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Reinforcement treatment (retention) in orthodontics

orthodontic treatmentThe measures applied to prevent the situation from deteriorating again constitute the reinforcement therapy.

Retention is necessary for 3 main reasons:

Dental support tissues are affected by orthodontic treatment and require time to reorganize.

After treatment, the teeth are in an unstable position and soft tissue pressures tend to recur.

Growth changes can alter the orthodontic outcome.

Tooth Reorganization of supporting tissues takes 3-4 months. Teeth are normally resistant to occlusal forces due to the shock absorbing system of the supporting tissues. Influence of supporting tissues by orthodontic tooth movement reduces or eliminates active stabilization. That also means orthodontic Immediately after treatment, the teeth will not be stable to occlusal and soft tissue pressures. This explains why all patients require retention for at least a few months. Between 4-6 months, while the collagen fibers in the gingiva complete their reorganization, the elastic supracrestal fibers remodel extremely slowly and can apply forces that can change the tooth position even 1 year after the removal of orthodontic appliances. So the retention principles are:

The direction of potential recurrence can be determined by comparing the tooth position at the end of treatment with the original position. teeth tend to return to their original positions. The reason for this is the elastic retraction of the gingival fibers and the out-of-balance tongue-glandular forces.

Teeth require all-day retention until 3-4 months after fixed treatment. However, the teeth should flex freely during chewing to increase the reorganization of the supporting tissues. This can be achieved by wearing the retention appliance other than meals.

If the teeth are quite irregular at the beginning of the treatment due to the slow response of the gingival fibers, the retention should last for at least 1 year (it can be reduced to half a day after 3-4 months). Retention can be stopped after 12 months in patients whose growth is finished. However, in patients who continue to grow, reinforcement should be continued until adulthood. If growth continues, skeletal defects in all three aspects of space tend to recur. This is because most patients retain their original growth patterns. Long-term studies in adults have reported that very slow growth continues in the original pattern in adulthood, and this may contribute to recurrence years after orthodontic treatment.