USTOM-MADE INGUAL in 3 steps 10 keys to the CLO3 technique 3 Dr. Pablo A. Echarri
3 USTOM-MADE INGUAL 3 The CLO Technique (Custom-made Lingual Orthodontics) has its simplified version CLO3 (Custom-made Lingual Orthodontics in 3 Steps) used in the treatment of malocclusions that affect only the anterior teeth: incisors and canines. st st The lingual brackets are bonded only from 1 bicuspid to 1 bicuspid, and the laboratory prepares the kit which contains the lingual brackets with customized prescription, the transfer trays for indirect bonding, and two arches to be used in the treatment, as well as the arch template used for arch design. The treatments are 4 to 6 months long, and during this treatment, two arches are used, although it may be necessary to introduce the third arch for finishing in some cases. The Adenta JOY brackets are used, and the prescription is customized in the laboratory. The CLO3 technique makes the training of lingual orthodontics easier, both for doctors and technicians. SIMPLICITY WITHOUT LOSING THE CONTROL 2013 Centro de Ortodoncia y ATM, Ladent, SL All rights reserved This book or any part thereof may not be reproduced, stored in retreival system or transmitted in any form or by any means electronic, mechanical, photocopying or otherwise, without prior written permission of the publishers.
10 KEYS TO THE 3 3 TECHNIQUE 1- Selection of the patient. 2- Diagnosis. Treatment plan. 3- Lingual brackets. 4- Prescription customizing. 5- Bonding and rebonding. 6- Customized arch template. 7- Sequence of arches. 8- Finishing. 9- Permanent retention. 10- Patient s comfort.
3 USTOM-MADE INGUAL 3 1Selection of the patient The lingual orthodontics allows the treatment of all cases, but not of all patients. Here are the most favorable and most unfavorable cases. Cases with mild anterior spacing and anterior deep bite. Flat and long lingual surfaces of the teeth, without resorations, crowns and prosthesis. Good gingival and periodontal health. Ideal cases to start the treatment Cases with mild anterior crowding and anterior deep bite. Patient with good molar/bicuspid occlusion. Difficult cases to start the treatment Reduced opening of the mouth (trismus). Cervical pathology of the neck which prevents the patient from the possiblity to have the extended head during the appointment. Short and irregular lingual surfaces of the teeth. Multiple crowns and fillings. Multiple rotations. Patient with low level of cooperation. 2Diagnosis and treatment plan The patient should be informed and motivated to overcome the tongue discomfort and chewing and pronunciation difficulties during the first weeks of the treatment. Diagnosis and treatment plan Customized diagnosis of the position of each tooth. Customized diagnosis of the size of each tooth. Decision on which movements should be carried out. Planning of the prescription customizing. Planning of arch customizing.
USTOM-MADE INGUAL 3 3 3Lingual brackets The JOY brackets offer the maximum of comfort to the patient, and a simple, low friction mechanics to the clinician. 4Prescription customizing The treatment protocol should be customized according to: - The characteristics of the patient. - The characteristics of the case. The prescription is customized in the laboratory, using the Set-Up Model Maker (SUM), Occlusal Plane Reference (OPR) y Accuracy Bracket Positioner (ABP). Set-up Model Maker (SUM) Occlusal Plane Reference (OPR) Accuracy Bracket Positioner (ABP)
3 USTOM-MADE INGUAL 3 5Bonding and rebonding The bonding and rebonding techniques are carried out with reusable trays. 6Customized arch template If necessary, the template allows the adaptation of arches, and it is customized according to the prescription.
USTOM-MADE INGUAL 3 3 7Sequence of arches The treatments are 4 to 6 months long. Two arches are usually used, and they are included in the CLO3 Kit. First arch Second arch 8Finishing If necessary, the finishing arch is carried out.
3 USTOM-MADE INGUAL 3 9Permanent retention Permanent, fixed double retention is recomended, as well as CA Clear Aligner Retention. Double retention. 10Patient s comfort The training of the patient in hygiene and comfort should be carefully carried out.
3 3 KIT A CLO3 Kit contains: st st 1. JOY lingual brackets from 1 bicuspid to 1 bicuspid. 2. Individual transfer trays for indirect bonding. 3. Customized arch template. 4. First arch. 5. Second arch. SIMPLICITY WITHOUT LOSING THE CONTROL
3 USTOM-MADE INGUAL 3 References BOOKS Echarri P. Segmental lingual orthodontics in multidisciplinary cases. En: Romano R, editor. Lingual Orthodontics. Ontario (Canada): Ed. B.C. Decker; 1998. Echarri P. Ortodoncia Lingual. Técnica completa paso a paso. Barcelona (España): Nexus Ediciones S. L.; 2003. Echarri P. Lingual orthodontics. Complete technique, step by step. Barcelona (Spain): Nexus Ediciones S. L.; 2003. Echarri P. Ortodoncia Lingual. Técnica completa paso a paso. Seoul (Corea del Sur): Public; 2003. (en coreano) Echarri P. La Ortodoncia Lingual en el siglo XXI. En: Libro de Congreso de la AIO 2008, Madrid (España): Ripano Médica; 2008. Echarri P, Uribe Restrepo G. Capítulo 43. Ortodoncia lingual. En: Ortodoncia. Teoría y clínica. Medellín (Colombia): Corporación para investigaciones biológicas; 2010. pp. 742-52. Echarri P, editor. Nuevo enfoque en ortodoncia lingual. Madrid (España):Ripano Médica; 2010 Echarri P, editor. New approach in lingual orthodontics. Madrid (España):Ripano Médica; 2010 Echarri P. Microimplants and lingual orthodontics. In: Romano R, editor, Geron S, Echarri P, associate editors. Lingual & esthetic orthodontics. London (United Kingdom):Quintessence Publishing; 2011. SCIENTIFIC ARTICLES Echarri P. Técnica de posicionamiento de brackets linguales Class System. Revista Iberoamericana de Ortodoncia 1997;16:1-17. 6.Echarri P. Carillas linguales de porcelana como retención permanente en casos de mordida profunda. Ortod Clin 1998;1(1):3-13. Echarri P, Baca A. Ortodoncia lingual. Determinación de la forma del arco. Revista Iberoamericana de Ortodoncia 1998;17:1-8. Echarri P. Procedimiento para el posicionamiento de brackets en Ortodoncia Lingual. (Parte I). Ortod Clin 1998; 1(2):69-77. Echarri P. Procedimiento para el posicionamiento de brackets en ortodoncia lingual. (Parte II). Ortod Clin 1998;1(3):107-17. Echarri P. Segmental lingual orthodontics in preprosthetic cases. J Clin Orthod 1998;32:716-9. Echarri P. Ortodoncia lingual. Puesta al día del procedimiento clínico de cementado indirecto. (Parte III). Ortod Clin 1999;2(1):28-36. Echarri P. 15 claves para optimizar los tratamientos de ortodoncia lingual. Cúspide 1999;(2):6-10. Echarri P. Técnica lingual (Parte IV). Preparación de la boca en 10 pasos. Ortod Clin 1999;2(2):74-81. Echarri P. Ortodoncia lingual. V parte. Tratamiento con extracciones. Ortod Clin 2000;3(1):22-31. Echarri P. Ortodoncia lingual. VI-A parte. Tratamiento sin extracciones. Ortod Clin 2000;3(2):86-93. Echarri P. Ortodoncia lingual. VI-B parte. Tratamiento sin extracciones. Ortod Clin 2000;3(3):132-42. Echarri P. Ortodoncia lingual. VII parte. Terminación de casos. Ortod Clin 2000;3(4):206-12. Echarri P. Ortodoncia lingual. VIII-A parte. Materiales e instrumental utilizados y confort del paciente. Ortod Clin 2001;4(1):40-8.
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