I often get questions about orthodontic fixed retainers. So, here is my short answer.
- I try to only place fixed retainers when I really need them. If a case started with spaces, or there was a diastema I like to place fixed retainers during treatment as soon as the teeth look nice.
- I try to keep fixed retainers as a temporary solution, only for 1-2 years after treatment. We give patients 4 sets of clear overlay retainer (usually Vivera), so the fixed retainers are only for an extra security. If the fixed retainer breaks after so many months, we just remove them and the patient still has the clear overlay retainers.
- I place fixed retainers with composite, and not flowable.
- I never ever and never call them permanent retainers. They are not permanent; they are fixed until they become unfixed.
- There are two schools of though for fixed retainers as follows.
- (A) It should be made with a flexible wire, because teeth move and if the wire is rigid the wire will break as the teeth shift during normal function.
- (B) A more rigid strong wire is the best like Bond-A-Braid. This is the wire I prefer.
- Now, as for placing the fixed retainers there are also two common methods.
- (I) Indirect carrying tray made by a dental lab.
- (II) Placing it direct.
- Here is what I prefer and this is what has worked for us the best.
- I prefer to only place fixed retainer on the upper arch ONLY and pretty much never on the lower arch. The lower canine transverse width should not be increased during treatment as this is one of the most unstable situation in orthodontics. Often, the lower teeth shift after debonding because during treatment the inter canine width was increased and it is soon after treatment relapses. So, I pay close attention not to “expand” the lower canine transverse.
- To place the fixed retainer:
- Isolate the teeth with Optiview.
- Pumice with no Fluoride pumice.
- Etch, rinse, and dry
- Bond the teeth upper 3-3. Cure.
- Place composite on the lingual of the upper right canine.
- Place Bond-a-brade wire on the lingual of the upper right canine. Cure.
- Adopt the wire to the right lateral, place composite, cure.
- Adopt the wire to the right central, place composite, cure.
- Keep doing this until I get to the other left canine.
- Cut the wire, and polish.
- Check occlusion.
- Scan for Vivera retainers.
Here are two examples of my fixed retainer.
This one is the direct placement with the Bond-a-braid wire.
This one is with an inderect bonding tray fabricated by Great Lakes Orthodontics with the Wildcat flexible wire.
Here is a related blog post “DO BONDED RETAINERS HARM PERIODONTAL HEALTH?” – Click Here.
I hope this helps.