Orthotown April 2020 - 61
Dr. Kravitz's personal
retention protocol
I place upper and lower multistranded
bonded lingual retainers with removable
overlay Hawleys. The upper arch receives a
Bond-a-Braid wire (Reliance Orthodontic
Products) lateral to lateral, and an overlay
circumferential Hawley. The lower arch
receives a stainless steel Ortho-FlexTech wire
(Reliance) canine to canine, and an overlay
standard Hawley (Figs. 1a and 1b). Plastic
retainers are used alternatively for adult
extraction cases to hold consolidation, or for
patients with bruxism (Fig. 2). The bonded
retainers are secured with Transbond LR
paste (3M Oral Care).
For the first six months after debanding, patients are instructed to wear their
removable overlay retainers all the time,
with the exception of eating, brushing and
sports. After six months, if good compliance
is shown, the retainers can be worn only at
night. Patients are recalled for retentioncheck appointments three months after
debanding, and again six to nine months
later, for a second set of final records after
tooth settling is completed and continued
good retainer compliance is confirmed.
Fig. 1a: Upper Bond-a-Braid retainer with an overlay circumferential
Hawley or plastic retainer. Ortho-FlexTech is not recommended on
the upper anterior teeth because it can stretch and result in relapsed
spacing, particularly if the patient has a thick-tissue biotype.
Conclusion
The five universal laws of retention can
be applied to every patient.
1. The quality of the finish
will influence stability.
2. Extractions are still needed.
3. Bonded retainers should be
accompanied by removable
overlay retainers.
4. Good habits must be established
with removable retainers.
5. The retention phase is ultimately
a practice management decision. ■
Fig 1b: Lower stainless steel Ortho-FlexTech retainer, canine
to canine, with an overlay standard Hawley or plastic retainer.
A lower circumferential Hawley is not preferred because of the
loose fit of the long-span labial bow.
Fig. 2: An illustration of Dr. Neal Kravitz's retention protocol.
orthotown.com \\ APRIL 2020
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Orthotown April 2020
Table of Contents for the Digital Edition of Orthotown April 2020
Orthotown April 2020 - Intro
Orthotown April 2020 - Cover1
Orthotown April 2020 - Cover2
Orthotown April 2020 - 1
Orthotown April 2020 - 2
Orthotown April 2020 - 3
Orthotown April 2020 - 4
Orthotown April 2020 - 5
Orthotown April 2020 - 6
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Orthotown April 2020 - Cover3
Orthotown April 2020 - Cover4
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