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CAD/CAM - international magazine of digital dentistry

I 23 case report _ CAD/CAM lingual orthodontic system I CAD/CAM 3_2013 CAD/CAM lingual system. Obviously, the results reflect the effects of not only the proclination of the mandibular anterior teeth, but also the relief of crowding in both arches and the accuracy of the model in reflecting the final result (Fig. 5). We still hadtoperforminterproximalreductioninthemax- illary arch to achieve a normal overbite and overjet, with the canines in a Class I relationship. Another treatment option would have been to extract the maxillary and mandibular first premolars. However, this was not a favourable treatment alternative owing to its negative effect on the facial profile. Performing lingual orthodontic treatment for each patient in the average orthodontic office is now a reality. The treatment results are of a high level, and all our patients may benefit from an in- visible appliance. Former problems, such as dis- comfort, speech alteration, finishing inaccuracies, and particular tooth anatomy, can be overcome in this manner.5 The extraction of the mandibular incisors con- stitutes a therapeutic alternative in treating cer- tain anomalies. It is not a standard approach to symmetrically treating most malocclusions, but the therapeutic aims must be adjusted in certain clinicalsituationstoindividualpatientneeds,even when this means that the final occlusion achieved isnotideal.Thedeliberateextractionofamandibu- lar incisor in certain cases allows the orthodontist to improve occlusion and dental aesthetics with minimal orthodontic treatment. In all cases, how- ever, a diagnostic cast is required to predetermine the occlusal possibilities precisely.6 _Conclusion The key to success in lingual orthodontics in terms of both professional and patient satisfac- tion is practice and training. The Incognito system can be used for all types of malocclusions with the same precision as labial braces. The possibility of incisor extraction should be a partofeveryclinician’sportfoliooftreatmenttech- niques. If it is planned carefully and executed prop- erly, incisor extraction can be an effective way of satisfying a particular set of treatment objectives._ Editorial note: A complete list of references is available fromthepublisher. Dr Khaled Abouseada is a consulting orthodontist involved in private practice in SaudiArabia,Bahrain and Egypt.He lectures orthodontics at the Batterjee Medical College and SpecializedAcademy for MedicalTraining.He has lectured at many international dental and orthodontic forums. He is a certified trainer for CAD/CAM orthodontics and serves on the editorial board of DentalTribune Middle East.He won the I Love My DentistAward in 2010–2012 and the MENAAward for Orthodontic Best Case in 2010–2012. Dr Khaled M.Abouseada Asnani Dental Clinic P.O.Box 122721 Jeddah 21332 SaudiArabia CAD/CAM_about the author Fig. 5d Fig. 5e Fig. 5f Fig. 5g