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CASE REPORT
Year : 2009  |  Volume : 27  |  Issue : 2  |  Page : 111-115
 

Two new methods for direct bonding 'lingual retainers'


Department of Orthodontia, Sharad Pawar Dental College, Sawangi (Meghe), Wardha-442 004, Maharashtra, India

Date of Web Publication31-Aug-2009

Correspondence Address:
P J Vibhute
Department of Orthodontia, Sharad Pawar Dental College, Sawangi (Meghe), Wardha - 442 004, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-4388.55337

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   Abstract 

In the last 20 years, two different techniques for bonding fixed retainers have evolved, direct and indirect. Various diameter and alloy of wires are used for this purpose. Indirect method requires an elaborate laboratory procedure for holding the retainer wire on teeth surface for bonding. In the direct method, the retainer wire needs to be prefabricated for accurate fit on the lingual surface of the teeth. These methods have certain shortcomings inherent in them. To overcome these problems, two new techniques have been developed.


Keywords: Bonded retainer, fixed lingual retainer, immobilization, periodontal splinting


How to cite this article:
Vibhute P J. Two new methods for direct bonding 'lingual retainers'. J Indian Soc Pedod Prev Dent 2009;27:111-5

How to cite this URL:
Vibhute P J. Two new methods for direct bonding 'lingual retainers'. J Indian Soc Pedod Prev Dent [serial online] 2009 [cited 2019 Dec 12];27:111-5. Available from: http://www.jisppd.com/text.asp?2009/27/2/111/55337



   Introduction Top


After orthodontic treatment, certain cases have a high potential of relapse. These cases invariably require fixed retainers. Most of the cases require bonding of retainer after the debonding of the labial appliance and in cases where after breakage of retainer bonding of new lingual retainer is difficult. [1],[2],[3] In the last 20 years, two different techniques for bonding fixed retainers have evolved direct and indirect. Various diameter and alloy of wires are used for this purpose. [1] The indirect method requires an elaborate laboratory procedure for holding the retainer wire on teeth surface for bonding. [4],[5],[6],[7] In the direct method, the retainer wire needs to be prefabricated for accurate fit on the lingual surface of the teeth. Till now, many methods have been developed to hold the wire on the lingual surface of the teeth. It may be held using finger, dental floss, orthodontic elastics ligatures, and ligature tacks welded to the retainer wire. These methods have certain shortcomings inherent in them. [8],[9],[10],[11],[12],[13]

To overcome these problems two new techniques have been developed:

Technique-1

  1. Take an impression of the arch and prepare a working model.
  2. The twisted 0.010'' ligature wire or multistrand wire is adapted on the working model along the lingual surface of the teeth to be stabilized.
  3. Pumice and polish the lingual surface of teeth on which retainer is to be bonded.
  4. Check the position of retainer wire (twisted 0.010'' ligature wire or multistrand wire) in mouth and adjust if necessary.
  5. Prepare labial wire assembly with 0.8- to 0.9-mm-hard round stainless-steel wire as shown in figure with helices distal to canine at both ends and long ligature wire (0.010'') attached at one end. This assembly should be prefabricated on the working model [Figure 1] and [Figure 2].
  6. Etch the enamel surfaces with 37% phosphoric acid for 30 seconds. Wash and blow dry. Apply a coat of primer (self-etching primer or moisture insensitive primer also can be used).
  7. Lingual retainer is held in place by ligating it to the labial arch [Figure 3]. Ligation of the labial arch is the unique feature of this method for effectiveness [Figure 4]. Pass the ligature wire from buccal to lingual side below the contact point and lingual retainer between canine and premolar, and it is then passed on buccal side from above the same contact point and retainer wire [Figure 5],[Figure 6],[Figure 7],[Figure 8],[Figure 9],[Figure 10],[Figure 11]. The ligature wire, which is buccal to labial arch now, is passed lingually below the next contact point and retainer at next interdental junction, then it is passed buccally at the same contact point but occlusal to the retainer through occlusal embrasure. In this way, the lingual retainer wire is fixed with the help of labial wire.
  8. Retainer wire is then tacked with adequate amount of adhesive.
  9. Check with a mouth mirror that enough adhesive is used. Light curing for 20 seconds mesially and 20 seconds distally is done.
  10. Cut the ligature wires and disengage the labial arch [Figure 12].
  11. Instruct the patient to maintain the oral hygiene.


Technique-2

  1. The retainer wire is prefabricated by incorporating perpendicular pieces of 1.5"-2" ligature wire at interdental region of respective teeth [Figure 13],[Figure 14],[Figure 15].
  2. Pumice and polish the lingual surface of teeth on which retainer is to be bonded.
  3. The retainer wire is then adapted on the tooth surface. The short ligatures are passed interdentally one occlusal to contact point and other gingival to contact point and tied over the labial wire [Figure 16],[Figure 17].
  4. Bonding procedure after etching and application of sealant is carried out [Figure 18].
  5. Enough adhesive should be used. Light curing for 20 seconds mesially and 20 seconds distally is done.
  6. Cut the ligature wires and pull them labially to disengage the labial arch [Figure 19].
  7. Instruct the patient to maintain the oral hygiene.


Advantages

  1. The cases that require bonding of retainer after the debonding of the labial appliance and in cases of broken retainer these techniques are useful.
  2. In both techniques, the retainer wire is held snugly at each contact point as compared to elastics and other methods.
  3. The material consumption is less.
  4. The retainers can be easily prefabricated.
  5. No transfer trays are required, which blocks the visibility of the operator.
  6. All teeth can be etched and bonded with adhesive simultaneously.
  7. The amount of adhesive spreading on lingual surfaces of a tooth can be controlled as compared to the indirect method thus increasing inter-tooth span which subsequently reduces the fatigue failure of the retainer wire.
  8. These techniques can also be used to immobilize or for splinting of periodontally involved teeth.


 
   References Top

1.Bearn DR. Bonded orthodontic retainers: A review. Am J Orthod Dentofac Orthop 1995;108:207-13.  Back to cited text no. 1    
2.Kaplan H. The logic of modern retention procedures. Am J Orthod Dentofac Orthop 1988;93:325-40  Back to cited text no. 2    
3.Zachrisson BU. Excellence in finishing. J Clin Orthod 1986;20:460-82, 536-56.  Back to cited text no. 3  [PUBMED]  
4.Chen RS. Prefabricated bonded mandibular retainer. J Clin Orthod 1978;12:788-9.  Back to cited text no. 4  [PUBMED]  
5.Hobson RS, Eastaugh DP. Silicone putty splint for rapid placement of direct-bonded retainers. J Clin Orthod 1993;27:536-7.  Back to cited text no. 5  [PUBMED]  
6.Ferguson JW. Multistrand wire retainers: An indirect technique. Br J Orthod 1987;15:51-4.  Back to cited text no. 6    
7.Corti AF. An indirect-bonded lingual retainer. J Clin Orthod 1991;25:631-2.  Back to cited text no. 7  [PUBMED]  
8.Rubenstein BM. A direct bond maxillary retainer. J Clin Orthod 1976;10:43.  Back to cited text no. 8  [PUBMED]  
9.Carter RN. Simplified direct-bonded retainer. J Clin Orthod 1978;12:221.  Back to cited text no. 9  [PUBMED]  
10.Zachrisson BU. Clinical experience with direct-bonded orthodontic retainers. Am J Orthod 1977;71:440-8.  Back to cited text no. 10  [PUBMED]  
11.Zachrisson BU. The bonded lingual retainer and multiple spacing of anterior teeth. J Clin Orthod 1983;17:838-44.  Back to cited text no. 11    
12.Eade P. A modified direct bond lingual retainer technique. Br J Orthod 1980;7:125-6.  Back to cited text no. 12  [PUBMED]  
13.Meyers CE, Vogel S. Stabilization of retainer wire for direct bonding. J Clin Orthod 1982;16:412.  Back to cited text no. 13    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12], [Figure 13], [Figure 14], [Figure 15], [Figure 16], [Figure 17], [Figure 18], [Figure 19]



 

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