Complex Treatment Procedures using the Lingual Technique

The Lingual Technique even allows very complex treatment procedures to be carried out reliably. Our second case history is that of a 59-year old woman with pronounced overcrowding and sticking-out teeth at 11/21, whose treatment had been complicated by the loss of 17, a hemisection at 36 and numerous precautionary and prosthetic repairs of varying quality. In spite of having 8 mm less space in the lower teeth quadrant, she refused extraction and would not accept any kind of appliance that would be visible from the outside. After conducting an extensive consultation with her, we agreed on a treatment plan involving a lingual device and extensive approximal enamel reduction in both teeth quadrants. After carrying out an enamel reduction on the 1. molars and premolars in the lower jaw, retraction of the canines was necessary before anything could be properly stuck onto the front teeth. In adult patients with frontal overcrowding, approximal enamel reduction is very often necessary for aesthetic reasons because, unless the width of the crowns are reduced after fixing the overcrowding, extensive black triangles will be visible between the teeth and these can disturb the overall aesthetic appearance in spite of the teeth now being straight. Without extensive enamel reduction in the front teeth, achieving such an aesthetically pleasing result as we did with this patient would have been simply impossible.