Once your dentist has finished straightening your teeth, the retention phase of your treatment will begin. During this phase , you will be required to wear some type of dental retainers. This is true no matter what kind of braces or orthodontic system was used.
Types of orthodontic retainers
There are generally two kinds of dental retainers, Removable and Fixed. And as their names imply, they differ by way of the fact that they are either permanently attached (bonded) to your teeth, or just worn according to your dentist instructions, maybe only at night.
Fixed orthodontic retainers
Fixed retainers are also referred to as “bonded” or “permanent” ones. And, as each of these names suggest, these types of appliances are attached (bonded) directly to your teeth. They cannot be removed.
The most common type of fixed dental retainer is a small wire that is supposed to be positioned on the backside of patient’s lower front teeth ( sometimes it’s called the “lingual wire”).
Fixed retainers are sometimes utilized on upper front teeth. However patient’s “bite” may make it difficult or impossible.
Advantages and disadvantages of fixed retainers
1) Permanent retainers make it harder to clean your teeth.
The biggest disadvantage of bonded retainers is that they make it difficult for the patient to brush and floss.
If a person doesn’t have the skills or motivation to perform effective oral home care, it’s likely that dental plaque and tartar will accumulate. Especially when the long-term is considered, this detritus (dirty) can place a person at greater risk for complications such as gum disease.
Flossing around a bonded retainer typically requires the use of a floss “threader.” This device helps the patient to position the floss in that area that’s between their teeth and below the retainer wire.
2) Permanent retainers do their job well.
The great advantage of bonded retainers is that the dentist does not have to rely on patient cooperation. Unlike removable retainers that may be lost or simply not worn, fixed appliances are always in place to perform their duty. They may be left in for the rest of patient’s life.
Removable Retainers
Removable retainers, such as the essix or hawley, are the most user-friendly devices. They are generally put in the mouth at night and taken out in the morning. With a removable retainer you can take it out and brush and floss your teeth with ease. To do the same with fixed retainer is more of a challenge. The removable retainer will also allow you to enjoy some retainer-free time. However, one thing to keep in mind is that a removable retainer can easily be forgotten at times. That means you won’t be taking full advantage of teeth retention. Although removable retainers can be very effective, if not used as you are told from your dentist, they will not be effective as permanent retainers.
Essix retainers are clear plastic vacuum-formed appliances that are made on a cast of the patient’s teeth. They look very similar to invisalign aligners. Essix retainers are relatively fragile. They can develop cracks, breaks or holes, especially if the patient has a tooth-grinding habit. They can also become distorted if exposed to heat (wet or dry).
Hawley retainers have a design that consists of wires and clasps embedded in a relatively thick plastic body that covers over the roof of the patient’s mouth or else lies along the tongue side of their lower teeth.
No retainer can perform its intended function if it is not in place. That’s why we prefer fixed retainers.
Spiral or multistrand wires appear to be the most popular for direct-bonded retainers. The main advantage of the use of multistrand wire is the irregular surface that offers increased mechanical retention for the composite. Moreover another asset is the flexibility of the wire that allows physiologic movement of the teeth, even when several adjacent teeth are bonded
Although traditional methods are successful, splinting teeth with reinforcement fibers that can be embedded in composites has gained popularity in last years . Fiber-reinforced composite containing various fibers such as carbon, polyaramid, polyethylene, and glass has received increasing acceptance as restorative materials.
The polyethylene fiber material adapted easily to dental contours and could be manipulated during the bonding process. It also has acceptable strength because of integration of fibers with composite resin that leads to good clinical longevity .The bonded orthodontic splint provides the patient with an efficient esthetic retainer that can be maintained in the long term.
Why dont give the oportunity to the patient to wear an esthetic splint instead of the unaesthetic traditional metallic wire?
dr.ssa Maria Barros Paredes & dr. Massimo Mazza
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