Journal Article

Self-ligating fully customized lingual appliance and chair-time reduction: a typodont study followed by a randomized clinical trial

Domenico Dalessandri, Elena Lazzaroni, Marco Migliorati, Maria Grazia Piancino, Ingrid Tonni and Stefano Bonetti

in The European Journal of Orthodontics

Published on behalf of European Orthodontics Society

Volume 35, issue 6, pages 758-765
Published in print December 2013 | ISSN: 0141-5387
Published online November 2012 | e-ISSN: 1460-2210 | DOI: https://dx.doi.org/10.1093/ejo/cjs093
Self-ligating fully customized lingual appliance and chair-time reduction: a typodont study followed by a randomized clinical trial

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SUMMARY

In this study, we tested the hypothesis that self-ligation can reduce the chair time necessary for inserting and removing the archwire in a fully customized, multi-bracket, orthodontic, lingual appliance. A permuted-block, randomized trial design was employed to treat seven patients, each with Incognito® lingual appliances and Harmony® self-ligating lingual appliances. Three operators (a third year resident in orthodontics, an orthodontic specialist, and an experienced lingual orthodontist) were instructed, and they were allowed to familiarize themselves with two typodonts. Next, the operators were asked to insert and remove a.014 NiTi customized archwire for each patient, and they were timed. The time required for removing and inserting archwires decreased proportionally with operator experience: it was shorter with self-ligating appliances (114.82±18.06 seconds versus 595.83±289.09 seconds, P < 0.001) and when testing the typodonts’ performances (480.61±285.74 seconds versus 518.65±296.97 seconds, P < 0.001). However, differences between operators were smaller when using typodonts (31.77±21.19 seconds versus 43.87±27.06 seconds, P < 0.001) and with self-ligation (15.17±9.29 seconds versus 45.37±25.44 seconds, P < 0.001). In vivo performance improved after typodont training, allowing for difference reductions between operators. Lingual self-ligation appears to require less hands-on ability and training of the orthodontist, for reduction of chair time.

Journal Article.  4105 words.  Illustrated.

Subjects: Restorative Dentistry and Orthodontics

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