A retrospective study of adults with severe bimaxillary protrusion treated with customized lingual orthodontics in

Objective Objective To evaluate the treatment approach including 3D digital setup and eBrace customized lingual system, extraction pattern and anchorage design in adults with bimaxillary protrusion. Methods Fifteen Class I adults (1 men, 14 women; age, 25.5±3.1 years) treated with four first premolar extraction were included. Palatal miniscrews and transpalatal arch combined with customized lingual appliance were used. Lateral cephalometric radiographs and CBCT were obtained before and after treatment. The superimpositions of CBCT images were analyzed three-dimensionally for tooth position change. Results Cephalometric analysis showed the upper and lower incisors were retracted by 7.5 mm and 6.3 mm, respectively. The average value of UI-SN decreased (-13.2±5.2). Upper and lower lips were retracted by 4.0 mm and 6.3 mm, respectively. Mean point was retracted 1.2 mm. CBCT also showed significant retraction of incisor and canine crowns. Three-dimensional position change of maxillary molars showed no significant differences. Conclusions This study developed an approach of customized lingual orthodontics with the use of a customized transpalatal arch and anchorage design, which can be an effective modality for adults with severe bimaxillary protrusion. Key words: Customized lingual orthodontics; Severe bimaxillary protrusion; extraction; Temporary anchorage device; 3D analysis