Digital technologies and CAD / CAM systems applied to lingual orthodontics : The future is already a reality

Lingual orthodontics has been gaining space around the world due to its particularity to offer a discreet treatment option, “invisible”, in “secret” for the correction of malocclusion, combining biomechanical efficiency and enhancement of the smile during treatment. As the brackets are on the lingual surface, the point of force application is closer to the center of resistance, maximizing the potential of induced tooth movement, which results in faster clinical achievements and significant control over the mechanics. A landmark study was published in 2001,by Dr. Scuzzo and Dr. Takemoto,9 which gave new perspective to lingual orthodontics describing the possibility of permanently eliminating compensating bends, with a Straight-Wire system, based on differential bracket positioning, placed more to the cervical region of the tooth. Within this context, the PSWb6 (Prieto Straight-Wire brackets), a Brazilian bracket that is now in its third generation, was developed based on three principles: more cervical bonding (base without gingival extension beyond the slot, higher gingival wing far from the gums), anterior bracket profile slightly increased (compensation for the StraightWire technique can be possible); distal offset in the canine bracket, the second premolar bracket with its profile slightly higher than the first premolar bracket. It is important to mention that this bracket enables the simplified indirect bonding technique as a routine in orthodontics practice, facilitating bonding, mechanics during treatment and finishing (Fig 1). The development of new technologies in image scanning and digital programs enabled the emergence of systems based on an ideal digital setup as reference for bracket positioning with remarkable accuracy by eliminating laboratory steps and, therefore, the chances of errors in them. The Orapix® system represents a major advance and was the result of a partnership between a company in South Korea and Dr. Fillion,2 allowing the use of the Straight-Wire technique in lingual orthodontics, with any kind of brackets, W h a t ́ s n e W i n D e n t i s t r y