Fixed Retainers

Fixed Retainer Wires After Multibracket or Aligner Treatment: Why They Are Often Useful

After active orthodontic treatment—whether with fixed braces or aligners—retention is a crucial part of the treatment’s success. This is because even after achieving a beautiful tooth alignment, there is a natural tendency for the teeth to shift again. This is exactly where fixed retainer wires come into play: they primarily stabilize the front teeth over the long term and help maintain a good treatment outcome. (ScienceDirect)

Why is retention necessary in the first place?

Biologically speaking, orthodontic treatment does not end with the last aligner or the removal of the brackets. Periodontal and gingival structures need time to reorganize, and growth, aging, musculature, and individual restorative forces continue to affect tooth position. A systematic review therefore describes the retention phase as an integral part of every orthodontic treatment. (Springer Link)

The same applies to aligners: A recent meta-analysis found no clear differences in post-treatment stability between aligner and multibracket treatment, but also emphasizes that the evidence is limited by heterogeneity and, in most cases, short follow-up periods. In practice, this means that regardless of the system used, retention remains crucial.

What are the advantages of fixed retainer wires?

The biggest advantage is that they do not rely on the patient’s cooperation. Unlike removable retainers, they do not need to be actively worn. This is precisely what makes them particularly valuable for tooth positions with a higher risk of relapse, such as in the lower front teeth. A systematic review and a meta-analysis explicitly emphasize that fixed retainers are less dependent on patient compliance. (Springer Link)

Another advantage is the continuous stabilization of the anterior teeth. The literature describes fixed retainers as particularly well-suited for maintaining the long-term alignment stability of the lower anterior teeth. A systematic review from 2023 even concludes that fixed retainers are the best devices for the long-term stabilization of the mandibular anterior teeth; among fixed systems, lingual stainless steel retainers are cited as the first choice. (ScienceDirect)

For whom are fixed retainers particularly beneficial?

Fixed retainers are particularly useful when there is an increased risk of relapse. According to review articles, this includes, among other things, severely rotated teeth, severe crowding, unstable positions of the lower front teeth, or, in general, conditions with a high tendency toward relapse. For this very reason, fixed bonded retainers are often preferred in clinical practice.

What do studies say about long-term stability?

The evidence supports the use of fixed retainers, particularly with regard to stability. A recent evidence-based review from 2025 emphasizes that long-term retention is now widely accepted, even though standardized evidence-based protocols are still lacking. This does not argue against retainers; rather, it shows that the choice of an appropriate retention strategy should be made on an individual basis. (ScienceDirect)

Studies have also shown that newer CAD/CAM-fabricated fixed retainers can be at least as effective as conventional retainers; some studies have even reported lower rates of relapse within two years, with similar error rates. (ScienceDirect)

Are there any limits?

Yes—and these issues should be addressed openly. Fixed retainers may be associated with greater plaque and tartar buildup than removable retainers. The aforementioned 2023 systematic review found higher levels of plaque and tartar with fixed retainers, particularly when compared to removable systems. At the same time, the same review continues to rate fixed stainless steel retainers as the best long-term option for stabilizing the lower front teeth. (ScienceDirect)

It is therefore important to understand this correctly: Fixed retainers are very useful, but they are no substitute for good oral hygiene or regular checkups. In addition, retainers may partially fail or come loose over time. A meta-analysis on retainer failure therefore emphasizes that the selection of the retainer, the bonding technique, and follow-up examinations remain clinically relevant. (Springer Link)

Conclusion

From an evidence-based perspective, it is clear that fixed retainer wires are a sensible and often very important component of long-term stabilization following active orthodontic treatment. Their greatest advantage lies in their continuous effect—which does not depend on patient compliance—and in the reliable stabilization of anterior tooth segments that are particularly prone to relapse. This applies equally to treatment following multibracket orthodontics and aligner therapy. (ScienceDirect)

To put it in scientific terms: Fixed retainers help maintain the achieved tooth alignment over the long term—especially in cases where the risk of relapse is high. Their benefits are well documented, provided they are combined with good oral hygiene and regular follow-up care. (ScienceDirect)