Nikhil Arolker highlights the benefits of the Lifetime Lingual ceramic hybrid retainer.
A revolution in permanent retention, the Lifetime Lingual (LTL) retainer has been designed to solve many of the problems associated with traditional fixed wire and fibre retainers, such as fractures, debonds, poor hygiene and poor aesthetics. Made from a ceramic hybrid material that is strong and flexible, the LTL retainer is delivered polished and etched with an Essix type location jig for fast fitting. It is available in five Vita shades.
Clinical report
We completed Yvonne’s Six Month Smiles treatment in mid-2013. Unfortunately, three years later, her lower fixed Orthoflex bonded retainer fractured across the midline. At first, Yvonne was unaware that the retainer had fractured until she noticed that her lower front teeth were starting to go crooked again. Fortunately, four weeks of sectional orthodontics was enough to correct the relapse.
I became aware that a new type of fixed retainer was available; an old friend and colleague introduced me to the LTL retainer. The benefits were clear and I was assured by the fact that to date, there had been no failures. When I showed a sample of the LTL to Yvonne, she was very keen to give it a go.
After four weeks of sectional orthodontics, Yvonne was happy with the position of her teeth, I placed some ribbon wax over the orthodontic brackets, from LR3 to LL3. This was to prevent the impression material from getting caught in any undercuts in the brackets.
On this occasion, I took a standard lower alginate impression, making sure good detail was captured particularly of the cingulums of lower 3-3 and their incisal edges. The alginate impression was disinfected and sent to Knight Dental Design with a lab docket requesting a LTL retainer. The retainer arrived a week later.
Placement of the Lifetime Lingual
Bonding took less than 30 minutes. First of all, the cingulums of lower 3-3 were cleaned with a mild abrasive to remove any biofilm that would inhibit bonding. The instructions suggested pumice but we used sodium bicarbonate instead, which was made into a slurry and applied to the teeth with a rubber cup in a contrangle handpiece.
We then tried the LTL retainer in place. The fit was perfect. Especially useful was the supplied lower Essix retainer mounting jig for the appliance. The fit of the retainer plus the overlying Essix retainer was also checked and deemed a good fit. The LTL retainer was then cleaned with isopropyl alcohol. After air-drying, a ceramic primer, Monobond Plus (Ivoclar Vivadent), was applied to the intaglio surfaces of the LTL retainer. Then Scotchbond Universal was used as the bonding agent. The cingulum of lower 3-3 were etched for 30 seconds and then rinsed. Then Scotchbond Universal was applied to the etched surfaces and air-dried with the three-in-one tip. Care was taken to make sure no saliva contaminated the etched teeth.
Variolink veneer cement was applied to the intaglio surface of the LTL retainer and carefully seated into place. The supplied Essix retainer was seated over the top of the LTL, ensuring that the latter was seated in place and in intimate contact with the teeth to be bonded to. A 3M S10 Deepcure LED light was used to set the cement on both lingual and facial aspects. The Essix retainer was removed and there was very minimal clean-up to do.
Patient satisfaction
Yvonne finds her new LTL retainer easier to clean than her previous Orthoflex bonded retainer. A pink Tepe brush fits easily in between all the embrasure spaces. As all the surfaces of the retainer are now smooth and highly polished, she says it is easier to clean with a toothbrush than her wire retainer. She values her LTL retainer and she seems committed to keeping it clean. It’s only been a month, but so far, Yvonne is still very happy with her LTL retainer.
The Lifetime Lingual retainer was developed by Inman Orthodontics in association with Knight Dental Design. It is exclusively available in the UK and Europe from Knight Dental Design. Call 0208 316 6248, email info@kdduk.net or visit www.lifetimelingual.com or www.knightdentaldesign.co.uk.
