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HISTORY OF LINGUAL ORTHODONTICS - FROM PAST, PRESENT AND FUTURE ISSN 2320-3722 Pawan Kumar Bhandari D’, Anbuselvan G J’, Karthi M? = CORRESPONDING ADDRESS 4. Dr. D, Pawan Kumar Bhandari Pos! Gractate Student Dept. of Orinodntcs and Dentofacial Orthopedics, SR Intute of Dental Science and Research, Tiruchengode, Namakkal~ 637 215, Tamil Nadu, India, 2, Dr.G.J Anbuselvan Vice Principal and HOD, Dept. of Orinodantcs and Dentofacial Orthopedics, SR Institute of Dental Science and Research Tiruchengode, Namakkal~ 637 215, Tami Nadu, India, 3. DrMKarthi Reader, Dep, of Orthodontics and Dentofacial Orthopedics, KSR Insute of Dental Science and Research Tiruchongode, Namakkal~ 637 216, Tami Nadu, India, ABSTRACT For many years, lingual orthodontics was perceived as extremely complex and problematic and. therefore not widely used internationally. During the last decade, the percentage of patients treated with lingual orthodontics has increased and the technique has developed to such an extent that in some cases, it is easier, quicker, and more accurate than traditional buccal orthodontics. Currently, an, increasing number of patients, especially young adults, are asking for esthetic alternatives to conventional orthodontics in the treatment of probiems related to malalignment of the anterior teeth. This article will endeavor to cover some of the aspects related to individuals and their contributions to, lingual orthodontics. KEY WORDS: Lingual brackets, STB Brackets, Incognito. INTRODUCTION One of the most important challenges in ‘orthodontics is to attain excellence in treatment with comfortable and esthetic appliances. From the esthetic perspective, lingual orthodontics provides the best option for comprehensive treatment of most malocclusions while maintaining {ull tree-dimensional control of the dentition, HISTORY OF LINGUAL APPLIANCES The Beginnings: Kinja Fujita, 6 was the first to develop the lingual multibracket technique using the mushroom shaped archwire. He Ree Loe submitted his concepts on lingual orthodontics in 1967, began his research in 1971, and published the Fujita method in 1978, treating Class | and Class II cases with extraction of four bicuspids. The Fujta bracket had three slots-occlusal, horizontal, and vertical EARLY CONTRIBUTORS Craven Kurz12 with Jim Mulick in 1975, using plastic bracket bonded to the lingual tooth surfaces. Apparently an employee of the Bunny. Playboy Club with crowded teeth came to Craven Kurz's office asking him for nonvisible orthodontic HISTORY OF LINGUAL ORTHODONTICS - FROM PAST, PRESENT AND FUTURE treatment, further stimulating his interest in the subject. Using plastic brackets, it was easy to reshape them fora better fitto the lingual surfaces; however, there were many problems, especially with regard to bonding failures and patient comfort. Jim Wildman, in 1976 treated the frst patient in the United States by using a lingual appliance.12 Craven Kurz, developed the first generation of the Kurz lingual bracket. The brackets were made up a bite plane, a base pad adapted to the anatomic characteristics of the lingual surfaces of the teeth, and a preangulated slot according to the conversion of the torque used on the labial surface. In 1990, The Kurz lingual bracket developed and evolved to the 7th Generation Ormeo Lingual Bracket.12 The first generation included a bite plane and rounded margins; hooks were absent and the bracket was large. The advantages of the bite plane included: opening the bite anteriorly with possible repositioning ofthe mandible, extrusion of molars, intrusion of incisors, and facilitating any expansion and mesiodistal movement of molars Uninhibited by occlusal forces. In the second generation (1980), hooks were added to canine brackets. In the third generation (1981), hooks were added to all brackets and to molar tubes. The fourth generation (1982-1984) included a lower profile facitating insertion of he archwire. The fith generation (1985- 1986), included the bite plane became more pronounced, the torque was increased, and the molar brackets included an accessory tube for a transpalatal bar. For the sixth generation (1987-1990), the hooks were elongated, the transpalatal bar attachment was optional, and the binge-cap tube for the second molar was developed. With the seventh generation (1990), the square bite plane became rhomboid shaped, increasing the interbracket distance, and the premolar brackets were widened mesiodistally for better rotational control.” Ree Loe Ormco founded a Task Forcet, 2 comprising Craven Kurz, Jack Gorman, Bob ‘Smith, "Wick" Alexander and "Moody’ Alexander, James Hilgers and Bob Scholz, and administrators, Floyd Pickrel, Ernie Strauch, and Michael Swartz. Paige10 in 1982, who used Begg light wire brackets on the lingual surfaces. Lingual lightwire technique has horizontal slotted unipoint combination bracket and both round and ribbon wires. ‘The Enlightenment: The TARG machine12 \was launched by the Ormco Society in 1984 as an important aid to the laboratory technique, It allows. the accurate placement of the brackets ata precise distance from the incisal and occlusal surfaces of the teeth, as well as making it possible to prescribe the torque and angulation for each tooth individually Didier Fillion? in 1986, developed precise ‘measuring device to the original TARG machine to allow compensation for the different thickness between the teeth called as the Electronic TARG. Creekmore3 (1989) developed a complete technique with vertical slot lingual brackets, together with a laboratory system. Creekmore also designed archwire templates and clinical instruments, Stagnation Abounds: Following this initial development and expansion of lingual orthodontics in the 1990s, interest, particularly in the United States, decreased, probably due to the poor standard of completed cases. The reasons for this were attributed to inadequate training, poorly developed laboratory systems, and the unavailability of preformed archwires. 12 HISTORY OF LINGUAL ORTHODONTICS - FROM PAST, PRESENT AND FUTURE In 1996, Craven Kurz, William Laughlin, Thomas Creekmore, Jim Wildman, Giuseppe Scuzzo, Didier Fillion, and Pablo Echarti together with other clinicians founded the Lingual Study Group, in Denver, Colorado, with the aim of relaunching lingual orthodontics, especially in the United States. Proliferation Abounds: The American Lingual Orthodontics Association (ALOA), founded in 1987 butwhich had been inactive for anumber of years, was reactivated in 1997 by Mario Paz, John Napoiitano, and Frank Andolino. Fillion has continues to play an important role in the history and development of lingual orthodontics. He developed European Society of Lingual Orthodontics (ESLO), Société Francaise dOrthodontie Linguale (SFOL), British Society of Lingual Orthodontics (BLOS), and most recentiy the World Society of Lingual Orthodontics (WSLO), In Waly, 1994, Massimo Ronchin13 developed, a self-ligating lingual bracket based on. the Begg technique. The same company also developed the Philippe bracket, a simple bracket, without torque control, but useful for alignment and leveling In Germany, Hatto Loidl developed a self- ligating lingual bracket, Evolution LT. Lingual Self Ligating Brackets 1. Philippe 2D seltligating lingual brackets by Forestadent. 2. Forestadent 3D Torque-Lingual self-ligating brackets. 3, The Adenta Evolution lingual bracket. 4. n-Ovation-L GAC International lingual brackets. 5. Phantom brackets from Gestenco international (ceramic selfligating) In Israel, the promoters of lingual orthodontics are Silvia Geron,8 who developed the. Lingual Bracket Jig for direct and indirect bonding in lingual orthodontics, and Rafi Romano, who edited a book'2 presenting an update on the state Ree Loe of the art oflingual orthodontics. Tae Weon Kim founded the Korean Society of Lingual Orthodontics (KSLO) and developed the Model Checker, a bracket positioner, and CRC Ready-Made Core Trays which togather form the Korean Indirect Bonding Setup System (KIS System).11 Hee-Moon Kyung founded the Korean Lingual Orthodontics Association (KLOA) and developed the Individual Indirect Bonding Technique (IIBT), the Mushroom Bracket Positioner, as well as the Lingual Straight Wire Technique. He is also well known for the development of the micro screw implant, a major advance in the provision of bony anchorage for both lingual and labial orthodontic techniques, 11 The Japanese Lingual Orthodontics Association (JLOA) is currenily the largest lingual orthodonticsociely. Toshiaki Hiro9, who developed the technique of creating individual indirect bonding trays for each bracket. The Hiro system was created by Toshiaki Hiro and improved by Kyoto Takemoto and Giuseppe Scuzzo. COMING OF NEWAGE ‘Scuzzo Takemoto Bracket Appliance (Ormeo Corp) Giuseppe Scuzz014, the third president of the ESLO, developed Associazione Italiana de Ortodonzia Linguale (AIL). Together with Kyoto ‘Takemoto from Japan, developed a prototype of a lingual straight wire bracket and technique, the STb (ScuzzofTakemoto bracket, Ormco). The ‘Scuzzo-Takemoto bracket (STb) was developed in 2003 to improve the comfort, speed, and reliability of lingual treatment. Because the LSW method requires the brackets to be much closer to the gingival margins and lingual tooth surfaces, however, a new STb Light Lingual System bracket, was introduced in 2009. This bracket represents a significant advance, because its design facilitates the use of light forces with reduced fricion and its, small ize enhances patient comfort. HISTORY OF LINGUAL ORTHODONTICS - FROM PAST, PRESENT AND FUTURE ‘This recently introduced smaller, more comfortable bracketed appliance siill requires indirect bracket placement in the manner developed over the past two decades. The STb appliance maximizes the inter-bracket distance ‘and uses very light forces to create very rapid initial alignment. It has been suggested that for certain non-extraction malocclusions, the STb appliance may be easily set up on the malocclusion model without a sophisticated laboratory set-up procedure. Such a treatment protocol would reduce laboratory procedures, resulting in lower laboratory fees, and therefore lessen the cost to the patient. In an extraction treatment program, the use of a more sophisticated diagnostic set-up is to, be recommended, Incognito Appliance (3M UNITEK) In Germany, Dirk Wiechmann15 developed a customized lingual bracket. The Incognito bracket is perfectly adapted to the lingual surfaces of the teeth, using a scanned model, the bracket, base, and the bracket itself is cast as one unit for each individual tooth. The prescription for tip and torque is customized according to the orthodontist’s treatment plan. He also developed a robot for designing and constructing lingual archwires perfectly adapted and customized for each dental arch. ‘This computer-generated appliance uses three dimensional (3D) computer ‘scanning to ensure efficiency of tooth movement by designing brackets and bonding pads specifically for each individual tooth with the bracket slot in the most advantageous position on the lingual surface of the dentition. A series of archwires is then created by a wire bending robot to achieve the orthodontist's, treatment goals; bending archwires by hand would be difficult and reduce the efficiency of this appliance. These computer-generated lingual appliances are expensive, FUTUR Orapix System: ‘The newest lingual orthodontic laboratory technique is the Orapix system. Ascannerwill scan @ patient's model and create a three dimensional Ree Loe (3D) data file. The orthodontist will receive the 3D data file of the patient and a 3-Txer software package via the Internet. With the 3-Txer software the orthodontist will visualize a 3D mode! and will be able to create his own virtual set-up on his computer for that particular patient. The orthodontist will decide on the required angulation, torque, curve of the arch, and any other adjustments of the occlusion. The main concept behind this technique is to make use of the precise bracket positioning produced by the computer software as opposed to using a technique that is. dependent on human hands and eyes, as is the case for mostother techniques. List of lingual brackets and their manufacturers: Brackets pe Manufacturer ‘Sleath, Farrony ramnorean OrmoOATES Zand 30 Lngual rackets | Foretadont ‘Sa Seuzzo Takoma Brackets [Ormco Tak generation — Karz Formas Ever aa Tgvaion, MW E-Cips | Denisa GAC ‘ORG=ORT Eg Wage Dana Tinga RAO Taeal Teo CONCLUSION Patient comforts improved by a low-profile, form-fiting appliance, speech is less affected, and the tongue less irritated. Currently excellent clinical results can and are being achieved with lingual orthodontics. For many patients, due to esthetic considerations, this is their only choice. This technique has introduced significant treatment alternatives in 21st century orthodontics. ACKNOWLEDGEMENT Thanks to Dr.S.Dwaragesh for contributing case photos of a treated lingual appliance patient. HISTORY OF LINGUAL ORTHODONTICS - FROM PAST, PRESENT AND FUTURE REFERENCE 1. Alexander CM, Alexander RG, Gorman JC, etl Lingual orthodontics: a status report. Part 1. J Clin, Orthod 16: 255-62, 1982. 2. Alexander CM, Alexander RG, and Gorman, JC et al: Lingual orthodontics: a status report. Part 5. Lingual “mechanotherapy. J Clin Orthod 17:99- 115, 1983. 3.Creekmore TD: Lingual orthodontics—its renaissance. Am J Orthod Dentofac Orthop 96:120-137, 1988. 4.Echari P: Lingual Orthodontics. Complete technique, step by step. Barcelona, Nexus Ediciones, 2003. 5. Fujita K: New orthodontic treatment with lingual bracket and mushroom archwire appliance. Am J Orthod 76: 657-675, 1979, 6. Fujita K: Multilingual bracket and mushroom, archwire technique: a clinical report. Am J Orthod 82:120-140, 1982. 7. Fillgn D: Improving patient comfort with lingual brackets. J Clin Orthod 31:689-694, 1997. 8, Geron S: The lingual bracket jig. J Clin Orthod 33:457-463, 1999, 9, Laura Buso-Frost Didier Filion. An Overall View of the Different Laboratory Procedures used in ‘conjunction with Lingual Orthodontics. Semin Orthod 2006; 12:203-210. 10. Paige SF: A lingual light-wire technique. J Clin Orthod 16:534-544, 1982. 11. Pablo Echarr. Lingual Orthodontics: Patient Selection and Diagnostic Considerations. Semin Orthod 2006; 12: 160-166, 12. Romano R’ Lingual Orthodontics. Ontario, BC Decker, 1998. 13.Ronchin M: Aesthetics with lingual orthodlontics. Resolving Class II malocclusion with, molar distaization. Pract Perio Aesthet Dent 6:51- 58, 1994. 414. Scuzzo G, Takemoto K: Invisible Orthodontics. Current Concepts and Solutions in Lingual Orthodontics. Berlin, Quintessenz Verlags-GmbH, 2003. 15.Wiechmann D, Rummel V, Thalheim AWiechmann L; Customized bracket and archwires for lingual orthodontic treatment. Am J Orthod Dentofacial Orthop 124:593-599, 2003, Ree Loe

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