Appliance removal and retention protocols

Introduction 307

Preparation for appliance removal - the final adjustment appointment 308

All-at-one-visit appliance removal 308

Progressive appliance removal 308

The appliance removal appointment 309

Bracket removal - metal brackets 309 Bracket removal - ceramic brackets 309 Band removal 310

Removal of remaining cement and bonding agents 310

Footprints from bonding agents 310 White spots 310

Positioners 311

Positioner construction 311

Bonded retainers 312

Lingual bonded retainers 312 Palatal bonded retainers 312 Labial bonded retainers 313

Removable retainers 314

Conventional wire and acrylic 314 Vacuum-formed 315

Post-treatment protocol 316

Post-treatment consultations 316 Patient letters 316

Long-term retention considerations 317 Upper arch 317 Lower arch 317

Fig. 11.2 This first premolar extraction case showed lower incisor relapse at age 18, and required further treatment to realign the lower anterior segment. A lingual bonded retainer would have prevented the relapse.

Fig. 11.1 A .015 bonded spiral wire retainer in place after non-extraction treatment. The authors routinely place lingual bonded retainers for most of their patients.

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