Lingual appliances have evolved through several generations of design, reflecting many years of trial and error. The most recent lingual brackets incorporate an increased tie wing area for easier ligation and improved gingival clearance ; modified ball hoo´c,, with slot ramps for improved lagation, elastic wear, and patient comfort ; reduced bracket size ; modified bite plane design ; and modified bracket base thicknesses to minimize 1st order bends.
With these improvements, as well as the advancements made in the laboratory set-up and bonding procedures, the lingual technique can be readily incoporated into busy practice. Sucess depends on good patient communications, sound diagnostic principles, and proper treatment mechanics.
Lingual patients must be well educated in oral hygiene. Oral hygiene instructions should cover the use of floss and floss threaders, dietary restrictions, a fluoride regimen, and routine prophylaxis.
However predetermined formulas may not always be reliable. We must depend upon the experience and judgment of the orthodontist to make final determination.
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