Lingual Retainer Placement (Jenny Sheets)

Purpose

·Anchor the teeth securely

Preparation:

1. Basic, hand pieces (high, slow), bur block, polishing cup

2. Cavitron, prophy angle, pumice and disposable cup (we use pumice instead of paste because paste contents fluoride, fluoride may interfere with bonding),

3. .032 twisted-wire (2 containers: use one with less, shorter wires; from ortho drawer).

4. Arch contouring pliers, three -prong pliers

5. Large wire cutter (yellow handle cutter)

6. Bracket/band remover

7. Acid etch, HVE suction, cotton rolls (2-3), 2x2 (1), prime & bond, resin Composite, light cure

8. Burnisher, Gingival retraction instrument

Procedure Sequence:

1. Remove patient's brackets and bands with remover. Use hand piece to remove the composite on the surface of patient's teeth.

2. Clean the working area well with cavitron, so there are no tartar and stain.

3. Make a lingual retainer with .032 twisted-wire, three prong pliers and Arch contouring pliers. Lingual retainer will be placed along the lingual side of lower arch from cuspid to cuspid. The method of bending .032 twisted-wire is below:

a. Begin with a length of wire substantially longer than is necessary for the retainer. Do not cut to ideal length.

b. Place the 3-prong pliers on the right end of the wire in the position shown as illustrated.

c. Using the 3-prong pliers, held as shown, make a slight bend in the wire as illustrated.

d. Turn the pliers around and position tips as illustrated.

e. Make a slight opposite/offset bend in the wire as illustrated.

f. This wire and bend will now be flipped over and actually placed on the patient’s left side. The circled part of the wire should be placed on the lingual side of lower left cuspid.

g. Use arch contouring pliers to shape the incisor area of the wire into an arched curvature.

h. Mark the wire mesial to the patient’s right cuspid and repeat the bends as illustrated.

i. Cut off excess wire.

4. After bending the wire, rough the lingual side of the lower teeth from cuspid to cuspid with wetted pumice, then rinse them well, HVE for suction.

5. Apply acid etch on the lingual side of the lower teeth from cuspid to cuspid. After 10 seconds, rinse the acid etch off the teeth, use HVE for suction. Then air dry with three-way syringe, place cotton roll on the lingual side to keep the working area dry.

6.  Apply prime & bond to the area that was acid etched, air blow the bond, then light cure the bond on each tooth for 10 seconds.

7. Glue the lingual retainer on bonded with resin composite, burnisher or gingival retraction instrument to shape the composite.

8. Light cure composite for 30s (3M) or 20s (Heraeus-Kulzer).

9. After light cure, test composite hardness with explorer, light cure again if needed.

10. Use slow-speed and polishing cup to smooth the surface of the composite.

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Xin Wei, DDS, PhD, MS 1st edition 03/10/2013, last revision 03/14/2013