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References

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Closure of residual space in lingual orthodontics: the linked module

From Volume 16, Issue 3, July 2023 | Page 157

Authors

Kaval Patel

BDS, MOrth, MDS, MSc, Director/Orthodontist

Specialist Orthodontist, e-Line Orthodontics Ltd, London

Articles by Kaval Patel

Email Kaval Patel

Carmen Costea

DDS, MDS, PhD

Specialist Orthodontist, e-Line Orthodontics Ltd, London

Articles by Carmen Costea

Article

In lingual orthodontics, it can be difficult to get the correct or ideal force levels for space closure, owing to the reduced inter-bracket distance. The main ways to close space are with a continuous elastomeric chain (Figure 1), or closing loops (Figure 2). Power chains are useful but are sometimes not strong enough to achieve space closure, especially in the anterior region. The author has found that a pre-stretched elastomer (module) can be a useful, simple, and easy way to get the desired outcome. (Figures 3–5).

Figure 1. Use of conventional elastic chain for space closure.
Figure 2. Use of conventional modules (elastomer) and closing loops.
Figure 3. Use of pre-stretched module (elastomer).
Figure 4. Close-up of the pre-stretched module (elastomer) for tighter space closure.
Figure 5. Patient's smile with lingual braces.

Place metal ligatures to secure the wire. This is also a fail-safe mechanism to prevent rotations in case a module breaks.

A standard module is pre-stretched and placed over two wings on two separate teeth. It is connected to the adjacent teeth as required to close residual space.

To avoid space appearing distally, place a laceback in the posterior segments.