ORTHO802: Retention "Post Orthodontic Treatment Management" & Outcome Assessment and Cephalometric Superimposition

Common Relapse Tendencies

incisor crowding

incisor rotations

spacing

open bites

deep bites

crossbites

class II/III

Static Functional ___ is important in orthodontics

occlusion

Etiologies of Relapse

Periodontal Memory

Arch Form

Over Expansion of Dental Arches

Poor Occlusion

Surgical Relapse

Functional Influences

excessive frenum

growth changes

poor root parallelism

inappropriate treatment plan/ retainer

Basic arch form is dictated by ____, ____, ___, and ___

muscles

cheeks

tongue

lips

Center of Resistance is maintained by only ___ teeth

tipping

Gingival and periodontal tissues requires time for ____ when appliances are removed

reorganization

How long does reorganization of the PDL take?

3-4 months

How long do collagenous fibers of gingiva take to reorganize?

4-6 months

How long do elastic supra-crestal fibers take to reorganize?

one year

Ortho treatment often concludes at age ____

14/15

What is the last arch form to finish growing?

VErtical

Theories of Mandibular Incisor Crowding

intense mentalis force

tongue muscle force

eruption of third molars

late mandibular growth

bone resorption superior to symphysis

Active _____ such as thumbsucking and tongue habits can cause an anterior open bite relapse

habits

In the absence of a habit, relapse of an anterior open bite is due to?

eruption of posterior teeth (upper molars)

Hawley Retainer

outerbow controls incisors

interproximal wires - crack open space

Canine-to-Canine Clip-On Retainer

can be dislodged

What appliance is often used to keep retention of the first premolar extraction?

Wrap-Around appliance

Cantilever Wrap Around Retainer

Dr. Tremont made this !

stabilizes the labial bow

Maxillary Splint/Retainer

Clear (Essix) Retainer

easy to wear

cheap

can crack

can deepen bite

T/F: Positioner Retainers are a great choice

FALSE

Positioner retainer

Fixed Bonded 3-3 Retainer

Advantages of a Fixed Retainer

esthetics

reduced need for cooperation

permanent retention

Disadvantages of Fixed Retainer

continued supervision

hygiene issue

What is commonly done to prevent diastema relapse?

bonded wire

Interproximal Stripping (IPR)

strips incisor contacts to allow realignment

How much can the width of each lower incisor be reduced in IPR?

0.25-0.5 mm

Usually reducing each incisor 0.25 mm per side gives a total of _ mm of space gain

2 mm

Modified Spring Retainer

Dr. Tremont's Retention Protocol

1. Deband - cement bonded wires and/or impression for removable retainers

2. two weeks later insert removable retainers, 10 hrs/ night

3. check 6 weeks later

4. check 3 months later , then 6 months / 2 years

Evidence-Based Care is ___

incomplete

"quality" begins with ___ ___

outcome assessment

What is used as a stable landmark in superimposition of pre-treatment tracing for a post-treatment ceph?

anterior cranial base

T/F: Having a growth spurt during treatment= complete fixing of class malocclusion

FALSE

What is the regional superimposition landmark for maxillary structures?

flow of orbit/nose

What is the regional superimposition landmark for mandibular structures?

IAN canal

tooth bud of 3rd moalr

When do you know a patient is done growing?

when X-rays have no change in a patient from years