How efficient is customized lingual orthodontics? An assessment of treatment outcome

To assess the efficacy of lingual orthodontics by comparing setups and post-treatment casts.

Thirty-two consecutive patients treated with a customized lingual orthodontic appliance were included in this retrospective study.

Initial casts, post-treatment casts and setups were scanned, and the digital models produced were analysed in terms of overjet; overbite; molar and canine relationships; intercanine, interpremolar and intermolar distances; upper and lower arch lengths; midline deviation; bucco-lingual angulation of all teeth and mesio-distal angulation of anterior teeth. Comparisons between setups and post-treatment casts were performed via paired t tests. Relationships between the planned and actual correction were studied using regression analysis.

Statistically significant differences in bucco-lingual torque between setups and post-treatment casts were found for all upper teeth, except for central incisors. In the lower jaw, statistically significant differences in bucco-lingual torque were found between setups and post-treatment casts for the lower incisors and molars. No statistically significant differences in mesio-distal angulation of anterior teeth were found between setups and post-treatment casts. Upper and lower arch widths did not vary significantly between setups and final casts, except upper inter-second premolar and intermolar distances.

Customized lingual appliances offer efficient control of mesio-distal angulation of all anterior teeth. Significant differences in torque between setups and post-treatment casts were observed for upper lateral incisors, canines, premolars and molars, as well as lower incisors and molars. However, the torque difference was clinically significant (over three degrees) for upper second premolars and molars only.