The current evidence and implications of lingual orthodontics

Abstract

The growing interest in lingual orthodontics is perhaps a reflection of the social and esthetic issues of orthodontics being addressed as more adults seek treatment. The issue remains confounded by the clinical manipulation of the appliance, the patient comfort, and the predictability of outcomes. For any technique or system to succeed, it must address the above three issues directly.The evidence available on lingual orthodontics traces a very clear and predictable pattern. The 80's were devoted to the limitation and progression of the concept, the 90's to the comparison between labial and lingual, and the evolution of laboratory technique and bracket system. The last decade focuses on innovations, predictability of outcomes, the impact of white spot lesion (WSL), and the patient acceptability.The purpose of this review is to investigate the current evidence and implications of lingual orthodontics. The electronic database search was done on PubMed, Cochrane Library, Embase, EBSCOhost, Web of Knowledge, and Google Scholar reporting on appliance design, bonding, and laboratory setup, biomechanics, survey studies, case reports, and treatment outcomes. An InsIght Into hIstoRy of LInguAL oRthodontIcsLingual orthodontics started in 1970's when Fujita in Japan and Kurtz in the USA used lingual brackets for the first time. It made a sensational debut as lingual brackets were invisible, and the number of initiated cases increased exponentially. A few years later, the number of lingual orthodontic cases decreased greatly. The reason was very clear; most doctors could not achieve satisfactory results with lingual orthodontics. Following this, initial development and expansion of lingual orthodontics in the 1990s, interest, particularly in the United States, decreased, probably due to the poor results of completed cases. [1] As time passed and problem-solving associated with lingual orthodontics was improved, lingual orthodontics expanded

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

“…Several studies have noted that the advancement in lingual systems have reduced limitations and allowed clinicians to successfully treat any case they would treat with traditional labial systems to a satisfactory level, including those combined with Herbst appliance and orthognathic correction of skeletal discrepancies ( 5 , 6 ). Yet, our study showed that more than half of the lingual practitioners are hesitant to treat complex cases with lingual braces.…”

“…Many esthetic appliances like lingual braces, ceramic brackets, clear aligners and coated esthetic archwires are currently available with their own advantages and disadvantages. However, lingual braces currently provide the ultimate esthetic advantages of being inconspicuous and capable of performing orthodontic tooth movements similar to traditional labial brackets ( 5 , 6 ).…”

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

“…La técnica de unión indirecta es la clave para el éxito de la ortodoncia lingual ya sea esta empleada de forma manual utilizando los modelos dentales de los pacientes o mediante la utilización de la técnica digital o personalizada. Cualquiera que se elija no influirá en el resultado del tratamiento siempre y cuando el cementado de los brackets sea de forma precisa y en la posición deseada (Saini et al, 2016).…”

“…Al analizar la ortodoncia lingual en los tres planos del espacio, se puede observar que en el plano sagital aplicando una fuerza de intrusión igual que sea igual a la fuerza de retracción, el vector de fuerza neta dará como resultado una fuerza de inclinación lingual, por lo que se debe realizar movimientos ligeros para generar una retracción en masa. En el plano vertical lo ideal es primero corregir las inclinaciones y luego realizar los movimientos de intrusión y finalmente, en el plano horizontal el momento de rotación va a ser menor en el lado lingual que en el labial, sin embargo, es importante destacar que el manejo clínico en casos de apiñamiento es más complicado motivo por el cual en esos casos se requiere de alambres más elásticos que ayuden en los movimientos que se necesita emplear (Rathod et al, 2020;Saini et al, 2016).…”

“…Es importante destacar que el reto más grande en ortodoncia lingual es controlar la inclinación de los dientes anteriores en las fases de retracción, para ello el control de torque de estos dientes se puede controlar con el uso de minitornillos palatinos y brazos de palanca que se colocan en el punto de aplicación de la fuerza a nivel del centro de resistencia de los dientes anteriores para una retracción en masa (Saini et al, 2016).…”