Aesthetic Orthodontic Management of an Iatrogenic Malocclusion Induced by Lingual Appliance Using In-House Clear...

Lingual treatment is becoming more and more common, but it is a field in which not all orthodontists excel. Moreover, patients wearing lingual appliances experience more pain, speech difficulties, and problems maintaining adequate oral hygiene, which may cause them to lose their patience with the technique. As a result, iatrogenic treatment outcomes are sometimes observed. In this case report, the patient's initial chief complaint was spacing. She had been wearing lingual brackets for 1.5 years with minimal improvement. The previous doctor had informed her that the total treatment time would be about 1-1.5 years. However, the patient lost her patience with the treatment and came to us seeking an alternative solution that maintains a similar focus on aesthetics. After discussing potential alternative treatments with the patient, we decided to proceed with in-house aligners. Initially, the patient opted to distribute the spaces for veneers on the anterior teeth to save time. However, after the first series of aligners, she changed her mind and decided to close all the spaces because she found the aligners effective. After 7 months with three series of aligners, the achieved outcomes included closing all spaces, improving the midlines, achieving a Class I canine relationship, and better intercuspation. The treatment outcomes remained stable at the 1-year follow-up. Using in-house aligners is an effective alternative to lingual brackets in certain cases.