The lingual mindset

24 February 2016
Volume 31 · Issue 6

Orthodontic specialist Asif Chatoo is committed to helping colleagues navigate the challenges of the lingual technique.  At the first module of his Learning Lingual course he told delegates: “The lingual technique is harder, but it’s a mindset. Adopt that mindset, and you will be filling an important void among treatment options.”

Other orthodontic techniques may be equally effective, but not equally attractive. Meanwhile, systems like aligners are nearly invisible but not so effective in challenging cases, especially in managing torque. “If you want to give your adult patients treatment which is invisible and effective in all dimensions and takes care of their bite, then lingual is the answer.”

The content of the course is aimed at clinicians who want to learn about the lingual technique from all perspectives, not a single system perspective. Throughout the first module he provided supporting evidence with references for his work and clinical preferences.

His first lesson identified the challenges which arise when brackets are being placed lingually:

  • Greater anatomical variation in the lingual surface compared to the labial surface which cause problems in the accuracy of bracket placement.
  • Limited access and visibility.
  • Rebonding of a fractured bracket accurately is difficult.
  • Wire-bending at some point is an integral part.

 

But customised lingual appliances, which allow for indirect bonding using transfer trays, help navigate some of these challenges. Indirect bonding is quicker and more accurate and the trays can be used for creating a pontic in extraction cases and rebonding of fractured brackets.

Asif explained how he manages a variety of aspects of treatment and the choices he makes, whether it’s the introduction of off-set bends, the forces used, anchorage control, slot orientation or wire thickness, amongst many other considerations. He is an advocate for the use of robotic wire-bending and demonstrated how and why robots create the wires for his patients. Delegates were able to try out digital scanning to understand the advantages of digital technology. Other topics Asif covered were biomechanics, bonding, elastics and ties, extraction cases, troubleshooting, patient communication and marketing.

The second advanced module will cover interdisciplinary care, working with the therapist, tackling the challenges of advanced systems, marketing and advanced troubleshooting. There are still places available for the advanced module: visit www.londonlingualbraces.com/learning-lingual.php or you can register interest with the next course by emailing office@londonlingualbraces.com