Factors affecting retention and relapse in orthodontics


  • Hussam E. Najjar Department of Orthodontics, Al Thagar Hospital, Jeddah, Saudi Arabia
  • Renad Mohammed Alasmari College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  • Asrar Mohammed Al Manie Al-Jurf Primary Healthcare Center, Ministry of Health, Abha, Saudi Arabia
  • Khalid Nassir Balbaid College of Dentistry, Misr University for Science and Technology, Cairo, Egypt
  • Kuthar Hassan Alzaher Dental Department, Qatif Central Hospital, Qatif, Saudi Arabia
  • Ashwaq Talal Assiri Al Noor Specialist Hospital, Mecca, Saudi Arabia
  • Sundus Saad Alqarni College of Dentistry, King Khalid University, Abha, Saudi Arabia
  • Abdullah Abdul Aziz Turkistani Makkah Health Cluster, Mecca, Saudi Arabia
  • Sarah Khalid Al Anzi Department of Dental, Dammam Medical Complex, Dammam, Saudi Arabia
  • Bassam Abdullah Alkhudhayr Ministry of Health, Al Qassim, Saudi Arabia
  • Shatha Ahmed Alfaifi College of Dentistry, King Khalid University, Abha, Saudi Arabia




Retention, Relapse, Orthodontics, Stability, Tooth movement


Orthodontic treatment aims to achieve stable and harmonious occlusion by correcting malocclusions and aligning teeth. However, the long-term success of orthodontic treatment relies heavily on the effectiveness of the retention phase. Retention involves maintaining the corrected tooth positions and preventing relapse, which refers to the tendency of teeth to return to their original maloccluded positions over time. The retention phase applied after treatment is important to obtain stable results. Various factors can influence the retention phase and contribute to relapse in orthodontics. Periodontium, soft tissue pressures, growth, and occlusion are among these factors affecting stability. Understanding these factors is crucial for orthodontists to design appropriate retention protocols and enhance treatment outcomes. To achieve successful long-term stability, orthodontists must comprehensively evaluate and address the factors during the retention phase. This review article will discuss factors that affect retention and relapse in orthodontics.


Iliadi A, Kloukos D, Gkantidis N, Katsaros C, Pandis N. Failure of fixed orthodontic retainers: A systematic review. J Dentistry. 2015;43(8):876-96.

Booth FA, Edelman JM, Proffit WR. Twenty-year follow-up of patients with permanently bonded mandibular canine-to-canine retainers. Am J Orthodont Dentofacial Orthop. 2008;133(1):70-76.

Bolla E, Cozzani M, Doldo T, Fontana M. Failure evaluation after a 6-year retention period: A comparison between glass fiber-reinforced (GFR) and multistranded bonded retainers. Int Orthodont. 2012;10(1):16-28.

Bearn DR. Bonded orthodontic retainers: A review. Am J Orthodont Dentofacial Orthoped. 1995;108(2):207-13.

Little RM, Riedel RA, Artun J. An evaluation of changes in mandibular anterior alignment from 10 to 20 years postretention. Am J Orthodont Dentofacial Orthoped. 1988;93(5):423-8.

Kotecha S, Gale S, Khamashta-Ledezma L. A multicentre audit of GDPs knowledge of orthodontic retention. Br Dent J. 2015;218(11):649-53.

Meikle MC. The tissue, cellular, and molecular regulation of orthodontic tooth movement: 100 years after Carl Sandstedt. Eur J Orthodont. 2006;28(3):221-40.

Reitan K. Clinical and histologic observations on tooth movement during and after orthodontic treatment. Am J Orthodont. 1967;53(10):721-45.

Henneman S, Von den Hoff JW, Maltha JC. Mechanobiology of tooth movement. Eur J Orthodont. 2008;30(3):299-306.

Costa JG, Galindo TM, Mattos CT, Cury-Saramago AA. Retention period after treatment of posterior crossbite with maxillary expansion: a systematic review. Dental Press J Orthodont. 2017;22(2):35-44.

Papagiannis A, Koletsi D, Halazonetis DJ, Sifakakis I. Relapse 1 week after bracket removal: a 3D superimpositional analysis. Eur J Orthodont. 2021;43(2):128-35.

Kusters ST, Kuijpers-Jagtman AM, Maltha JC. An experimental study in dogs of transseptal fiber arrangement between teeth which have emerged in rotated or non-rotated positions. J Dental Res. 1991;70(3):192-7.

Redlich M, Shoshan S, Palmon A. Gingival response to orthodontic force. Am J Orthodont Dentofacial Orthopedics. 1999;116(2):152-8.

Southard TE, Southard KA, Tolley EA. Periodontal force: a potential cause of relapse. Am J Orthodont Dentofacial Orthoped. 1992;101(3):221-7.

Proffit WR. Equilibrium theory revisited: factors influencing position of the teeth. Angle Orthodontist. 1978;48(3):175-86.

Artun J, Krogstad O, Little RM. Stability of mandibular incisors following excessive proclination: a study in adults with surgically treated mandibular prognathism. Angle Orthodontist. 1990;60(2):99-106.

Millett D. The rationale for orthodontic retention: piecing together the jigsaw. Bri Dental J. 2021;230(11):739-49.

Antonarakis GS, Kjellberg H, Kiliaridis S. Bite force and its association with stability following Class II/1 functional appliance treatment. Eur J Orthodont. 2013;35(4):434-41.

Vasilakos G, Koniaris A, Wolf M, Halazonetis D, Gkantidis N. Early anterior crossbite correction through posterior bite opening: a 3D superimposition prospective cohort study. Eur J Orthodont. 2018;40(4):364-71.

Wiedel AP, Bondemark L. Stability of anterior crossbite correction: a randomized controlled trial with a 2-year follow-up. Angle Orthodont. 2015;85(2):189-95.

Fleming PS. Timing orthodontic treatment: early or late? Aust Dental J. 2017;62(1):11-9.

Mandall N, Cousley R, DiBiase A. Early class III protraction facemask treatment reduces the need for orthognathic surgery: a multi-centre, two-arm parallel randomized, controlled trial. J Orthodont. 2016;43(3):164-75.

De Bernabé PG, Montiel-Company JM, Paredes-Gallardo V, Gandía-Franco JL, Bellot-Arcís C. Orthodontic treatment stability predictors: A retrospective longitudinal study. Angle Orthodont. 2017;87(2):223-9.

Millett DT, Cunningham SJ, O'Brien KD, Benson PE, De Oliveira CM. Treatment and stability of class II division 2 malocclusion in children and adolescents: a systematic review. Am J Orthodont Dentofacial Orthop. 2012;142(2):159-69.

Diouf JS, Beugre-Kouassi AML, Diop-Ba K. Long-term stability and relapse of deep bite correction: a systematic review. L' Orthodontie francaise. 2019;90(2):169-87.

Janson G, Valarelli DP, Rizzo M, Valarelli FP. Prevalence of extraction space reopening in different orthodontic treatment protocols. Am J Orthodont Dentofacial Orthop. 2017;152(3):320-26.

Janson G, Caffer Dde C, Henriques JF, de Freitas MR, Neves LS. Stability of Class II, division 1 treatment with the headgear-activator combination followed by the edgewise appliance. Angle Orthodont. 2004;74(5):594-604.

Oliver GR, Pandis N, Fleming PS. A prospective evaluation of factors affecting occlusal stability of Class II correction with Twin-block followed by fixed appliances. Am J Orthodont Dentofacial Orthoped. 2020;157(1):35-41.

Koletsi D, Makou M, Pandis N. Effect of orthodontic management and orofacial muscle training protocols on the correction of myofunctional and myoskeletal problems in developing dentition. A systematic review and meta-analysis. Orthodont Craniofacial Res. 2018;21(4):202-15.

Foosiri P, Changsiripun C. Stability of anterior open bite in permanent dentition treated using extraction or non-extraction methods: A systematic review and meta-analysis of each method. Orthodontic Waves. 2019;78(1):1-10.

Al-Thomali Y, Basha S, Mohamed RN. The Factors Affecting Long-Term Stability in Anterior Open-Bite Correction-A Systematic Review. Turk J Orthodont. 2017;30(1):21-7.

Morais JF, Freitas MR, Freitas KM, Janson G, Castello Branco N. Postretention stability after orthodontic closure of maxillary interincisor diastemas. J Applied Oral Sci. 2014;22(5):409-15.

Fleming PS, Dibiase AT, Lee RT. Arch form and dimensional changes in orthodontics. Progress in Orthodont. 2008;9(2):66-73.




How to Cite

Najjar, H. E., Alasmari, R. M., Manie, A. M. A., Balbaid, K. N., Alzaher, K. H., Assiri, A. T., Alqarni, S. S., Turkistani, A. A. A., Anzi, S. K. A., Alkhudhayr, B. A., & Alfaifi, S. A. (2023). Factors affecting retention and relapse in orthodontics. International Journal Of Community Medicine And Public Health, 10(8), 2946–2950. https://doi.org/10.18203/2394-6040.ijcmph20232173



Review Articles