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The rationale for orthodontic retention: piecing together the jigsaw

Abstract

Retaining teeth in their corrected positions following orthodontic treatment is one of the most challenging aspects of orthodontic practice. Despite much research, the rationale for retention is not entirely clear. Teeth tend to revert to their pre-treatment positions due to periodontal and gingival, soft tissue, occlusal and growth factors. Changes may also follow normal dentofacial ageing and are unpredictable with great variability. In this overview, each of these factors are discussed with their implications for retention, along with adjunctive procedures to minimise relapse. The state of current knowledge, methods used to assess relapse, factors regarded as predictive of or associated with stability as well as overcorrection are outlined. Potential areas requiring further investigation are suggested. The way in which the clinician may manage current retention practice, with a need for individualised retention plans and selective retainer wear, is also considered.

Key points

  • Retention is an integral part of orthodontic treatment and aims to prevent or minimise post-treatment changes. The rationale for retention must be discussed pre-treatment with informed consent.

  • The aetiology of post-treatment change remains elusive but gingival and periodontal, soft tissue, occlusal and growth factors contribute. It is variable and unpredictable, requiring individualised retention plans.

  • Pericision and interproximal stripping are useful adjuncts to retention.

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Acknowledgements

Monica Riordan is thanked for her assistance with the bibliography and Mairead Harding for her very helpful comments. Thanks also to David Morris, Simon Littlewood and Joey Donovan for provision of some of the illustrations.

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Millett, D. The rationale for orthodontic retention: piecing together the jigsaw. Br Dent J 230, 739–749 (2021). https://doi.org/10.1038/s41415-021-3012-1

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