First fitting of removeable retainers

When the appliance is received from the laboratory, as with any appliance, basic
checks should be undertaken to confirm:

It is correct appliance for the patient

It is the prescription requested
The appliance fits the model correctly
There are no obvious deformities in the working model. This is not alaways
possible to assess for VFRs, since the model may have been destroyed when
the appliance was removed from it.

In addition , once the above are confirmed as correct, the appliance should be
checked to see there are no sharp edges or acrylic blips, which may cause
discomfort or demage to the patient

Checking the fit of hawley retainers in the mouth

The appliance should seat down fully around the teeth an the labial bow (modified
with or without an acrylic facing) should fit snugly against the teeth without any
obvious air gaps between the wire and the teeth or between the acrylic facing (if
used) and teeth

Appliance not seating down fully

If well made, these appliance should fit down properly. However, occasionally the
appliance may not seat down fully if the colleting has not been sufficiently trimmed
from around the teeth. If this occurs, often further trimming is needed in the
premolar or molar region. You will need to check how far occlusally the acrylic lies. If
it is preventing full seating, then an acrylic bur and straight handpiece should be
used to trim the acrylic in the colleted areas such that the collets rise only to about
half way along the palatal sufaces of, for example, the premolars and / or first
permanent molars.
Another reason the appliance may not seat fully is if acrylic has crept along
the arms of the fly-overs between the contact points. In this circumtance, adams
pliers can be used to simply crunch off any stray acrylic by squeezing the acrylic
between the beaks of the pliers.
Whre any acrylic is to be trimmed, this should of course be done outside the
mouth. The patient, nurse and operator hould wear eye protection whilst trimming is
being undertaken.
Appliance loose

If the appliance fits properly, but is loose, there are usually two simple solutions:

Consider tightening the adams clasp to engage the undercuts more deeply
using adams pliers. This should be done by gripping each of the flyovers in
turn at the most buccal point and bending the arrowheads downward so that
they engage the undercuts more.
Either alternatively or in addition to the adams clasp adjustment, it may be
necessary to adjust the labial bow. This will depend on where the appliance is
loose

Appliance not fitting

If a new appliance simply does not fit, despite undertaking the checking and
adjustments described above, the fit on the working model should be checked. If it
fits the model well, but not the mouth, then it may be that:

A tooth or teeth have moved since impression was taken, or

The impression was dragged or has other wise been distorted, either at the
time it was taken or at some point subsquently.
Any such scenario will mean a re-make with a new impression is needed

Checking the fit of vacuum formed retainers

The appliance should seat down fully around the teeth and there should be no
rebound as it is seated. The margin of the appliance extends just onto the ginggivae,
bucally and palatally/ lingually in both arches. These appliance will normally fit very
tightly, so to avoid surprising the paient, they should be advised of this before you
actually fit them.
As you push the appliance down over the teeth , be vigilant: if on fitting down, the
appliance is seen to be forcibly presssing against the ginggivae (causing blanching),
stop and remove the appliance as this is likely to be painful for the patient; it will
need easing in those areas before attempting the fit again. The appliance can be
trimmed with scissors and then smoothed with greenstone in a straight handpiece if
it is extended ecessively onto the gingivae and engages undercuts. Alternatively, or
as well, it may need easing on the inner (fit) surface again.