Our Smiles:
Lingual Orthodontics

Morgane C.

I HAVE THE CENTRAL INCISORS TURNED INWARDS

CM presented in consultation with her central incisors moving backward and her lateral incisors moving forward. Clinical radiological examination revealed a shift of the jaws and a complete overlap of the lower teeth with the upper teeth. After explanation, the patient favored surgical treatment, particularly because she felt that the lower level of her face was really too short. The simplified treatment plan was as follows: a mixed lingual treatment with advancement and hourly rotation of her lower jaw.

After 24 months of treatment, rigid retention wires were placed superiorly and inferiorly from canine to canine on the lingual surfaces. Safety splints were also made.

Florence D.

A CASE OF A NON-SURGICAL GAP

DL presented to an orthodontic consultation with an inverted smile line and a gap in her mouth. The clinical and radiological examination revealed a gap that was mainly thumb-related with very little skeletal involvement. The simplified treatment plan was as follows: a mixed lingual treatment with inter-maxillary elastics.

The duration of treatment was 20 months. Rigid wire restraints were placed superiorly and inferiorly from canine to canine on the lingual surfaces. Safety splints were also made.

Romuald M.

I HAVE AN INTERINCISAL DIASTEMA

MR presented for consultation with the reason of gaps between his teeth. Clinical and radiological examination also revealed a major overlay and jaws in good position. The treatment plan chosen was a mixed lingual treatment with incisor ingression.

The treatment lasted 22 months. Rigid retention wires were placed superiorly and inferiorly from canine to canine on the lingual surfaces. Safety splints were also made.

Ludivine O.

I HAVE BLACK TRIANGLES

OL came to the orthodontic clinic with her black triangles, her misalignments, especially in her lower jaw. She had already been treated before. The clinical and radiological examination confirmed the patient’s reason for consultation and also revealed that her lower jaw was deviated to the left and that periodontal damage was ongoing. The simplified treatment plan was as follows: total lingual treatment with stripping and associated periodontal management by an exclusive periodontist.

The duration of treatment was 18 months. Rigid wire restraints were placed superiorly and inferiorly from canine to canine on the lingual surfaces. Safety splints were also made.

Cécile P.

I HAVE MY TOP TEETH IN FRONT

PC presented for orthodontic consultation with her upper teeth far forward and her lower lip wedged between her upper and lower teeth and hemmed in.

Clinical and radiological examination revealed a recessed lower jaw, thick lips, and a damaged maxillary first premolar.

The simplified treatment plan was as follows: a mixed lingual treatment with extraction of the maxillary first premolars. Because of her thick lip, there was no concern about significant recession of her upper lip and her face was very harmonious, so the surgical treatment option was rejected. Extractions of the 14 and 24 premolars were performed 4 months after band placement and aesthetic veneers were placed in the extraction spaces the next day.

After 24 months of treatment, rigid wire restraints were placed superiorly and inferiorly from canine to canine on the lingual surfaces. Safety splints were also made.

Ornelia P.

A CASE OF LATERAL INCISOR ALGESIA

OP presented to an orthodontic consultation with the reason for consultation symmetry of her smile, as she was missing her right lateral incisor.

Clinical and radiological examination confirmed the reason for consultation and also revealed the persistence of her milk canine and a counterlateral rice incisor. The simplified treatment plan was as follows: a total lingual treatment with opening of a space to place a prosthetic incisor in place of the missing lateral incisor, closure of the extraction space of the persistent milk canine, and opening of a space on either side of the rice-shaped incisor to place a veneer. The prosthetic restoration chosen was a cantilever bonded bridge. A space between the two central incisors was created at the patient’s request.

The duration of treatment was 24 months. Rigid wire restraints were placed superiorly and inferiorly from canine to canine on the lingual surfaces. Safety splints were also made.

Castille P.

I HAVE A CROSS JOINT

PC presented for an orthodontic consultation. Clinical and radiological examination revealed a right crossbite, narrowness of her upper jaw, deviation of her mandible, and misalignment. The treatment plan chosen was as follows: 10 months with a circuit breaker (fixed, rigid upper jaw widening appliance with skeletal effect), followed by 20 months of mixed lingual treatment.

The duration of treatment was 30 months. Rigid wire restraints were placed superiorly and inferiorly from canine to canine on the lingual surfaces. Safety splints were also made.

Juliette S.

I HAVE AN INCLUDED CANINE

JS presented to an orthodontic consultation with a milk canine that persisted on the arch but was beginning to be painful and an impacted permanent canine. The clinical and radiological examination revealed a canine in a fairly high position but without any image of resorption.

The simplified treatment plan was as follows: mixed lingual treatment with exposure of the impacted canine, extraction of the deciduous tooth, and placement of a veneer following the extraction. The patient was warned of the risk of ankylosis of the impacted tooth during traction. It is indeed rare but possible for an impacted tooth to remain fused to the bone without our being able to anticipate it. In case of ankylosis, the orthodontic treatment will have made room for an implant and a permanent tooth crown, as the milk tooth is much narrower.

The duration of treatment was 24 months. Rigid wire restraints were placed superiorly and inferiorly from canine to canine on the lingual surfaces. Safety splints were also made.

Andrea V.

A CASE OF ANTERIOR CRUCIATE JOINT

VA presented for orthodontic consultation with his upper teeth behind his lower teeth, and “vampire teeth” (protruding canines). Clinical and radiological examination revealed good jaw position and a strong potential for arch widening. The simplified treatment plan chosen was therefore as follows: total lingual treatment with wire expansion and without surgery or extraction. Some stripping was also performed to remove black triangles that had appeared during treatment due to initial overlapping.

The treatment lasted 20 months. Rigid retention wires were placed superiorly and inferiorly from canine to canine on the lingual surfaces. Safety splints were also made.

Hongfei W.

A CASE OF BIPROALVEOLISM

WH presented for orthodontic consultation with her teeth forward, her lips forward and her chin contracted when she closed her lips.

Clinical and radiological examination also revealed a left deviated mandible associated with a right crossbite. The patient was warned before starting that her mandibular midline would remain deviated to the left and that her occlusion would remain asymmetric, as only surgery would correct it. Since the aesthetic impact of this deviated midline and asymmetric bite was almost nil, I advised her not to consider surgery, which she was very pleased about.

The simplified treatment plan chosen was as follows: 4 premolar extractions, the first ones on top and the second ones on the bottom in total lingual. The day after the extractions, veneers were placed in the spaces to prevent them from showing. In general, extractions take place 4 months after the placement of the braces.

The treatment lasted a little more than 2 years and rigid restraining wires and trays were made for each arch.