Adjustment

After the acrylic resin is cured, all acrylic resin in the embrasure areas is removed during trimming (Fig 19-18). If the patient underwent treatment with expansion mechanics, the acrylic resin touching the lingual of the posterior teeth is maintained, because studies have shown that some relapse occurs in maxillary buccal expansion cases.

If expansion is not an issue or the patient has excessive buccal overjet at the end of treatment, adequate acrylic resin is removed so that it is not touching the teeth (Fig 1919). This allows enough space to give the teeth freedom to seek their own final occlusion, buccolingually.

Fig 19-20 Labial bow adjustment, (a) Forty-five degree retainer pliers, (fej Tightening of the labial bow. (c) Paralleling the posterior and anterior parts of the wire.


Fig 19-21 Fixed mandibular lingual retainer.



Fig 19-23 Adjustment of slight rotation with the utility pliers.


Fig 19-22 Two views of the 90-degree angle utility pliers used to correct incisor rotation during 3x3 bonding.


When the retainer is adjusted before delivery, excess acrylic resin is also removed from the area that touches the lingual surfaces of the maxillary incisors. It is also preferable to remove the acrylic resin from the anterior lingual embrasures. This allows more pressure to be placed labially on the incisors when the retainer is tightened.

The bite plate is adjusted so that the acrylic resin is just out of occlusion with the mandibular incisal edges. Occasionally, when a patient who had excessive overbite pretreatment still has too much overbite, a minor bite plate is left to keep the teeth slightly out of occlusion.

Before the retainer is delivered to the patient, the closing loops are adjusted so that the patient can feel a tightness and firmness on the teeth (Fig 19-20).

If a slight rotation is present, it can be corrected with a special 90-degree utility pliers while the lingual wire is bonded (Fig 19-22). One beak of the utility pliers is placed on the mesiolingual of one tooth and the other beak is placed on the distolabial of the adjoining tooth. A gentle squeeze of the pliers will move these teeth into their ideal contact point relationships (Fig 19-23). While the rotated teeth are held in this position, the adhesive is polymerized with the curing light.

When patients wore banded 3x3 retainers, they continued to return for retainer examination appointments until the 3 X 3 was removed. Patients tend to be so happy with the current bonded lingual retainer's design that they sometimes miss the retainer recall appointments and do not return for their annual examinations.

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