Practice of lingual orthodontics and practitioners’ opinion and experience with lingual braces in the United States

Abstract

Background A survey was done on practicing Orthodontists in the United States on their experience with lingual orthodontics. The objectives of this survey study were to assess 1) the satisfaction level with cases treated with lingual orthodontics, 2) factors that influence clinicians’ decision to utilize or not utilize lingual braces in their current practices, and 3) intention of using lingual braces in their future practices, if not used currently, in the U.S. Material and Methods A survey questionnaire was electronically distributed to 2,200 active U.S. members of the American Association of Orthodontists (AAO). Results 85 orthodontists completed the survey. About 25% of respondents practiced lingual orthodontics. Direct mentorship was the most common approach used by orthodontists to learn lingual technique. The most used lingual system among the clinicians that use lingual braces was INBRACE® (34.6%). All respondents were either satisfied or very satisfied with their treatment outcome of cases treated with lingual braces. Improved esthetics and practice differentiation were perceived to be the biggest advantages of practicing lingual orthodontics. Biggest challenges with lingual orthodontics were found to be patient discomfort, cost, longer chair time and technical difficulties. Most common reason for not using lingual braces was technical difficulty, followed by availability of alternative appliances, lack of demand and patient discomfort. Approximately, 70% of those that did not use lingual orthodontics in their current practices responded that they were very likely to incorporate lingual orthodontics in their future practices. Conclusions Overall outcome satisfaction level with cases treated with lingual braces was high among the orthodontists that practiced lingual orthodontics. There seemed to be a strong interest in incorporating lingual orthodontics in future practices by clinicians that did not use lingual braces in their current practices. Some of the factors that influenced clinicians’ decision to practice lingual orthodontics were improved esthetics, practice differentiation and increased case acceptance. Technical difficulties, availability of alternative appliances, lack of demand and patient discomfort were some of the factors that were identified to have influenced practitioners’ decision to not offer lingual orthodontics in their current practices. Key words: Orthodontic brackets, Lingual braces, Lingual orthodontics.

Ortodoncia lingual: su biomecánica y efectividad. Una revisión de la literatura

“…En tanto, el 70% de Diana González-Calle | Danny Guerrero-Alvarado | pp. 104-113 profesionales en la India realiza ortodoncia lingual, sin embargo cabe destacar que la técnica lingual completamente personalizada tiene más popularidad y uso que los sistemas prefabricados (Huh et al, 2021).…”

“…Huh et al en el 2021, menciona que en Estados Unidos el 25 % de ortodoncistas practican ortodoncia lingual, siendo el más utilizado INBRACE (34,6%), pero en países de los otros continentes la práctica de esta técnica es mayor por ejemplo en la India alrededor del 70% de profesionales lo usan. Los factores que más influyen en el profesional al momento de decidir utilizar esta técnica es lidiar con dificultades técnicas, disponibilidad de aparatología alternativa, carencia de demanda (Huh et al, 2021). Lo que concuerda Poveda en el 2021 en donde hace énfasis que en los países latinoamericanos no poseen aún todas las facilidades técnicas y laboratorios donde elaboren los brackets linguales personalizados, situación que limita la posibilidad de conseguirlos, y por ende aumenta el tiempo de espera y costo de este sistema (Poveda, 2021).…”

“…El continuo avance de la tecnología ha demostrado que el cambio es inminente en muchos áreas de estudio, desde el punto de vista ortodóntico cabe destacar el progreso que ha tenido la ortodoncia lingual en los últimos años, pues día a día, la parte estética ha tomado importancia en la sociedad sobre todo en los pacientes adultos que buscan una alternativa casi imperceptible dentro de los tratamientos de ortodoncia, sin embargo, en los primeros años no tuvo mucha aceptación debido al poco o nulo conocimiento de la correcta planificación, biomecánica y ejecución del tratamiento (Rathod et al, 2020). Los ortodoncistas han manifestado la incomodidad en la colocación de los brackets por la inexperiencia y por la visualización indirecta, variación anatómica de las superficies linguales, juego de torsión y corta distancia interbracket, además de que los resultados tenían una alta ineficacia clínica, y al mismo tiempo se encontró que tenía que competir con los brackets cerámicos lanzados al mismo tiempo al mercado, los cuales inmediatamente generaron la caída de esta técnica (Huh et al, 2021).…”

Toxicological Assessment of an Acrylic Removable Orthodontic Appliance Using 2D and 3D In Vitro Methods

“…One of the therapeutic options for malocclusion is to use smaller brackets made of stainless steel [ 5 ], but, although they are therapeutically effective, they do not meet the esthetic criteria [ 6 ]. On the other hand, lingual orthodontics, another therapeutic approach to malocclusion, have the advantage of being esthetic, but they are not as effective and raise several problems for both therapist and patient [ 7 ]. Another alternative to fixed orthodontic appliances is clear aligner systems.…”

Are We Ready to Embrace the Changes in the Field of Orthodontics?

“…But the present concept not supports this dogma of limitation in the case selection for the lingual orthodontics. 10…”