The retention phase of treatment: retention--still the stepchild.
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OBJECTIVE: To collect baseline data on practice types and services provided by orthodontists in Australia and New Zealand. METHOD: A total of 510 questionnaires was sent and 258 were returned. The response rate was 53 per cent. RESULTS: The average age of respondents was 50 years (SD: 9.8 years) with female orthodontists being younger (Mean: 42.3 years; SD: 6.5). The ratio of responding female to male orthodontists was 1:8.8. Overall, more orthodontists were in solo private practice than associateships or partnerships. New Zealand orthodontists were more likely to be in associateships. Australian orthodontists had twice the number of practices (Mean: 2.4; SD: 1.4) than their New Zealand counterparts (Mean: 1.1; SD: 0.3). Orthodontists estimated they saw a mean of 21.3 (SD: 11.3) patients per day. Older orthodontists saw few patients in a day and spent fewer hours in any practice activity in a week. The mean waiting time for a consultation appointment in the private sector in New Zealand was nearly twice that in Australia. There was a significant association between male orthodontists and referral of patients by general dental practitioners. More than three quarters of respondents incorporated retention fees into the treatment fee. Overall, orthodontists were satisfied with the workload and did not want more orthodontists in their geographical area. CONCLUSION: This study provides a sound basis for consideration of challenges in practice and changes over time.
An adult male patient who had lost his maxillary left central incisor seven years ago in a traffic accident presented with a chief complaint about his unaesthetic appearance associated with the loss of his maxillary left central incisor space, a Class III molar occlusion, and an anterior open bite malocclusion due to tongue-thrust swallowing. Fixed orthodontic treatment was rendered following fan-type expansion of the maxilla. A Maryland bridge as a minimally invasive dentistry approach was used as a retention appliance and the patient's aesthetic appearance was restored.
The aim of this randomized clinical trial was to carry out a biometric comparison between the orthodontic extrusion (OE, group B) technique and OE combined with fiberotomy and root planing (OEFRP, group A). Twenty single-root teeth were extruded and assigned to two different groups. In both groups, fixed orthodontic appliances were activated weekly during the course of 3 weeks. After activation, the extruded teeth were maintained in retention for a period of 8 weeks. In group A, along with weekly activation, fiberotomy and root planing were carried out on the top of the alveolar bone crest. Statistical analysis revealed that the amount of dental structure exposed was greater in group A, where the gingival margin and bone tissue remained stable (P < .05). Group B presented coronal migration of the gingival tissue and bone tissue of 2 mm and 1.5 mm, respectively.
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Retention is one of the most important factors in the long term success of orthodontic treatment. In the adult patient when orthodontic movement is part of an overall treatment plan involving other disciplines, the provision of permanent retention can he complicated. Several methods have been proposed in the literature to date, all with their own problems and risks. This case report presents a technique that may solve this problem for suitable patients in a way that is both non-invasive and has excellent long-term maintenance potential.
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The C.T. Rowland award is presented annually by the Texas Orthodontic Study Club (formerly "Texas Tweed"). The award was first presented in 1954 in recognition of the group's president, C. T. Rowland. Applicants to the study club, which numbers almost 200 orthodontists from Texas and surrounding states, are required to present five cases for membership. These cases, with before and after records, represent a variety of malocclusions demonstrating the applicants' knowledge and expertise in diagnosing, treating, and finishing cases with quality results. The qualifying committee reviews each applicant's cases and, based on the difficulty of the original malocclusions and the degree of excellence of the finished result, chooses one person to receive their award. The 2005 winner of the C. T. Rowland award is Dr. Kyle Shannon. He is in the exclusive practice of orthodontics in Tulsa, OK.
Orthodontic relapse and tooth migration are commonly observed in patients with severe postorthodontic root resorption. If conventional removable retention is not adequate, fixed splint retention is necessary. Proponents of flexible splints suggest that the difference in mobility between natural teeth and the rigid systems is responsible for the loss of cement seal in the rigid systems. Proponents of rigid splints suggest that the flexibility that allows physiologic movement of the teeth also contributes to fatigue and subsequent failure of the material in the flexible splint systems. A clinical technique for increasing retention, consequently improving the prognosis of a resin-bonded fixed splint, is described.
This case report was presented at a regular meeting of the Southern California Component of the Edward H. Angle Society in 1994. It demonstrates the value of two-phase treatment which resulted in effective vertical control.
DSSNY has legally challenged the New York State Department of Taxation and Finance twice over the propriety of the department imposing sales tax on various dental purchases. In those cases, the court upheld the department's determination that "cavity-fillers," orthodontic retainers, positioners and habit-breaking appliances are taxable to dentists. However, the court agreed with the Dental Society that space maintainers are not subject to tax. The following is a brief tax guide for dentists that takes into account these two decisions.
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This article briefly describes several factors that should be considered during orthodontic retention. These factors may influence occlusal stability following the completion of the active phase of orthodontic therapy. Orthodontic retention is an important part of orthodontic treatment. It should always be considered and included in the initial stages of treatment planning, rather than added on at the end of treatment as an after-thought.
This article gives an overview of generally accepted and special concepts of the last and often life-long treatment-phase in adult orthodontics, the retention phase. The secret of successful adult orthodontics lies in adult-specific principles of histology and physiology and the interrelation of joint, occlusion, and muscles, which helps define the requirements of proper diagnosis, mechanics, and retention. Retention in adults should include maintenance of tooth position, overall dental health, and a periodontal status that can be attained by combinations of several retention concepts: retention appliances and surgical and restorative retention procedures. Short- and long-term postretention follow-up studies have shown that there is no guarantee for long-life stability after orthodontic tooth movements in adults without an anomaly- and treatment--specific retention phase.
Missing anterior teeth are being replaced by implant-supported restorations quite frequently in modern dentistry. Providing the patient with a temporary prosthesis prior to or following implant fixture placement must satisfy established esthetic and functional criteria. When orthodontic treatment is included as part of the overall treatment effort, additional considerations include the retention and stabilization of newly established tooth positions. This article describes the fabrication, use and advantages of a provisional anterior prosthesis that replaces missing teeth prior to or following implant placement.
After a detailed historical review of implantology applied to orthodontics, and an analysis of experimental studies on orthodontic implants, the authors assess the interest of implant clinical uses as anchorage for orthodontic movement, prosthetic supports in agenetic cases or retention devices after orthodontic therapy. Different specifications and requirements are also given for a multidisciplinary approach of treatment plants.
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