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: 13‑01‑14
: 13‑03‑14
: 29‑03‑14
A SIMPLE CLIP FOR SECURING LINGUAL RETAINER WIRE
Pravinkumar S Marure, * Sumitra Reddy, ** Ashwin Kodgi, *** Yatishkumar Joshi †
* Assistant professor, Department of Orthodontics, MIDSR Dental College and Hospital, Latur, Maharashtra, India
** Professor & Head, Department of Orthodontics, KLE’S Institute of Dental Sciences, Bangalore, Karnataka, India
*** Assistant Professor, Department of Prosthodontics, MIDSR Dental College and Hospital, Latur, Maharashtra, India
† Assistant Professor, Department of Orthodontics, MIDSR Dental College and Hospital, Latur, Maharashtra, India
________________________________________________________________________
ABSTRACT
Retaining the orthodontic corrections has been
an enigma for orthodontists since a long-time.
Angle stated that ‘the problem involved in
retention is so great as to test the utmost skill
of the most competent orthodontist, often
being greater than the difficulties being
encountered in the treatment of the case up to
this point.’ One of the means of maintaining the
stability has been to use the fixed retainers.
The most commonly used fixed retainers is
multistranded stainless steel wire. Many
orthodontists believe permanent retention is
the only way to maintain ideal tooth alignment
after treatment. Fixed bonded retainers are
now routinely left in place for many years,
even decades. A simple clip presented here for
stabilizing the retainer wire prior to bonding
which provides good stabilization and quick
positioning of the retainer wire without any
assistance.
KEYWORDS: Simple clip; retainer; relapse
INTRODUCTION
Retaining the orthodontic corrections has been an
enigma for orthodontists since a long-time. Angle
stated that ‘the problem involved in retention is so
great as to test the utmost skill of the most
competent orthodontist, often being greater than
the difficulties being encountered in the treatment
of the case up to this point. After completion of
orthodontic treatment, a strong tendency towards
relapse is reported.[1] This relapse tendency is
especially evident if: the lower incisors have been
excessively proclined during treatment; where a
number of significant rotations have been
corrected; in initially spaced dentitions; where
some expansion of the arch has been provided;
where the inter-canine width has been
significantly altered.[2] A bonded retainer is very
IJOCR Apr - Jun 2014; Volume 2 Issue 4
useful, especially when the patient is keen to
minimize risk of any relapse whatsoever. There
are several techniques, direct and indirect,
available for placing bonded retainers.[3-5]
Orthodontic fixed retainer is widely used, as an
orthodontic retention appliance, for nearly four
decades. It answers the need for prolonged
retention with minimum patient compliance. The
effectiveness of fixed retainers was compared to
other retention devices in several studies, and was
found as effective as removable appliances. But,
further high quality research is still needed. A
bonded fixed retainer was suspected as an
obstacle that impedes the patient's ability to keep
satisfactory oral hygiene. But research failed to
prove the influence of fixed retainers on
periodontal health or white spot lesion occurrence
as clinically significant. The definite downsides
of fixed retainer are the risk of retainer breakage,
and unwanted tooth movements. A typical tooth
movement can appear even without a retainer
breakage, including a change of torque of a
mandibular incisor or skewing of the anterior
mandibular arch segment. Both the dentist and the
orthodontist are encouraged to be familiarized
with these possible side effects, recognized them
as soon as possible, and consider changing the
retention protocol, when appropriate. In
Orthodontics the stability of the achieved result
remains a fundamental issue of concern and
debate. Tirk has said “The result of Orthodontic
therapy, 1) good, bad or indifferent is only
evident many years out of retention”. 2)
Maintaining teeth in their corrected positions after
Orthodontic treatment has been and continues to
be a challenge. 3) A phase of retention is
normally required after active Orthodontic tooth
movement to hold teeth in ideal aesthetic and
functional relation and combat the inherent
tendency of the teeth to return to their former
position. 4) Stability can only be achieved if the
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Lingual Retainer Wire
Marure PS, Reddy S, Kodgi A, Joshi Y
Fig. 1
Fig. 3
forces derived from the periodontal and gingival
tissues, the orofacial soft tissues, the occlusal
forces and post treatment facial growth and
development are in equilibrium. Keeping in mind
the importance of retention in orthodontic
treatment, this article makes an attempt to refresh
our knowledge on retainers by exploring the
literature. A simple clip presented here for
stabilizing the retainer wire prior to bonding
which provides good stabilization, adaptation, and
quick positioning of the retainer wire without any
assistance. This same clinical strategy can be used
to stabilize wires for splinting periodontally
affected teeth. The same clips can be sterilized
and used for many patients.
TECHNIQUES
1. This simple clip can be fabricated with 22 or
23 gauge stainless steel wire. The clip having
labial arm with triangular shape wire bending
for holding and engaging the clip while
securing retainer wire, helix is given to
increase flexibility and easy to place and
lingual arm with rubber tube which will
increase friction and secure retainer tightly
(Fig. A).
2. On the patient plaster cast, adapt 0.0175"
stainless steel flexible twisted wire to the
lingual surfaces from canine to canine. Place
the retainer wire in the patient’s mouth,
engage the retainer wire with two clips by
IJOCR Apr - Jun 2014; Volume 2 Issue 4
Fig. 2
Fig. 4
placing them between right and left side
lateral incisor and canine teeth (Fig. B).
3. Etch, rinse, and dry the enamel surfaces with
the retainer passively in place, then bond the
retainer with a light-cured adhesive (Fig. C).
4. Once the curing of retainer is done then take
out the clip and remove the adhesive flash
from the tooth surfaces (Fig. D).
The technique presented here for stabilizing the
retainer wire prior to bonding provides good
stabilization, adaptation, and proper positioning
of the retainer wire while eliminating
contamination of etched surfaces which might
arise during wire positioning before bonding. This
same clinical strategy can be used to stabilize
wires for splinting periodontally affected teeth
and traumatized teeth.
CONCLUSION
We have found it fast, accurate, simple, reliable,
and economical; because it can be used on
multiple patients, it saves considerable chair time
and even assistance also not required.
CONFLICT OF INTEREST & SOURCE OF
FUNDING
The author declares that there is no source of
funding and there is no conflict of interest among
all authors.
BIBLIOGRAPHY
1. Little RM, Riedel RA, Artun J. An
evaluation of changes in mandibular anterior
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Lingual Retainer Wire
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Marure PS, Reddy S, Kodgi A, Joshi Y
alignment from 10 to 20 years postretention. Am J Orthod Dentofac Orthop.
1988;93:423-8.
Shah AA. How to ... place a lower bonded
retainer. Journal of Orthod. 2005;32:206210.
Lim S, Hong R, Park J. A new indirect
bonding technique for lingual retainers. J
Clin Orthod. 2004;38:652-5.
Zekic E, Gelgor IE. An acrylic transfer tray
for direct bonded lingual retainers. J Clin
Orthod. 2004;38:551-3.
Zachrisson BU. Clinical experience with
direct bonded orthodontic retainers. Am J
Orthod. 1977;71:440-8.
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