Study on the angulation between the labial and lingual surfaces of anterior maxillary teeth for the creation of an innovative concept of an adjustable lingual brace

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Dr. Dhruv Yadav, Dr. Rajiv Ahluwalia, Dr Sanjay Labh, Dr. Robin Malik, Dr Mohit Chaturvedi


Introduction: The lingual appliance is genuinely an aesthetic device since it is positioned on the lingual surface of the tooth. In comparison to labial appliances, lingual appliances have encountered challenges with sophisticated laboratory procedures, uneven lingual tooth morphology, high cost, and bonding trouble over time.

Objective: The aim of this study was to develop a preadjusted lingual bracket system that will be as efficient as labial orthodontics and can remove laboratory dependency. To accomplish it two parameters namely labiolingual angulation and labiolingual width were studied with the help of cast analysis.

Material & Methods: The sample consists of 100 Dental Casts (Maxillary & Mandible) of patients aged 16-20 years which were selected on the basis of Angle’s Class I molar relationship without any crowding, rotation, attrition, abrasion, erosion, abfraction and anomaly on any tooth. Dental models / Impressions were made at Santosh Dental College, Ghaziabad, and were immediately poured by Orthokal at normal room temperature. Two important parameters were studied to develop the concept of the new Preadjusted Lingual Bracket. It includes measurement and comparison of two parameters i.e. (1) Average angulation between the Labial & Lingual surface of the crown of each anterior tooth and (2) Labio-Lingual width of each anterior tooth crown at different heights to compensate for in-out discrepancy of the anterior teeth. These measurements were done on the dental models and compared with the help of appropriate statistical analysis.              

Results: In the study with cast conventional method, the maximum mean labio-lingual angulation for central incisor, lateral incisor, and canine was found to be 49.16 ± 5.18º, 49.84 ± 4.59º and 59.08 ± 4.87º respectively. The mean labio-lingual width for all three maxillary anterior teeth ranged from 2.2 ± 0.5mm at 2mm height and 6.64 ± 0.66 mm at 7 mm height, mesially, centrally, and distally in gradation with various dental heights.

Conclusion: Lingual orthodontics' future depends on technological advancements in appliance design, and laboratory operations. The preadjusted lingual system aims to provide a consistent, rapid, and economical way in the future, so many patients will choose Lingual orthodontics. especially adult patients who don't want to wear traditional visible appliances for social or professional reasons and want to maintain their appearance.

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