Retention & Stability Cephtactics & DB Orthodontics

Arguably the most important part of orthodontics is the retention phase. “It’s easy to align the teeth but to keep them straight, that’s the challenge,” says Raj from Cephtactics. 

Cephtactics is an orthodontic research and development organization, liaised with DB Orthodontics, which also has a training wing, where we train GDPs and orthodontists in contemporary orthodontics, lingual and aligner therapy.

The fundamental component of this part of the treatment is how can we maintain the teeth in the end position we have brought them to which is actually artificial in some way and where the body itself is not only not accustomed to, but also in many cases is fighting against. Stability should begin with the treatment planning phase and the appointments towards the end of the active phase need to be planned and executed with precision.

There are 3 specific traits which orthodontists fight the most in regards to retention.
Arguably the most unstable situations in orthodontics are:

·       Rotations of any tooth
·       Spacings including the infamous midline diastema
·       Vertical Problems such as deep and open bites

Here we will entail how to complete a patient’s finishing stages, and how best to use DB Orthodontics retainer materials.

1.     The patient must consent to end the orthodontic phase  – the rule is, if they are not happy, then the braces are not removed or the orthodontics does not end.

2.     The DB Orthodontics Bracket Removing Plier is one of the best instruments coming from their famous Ixion range. We would recommend using them with a soft, slow but firm pressure in a labio-lingual rotation movement.

3.     Any attachment used in aligner cases can be removed first with a DB Orthodontics Debonding Bur that doesn’t damage the teeth, and a little polishing of the surface to ensure no residual composite remains.

After a scale and polish, the patient would be ready for a fixed retainer. We at Cephtactics pride ourselves in our instruction on how to place these technique sensitive devices and ensure that we use the best materials to do so. Our chairside fixed retainer method takes approximately 4 minutes by even the most novice of individuals.

1.     Surface preparation involves the use of DB Orthodontics Micro Etcher. This is one device that no clinician who works with any form of orthodontics can do without. The Micro Etcher uses 50-micron Aluminium Oxide particles to increase the bond strength to up to 400 times.

2.     Etching and bond the surfaces of the teeth.

3.     Direct chairside placement of the fixed retainer is possible with DB Orthodontics Straight 8+ fixed retainer material. It is a flattened 8 stranded braided wire and is a lower profile than other leading brands, only 0.028" x 0.008". The wire contours easily to the lingual surface of the tooth. The finished result is not only comfortable but also robust and highly effective in ensuring that even minor relapse is controlled.

4.     Flowable composite placement and curing.

The main failures in the fixed retainers come due to poor isolation of the teeth prior to bonding. The loss of retention detaches the pad of composite from the tooth and is something that is very easily repaired using the Micro Etcher to re-prepare the surface of the tooth prior to bonding. Broken fixed retainers using the Straight 8 are extremely rare, with such an intricate and robust weaved design this is usually due to some mechanical trauma to the wire itself.

Once the fixed retainer has been placed then impressions are taken for the removable retainers and this is where we find little to fault in using anything other than the vacuum formed retainer materials from DB Orthodontics. Iconic Alpha is an accurate and durable thermoforming retainer material, which has shown to be very easy for the lab team to use. The issues with retainer material have always been the balance between something too thick where the strength and longevity will be enhanced and one, which would be thin enough where accuracy will take precedent. The Iconic series does find that balance. In some cases, modified retainers can be manufactured using the same material to act in a way as an orthodontic aligner.

Using the Iconic Thermowax Material is extremely easy and mess-free, whereas trimming the excess using the Iconic Wheel Saw ensures a smooth cut so that only a little work is needed using the Iconic Polishing Discs which are made from 3M Scotch Brite polypropylene, non-woven material and the head of the disc is thicker than other polishing heads. 

Retention will always be a tricky and experience-dependent component to orthodontics, but with the correct materials the end results would always be ensured and DB Orthodontics help in every regard with their excellent materials which have been tested by clinicians and modified over time.

-Dr Raj Jabbal
Specialist Orthodontist