Aim: Treatment of adult patients with advanced periodontal disease is a challenge to the orthodontist using lingual appliance therapy, which is the preferred technique for many adult patients due to its relative invisibility. The lingual technique has been shown to be capable of correcting severe malocclusions, deep bite as well as open bite cases. However, the treatment mechanics are different from the labial technique and require different considerations.
Methods: The potential problems during lingual orthodontic treatment of patients with advanced periodontal disease are discussed, including esthetics during and after orthodontic treatment, efficacy of treatment, adaptation of biomechanics, etc. Three cases are presented to demonstrate the problems and solutions.
Conclusion: Successful treatment of patients with advanced periodontal disease using the lingual appliance requires specific considerations and a biomechanical approach.