Papakostopoulou Margarita, Stradi Roberto

Title: Early intervention with lingual appliances in an adolescent patient: A case report

Aim: Restoration of facial/smile aesthetics and occlusal stability of a patient with 3 retained deciduous teeth, 3 late erupting, lower anterior crowding and increased overbite. Early onset of treatment was indicated in order to prevent the eruption of canines in reverse bite.

Materials and methods: A 15-year-old female patient with dental/skeletal Angle class I malocclusion presented with retention of 53,63,65, distally rotated peg laterals, retruded 11,21, increased overbite and lower anterior dental crowding. OPG confirmed the presence of the succedaneous permanent teeth and all 4 third molar germs. In both jaws the patient was treated with Incognito TM 7-7 appliances. Initially the extractions of 53,63,55,65,75,85 took place. The archwire sequence in both arches was: NT 0.14, NT 0.16*0.22, NT 0.18*0.25, SS 0.16*0.24 (ET in the UJ), betaIII Ti 0.182*0.182. Maxillary permanent canines erupted palatally and they were bonded to the archwire with composite in order to facilitate their vestibular shift. When 13,23,15,25 were fully erupted, silicon impression was taken, in order to fabricate the customized lingual attachments. Total treatment duration was 3 years.

Results: The impacted permanent teeth were brought into right position and normal occlusion. Lower anterior crowding and deep bite were corrected. Upper frontal spacing was eliminated.

Conclusion: Early onset of fixed orthodontic treatment is sometimes indicated and with lingual appliances it can be more aesthetic and tolerable to adolescents.