Lingual Orthodontic Treatment: Efficacy and Complications

Aims and Objectives: The high esthetic demands led to the promotion of various esthetic appliances like lingual orthodontics. This study aimed to review clinical outcome and potential complications of lingual orthodontics to achieve an evidence-based decision for orthodontic therapies.Materials and Methods: A comprehensive electronic search was conducted from January 1975 to March 2019 which was limited to English language and administrations of lingual orthodontics treatment which evaluated its efficacy and potential complications. Data extraction was performed according to the PRISMA statement.Results: 49 studies were selected and analyzed in this systematic review. The pain of lingual appliances starts a little earlier and lasts longer, and patients with lingual appliances experience more tongue discomfort and less cheek and lip pain and greater eating difficulties especially after placement and take a longer time to adapt to appliances. Lingual appliances generally cause more plaque accumulation and gingivitis especially in lingual anterior teeth; however, labial appliances are associated with high frequency in posterior maxillary teeth.Conclusion: This systematic review shows that despite the drawbacks of these appliances such as pain and eating difficulties, they can accomplish treatment goals with the same outcomes in comparison with conventional approaches, within the same duration and even lesser anchorage loss.