ORTHOBITES Retainers & By David Jackson, DDS, FAGD, IBO o what is the clinical significance of retainers and proper retention? Well, it is everything. In the following article, I will set forth my clinical opinions and findings on retention and various types of retainers and why. These come from twenty five years of clinical experience in orthodontic Fig. 1 S Retent treatment and retention of several thousand patients. I will now share my thoughts. Let us begin with Phase I Retention or Interceptive Reten-tion. First of all, we must decide whether to treat the patient with Phase I therapy. My guidelines in deciding to treat a patient with early treatment are: I. Address Transverse Issues I always attempt to correct a crossbite as soon as possible. I also attempt to develop both arches simultaneously. Depending on which analysis you employ to deter-mine transverse needs (I personally employ the Sim Analysis*), I calcu-late the transverse needs of the patient and choose an appliance. For me, I prefer to have the six-year molars to work with, as I employ a fixed/functional approach. My preferred orthodontic appli-ances for crossbite issues are upper Nitanium Palatal Expander (Ortho Organizers 2) or an RPE (Labora-tory Appliance) (Figs. 1-4) and lower a Transverse Transforce Appliance (Ortho Organizers 2) or a Williams Appliance (Laboratory Appliance) (Figs. 5-8). The advan-tage of the OO2 appliances are that I do not need to take impressions with these; they come in kits with an assortment of sizes and fit cleanly into the horizontal sheaths on my first molars bands. I can measure per instructions supplied with pre-fabricated appliances; no alginate impressions are needed; no wait for the lab; no worry about fit; and the prefab appliances can Fig. 3 Fig. 2 Fig. 4 10 January/February 2013 JAOS
Journal of the American Orthodontic Society January-February 2013: Page 10
