Abstract

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Lingual orthodontics was developed for adult treatment and aesthetic reasons, but today many adolescents are seeking orthodontic treatment. They often prefer treatment with invisible or nearly invisible appliances because they want to achieve a treatment objective without aesthetic impairment. Lingual orthodontics is getting more and more popular because this appliance system deliver both high patient satisfaction and clinically excellent results. It is necessary that a lingual appliance solves every orthodontic problem (as conventional labial appliances do). Incognito™ Appliance is the only customized individually fabricated lingual orthodontic appliance. The topic of this article is to detail the Incognito™ System (particularly features and advantages).

Introduction

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The Incognito™ Appliance System was introduced to the market in 2004 as the first fully customized Lingual Bracket System in the world and, subsequently, technicians, engineers and clinical experts continued to further develop and evolve the system.

Incognito™ is suitable for tratment of all malocclusions and for all ages. It is a perfect combination of efficiency and aesthetics to achieve optimum results by means an invisible appliance. Thanks to full brackets-archwires customization, it allows the clinician to maximize quality of malocclusion corrections, predictability of treatment objectives and overall lenght of treatment. Moreover, it is also characterized by excellent aesthetics and a high level of comfort for the patient. Former problems such as discomfort, speech alteration, finishing difficulties, particular tooth anatomy have been overcome.

Clinicians have available two types of appliances: Incognito™ Appliance System and Incognito™ Lite Appliance System.

Fig. 1. Incognito™ Lite Appliance System and Incognito™ Appliance System.

Table I. Differnces between Incognito™ Lite Appliance System and Incognito™ Appliance System.

Discussion

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To begin Incognito™ therapy, the clinician have to take a two-phase, two step PVS (polyvinyl siloxane) impression. The plaster models are then used to prepare an individualized therapeutic setup (manual or digital setup). A 3D scanner scans the setup to create a complete 3D digital representation of the teeth: it consists of many thousands of triangles that can be observed and processed in the computer. CAD/CAM software is used to produced a truly individualized appliance: it design and build customized brackets (with large pad surfaces that provide improved bond retention). Brackets are made out of a dental gold alloy, which ensures optimum precision, additional comfort and a low risk of allergies.

Fig. 2. Bracket.

Customized archwires are realized by the CAD/CAM program and each one in the sequence has the same geometry, target to the final position of the teeth. The appliance is designed with 2nd and 3rd order prescription values built into the custom brackets, while 1st order values are built into the archwire.

Fig. 3. Manufacturing process.

Incognito™ has several advantages.

Table II. Advantages of this appliance.

The Incognito™ Appliance System presents a double insertion: the same archwire is inserted vertically from canine to canine and horizontally from first premolar to second molar.

Conclusions

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The growing demand for aesthetic treatment (both in younger and adult patients) necessitates a fixed appliance system with specific characteristics. The Incognito™ Appliance System seems to be the ideal solution. In fact, it is a perfect combination of efficiency and aesthetics to achieve optimum results by means an invisible appliance.

Fig. 4. The Incognito™ Appliance System is suitable for tratment of all malocclusions and for all ages. It is an invisible appliance with a perfect combination of efficiency and excellent aesthetics. It is also characterized by a high level of comfort for the patient.

The high quality technology that characterizes the laboratory processes allows to create an individually targeted setup. This is used as a basis for designing an optimized appliance. Utilizing this technology (including CAD/CAM design), the Incognito™ System allows full customization of each bracket for each tooth for each patient.

It is the first fully customized appliance and this system delivers both high patient satisfaction and clinically excellent results. The end result is a precision appliance that provides optimum patient comfort combined with minimal speech disruption, and at the same time provides easier and fully predictable finishing of every case.

References

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1. Demling A, Dittmer MP, Schwestka-Polly R. Comparative analysis of slot dimension in lingual bracket systems. Head Face Med. 2009 Dec 15;5:27
2. Grauer D, Proffit WR. Accuracy in tooth positioning with a fully customized lingual orthodontic appliance. Am J Orthod Dentofacial Orthop. 2011 Sep;140(3):433-43
3. Wiechmann D, Rummel V, Thalheim A, Simon JS, Wiechmann L. Customized brackets and archwires for lingual orthodontic treatment. Am J Orthod Dentofacial Orthop. 2003 Nov;124(5):593-9
4. van der Veen MH, Attin R, Schwestka-Polly R, Wiechmann D. Caries outcomes after orthodontic treatment with fixed appliances: do lingual brackets make a difference? Eur J Oral Sci. 2010 Jun;118(3):298-303.

Source(s) of Funding

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No source of funding.

Competing Interests

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No competing interests.