Considerations of dentofacial growth in long-term retention and stability: is active retention needed?

It is extremely important to pay attention to the person's growth pattern, and a distinction must be made in the selection of retention devices on the basis of the nature and the extent of dentofacial dysplasia (growth pattern). The nature and duration of retention should depend on the maturation status of the patient and on anticipated future growth. Retention guidance is necessary for adjustment of the dentition to late growth changes and maturation of neuromuscular balance. "Active retention" is a concept we accept as readily as the orthopedic surgeon does for his scoliosis patients. There is some merit in the philosophy of those clinicians who advocate permanent retention guidance. Without always being aware of the biomechanics of growth change, they are in fact carrying the patient through the active stages of growth with their retention appliances. Finally, one may philosophize that nothing about the human morphology is stationary. Aging is a well-documented process of change. Lifetime dentitional adjustment and changing dental relationships are known to all, even in otherwise healthy persons. Then why do we expect long-term stability in every case? The answer to the question of long-term stability is long-term retention--dynamic, not static.