A subjective comparison of two lingual bracket systems

Abstract

The purpose of this prospective, longitudinal study was to compare the influence of two lingual bracket systems on subjective oral comfort, speech, mastication and oral hygiene. Forty-two native speakers of standard German (32 females, 10 males; mean age 27.1 years, standard deviation 12.2) were enrolled and completed a standardized questionnaire directly before insertion of lingual brackets (T0), within 24 hours of bond-up (T1) and 3 months (+/- 1 week) later (T2). Eighteen of the patients were treated with prefabricated brackets (Ormco, seventh generation) (PB group) and 24 with customized brackets (Incognito) (CB group). While no significant intergroup differences were recorded at any of the times with respect to tongue position, conversation pattern, swallowing or oral hygiene, the CB group experienced significantly fewer tongue space restrictions, speech disturbances and impairments in chewing and biting than the PB group at T1 and T2. At T2, pressure sores, reddening or lesions to the tongue were recorded significantly less often in the CB group than in the PB group. This enhanced patient comfort in the CB group was attributed to the smaller dimensions of the customized brackets. This aspect could play a role in attracting more patients to lingual orthodontics in the future. Information given to the patient on the duration and extent of the restrictions associated with lingual orthodontics must be differentiated according to the bracket system used.

Conforto e fonação com a nova geração de bráquetes ortodônticos linguais individualizados

“…Diversos dispositivos linguais têm sido descobertos e clinicamente usados particularmente em pacientes adultos. Sabe-se que quanto menor as dimensões dos dispositivos linguais menor os efeitos na articulação de palavras 12,[15][16][17] , no conforto…”

“…O posicionamento dos bráquetes é outro fator de grande importância. Sabe-se que quanto mais pró-ximo ao dente, menores são as desvantagens causadas pelos acessórios, mesmo quando se utiliza o mesmo tipo de bráquete 17 . A colagem indireta é significantemente mais precisa no posicionamento dos bráquetes do que a técnica indireta 20 .…”

“…Recentemente o número de pacientes desejando um tratamento ortodôntico aumentou consi-oral [15][16][17] , na mastigação 16 , na restrição do espaço da língua e irritações em forma de lesões 12,16,17 . Além disso, dependendo do posicionamento do bráquete, diferentes espessuras podem ser estabelecidas com a utilização de um mesmo dispositivo, podendo alterar a adaptação do paciente 12 .…”

“…Além disso, dependendo do posicionamento do bráquete, diferentes espessuras podem ser estabelecidas com a utilização de um mesmo dispositivo, podendo alterar a adaptação do paciente 12 . Outro fator importante a se considerar é a colagem indireta dos bráquetes, pois esta permite uma maior precisão no posicionamento e, consequentemente, um tratamento ortodôntico lingual mais confortável e eficiente 13,17,18 .…”

Wire Roughness Assessment of 0.016″ × 0.022″ the Technique Lingual Orthodontics

“…[1][2][3] An initial disadvantage of the lingual orthodontic technique is that the patient may experience difficulty with phonation, eating, and performing oral hygiene; however, all the symptoms are well tolerated and minimized after the first month of use. [4][5][6] With advancement in the technique, various laboratory protocols have been developed, seeking placement of lingual brackets in a more gingival position of the teeth. Thus, the differences between the morphologies of the lingual faces have been diminished, allowing the use of straight arches without bends.…”