|
|
|
|
|
|
Labial versus Lingual Orthodontics:
A 20 year retrospective time, cost, and clinical outcome comparison
Klaus Gerkhardt, Germany
www.lingualnews.com, Volume 1 Number 2 - March 2003
|
|
|
|
|
|
|
Two groups, each consisting of 25 consecutively treated adult patients, the first with labial and the second by lingual orthodontics were compared as to treatment time and cost, and clinical outcome.
Mean age for the lingual group was 26,5 years and for the labial group 28,84 years. Sex distribution is described in Figure 1, and the ratio of extraction to non extraction cases is described in Figure 2. |
|
|
|
|
|
|
 |
 |
|
|
|
|
|
|
Fig 1: Ratio of sex in labial and ligual groups |
Fig 2: Ratio of extraction and non extraction cases |
|
|
|
|
|
|
Lingual patients: |
|
|
|
|
|
|
 |
|
|
|
|
|
|
Labial patients: |
|
|
|
|
|
|
 |
|
|
|
|
|
|
The above tables show that the average treatment time in the lingual group was 34.6 months, and 14.5 months for the labial group (fig 3,4). In addition, chairtime invested by the doctor ran 791.4 minutes (i.e. 13.2 hours) for the lingual patients, but only 536.8 minutes (i.e. 8.9 hours) for labially treated patients (Fig 5). Furthermore, auxiliary staff spent 643 and 926.4 minutes on the labial and lingual patients, respectively.
Meaning, lingual therapy consumes 48% more time in the office than labial treatment.
|
|
|
|
|
|
|
 |
|
|
|
|
|
|
 |
|
|
|
|
|
|
Fig 3,4: Treatment time for the labial and lingual groups |
|
|
|
|
|
|
 |
Fig5: Chairside time for the lingual group. |
|
|
|
|
|
|
Deligation of duty depends very much on the legal regulations of each region. In my office all bonding, archwire bending and ligating as well as debonding must be done by the doctor only. Therefore, the distribution of time is reflected in the above description. On the other hand, increased delegation may result in increased chairtime for the individual patient. In this evaluation, an assistant is only permitted to undertake the following adjunct procedures:
- cleaning the tooth surface before bonding and following debonding
- instructing patients with regard to tooth brushing, flossing, etc.
- coaching patients about speech and tongue problems
The average risk of bracket loss was found to be 2.86 and 4.7 brackets for the labial and lingual groups, respectively (Fig 6). |
|
|
|
|
|
|
 |
|
|
|
|
|
|
Fig 6: Bracket failure in the labial and lingual groups |
|
|
|
|
|
|
Conclusion:
Doctor's chairtime is 47 % greater in administering lingual orthodontic therapy. This difference exists despite the use of light curing bonding agents, as well as other ergonomic materials. The risk of bracket loss is higher in the lingual technique, however, it should be noted that the lingual cases were bonded 7 to 7 and labial cases were only bonded 5 to 5 with the 6´s and 7´s banded. |
www.lingualnews.com
Adult and Lingual Orthodontics
EDITORS:
Dr. Silvia Geron D.M.D., M.Sc
Dr. Rafi Romano D.M.D., M.Sc
Dr. Pablo Echarri D.M.D., M.Sc
|
|
|
|
|
|
|
 |
|
|
|
|
|
|
