One-year rotational relapse frequency following conventional circumferential supracrestal fiberotomy

TAD's for the Derotation of 90° Rotated Maxillary Bicuspids

It is undeniable that the advent of extra-alveolar mini-implants for anchorage purposes has revolutionized the field of Orthodontics. This case report sheds light on an innovative anchorage plan using TADs, to carry out treatment for a 15-year-old female patient. The patient reported to the clinic with a chief complaint of rotated second premolars, crowding, and a deep bite. On examination, it was seen that the patient had a Class I skeletal pattern, Class II subdivision molar relationship, 90-degree maxillary second premolar rotations, crowding in both the arches, and a deep bite. In this case, the clinicians decided to use TADs for premolar derotation as it not only provides a pure rotational couple without any deleterious effects on the adjacent teeth but also helps shorten the overall treatment time. The total treatment time for this case was 10 months.

The rationale for orthodontic retention: piecing together the jigsaw

Retaining teeth in their corrected positions following orthodontic treatment is one of the most challenging aspects of orthodontic practice. Despite much research, the rationale for retention is not entirely clear. Teeth tend to revert to their pre-treatment positions due to periodontal and gingival, soft tissue, occlusal and growth factors. Changes may also follow normal dentofacial ageing and are unpredictable with great variability. In this overview, each of these factors are discussed with their implications for retention, along with adjunctive procedures to minimise relapse. The state of current knowledge, methods used to assess relapse, factors regarded as predictive of or associated with stability as well as overcorrection are outlined. Potential areas requiring further investigation are suggested. The way in which the clinician may manage current retention practice, with a need for individualised retention plans and selective retainer wear, is also considered.