Following orthodontic treatment there is usually a period of retention to maintain the treatment result. This period can vary from a few years to even lifelong retention all depending upon the clinician, type of treatment and severity of the initial malocclusion. In most cases retention is planned for one to two years, but some clinicians routinely recommend continuous retention into adulthood. The retention planned for a patient is unfortunately often based on intuition rather than on scientific evidence. Furthermore, the retention is frequently not planned based on the initial malocclusion, the patient's facial growth pattern nor is attention paid to the etiology of the initial malocclusion. The literature clearly shows that numerous factors are involved in the post treatment changes that can be observed and one of the most important of these is late facial growth which is rarely studied. The growth changes that take place after treatment can result in relapse of the occlusion and of the tooth alignment. The traditional short-term retention of one or more years therefore needs to be more differentiated to improve the stability of the treatment result. It is our intention in this review to provide answers to questions about the role late growth changes play in the relapse so often seen. Besides growth there are numerous other factors involved which can affect the post treatment instability. These factors include, but are not limited to, unresolved airway problems, TMJ dysfunction and periodontal changes. In this review we focus on the normal facial growth changes and discus the individual variations as they relate to skeletal and dentoalveolar devel-opment. We shall further provide a historical review of some of the most relevant studies that have looked at the different factors that can be the cause of lack of stability post treatment. Finally, we shall recommend differentiated retention protocols based on the individual facial growth patterns to increase the chances of long-term stability.

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.