Lingual Fixed Orthodontic Appliances May Be Associated With More Adverse Effects Than Buccal Appliances

Evaluation of the Oral Health-Related Quality of Life (OHRQoL) in Patients Undergoing Lingual Versus Labial Fixed Orthodontic Appliances: A Randomized Controlled Clinical Trial

Background

Wearing fixed orthodontic appliances may negatively impact oral health-related quality of life (OHRQoL) during treatment. This study aimed to compare the OHRQoL of patients treated with labial or lingual appliances.

Methodology

A total of 38 patients (23 females, 15 males; mean age: 21.3 years) with class I malocclusion and moderate crowding in the upper and lower dental arches were included. These patients were planned to be treated on a non-extraction basis and were randomly divided into the following two groups: the lingual appliance (LA) group and the buccal appliance (BA) group. The Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to measure the OHRQoL at the following six assessment times: before treatment (T0), one week after treatment (T1), one month after treatment (T2), three months after treatment (T3), six months after treatment (T4), and at the end of the active treatment (T5).

Results

In total, 19 patients in each group were included in the final analysis with no dropouts. In both groups, the overall OHIP-14 scores increased and peaked on the first week following appliance placement and then significantly decreased over time. The LA group had significantly greater overall OHIP‑14 scores than the labial group at T1 (p < 0.001) and T2 (p = 0.004) only.

Conclusions

The OHRQoL improved in both lingual and labial groups after treatment. Moreover, it was better in the labial group compared to the lingual group during the first month of treatment. In both groups, the greatest deterioration in OHRQoL occurred in the first week and gradually decreased over time.

Digital Workflow for Indirect Bonding with 2D Lingual Brackets: A Case Report and Procedure Description

Objective

During orthodontic therapy, accuracy in bonding procedures makes it easier to correct tooth alignment by decreasing the need for midcourse corrections by changing bracket positions. Indirect bonding allows the transfer of the appliance components from model casts to patient's teeth potentially meaning shorter appointments for bracket bonding and rebonding and best comfort during chairside practice. At the same time, there has been a steady increase in requests for invisible lingual orthodontic treatment.

Clinical Considerations

Accordingly, the aim of the present report is to illustrate the workflow to realize a complete digital indirect bonding for lingual brackets (2D, Forestadent). The procedure starts with intraoral digital scans, digital 3D model, and virtual bracket positioning, ending with the realization of a CAD-CAM prototyped transfer tray. A 3D intraoral scanner (True Definition, 3M) is used to create digital scans and digital models. A virtual bracket positioning is performed using software (NemoCast, Dentaurum), and a prototyped transfer tray is created by a CAD-CAM device. 2D lingual brackets were positioned inside the tray, so the appliance was bonded to the dental surface using light curing adhesive resin.

Conclusions

During orthodontic treatment, CAD/CAM technology could help clinicians. Computer-constructed transfer trays can reduce clinician error and improve the everyday workflow in the office.