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Lingual orthodontics with customized functional appliance

From Volume 12, Issue 4, October 2019 | Pages 151-156


Sridhar Premkumar


Professor and Head of Orthodontics, Department of Orthodontics, Tamilnadu Government Dental College and Hospital, Chennai, India

Articles by Sridhar Premkumar

Email Sridhar Premkumar

Varun Peter

Postgraduate Student

Department of Orthodontics, Tamilnadu Government Dental College and Hospital, Chennai, India

Articles by Varun Peter


Every treatment technique in the orthodontic specialty has its own set of advantages. Combining the techniques in an effective manner could result in a synergistic effect. Two such techniques are lingual orthodontics and functional orthopaedic appliances. This case report shows the effective and efficient use of a customized functional appliance, along with lingual orthodontics, in the management of Class II division 1 malocclusion. It emphasizes the importance of combining the benefits of different strategies of orthodontic treatment.

CPD/Clinical Relevance: The use of a customized functional appliance along with lingual orthodontics can produce desirable changes in Class II division 1 cases and clinicians should be aware of these advantages.


Orthodontic treatment offers our patients improvement of mastication, speech, appearance, as well as overall health, comfort and self-esteem. Many adult patients require well aligned teeth to improve their aesthetics, as dental exposure and smile are fundamental for the aesthetics of the face. The clinical case presented is an example of treatment in a case of Class II division 1 malocclusion. This article describes the use of a customized functional appliance, along with lingual orthodontics, in an adult patient with a Class II, division 1 malocclusion treated without extraction.

An 18-year-old female patient reported to the department of orthodontics with a chief complaint of protrusive upper front teeth. No relevant medical and dental history was elicited. She was a mesomorphic individual and her facial analysis revealed an average clinical facial height. The patient also had a convex facial profile with acute nasolabial angle, deep mentolabial sulcus and incompetent lips. Intra-oral clinical examination revealed a deep overbite with a Class II molar relation, asymmetric maxillary and mandibular arches, spaced anterior dentition, with the lower midline shifted towards the patient's right side and a moderate amount of crowding in the mandibular premolar region. The upper incisors were proclined with an overjet of 14 mm (Figure 1).

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