orthodontics

Orthodontics is the specialty field of dental medicine that is concerned with the prevention, detection and treatment of misalignments of the jaws and teeth (malocclusions). The content encompassed in the field is better described by the term dental maxillary orthopedics (orthodontic adjustment). The term orthodontics (orthodontic treatment) is used in non-German-speaking countries.

ORTHODONTICS
As opposed to functional orthodontia influences upon skeletal structures, orthodontics relates to the movement of teeth. Orthodontic tooth movements can be implemented with removable as well as fixed appliances, whereby fixed appliances are generally more advantageous due to the scope of movements that can be implemented and the treatment duration as well as the non-reliance upon patient compliance. Orthodontic measures can even be implemented after growth termination, that is, during adulthood.

LINGUAL TECHNOLOGY
In plain English, "lingual" means "from the side of the tongue" and lingual technology concerns itself with the correction of tooth misalignments with the aid of braces that are attached on the inner side of the teeth. An ever-increasing number of adult patients undergo orthodontic treatment. It is exactly in this patient group that the requirements relating to aesthetic aspects are very high and elevate the demands placed upon orthopedic therapy.

History of lingual technology
At the end of the 1970s, the Californian orthodontist Dr. Craven Kurz treated the first patients with a sort of "invisible" appliance, whereby he glued normal brackets on the lingual side of the teeth. In less acute cases he achieved good results. However, problems arose as the exact positioning of the brackets on the tongue-side is considerably more difficult than on the outer side of the teeth. Furthermore, accurate bending of the wire is extremely complicated due to the different tooth thicknesses (a factor which does not play a role on the outer side of the teeth). At the same time, precision is the highest priority if short treatment duration and optimal results are desired. Ormco, a company that produces brackets, set up a consortium consisting of seven orthodontists with the purpose of further developing lingual technology and the manufacture of their own lingual brackets. The first lingual brackets (Generation # 1) from the Ormco company went into production in 1976. Fully independent of Ormco, the K. Fujita of Japan developed his own bracket system in the Far East. 1986: Thousands of orthodontists around the world treat their patients with lingual technology. The appliances were not far enough developed at this stage and characterized by "beginner errors" so that many orthodontists had to admit that they'd lost control over the teeth and such cases needed to be retreated using brackets on the tooth exteriors. Lingual technology was prematurely made accessible to the dental public before the technology had sufficiently matured. 1990: Ormco presents the brackets of Generation # 7. In the middle of the 1990s, associations dealing with lingual orthodontia were formed around the globe. Among others, the German orthodontist Dr. Wiechmann was one of those who considerably drove development of lingual technology forward. Since then, there have constantly been more improvements. New materials, new procedural techniques, new brackets as well as new technologies for placement of the brackets have been developed.

What are the new procedures relating to lingual technology?
The company "T.O.P. Service für Lingualtechnik" was founded in 1997 and has since become one of Germany's leading companies in the field of lingual therapy. In the meantime, there have constantly been more improvements. The most modern computer-aided technologies now enable the production of completely individualized lingual devices. Thermoelastic archwires, which look like mushrooms (the reason why this is also called the "mushroom technique"), are preformed by means of the "hot robot hand". This results in improved application options in lingual technology and a higher degree of comfort for patients. At the same time, only 3-4 archwires are required per jaw, which, in turn, equates to a higher level of treatment comfort for the patients. The acting forces are also less than those exerted in earlier days and this is better tolerated by patients. The T.O.P. company is also our cooperation partner and the treatment system developed by our colleague, Dr. Wiechmann in Bad Essen, is regarded today as the most successful system for lingual technology in Europe and is already gaining importance at the intercontinental level.

Indications for lingual technology
Lingual technology is particularly suited for treatment of serious overbite dentitions and for extraction cases. However, it is likewise suited for other treatment scenarios – even if there are other well-known alternative treatments for theses same cases, such as for example, Invisalign – the technology from the Align Technology company. Despite ever new developments in the technology, lingual braces are not suitable for every patient. We do not recommend lingual-side correction for patients who neglect dental hygiene or who clean their teeth too seldom because the associated tooth-brushing must be done with great thoroughness. Otherwise residual food forms deposits where the brackets are attached and this results in cavities. The treatment indication should be chosen very carefully.

Advantages of lingual technology
With a lingual technology appliance, the brackets are bonded to the inside of the teeth. From the outside, these braces are completely invisible which is a big advantage. Not to mention the psychological effect of "invisible braces".

Disadvantages of lingual technology
Summed up, these days every tooth CAN be adjusted using lingual technology, however, the stress load for the patients as well as the effort level of the treating staff are not comparable to that associated with labial multi-band appliances or with Invisalign. The disadvantages of a lingual-side treatment for the orthodontist consist primarily in the time- and resource-intensive dental lab process and the more strenuous course of treatment course for the treating personnel. Treatment with lingual technology requires significantly more of the orthodontist's time. The lingual-side appliance affects the patient's speaking pronunciation during the first 6 to 12 weeks and problems during eating and irritations to the tongue may occur.

Treatment costs of lingual technology
Lingual technology is more cost intensive than treatment with Invisalign or multi-band braces. The external lab costs are relatively expensive and this essentially amounts to the cost difference compared to "normal" multi-band (MB) treatment (8000-16000 €).

Invisalign
Your Invisalign treatment consists of a series of nearly invisible, removable aligners that you change every two weeks for the next set of aligners. Each aligner is individually manufactured for your teeth, and your teeth only. As you replace each aligner, your teeth can be moved little by little, week by week, toward their final position as prescribed by your dental practitioner.
But that is not all: A virtual 3D treatment plan (ClinCheck® software) shows the series of movements your teeth are expected to go through over the course of the treatment. This allows you to see upfront what your teeth are expected to look like at the end of the treatment. From the results of the ClinCheck set-up, your custom-made, clear aligners are produced especially for you.
If you're ready for a smile that transforms your appearance, Invisalign may be your answer. Although there are many choices out there, no other treatment works as comfortably as Invisalign.
Invisalign can transform your smile without interfering with your day-to-day life. Convince yourself of the benefits.
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D - 76530 Baden-Baden
Phone +49 (0) 7221.398730
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