teeth.
The material used to produce Vivera retainers is 30% stronger than the materials used by many other brands. This allows for a stronger hold on the teeth, keeping them in their proper position more efficiently. It also reduces the risk of breakage, increasing the longevity of the product.
Despite their durability, these retainers come in a set of three.
Fixed Retainers
A fixed or bonded retainer works differently compared to a removable retainer in that it is bonded to your teeth for the duration of your treatment.
The benefit of a fixed retainer is that it works without relying on the patient remembering to use it. There is a greater chance of long-term retention for patients with fixed retainers compared to those who incorrectly use a removable retainer.
There are four main types of fixed retainers. The first is a reinforced fibre retainer. This is generally not the first choice because the fibres tend to fracture. The second is the fixed canine-to-canine retainer. In this case, only the canine teeth are bonded, which means that the incisors can relapse.
Because research has proven them to be highly effective, Pedro prefers to utilise the the standard fixed lingual retainer and the Memotain CAD/CAM digitally designed fixed lingual retainer.
Standard Fixed Lingual Retainer
The standard fixed lingual retainer bonds to the canines and all the teeth in between. It is bonded to the teeth with either an acid-etch composite or composite resin to make sure it is secure. The device is crafted by hand before it is fitted and bonded.
Memotain CAD/CAM Digitally Designed Fixed Lingual Retainer
A Memotain lingual retainer is created digitally from Nitinol alloy using state-of-the-art CAD/CAM technology. The digital process means the retainer’s micro-measurements will be more precise than a handcrafted alternative. This digital technology also enables technicians to create more intricate designs without bending the material during manufacture. This lowers the risk of weaknesses in the retainer, which can lead to breakage.
The fitting process for Memotain retainers is simple. The precise positioning on both the lower and upper jaw provides long-term comfort and lowers the risk of biting the retainer. The result is a fixed retainer that is well-fitted, comfortable and strong.
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