What Type of Retainer Should I Use After Closing my 5mm Diastema with Invisalign?

A 5 mm diastema is difficult to keep together in the best of cases.  I like Vivera retainers from Invisalign but would also add a metal retainer at the back of our upper teeth to help keep the space closed.  

Retention is a must, meaning wearing a removable retainer for at least a part of each day, usually at night.  As mentioned, a metal or ceramic fixed retainer placed on the back of the front anteriors ensures complaince.  The teeth will only stayed closed as long as a retainer is regularly worn for the rest of your life and hence the fixed retainer on the back of these teeth may be preferred.

With a 5 mm diastema there is a strong relapse potential; even if you wear a clear Invisalign type retainer there will be a tendency for the space to open up if you wear the retainer less than full time.  To prevent this, a small metal bar bonded on the tongue side of the two front teeth is the preferred retainer ... in addition to the clear plastic one worn at night.  One potential problem with this type of retianer is if the lower teeth contact the back side of the upper front teeth in a "deep bite" or "overbite" type of way there may not be any room for the bonded retainer.  Hopefully Invisalign has successfully reduced the overbite so this is not an issue.

I prefer to use the retainers supplied by Invisalign called Vivera Retainers.  They send you four new sets over the course of a year which should be plenty.  Of course, how well they work depends on whether you are diligent in wearing them.  Another option would be to bond a wire on the back of the teeth but you need to make sure there is room to do so when you bite together.  A wire is harder to keep clean but it is there all the time so you don't need to always remember to wear your retainer. 

Of all problems we correct as orthodontists, one of the more likely to be a recurring problem is a large diastema.  To minimize this from happening, fixed retention is critical to assure the space stays closed.  This is a small wire or bar that is bonded to the back of at least the two middle teeth.  As long as your bite will allow it to be there without the lower teeth biting against it, it should last a long time and be invisible to anyone but you and your dentist.  Since your other teeth need to be retained as well, either a clear "Essix" or "Vivera" retainer would be fine.  However, one advantage of using a traditional Hawley retainer is that it can be adjusted should the bonded retainer break and the space start creeping back open before you can get it fixed.  And it can happen rapidly, even years after your treatment.

After Invisalign It is important to keep your teeth from relapsing.  A 5 mm diastema is a big gap to close.  There are numerous physiological forces at play that want to cause the diastema to reopen and your teeth to go back to where they were.  I would recommend a bonded ceramic retainer behind the front  teeth.  They are more expensive than the metal ones, but the metal can cause the teeth to look dark because they do not allow the light to pass through and cast a dark shadow.  I would also suggest a traditional Hawley retainer.  They last longer than the clear retainers and are more likely to hold your teeth where you moved them to

If a person is TOTALLY diligent, a clear retainer (similar to the Invisalign aligners) CAN work, but my experience with large gaps being closed is they REALLY want to open back up.  The biggest challenge with a removable retainer is compliance.  

If a small wire is bonded BEHIND the teeth (nobody will see) they tend to stay put.