Orthotown March 2016 - (Page 38)

retention // feature A Brief Guide on Retainer Clasps An overview on clasps Back in the early '80s when I broke into the industry, the most popular forms of retention were ball clasps and interproximal retention for finished cases, and the Adams clasp on deciduous and mixed-dentition cases. In orthodontics, retention is support that is given to the tooth in order to maintain the position in which the tooth is meant to stay after being treated. As simple a premise as that sounds, the reality of it is a fine and sometimes frustrating science. The type of case and where the retention is needed will determine which type of clasp should be used. There are many types of different clasps used for retention, and each one can offer specific benefi ts. One of the most successful was proposed in 1955, which we now refer to as the Adams clasp. The Adams clasp does not separate teeth and can be placed on any tooth, including a semi-erupted tooth, as long as it is modified. It has been my experience that the Adams clasp in retention works better than any clasp on deciduous and mixed dentitions. Ball clasps are difficult to adjust, and not useful if the adjacent tooth is absent. They can be purchased from several companies. In my experience, a custom clasp can improve retention. The clasp lends itself well to modification in the right hands, as the auxiliary springs, hooks and clasp can all be modified as needed to bridge the clasp and assist with maxillary elastics. There is less gingival irritation, and they are easier to replace and fabricate. Another form of reliable retention is with an Arrow clasp. It has all the retentive power of an Adams clasp, and the ease and adjustability of a ball clasp. The crescent clasp is another, lesser-used system, and is distinguishable by its curve. It is soldered onto the base. The L clasp is a form of retention for Phase I and post RPE cases. It fits over the buccal headgear tubes and allows the doctor to leave the bands in the mouth. A Cowhorn clasp is soldered to the labial bow that not only holds it, but also allows the doctor to close a diastema. A great way to hold all of the teeth where by David Gergen, CDT they are is the Serrano fixed retainer. It came about in the late '80s when Dr. Paul Serrano and I were trying to figure out a better way to hold the lower teeth exactly where they were. The fixed retainer is a wire that is bonded to the lingual of the lower anterior teeth. The traditional fi xed retainer was made out of stainless-steel wire and could bend if a patient bit down hard on food. That, in turn, would make the teeth shift. Because of this flaw, we later came up with the idea of using a TMA wire, which would not bend. Rather, if pressure were put on it, it would come off instead. That way the teeth are still in the right position. The wire is loaded into a clear tray and cemented in using the light-curing technique. Lastly, there is mechanical retention, which is a form of retention that does not use a clasp at all. Instead, it uses the height of the tooth's contour and engages the proximal spaces in a way that creates a tight fit. The options out there for retention are vast and highly modifiable. As unique as treatment plans can be, there is always a form of retention that will best suit the needs of both the patient and the orthodontist. ■ David Gergen is the owner and operator of Gergen's Orthodontic Lab in Phoenix. He started his lab in 1986 and has grown it into one of the most respected labs in the country employing more than 40 people. One of his proudest achievements is receiving the National Leadership Award for Arizona Small Businessman of the Year in 2004. He also received a lifetime achievement award by the Gelb Academy as America's greatest orthodontic technician of all time in 2012. Have questions on retention? Ask the author at Orthotown.com/magazine.aspx. 38 MARCH 2016 // orthotown.com http://www.orthotown.com/Orthotown/Article.aspx?i=408&aid=5813 http://www.orthotown.com

Table of Contents for the Digital Edition of Orthotown March 2016

Orthotown.com Highlights
Embrace Progress: Organizing the Digital Office
Wired for Success: Google Voice: The Future of Patient Communication
Welcome, Dr. Edmund Khoo, to the Orthotown Advisory Board!
Industry News
Simplifi ed Correction of Class II Using PowerScope
Looking Toward the Social Media Horizon
What’s On Your Tray? Tray for Bonding Brackets
Herbst Fixed Functional Treatment for a Severe Class II
I’ve Done a Tongue Guard … Now What?
Modern-Day Retention
Retainer Clasps
Message Board: Retention
New Products
Software Showcase
Product Profile: Burleson
Poll
How to Manage Overhead Percentages in the Practice
Ad Index

Orthotown March 2016