The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 20 , ISSUE 7 ( July, 2019 ) > List of Articles


Orthodontic Retainers: A Contemporary Overview

Keywords : Orthodontic retainers, Relapse, Removable retainers, Retention, Vacuum formed retainers

Citation Information : Orthodontic Retainers: A Contemporary Overview. J Contemp Dent Pract 2019; 20 (7):857-862.

DOI: 10.5005/jp-journals-10024-2611

License: CC BY-NC 4.0

Published Online: 00-07-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Aim: The aim of this article is to provide an insight into the various modalities of retention and types of appliance used in achieving this objective. Background: Maintaining the orthodontically treated teeth in their corrected position is a challenging and ominous task since the inception of this specialty. Orthodontic retainers play a pivotal role in preventing posttreatment tooth movement, thereby maintaining the esthetic, function, and stability of the stomatognathic system. Results: An extensive study of literature suggests that there are significant variations in the results describing the effectiveness, cost factors, survival times, oral hygiene status, and regimen of various orthodontic retention appliances. In terms of patient\'s satisfaction and speech articulation, vacuum-formed retainers (VFRs) are better than Hawley retainers. Occlusal contacts are better achieved with Hawley retainers than VFRs. Conclusion: Currently, there is insufficient high-quality evidence in favor of a particular retention appliance/regime or protocol. There is a need for further evidence-based high-quality studies/randomize controlled trial studies (RCTs) to evaluate different orthodontic retention appliances and regime after the orthodontic treatment. Clinical significance: Irrespective of the appliance, the patients should be prepared for a long-term or indefinite retention phase following orthodontic treatment to prevent relapse.

PDF Share
  1. Case CS. Principles of retention in orthodontia. Am J Orthod Dentofacial Orthop 2003 Oct;124(4):352–361. DOI: 10.1016/S0889-5406(03)00541-9.
  2. Tweed CH. Clinical Orthodontics. St. Louis: Mosby; 1966. vol. 1 and 2.
  3. Angle EA. Treatment of malocclusion of teeth, 7th ed. Philadelphia: SS White Manufacturing Co.; 1907.
  4. Hawley CA. A removable retainer. Int J Orthod 1919;2:291–298. DOI: 10.1016/S1072-348X(19)80039-6.
  5. Kneirim RW. Invisible lower cuspid to cuspid retainer. Angle Orthod 1973;43:218–219.
  6. Reitan K. Tissue rearrangement during retention of orthodontically rotated teeth. Angle Orthod 1959;29:105–113.
  7. Littlewood SJ, Millett DT, et al. Retention procedures for stabilising tooth position after treatment with orthodontic braces. Cochrane Database Syst Rev 2016 Jan 29(1):CD002283. DOI: 10.1002/14651858.CD002283.pub4.
  8. Littlewood SJ, Millett DT, et al. Orthodontic retention: a systematic review. J Orthod 2006 Sep;33(3):205–212. DOI: 10.1179/146531205225021624.
  9. Proffit W, Fields H, et al. Contemporary orthodontics. Mosby Inc.; 2007.
  10. Little RM. Clinical implications of the University of Washington post-retention studies. J Clin Orthod 2009;43:645–651.
  11. Ponitz RJ. Invisible retainers. Am J Orthod 1971;59:266–272. DOI: 10.1016/0002-9416(71)90099-6.
  12. Raja TA, Littlewood SJ, et al. Wear resistance of four types of vacuum-formed retainer materials: a laboratory study. Angle Orthod 2014;84:656–664. DOI: 10.2319/061313-448.1.
  13. Sheridan J, LeDoux W, et al. Essix retainers: fabrication and supervision for permanent retention. J Clin Orthod 1993;27(1):37–45.
  14. Mai W, He J, et al. Comparison of vacuum-formed and Hawley retiners: a systematic review. Am J Orthod Dentofac Orthop 2014;145:720–727. DOI: 10.1016/j.ajodo.2014.01.019.
  15. Meade MJ, Millett D. Retention protocols and use of vacuum-formed retainers among specialist orthodontist. J Orthod 2013 Dec;40(4): 318–325. DOI: 10.1179/1465313313Y.0000000066.
  16. Rowland H, Hichens L. The effectiveness of Hawley and vacuum-formed retainers: a single-center randomized controlled trial. Am J Orthod Dentofac Orthop 2007;132:730–737. DOI: 10.1016/j.ajodo.2006.06.019.
  17. Butler J, Dowling P. Orthodontic Bonded Retainers. J Ir Dent Assoc 2005 Springs;51(1):29–32.
  18. Bearn DR. Bonded Orthodontic Retainers: A Review. Am J Orthod Dentofac Orthop 1995;108:207–213. DOI: 10.1016/S0889-5406(95)70085-4.
  19. Anjli P, Sandler J. First Aid for Orthodontic Retainers. Dent Update 2010;37:627–630. DOI: 10.12968/denu.2010.37.9.627.
  20. Patel A, Farhad, B, et al. Bonded Orthodontic Retainers. Ortho Update 2013;6:70–77. DOI: 10.12968/ortu.2013.6.3.70.
  21. Artun J, Zachrisson B. Improving the handling properties of a composite resin for direct bonding. Am J Orthod 1982;81:269–276. DOI: 10.1016/0002-9416(82)90212-3.
  22. Artun J, Spadafora AT, et al. A 3-year follow-up of various types of orthodontic canine-to-canine retainers. Eur J Orthod 1997;19: 501–509. DOI: 10.1093/ejo/19.5.501.
  23. White LW. The combination retainer. Orthod Pract 2011;2(2):72–73.
  24. Taner T, Haydar B, et al. Short-term effects of fiberotomy on relapse of anterior crowding. Am J Orthod Dentofacial Orthop 2000;118: 617–623. DOI: 10.1067/mod.2000.110637.
  25. Thickett E, Power S. A randomized clinical trial of thermoplastic retainer wear. Eur J Orthod 2010;32:1–5. DOI: 10.1093/ejo/cjp061.
  26. Jäderberg S, Feldmann I, et al. Removable thermoplastic appliances as orthodontic retainers—a prospective study of different wear regimens. Eur J Orthod 2012;34:475–479. DOI: 10.1093/ejo/cjr040.
  27. Hichens L, Rowland H, et al. Cost-effectiveness and patient satisfaction: Hawley and vacuum formed retainers. Eur J Orthod 2007;29:372–378. DOI: 10.1093/ejo/cjm039.
  28. O'Rourke N, Albeedh H, et al. Effectiveness of bonded and vacuum-formed retainer: a prospective randomized controlled clinical trial. Am J Orthod Dentofacial Orthop 2016;150(3):406–415. DOI: 10.1016/j.ajodo.2016.03.020.
  29. Ramazanzadeh B, Ahrari F, et al. The retention characteristics of Hawley and vacuum-formed retainerswith different retention protocols. J Clin Exp Dent 2018 Mar;10(3):e224–e231. DOI: 10.4317/jced.54511.
  30. Jin C, Bennani F, et al. Survival analysis of orthodontic retainers. Eur J Orthod 2018 Sep 28;40(5):531–536. DOI: 10.1093/ejo/cjx100.
  31. Segner D, Heinrici B. Bonded retainers—clinical reliability. J Orofac Orthop 2000;61:352–358. DOI: 10.1007/PL00001905.
  32. Artun J, Urbye KS. The effect of orthodontic treatment on periodontal bone support in patients with advanced loss of marginal periodontium. Am J Orthod Dentofac Orthop 1988;93:143–148. DOI: 10.1016/0889-5406(88)90292-2.
  33. Dahl EH, Zachrisson BU. Long-term experience with direct-bonded lingual retainers. J Clin Orthod 1991;25:919–932.
  34. Zachrisson BU. Long term experience with direct-bonded retainers: update and clinical advice. J Clin Orthod 2007;41:728–737.
  35. Stormann I, Ehmer U. A prospective randomized study of different retainer types. J Orofac Orthop 2002;63:42–50. DOI: 10.1007/s00056-002-0040-6.
  36. McDermott P, Field D, et al. Operator and Patient Experiences with Fixed or Vacuum Formed Retainers. Cork: International Association of Dental Research, 2007; 17 abstract.
  37. Sun J, Yu YC, et al. Survival time comparison between Hawley and Clear Overlay Retainers: a Randomized Trial. J Dent Res 2011;90(10):1197–1201. DOI: 10.1177/0022034511415274.
  38. Booth F, Edelman J, et al. Twenty year follow-up of patients with permanently bonded mandibular canine-to-canine retainers. Am J Orthod Dentofacial Orthop 2008;133:70–76. DOI: 10.1016/j.ajodo.2006. 10.023.
  39. Årtun J. Caries and periodontal reactions associated with long-term use of different types of bonded lingual retainers. Am J Orthod 1984;86:112–118. DOI: 10.1016/0002-9416(84)90302-6.
  40. Pratt MC, Kluemper GT, et al. Patient compliance with orthodontic retainers in the postretention phase. Am J Orthod Dentofacial Orthop 2011;140:196–201. DOI: 10.1016/j.ajodo.2010. 02.035.
  41. Wan J, Wang T, et al. Speech effects of Hawley and vacuum-formed retainers by acoustic analysis: a single-center randomized control trial. Angle Ortho 2017;87(2):286–292. DOI: 10.2319/012716-76.1.
  42. Sauget E, Covell DA, et al. Comparison of occlusal contacts with use of Hawley and clear overlay retainers. Angle Orthod 1997;67:223–230. DOI: 10.1043/0003-3219(1997)067<0223:COOCWU>2.3.CO;2.
  43. Kaplan H. The logic of modern retention procedures. Am J Orthod Dentofacial Orthop 1988 Apr;93(4):325–340. DOI: 10.1016/0889-5406(88)90163-1.
  44. Littlewood SJ, Kandasamy S, et al. Retention and relapse in clinical practice. Aust Dent J 2017;62:51–57. DOI: 10.1111/adj.12475.
  45. Silva Filho OG, Kubitski MG, et al. Contenção fixa inferior 3x3: Considerações sobre sua confecção, colagem direta e remoção. Rev Clin Ortod Dental Press Dez 2004–Jan 2005;3(6):17–24.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.