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As adults increasingly seek orthodontic treatment, a growth has been witnessed in the demand for aesthetic orthodontics, the ultimate of which are appliances bonded to the lingual surfaces of the teeth. Development has spanned 30 years and many of the initial challenges faced with this approach have now been overcome. An overview is provided on the development of lingual appliances from conception through to the current systems available. Lingual orthodontics is not for every patient seeking treatment and therefore the indications and contra-indications are discussed, together with the advantages and disadvantages of this increasingly popular approach.
Clinical Relevance: Patients are increasingly asking dental professional about lingual appliances.
Article
Most orthodontists would report that, in recent years, there has been a marked increase in the number of adults, particularly females,1 seeking orthodontic treatment. Tooth-coloured brackets have become widely available in response to the patient's desire for discreet treatment. Although plastic and porcelain brackets reduce the visual presence of the appliance, they are nevertheless still visible and this remains a problem for some patients. Other systems, such as Invisalign (Align Technology Inc, San Jose, USA), have been promoted as effective alternatives. However, their moderate aesthetic appeal and clinical limitations are well documented.2 Lingual appliances are unique in this respect as they provide the ultimate in aesthetics by attachment to the lingual surface of the teeth (Figure 1).
This article reviews the development and challenges of lingual appliances, the clinical procedure, treatment considerations, as well as the advantages and disadvantages of lingual appliances. It will provide readers with information that they can pass on to their patients who may be seeking an orthodontic referral for lingual appliances.
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