Why Use an Essix Retainer Versus a Flipper During Dental Implant Therapy

February 16, 2024 Lee Ann Brady DMD

Why Use an Essix Retainer Versus a Flipper During Dental Implant Therapy 

Lee Ann Brady, DMD 

When it comes to choosing a provisional during implant therapy in the anterior aesthetic zone, we have two removable options. One is called a “flipper.” It’s an interim partial denture composed of an acrylic base and a denture tooth. The other is an Essix retainer.  

There is no question that both options are taxing for the patient for the three to five months that the patient is edentulous and must deal with having this removable device to replace the tooth. So, I always tell my patients that they are going to have to manage the provisional for that time, but it’s worth it because, in the end, they have replaced the tooth with an implant with all the benefits of an implant versus an alternative prosthetic solution. 

In my practice, I use Essix retainers in nearly 100% of the cases. Why? Because an Essix retainer is tooth-borne. The pressure is placed on the teeth and not on the surgical site. In the case of a flipper, the prosthesis is primarily tissue-borne with a little pressure placed on the adjacent teeth. We really don’t want any pressure on the surgical site while it is healing. Pressure can induce biological problems in bone grafts and connective tissue, which affect the long-term outcome. From an aesthetic perspective, the most challenging thing about anterior implant aesthetics is replicating the size, shape, and position of the tissues of the alveolar ridge and papilla. I want to do everything I can to eliminate pressure on the healing tissue. 

In my practice, we do Essix retainers that don’t have a full solid tooth in them. Instead, we simply paint flowable on the facial so that there’s zero pressure anywhere around that surgical site after extraction, after grafting, and after implant placement.  

In addition to explaining the improved outcomes associated with using an Essix retainer, I assure my patients that the retainer will be more comfortable to wear than a denture and be easily removed by them for eating, for drinking liquids other than water that are likely to stain the retainer, for teeth cleaning, and for cleaning the prosthesis. When out in public, such as in a restaurant, patients may carefully eat while wearing the Essix retainer.  

Related Course

Worn Dentition: Direct & Indirect Adhesive Management Through a Non-Invasive Approach

DATE: October 24 2025 @ 8:00 am - October 25 2025 @ 2:30 pm

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Enhance Restorative Outcomes The main goal of this course is to provide, indications and protocols to diagnose and treat severe worn dentition through a new no prep approach increasing the…

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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Retention & Orthodontic Treatment

August 28, 2017 Lee Ann Brady DMD

How Understanding Orthodontic Treatment Can Improve Your General Care

The question of what to tell patients when they ask, ‘How long do I need to wear my retainer?’ is a conundrum on many fronts. First of all, we aren’t the orthodontist! But more than that, we have to look at things from the orthodontist’s perspective before we can decide on the best answer.

In my last blog on this topic, I went into more detail about why answering this patient question is so tricky. I also outlined five questions only an orthodontist can answer that lead to a better general understanding of retention after orthodontic treatment. Below, I give the answer to the first:

What is the Orthodontist’s Responsibility With Regard to Retention After Orthodontic Treatment?

Most orthodontists have a protocol for how they manage retention. This is why general dentists should discuss the specific protocol of orthodontists they refer to with those orthodontists. One way of doing this is to ask, “How much is management of retention included in the treatment fee?” and “What about after that?”

Protocols usually have a clearly defined endpoint to treatment. This includes how long they expect to monitor retention. An example of this is an orthodontist who includes 2 years of retainer checks in their treatment fee. Orthodontists might then ensure their patients are aware that the fee includes a defined period of supervised retention after treatment. In this case, monitoring retention after the fact incurs an additional fee.

Because orthodontists usually recommend long-term retention, ideally they would make patients aware of the cost (both in time and money) of maintenance care. Unfortunately, most orthodontists may not stress the importance of retention at the beginning of treatment and most don’t want to have a long-term relationships with their patients. Their business model is based on case starts, whereas a general dentist’s business model is based on life-long recall and dental maintenance.

It’s somewhat unlikely to find an orthodontist who actively encourages patients to return long after treatment ends. This is perfectly fine because patients like it that way. Orthodontists might want to discuss their retention protocol with you and referred patients (before treatment) because they have a vested interest in the maintenance of treatment results. The patient is a compelling advertisement for their skills as long as the quality of the work is retained. On the other hand, it isn’t always possible for the patient to see the orthodontist again and vice versa due to long distance moves or retirement.

In short, get to know the orthodontist(s) you refer to so that you can better understand what patients expect of retention maintenance after orthodontic treatment.

Do you find it valuable to see things from the perspective of doctors you refer to? We’d love to hear your thoughts in the comments!

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DATE: March 30 2025 @ 8:00 am - April 3 2025 @ 2:30 pm

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Single Occupancy with Ensuite Private Bath (per night): $ 345

Understanding that “form follows function” is critical for knowing how to blend what looks good with what predictably functions well. E3 is the phase of your Essentials journey in which…

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About Author

User Image
Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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