Title: Preserving missing spaces or creating stabilisation cases? - a cautionary example in the use of VFRs for hypodontia management
Abstract:
My case based presentation examines the use of Vacuum Formed Retainers (VFRs) in managing hypodontia, highlighting their benefits and potential risks. VFRs are clear, removable retainers commonly used after orthodontic treatment to maintain alignment and prevent relapse. In hypodontia cases, they can be adapted to aid space maintenance, aesthetics, and soft tissue development for future prosthetic restorations. A 19-year-old male with hypodontia, missing multiple teeth, presented post-orthodontic treatment seeking a resin-bonded bridge (RBB) for his lateral incisors. He had a history of depression and anxiety, which, combined with stress from studies and shift work, contributed to poor oral hygiene, enamel demineralisation, and plaque- induced gingivitis. While VFRs offer advantages such as preserving space and enhancing aesthetics, challenges include the need for patient compliance, social inconvenience, and an increased risk of oral health issues if not maintained correctly. The management of this case involved a holistic, multidisciplinary approach: Oral Hygiene & Retainer Care: Detailed oral hygiene instruction was given, incorporating SMART goals and plaque disclosing to improve compliance. Patient was advised according to British Orthodontic Society guidelines on retainer wear and maintenance. Holistic Care & Medical Coordination: Blood tests arranged through the Oral Medicine team revealed a folate deficiency, leading to GP-facilitated supplementation. Dietary modifications were advised to reduce caries risk. Repair & Remineralisation: Minimally invasive composite restorations were placed, and GC Tooth Mousse was provided for nightly application using the retainer as a reservoir to promote enamel repair. This case highlights the multifunctional benefits of VFRs but also the importance of considering both oral and systemic health factors in dental management. This comprehensive approach to patient care ensures that the tools and methods used to help our restorative/ prosthetic work don't hinder us or harm our patients.
What will the audience take away from presentation?
1. Recognise the multifunctional role of Vacuum Formed Retainers (VFRs) in space maintenance, aesthetics, and soft tissue development, particularly in cases of hypodontia.
2. Highlight the significance of patient compliance with retainer wear and oral hygiene, and the use of strategies like SMART goals and plaque disclosing to improve adherence.
3. Understand the role of preventive care in managing enamel demineralisation, including the use of minimally invasive treatments and remineralising agents like GC Tooth Mousse.
4. Acknowledge the impact of systemic health conditions (e.g., folate deficiency) on oral health, emphasising the need for coordinated care between dental and medical professionals.
