The Biological Background of Relapse of Orthodontic Tooth Movement

Maltha, Jaap C.; Vandevska‐Radunovic, Vaska; Kuijpers-Jagtman, Anne Marie (2021). The Biological Background of Relapse of Orthodontic Tooth Movement. In: Krishnan, Vinod; Kuijpers-Jagtman, Anne Marie; Davidovitch, Ze’ev (eds.) Biological Mechanisms of Tooth Movement (3rd ed.) (pp. 297-307). Wiley 10.1002/9781119608912.ch19

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Recent years have shown increased interest and research activity in retention procedures, and a number of clinical trials have tested retainer wear and effectiveness. In contrast, published data on the biological basis of relapse after a successful course of orthodontic treatment are still scarce. The majority of the studies on this issue are descriptive and led to the hypothesis that relapse is caused by the fibrous structures within the supporting tissues of the teeth. That would suggest that retention is needed until these structures are completely reorganized. However, there is considerable evidence that the rate of collagen turnover in the periodontal ligament is extremely fast, and that the gingival fibers, and especially the transseptal fibers, are remodeled rapidly. Therefore, it is concluded that collagen turnover is probably not the important factor in the etiology of relapse, and other extracellular matrix components may contribute significantly to this process. There is a definite need for more experimental and well‐designed clinical studies to elucidate the biological basis of relapse. This process will be time consuming, but only if the etiology has been unraveled, we will be able to design evidence‐based retention strategies.

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