Orthotown March 2020 - 40

This young adult presented with relapse from treatment as a teenager. I used an InBrace appliance with minimal IPR over seven months. After initial tissue healing with a
removable clear retainer, a lower fixed retainer was subsequently placed.
Fig. 4a

*

Fig. 4b

*

*

40

Some of the newer lingual systems
mentioned previously may not be
predictable for severe cases. Many
patients who need extraction
treatment, TADs or other complicated
mechanics cannot predictably be
treated without a more robust lingual
appliance. For these cases, a fully
customized system is preferable, such
as eBrace (China), Lingual Liberty
(France/USA), Incognito (Germany)
or SureSmile (USA, wires only).
Unless you're willing to learn how to
perform in-house indirect bonding
well, you will need the help of a lab
to set up cases. This dependence on
a lab can initially be dissuasive for
doctors mainly familiar with directbonding-only labial fi xed appliances.
The easier the communication with
the lab, the less frustration and better
outcomes when problems arise.
Patients may need some convincing
of the benefits of a lingual appliance.
Most patients are already familiar
with and request clear aligners, so
encouraging them to select a different
appliance may be difficult. You must
identify why patients are particularly
requesting clear aligner therapy and
see if, in fact, they are motivated by
the unique characteristics of plastic or
they just want an aesthetic appliance.
I focus on aesthetics, compliance and

finish quality when discussing the
advantages of fi xed lingual treatment.

Advantages
*

*

*

Nothing is more aesthetic than fi xed
lingual orthodontic treatment-no
removing trays in public, no anterior
attachments and, often, no labial
attachments at all.
Fixed appliances may leave more in
your control as a clinician and less
to the winds and whims of patient
compliance. Better control typically
translates to more predictability,
efficiency, high-quality results and
happy patients.
As clear aligner treatment is increasingly provided by nonspecialists, it
is appropriate to have an aesthetic
option that clearly identifies you as
the master of your domain.

I'd encourage you to explore the option
of adding a lingual fi xed appliance to your
arsenal. The newer lingual companies have
wonderful customer service and can help
the uninitiated successfully onboard a new
treatment option in their office. I've been
thrilled with the lingual treatment we've
performed and look forward to encouraging
more aesthetically inclined patients to use
it. Ultimately, with patience, attention and
practice, you'll succeed in providing your
patients another aesthetic treatment option. ■

MARCH 2020 // orthotown.com

OT0320_Schofield_Lingual_AG.indd 40

2/25/20 11:31 AM



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Orthotown March 2020

Table of Contents for the Digital Edition of Orthotown March 2020

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Orthotown March 2020 - 1
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