Inadvertent Tooth Movement from a Bonded Mandibular Lingual Retainer—A Case Report with a Follow-Up 3D Analysis of Tooth Movement and a Microscopic Evaluation of the Wire

Abstract

Background: One of the rarest complications of fixed orthodontic retention is inadvertent tooth movement of the teeth bonded to the retainer. A 25-year-old patient presented at the orthodontist as she was preoccupied about the position of the lower teeth. The aim of this case report was to present a follow-up of anterior teeth alignment after fixed retainer removal and to analyze the structure of the removed fixed orthodontic retainer in a patient suffering from a twist effect. Materials and Methods: The retainer that caused inadvertent movement has been removed, and subsequent teeth displacement was assessed with scan superimposition. The retainer structure and diameter were analyzed with a laser confocal microscope. Results: The superimposition showed significant improvements in the position of the teeth. The sole removal of the activated retainer resulted in a partial self-correction of the twist effect. Under microscopic observation, changes in the dimensions of the wire were found but were too small to cause significant changes in tooth position. Conclusions: A fixed retainer should always be removed when a twist effect is diagnosed. The wire sections covered with composite are less likely to untwist. In the presented case, the changes in the dimensions of the round retainer wire could not have led to changes in the teeth’s positions.

Keywords

• orthodontic retention
• fixed retainer
• twist effect
• intraoral scan
• 3D
• fixed retention