iDentistry The Journal September-December 2017 | Page 23

The Journal
Post treatment tooth positioning and
establishment of functional occlusion
The importance of a functional and stable
occlusion post treatment is repeatedly stressed
18,46,47
in the literature.
Adequate interincisal
contact angle may prevent overbite relapse and
good posterior intercuspation prevents relapse
of both crossbite and AP correction. Less
relapse of mesiodistal movement occurs in the
absence of occlusal stress. 35 A perfect molar
relationship was found to be a significant factor
in maxillary incisor alignment in a study of 226
post retention cases,18 and a RCP – ICP slide
was found to have a statistically significant,
though clinically only moderate, influence on
48
mandibular incisor irregularity post retention.
Conclusion
We should aim to remove the primary burden of
preventing relapse from our patients and would
be well advised to maintain as treatment goals
the following well documented basic principles:
1. The patient’s pre treatment lower arch form
should be maintained during orthodontic
20,21,24-27,31,33
treatment as much as possible.
2. Original lower intercanine width should be
maintained as much as possible because
expansion of
lower intercanine width is the most predictable
of all orthodontic relapse. 20,21,24-27,33,10
3. Mandibular arch length decreases with time.
4. The most stable position of the lower incisor is
its pre treatment position. Advancing the lower
incisors is unstable and should be considered
as seriously compromising lower anterior post
treatment stability. 22
5. Lower incisor reproximation shows long-
term improvements in post treatment stability.4
A reawakening needs to occur in our profession
where by the measure of success is based upon
compassion and the drive for excellence. It is
the prime responsibility of the clinician to look
after the best interest of their patients. The
rewards to the patient and the self satisfaction
of obtaining an aesthetic, healthy, functional
and stable result far outweigh the effort and
discipline it takes to achieve it. It is hoped that
the orthodontists will provide a first step toward
better defining the reactions of the untreated
and treated dentition and help better delineate
factors associated with stability and relapse.
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Vol. 13 No. 3
Sep-Dec 2017