Palatal bonded retainers

These are not used as frequently as lower lingual retainers, because of the potential for breakage due to occlusal contact, or contact during biting. However, they are essential to ensure good retention of many adult cases, because some patients experience persistent spacing (especially in the midline) or other upper incisor movements. The advantages of palatal bonded retention outweigh the potential risk of breakage in such cases.

Before placement, the patient's overbite and overjet should be evaluated. Care should be taken to place the wire away from the area of contact. A multistrand wire of size .015 to .0195 can be used, and placed in a manner similar to the lower bonded retainer (Figs 11.8 & 11.9). The patient should be asked to be careful with this wire, in order to avoid breakages. With proper care, they can remain in place for a long time.

Fig. 11.10E and F The bonded brackets were removed, and an upper labial bonded wire was placed to stabilize the improvement Molar bands were left in place. After a 6-month pause, and following the necessary primary tooth extractions and eruption of the lower second premolars, it was possible to resume the treatment. During the pause, there was spontaneous improvement amongst the buccal occlusion, and minimal patient cooperation was required with retention.

Fig. 11.10C and D It was necessary to pause to allow extraction of lower second primary molars and eruption of the lower second premolars.

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