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“invisibles” feature Forestadent Lingual Brackets by Marco Pinto, DMD Forestadent’s 2D lingual brackets are extremely flat. The 2D lingual bracket has a total thickness of 1.3 to 1.65mm. In combination with its round edges and smooth surfaces, it is the number-one bracket in terms of patient comfort. Thanks to its uncomplicated technique, it is ideally suited for clinicians who would like to enter the field of lingual orthodontics. The 2D lingual brackets were used in these cases because the patients desired an “invisible bracket” that was comfortable for their tongue. Case #1 A 24-year-old female patient presented with a Class I malocclusion with moderate maxillary and mandibular crowding. Her medical history is nonremarkable. Her chief complaint was the lower crowding. She wanted to straighten her teeth without showing metal braces. Forestadent lingual brackets were recommended. The treatment time was eight months. It is possible to bond all the way back to the molars, and use pre bent wires to accommodate the lingual surfaces of the teeth. In this case, the maxillary left first premolar was rotated. In the final pictures this was improved, as was the position of the maxillary right canine. One month Two months Three months Initial Final eight months continued on page 40 orthotown.com n October 2010 39 “invisibles” feature continued from page 39 The following is a summary of this case: Beginning Progress three months Final at eight months 40 October 2010 n orthotown.com “invisibles” feature Case #2 A 26-year-old female reported to the ASDOH clinic for postretention relapse. The patient had a nonremarkable medical history and excellent dental hygiene. The patient presented with a Class I molar and cuspid occlusion with mild crowding in the maxilla and mandibular anterior segments. In addition, a 1mm open bite in the maxillary right lateral incisor was present. The patient’s chief complaint was to fix the “lower crowding.” The patient also did not want buccal appliances. The treatment offered was Forestadent lingual brackets. Composite was bonded on the palatal surfaces of the maxillary lateral incisors to compensate for in and out positions of the teeth. The wire sequence was 013 CuNiti, 014 Niti, 016 Niti and 016 SS. The final wire included finishing bends. The patient reported comfort with the brackets, no complaints, and is thrilled with the outcome. Notice that the open bite has been reduced in the maxillary right lateral incisor area. Pretreatment Initial bonding Progress three weeks Progress eight weeks Final continued on page 42 orthotown.com n October 2010 41 “invisibles” feature continued from page 41 Case #3 A 25-year-old female patient presented with full step Class II molar and canine. She was previously treated in private practice and rejected surgical correction of her Class II. Her medical history was not remarkable. Her chief complaint was “My maxillary left central incisor has fallen back.” Modification of her maxillary Hawley retainer with a finger spring proved bothersome to the patient, and she wanted to try Forestadent lingual brackets. During treatment, some wear developed on her mandibular right canine due to clenching and grinding at night. To alleviate this, a lower essix retainer was worn at night. The wire sequence was a 014 Niti, 016 Niti and 016 SS with finishing bends. Progress eight weeks Initial Final Author’s Bio Progress two weeks Conclusion Patients treated with the Forestadent 2D lingual bracket were amazed how comfortable this bracket is. Orthodontists who use this lingual system love the fact that these brackets are easy to handle and are reasonably priced. This bracket system is a cost effective way to introduce lingual orthodontics into any practice. n 42 October 2010 n orthotown.com Dr. Marco Pinto, a native of South America, moved to the U.S. to attend college, dental school and to become certified in the orthodontic specialty. The focus of his private practice is the application and advanced study of lingual braces. Pinto has held teaching positions at University of Kentucky College of Dentistry and Arizona School of Dentistry. He is Director of the Pre-Doctoral Orthodontic Curriculum and the Orthodontic Rotation Program as well. With an outstanding commitment to community, he founded the Hispanic Dental Student Association (Bluegrass Chapter).