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Metallic Ligatures, a Lingual Comfortable Retainer, Fast and Effective

By: Dr. Pedro Colino

The stability of our treatments throughout time, especially on the front section of the

lower teeth (arcade), continues being one of the main concerns of orthodontists and

probably the main reason for consultation for our post-treatment patients. The breakage

or the detachment of the lingual retainers has become a common fact in the orthodontics

consultations, moreover, at the moment, there is no global consensus on which is the

best retention method to prevent the relapse occurring in this anterior lower section.

Based on important concepts for our usual practice such as chair time, patient comfort,

quality of life, cost-benefit considerations, stability of the retainers, or adverse reactions

(detachment, pain, gingivitis, enamel decalcification or root resorption) there is no

evidence from RCTs to demonstrate that one type of retainer is superior to another1, and

as result, nowadays, there is an enormous variety of retainers both removable and fixed.

We propose an easy, quick, non-expensive and convenient method of creating a lingual

retainer based on traditional metallic ligatures .012.

Preparation and placement: in order to construct a lingual retainer from a metallic

ligature .012 we need two Mathieu forceps, one on each side of the metallic ligature,

avoiding the notch in the closed side of the ligature, then 360º turns are made with the

two forceps in opposite directions until the ligature acquires a rigid but malleable

consistency. At this point, we will mold it into a shape as close to the patient’s lower

front teeth (arcade) as possible and we will cut the ligature distal to the canines.

Having prepared the ligature to be cemented, the process is exactly the same as the

placing of any lingual retainer, using dental floss and compressing the ligature against

the lingual surface, at an interdental level so that it acquires the individualized shape we

are looking for.

References:

1. Yu,Yongchun;Sun,Jie;Lai,Wenli;Wu,Taixiang;Koshy,Stephen;Shi,Zongdao.

Interventions for managing relapse of the lower front teeth after orthodontic treatment.

Cochrane Database of Systematic Reviews. 2013, 9, 008734