Lingual appliances reduce the incidence of white spot lesions during orthodontic multibracket treatment

Wiechmann, Dirk; Klang, Elisabeth; Helms, Hans‐Joachim; Knösel, Michael

doi:10.1016/j.ajodo.2015.05.015

Cited by 43 publications

(20 citation statements)

References 24 publications

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“…In addition to advantages shown for patients, the risk of developing white spot lesions appears to be drastically reduced when using lingual compared to labial appliances [7, 8, 15, 17]. …”

Section: Introductionmentioning

confidence: 99%

Therapeutic accuracy of the completely customized lingual appliance WIN

Pauls¹,

Nienkemper

Schwestka-Polly

et al. 2016

J Orofac Orthop

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ObjectiveThe aim of this retrospective cohort study was to assess the accuracy of the completely customized lingual appliance WIN (DW Lingual Systems, Bad Essen, Germany) employing a three-dimensional (3D) comparison between the setup and the final result.Materials and methodsThe setup and final models of 20 consecutively debonded patients (40 jaws; 7 males, 13 females; mean age 15.76 ± 4.45 years) with various malocclusions of a private practice specialized in orthodontics were digitalized using a 3D scanner. The 3D models of the setup and the final model of each jaw were then digitally matched using the best fit algorithm and segmented into single teeth. After placing individual coordinate systems, the homologous teeth of the setup and the final model were matched to be able to calculate the exact deviations of all rotational and translational components. The t test for unpaired samples, Kruskal–Wallis tests, U tests, and ANOVA with Duncan post hoc test were applied statistically.ResultsRegarding the incisors, the angle discrepancies between the setup and the final result appeared to be less than 3° (torque 2.96°; tip 2.04°; rotation 2.00°). The translations showed mean values less than 0.3 mm (mesiodistal 0.16 mm; buccolingual 0.15 mm; vertical 0.29 mm). Slightly higher values could be measured in the lateral segments regarding rotations (torque 5.18°; tip 3.10°; rotation 3.70°) as well as regarding translations (mesiodistal 0.26 mm; buccolingual 0.64 mm; vertical 0.36 mm).ConclusionsUsing the completely customized lingual appliance WIN, it is possible to achieve the final result predicted by the setup with a high accuracy.

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“…In addition to advantages shown for patients, the risk of developing white spot lesions appears to be drastically reduced when using lingual compared to labial appliances [7, 8, 15, 17]. …”

Section: Introductionmentioning

confidence: 99%

Therapeutic accuracy of the completely customized lingual appliance WIN

Pauls¹,

Nienkemper

Schwestka-Polly

et al. 2016

J Orofac Orthop

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“…The present model simulates a very high sample size of 1,000,000 orthodontic treatments in order to achieve robust cost calculations, but it also necessarily simplifies some potential factors that may have an influence on WSL or cavitation treatment costs: Labial or lingual enamel decalcification or cavitation incidence rates per month were based on two of the largest reports on the subject, with adequate sample sizes of least of 350 patients [2, 12]. Previous reports on lingual post-orthodontic lesions yielded slightly decreased numbers of WSL compared to the report used here but were also smaller in sample size [10, 11, 13]. Many of the reports on labial post-orthodontic lesions also did not assess decalcifications in complete dental arches, but in specific tooth groups, such as upper incisors only [4].…”

Section: Discussionmentioning

confidence: 99%

Comparison of potential long-term costs for preventive dentistry treatment of post-orthodontic labial versus lingual enamel cavitations and esthetically relevant white-spot lesions: a simulation study with different scenarios

et al. 2019

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Background Post-orthodontic white-spot lesions (WSL) in esthetically relevant incisor and canine areas impair dentofacial esthetics, and preventive dentistry treatment is definitely required in case of enamel cavitations. The incidence of lingual post-orthodontic WSL and cavitation following lingual MB treatment has been reported to be distinctively decreased compared to labial MB treatment. Moreover, lingual WSL do not impair dentofacial esthetics. It was the objective of this study to calculate consequential costs of preventive dental care necessary to recover labial or lingual post-orthodontic cavitations as well as esthetically relevant WSL following either labial or lingual MB interventions. Methods MB treatments (labial / lingual) were simulated in 1,000,000 patients between the ages of 12-18Y, with a median residual life time expectancy of 58Y based on local mortality tables. Range of MB Tx duration was 9–45 mo. Frequencies of post-orthodontic (labial / lingual) enamel damages were derived from large-scale WSL incidence studies. Anterior composite survival rates were based on a systematic review on the subject. Within the context of the German dental fee system (GOZ 2.3 and 3.5 fee increments), simulation of costs for enamel damage treatment and re-treatment (maximum: 5x) were based on single-surface composite restorations for lingual or labial cavitations and labial WSL treatment; and lingual WSL fluoridation. Results Overall mean total costs for Tx and re-Tx of both WSLs and cavitations may sum up to 1718.91 Eur in the high-cost (GOZ 3.5) scenario for conventional MB cases, versus 19.94 Eur for lingually treated cases, given that renewal of simulated single-surface restorations takes place at 15-year intervals. When focussing on patients diagnosed with least of one WSL, and/or cavitation, these mean costs increase up to 2332.35 Eur for conventionally treated MB patients, or 65.03 Eur for lingual MB patients. Conclusion Costs for repeated treatment of post-orthodontic enamel damages produced by conventional vestibular fixed appliances may easily exceed the initially higher costs associated with lingual orthodontic treatment. Judged economically in the long term, lingual MB Tx may be considered as a more cost-effective solution for a correction of malocclusion.

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“…Der Methodenfehler zur Klassifizierung von Schmelzentkalkungen wurde von den Autoren im Rahmen einer vorangegangenen Studie [16]…”

Section: Inter-and Intra-individueller Methodenfehlerunclassified

Vollständig individuelle linguale Apparaturen vermindern das Schmelzentkalkungsrisiko bei einer Multibracketbehandlung um ein Vielfaches

Knösel

Klang²,

Helms

et al. 2015

Inf Orthod Kieferorthop

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Zusammenfassung Hintergrund und Zielsetzung: Das Entstehen von Schmelzentkalkungen oder White-Spot-L?sionen (WSL) ist eine h?ufig auftretende unerw?nschte Begleiterscheinung der herk?mmlichen festsitzenden kieferorthop?dischen Behandlung. Die Lingualtechnik kann einen Beitrag dazu leisten, die Schwere der Nebenwirkungen zu mindern, indem die Bracketplatzierung in einen Bereich verlagert wird, der durch eine geringere Anf?lligkeit gegen?ber Karies gekennzeichnet ist. Ziel der Studie ist das Bestimmen der Inzidenz von lingualseitigen WSL und Kavitationen als Folge einer festsitzenden lingualen Behandlung, unter Ber?cksichtigung einzelner Zahngruppen (12?22; 13?23; 16?46; 17?47) sowie der Einflussfaktoren Behandlungsdauer, Geschlecht und Altersgruppe. Patienten und Methode: In dieser retrospektiven Untersuchung wurde die WSL- und Kavitationsinzidenz in 385 mit der vollst?ndig individuellen lingualen Apparatur WIN (DW LingualSystems, Bad Essen, Deutschland) behandelten F?llen mit insgesamt 10?162 auswertbaren Z?hnen anhand hochaufl?sender Aufsichtsaufnahmen vor und nach der aktiven Behandlung ermittelt. Ausschlusskriterium war ein Alter der Patienten von ?ber 18 Jahren bei Behandlungsbeginn. Die Auswertung erfolgte deskriptiv sowie anhand non-parametrischer ANOVA zum Signifikanzniveau von 5%. Ergebnisse: Die mittlere Behandlungsdauer mit der WIN-Apparatur betrug 22,32?7,18 Monate. Es ergab sich im Bereich der oberen Inzisivi eine zahnbezogene WSL- [Kavitations-] Inzidenz von 5,8% [0,2%], patientenbezogen (F?lle mit mindestens einer neuen WSL) betrug diese Inzidenz 13,8% [0,8%]. Bei Betrachtung der kompletten behandelten Zahnb?gen 17?47 ergab sich zahnbezogen eine WSL- [Kavitations-] Inzidenz von 3,2% [0,1%]. Bei m?nnlichen Patienten war das Auftreten von Kavitationen im Bereich der Zahngruppe 13?23 signifikant erh?ht (0,4% aller Z?hne 13?23). Eine l?ngere Behandlungsdauer wurde als signifikant verschlechternder Faktor in Bezug auf die WSL-Formation in der Zahngruppe 13?23 und 16?46 festgestellt. Schlussfolgerung: Die Inzidenz von lingualen post-orthodontischen Schmelzentkalkungen ist im Vergleich zu den in der Literatur berichteten WSL-Inzidenzen nach der Behandlung mit vestibul?ren Multibracketapparaturen je nach betrachteter Zahngruppe bis um den Faktor 10 reduziert. Inaktive, remineralisierte linguale L?sionen stellen auch ohne weitere Behandlung kein ?sthetisches Manko dar.

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Lingual appliances reduce the incidence of white spot lesions during orthodontic multibracket treatment

Cited by 43 publications

References 24 publications

Therapeutic accuracy of the completely customized lingual appliance WIN

Therapeutic accuracy of the completely customized lingual appliance WIN

Comparison of potential long-term costs for preventive dentistry treatment of post-orthodontic labial versus lingual enamel cavitations and esthetically relevant white-spot lesions: a simulation study with different scenarios

Vollständig individuelle linguale Apparaturen vermindern das Schmelzentkalkungsrisiko bei einer Multibracketbehandlung um ein Vielfaches

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