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. 2017 Oct 10;13(1):18.
doi: 10.1186/s13005-017-0152-2.

Single tooth torque correction in the lower frontal area by a completely customized lingual appliance

Collin Jacobs  1 , Milena Katzorke  2 , Dirk Wiechmann  2   3 , Heiner Wehrbein  4 , Rainer Schwestka-Polly  3
Affiliations

Single tooth torque correction in the lower frontal area by a completely customized lingual appliance

Collin Jacobs et al. Head Face Med. .

Abstract

Background: Aim of this study was to analyze the efficacy and precision of the completely customized lingual appliance (CCLA) regarding the single tooth torque correction. The study also examined external apical root resorptions as possible side effects of torque correction and the changings of the periodontal situation.

Methods: A case series of three patients were included. The patients showed a single tooth torque problem with a gingival recession and were treated with the CCLA. Plaster casts before and after treatment and plaster casts of the set up were scanned and superimposed. Deviations between the two plaster casts were analyzed at different points of interest. Changes of the gingival recession were compared before and after treatment. Relative root resorptions were measured by the orthopantomograms. Treatment times were assessed by the records of the patients. Results were presented descriptively.

Results: The mean change of the most apical part of the root reached by the orthodontic treatment was 1.8 ± 0.3 mm. The largest deviation between set up and final model was measured on the occlusal surface of the tooth 36 with 0.8 mm. Most measurement points showed a deviation of 0.5 mm or less. The depths of the gingival recession showed a significant reduction of 4.7 mm. The widths of the gingival recession were reduced by 1.1 mm. The average relative root resorption of the corrected teeth was 2.7 ± 1.5%. The average treatment time was 13.8 ± 4.5 months.

Conclusions: This is the first study showing that the CCLA with its high precision is very effective in correcting single tooth torque problems. Orthodontic torque correction resulted in a significant reduction of gingival recessions and caused only negligible root resorptions.

Keywords: Lingual appliance; Periodontal recession; Root resorption; Torque correction.

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Conflict of interest statement

Ethics approval and consent to participate

Due to the medical law of Rheinland-Pfalz (Germany), for a retrospective study there is no need for an ethics approval. No additional examinations were performed for this study and all data were anonymized. All patients signed the informed consent form to participate.

Consent for publication

All patients gave their consent for publication.

Competing interests

DW is the inventor of the WIN system. The WIN system is manufactured by DW LingualSystems and DW is the CEO of this company. All other authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
A completely customized lingual appliance (WIN, DW Lingual Systems, Bad Essen, Germany) bonded to the lingual surfaces of the teeth in the lower jaw
Fig. 2
Fig. 2
Representation of a superposition of two plaster casts (before and after treatment). Different colors show the amount of position change, which can be measured by the software at any point of interest
Fig. 3
Fig. 3
Orthopantomogram of a patient before orthodontic treatment. Lengths of the crown and root of the incisor with the torque discrepancy was measured and compared to the lengths of the crown and the root after treatment
Fig. 4
Fig. 4
Example of a 3D superimposition of the plaster cast before treatment and after treatment. Different colors show the amount of tooth movement. In this case changes of the most apical point of the lingual recession (white arrow) at tooth 42 were measured
Fig. 5
Fig. 5
Example of a 3D superimposition of the set up and the final situation after treatment. Different colors show the amount of deviation. Different points of the arch were analyzed and the deviations in every axis of the coordinate system were observed. Target points were on the middle of the occlusal surface of the teeth 36 and 46, the top of the canines 33 and 43 and the most apical point of the recession at the affected teeth
Fig. 6
Fig. 6
Intraoral clinical pictures of the three patients (I-III) before (upper line) and after orthodontic treatment (lower line)
See this image and copyright information in PMC

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