[Orthodontic retention: problems and problem-solving strategies]. / Orthodontische retentie: problemen en oplossingen.

The aim of orthodontic retention is to counteract post-treatment changes and thereby to preserve the result of active treatment. For active orthodontic treatment, a certain level of patient compliance is necessary and the same applies for the retention phase. Ideally, the retainer will never fail or get lost, the patient will adhere to all recommendations and will wear the retainer in accordance with the instructions, necessary precautions with the fixed retainer are followed, the patient reports a problem immediately, and appointments for retention check-ups will always be met. Unfortunately, the reality is often different. This article considers the need to provide the patient with information about retention before treatment and the problems that may arise during the retention phase. Recommendations are made on how to avoid these problems as much as possible, and solutions are offered for problems that do arise. Finally, it is made clear how the orthodontist, patient and dentist can be jointly responsible for the retention phase.

[Retention after orthodontic treatment]. / Retentie na de orthodontische behandeling.

In general, the result of orthodontic treatment is not stable. After active treatment, changes can occur as a result of a number of biological processes. The application of retention aims to counteract such changes and thereby preserve the result of orthodontic treatment. The way practitioners design the retention phase varies considerably. To reduce undesired variation in orthodontic retention between practices and to improve quality of care, clinical practice guidelines for retention were developed by the Dutch Association of Orthodontists. These guidelines contain recommendations for the application of retention. The duration of retention, additional techniques and retention after treatment of Class II malocclusions are discussed; consensus has not yet been reached on these subjects.

[Gingival recessions and orthodontics]. / Gingivarecessies en orthodontie.

Gingival recessions represent the most visible periodontal disease. The prevalence of gingival recessions is high. The root surface is literally exposed to negative influences such as erosion, abrasion, discoloration and decay. Moreover, gingival recessions can affect the quality of life by increased thermal sensitivity and reduced dento-gingival aesthetics. The aetiology of gingival recessions is complex and considered to be multifactorial. In order to prevent the development of gingival recessions during and after orthodontic treatment, several factors should be taken into account, among which maintenance of optimal oral hygiene and respect for the 'biological envelope' are decisive. Once gingival recessions have developed, orthodontic therapy can play a positive role in their treatment.

[Gingival recessions and periodontal plastic surgery]. / Gingivarecessies en parodontale plastische chirurgie.

Periodontal plastic surgery is defined as the set of surgical procedures that are performed to prevent or correct developmental disorders and anatomical, traumatic and pathological abnormalities of the gingiva, alveolar mucosa, and alveolar bone. Root coverage procedures fall under this term and have been applied for more than fifty years with varying degrees of success. There are several indications for the treatment of gingival recessions. When the treatment of choice - a conservative approach - offers no solace (any more), gingival recessions can be treated by applying periodontal plastic surgery. The goal of this surgery is complete recovery of the anatomical structures in the area of the recession. To this end several surgical techniques have been developed during the last decades. The choice of a particular technique depends on various factors, such as the number of defects, their size and the amount of keratinized gingiva around the defect.