40 AUSTRALASIAN DENTIST PROFILES According to Orthodontics Australia1, patients can pay anywhere from around $6,000 for traditional metal braces, right up to $15,000 for lingual braces. That’s a sizable investment many people are making in their smile. However, postorthodontic relapse can wipe away the gains – and fast. It’s why post-orthodontic retainers are so important, and why patients must be made aware that following retainer protocols is critical to maintaining orthodontic treatment. Dr Lawrence Neville, principal dentist and co-owner of Spa Dental in Sydney, says post-orthodontic retainers – whether fixed or removable – are non-negotiable for successful treatment outcomes over the long term. “Retainers hold up your smile. Teeth tend to move as we age, and people who have had orthodontic treatments may be more prone to tooth movement,” he says. “We can stop that with retainers.” When to use lingual wire retainers Dr Neville says that patients who have required significant tooth realignment are at higher risk of experiencing postorthodontic relapse. “For example, if you moved a tooth from a 90-degree angle all the way around to zero, that tooth has more chance of relapsing than a tooth that may have only required a 20-degree adjustment,” he explains. Dr Neville says that while removable and fixed retainers can both effectively prevent post-orthodontic relapse, the overall success of the treatment depends on patient compliance. “If the patient fails to use their retainers appropriately, then there’s a good chance they’ll be back with another relapse case,” he says. Dr Neville points out that poor oral hygiene can be a signal that the patient may struggle to commit to removable retainers, or patients who are apprehensive about removable retainers during your initial discussion may also be good candidates for fixed or lingual wire retainers. “The hardest thing about removable retainers is getting patient compliance. A fixed lingual or wire retainer overcomes that patient compliance issue. They are very durable and typically much less prone to breakage, damage or loss than removable retainers.” Correcting post-orthodontic relapse If thepatient does choose tousea removable retainer after an orthodontic treatment, and fails to consistently wear it, Dr Neville says correcting minor post-orthodontic relapse is now relatively straightforward with clear aligners. “Clear aligners can also be useful for repositioning teeth prior to a crown or bridge restoration,” he adds. “If we put the teeth into the right position first with clear aligners, we can be a lot more minimal with how much tooth we need to cut away. That will mean that we won’t have to use a bulky ceramic, and we’ll get a much nicer overall result.” Ian Feigen, Technical Director at Avant Dental, says the latest digital design and manufacturing technology is speeding up workflow times and improving accuracy for clear aligners. “Our new Refine Aligner workflow couldn’t be simpler,” he explains. “The dentist takes a scan or impression, then Avant reviews the case and provides a PDF treatment plan and a video showing the movement of the treatment for your review and approval.Then Avant custom fabricates Refine Aligner trays from medical grade TGA-approved materials and completes a quality control check. Finally, we will send the complete treatment kit to your practice.” Dr Neville also points out that clear aligner treatments are not just helpful for treating post-orthodontic relapse or prior to a crown or bridge restoration. He says it’s a treatment option that’s open to almost all patients. “Anyone can experience teeth shifting – and not just following an orthodontic treatment. A patient in their 20s might be lucky and have naturally straight teeth. But as they get into their late 30s, 40s and 50s their teeth may start to move. As long as the patient has good general oral health, they will likely be a good candidate for clear aligners.” u Avant Dental can design and manufacture all your removable retainers, fixed lingual retainers and clear aligners. Call 1800 287 336 or visit www.avantdental.com.au to get started. References 1 https://orthodonticsaustralia.org.au/howmuch-braces-cost/#What_is_the_cost_of_ braces_in_Australia Post-orthodontic retainers: Lingual wire or removable? Retainers are critical for preventing post-orthodontic relapse. But knowing when to use fixed lingual wire retainers versus removable retainers is the key to ensuring the best treatment outcomes.
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