CUSTOM-MADE
LINGUAL
ORTHODONTICS
in
3 steps
10 keys to the CLO3 technique
3
CLO
Dr. Pablo A. Echarri
CLO 3
CUSTOM-MADE LINGUAL ORTHODONTICS3
The CLO Technique (Custom-made Lingual Orthodontics) has its simplified version CLO3
(Custom-made Lingual Orthodontics in 3 Steps) used in the treatment of malocclusions that
affect only the anterior teeth: incisors and canines.
The lingual brackets are bonded only from 1st bicuspid to 1st bicuspid, and the laboratory
prepares the kit which contains the lingual brackets with customized prescription, the
transfer trays for indirect bonding, and two arches to be used in the treatment, as well as the
arch template used for arch design.
The treatments are 4 to 6 months long, and during this treatment, two arches are used,
although it may be necessary to introduce the third arch for finishing in some cases.
The Adenta JOY brackets are used, and the prescription is customized in the laboratory.
The CLO3 technique makes the training of lingual orthodontics easier, both for doctors and
technicians.
SIMPLICITY WITHOUT LOSING THE CONTROL
© 2013 Centro de Ortodoncia y ATM, Ladent, SL
All rights reserved
This book or any part thereof may not be reproduced, stored in retreival system or transmitted in any form or by any means electronic,
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10 KEYS TO THE
3
CLO
1- Selection of the patient.
2- Diagnosis. Treatment plan.
3- Lingual brackets.
4- Prescription customizing.
5- Bonding and rebonding.
6- Customized arch template.
7- Sequence of arches.
8- Finishing.
9- Permanent retention.
10- Patient’s comfort.
3
TECHNIQUE
CLO 3
1
CUSTOM-MADE LINGUAL ORTHODONTICS3
Selection of the patient
The lingual orthodontics allows the treatment of all cases, but not of all patients. Here are the most
favorable and most unfavorable cases.
Ideal cases to start the treatment
Cases with mild anterior crowding and anterior deep bite.
Cases with mild anterior spacing and anterior deep bite.
Flat and long lingual surfaces of the teeth, without resorations, crowns and prosthesis.
Good gingival and periodontal health.
Patient with good molar/bicuspid occlusion.
Difficult cases to start the treatment
Reduced opening of the mouth (trismus).
Cervical pathology of the neck which prevents the patient from the possiblity to have the
extended head during the appointment.
Short and irregular lingual surfaces of the teeth.
Multiple crowns and fillings.
Multiple rotations.
Patient with low level of cooperation.
2
Diagnosis and treatment plan
The patient should be informed and motivated to overcome the tongue discomfort and chewing and
pronunciation difficulties during the first weeks of the treatment.
Diagnosis and treatment plan
Customized diagnosis of the position of each tooth.
Customized diagnosis of the size of each tooth.
Decision on which movements should be carried out.
Planning of the prescription customizing.
Planning of arch customizing.
CUSTOM-MADE LINGUAL ORTHODONTICS3
3
CLO 3
Lingual brackets
The JOY brackets offer the maximum of comfort to the patient, and a simple, low friction mechanics
to the clinician.
4
Prescription customizing
The treatment protocol should be customized according to:
- The characteristics of the patient.
- The characteristics of the case.
The prescription is customized in the laboratory, using the Set-Up Model Maker (SUM), Occlusal
Plane Reference (OPR) y Accuracy Bracket Positioner (ABP).
Set-up Model Maker (SUM)
Occlusal Plane Reference (OPR)
Accuracy Bracket Positioner (ABP)
CLO 3
5
CUSTOM-MADE LINGUAL ORTHODONTICS3
Bonding and rebonding
The bonding and rebonding techniques are carried out with reusable trays.
6
Customized arch template
If necessary, the template allows the adaptation of arches, and it is customized according to the
prescription.
CLO 3
CUSTOM-MADE LINGUAL ORTHODONTICS3
7
Sequence of arches
The treatments are 4 to 6 months long. Two arches are usually used, and they are included in the
CLO3 Kit.
First arch
8
Finishing
If necessary, the finishing arch is carried out.
Second arch
CLO 3
9
CUSTOM-MADE LINGUAL ORTHODONTICS3
Permanent retention
Permanent, fixed double retention is recomended, as well as CA Clear Aligner Retention.
Double retention.
10
Patient’s comfort
The training of the patient in hygiene and comfort should be carefully carried out.
3
CLO
KIT
3
A CLO3 Kit contains:
1. JOY lingual brackets from 1st bicuspid to 1st bicuspid.
2. Individual transfer trays for indirect bonding.
3. Customized arch template.
4. First arch.
5. Second arch.
SIMPLICITY WITHOUT LOSING THE CONTROL
CLO 3
CUSTOM-MADE LINGUAL ORTHODONTICS3
References
BOOKS
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Echarri P. Segmental lingual orthodontics in multidisciplinary cases. En: Romano R, editor.
Lingual Orthodontics. Ontario (Canada): Ed. B.C. Decker; 1998.
Echarri P. Ortodoncia Lingual. Técnica completa paso a paso. Barcelona (España): Nexus
Ediciones S. L.; 2003.
Echarri P. Lingual orthodontics. Complete technique, step by step. Barcelona (Spain): Nexus
Ediciones S. L.; 2003.
Echarri P. Ortodoncia Lingual. Técnica completa paso a paso. Seoul (Corea del Sur): Public; 2003.
(en coreano)
Echarri P. La Ortodoncia Lingual en el siglo XXI. En: Libro de Congreso de la AIO 2008, Madrid
(España): Ripano Médica; 2008.
Echarri P, Uribe Restrepo G. Capítulo 43. Ortodoncia lingual. En: Ortodoncia. Teoría y clínica.
Medellín (Colombia): Corporación para investigaciones biológicas; 2010. pp. 742-52.
Echarri P, editor. Nuevo enfoque en ortodoncia lingual. Madrid (España):Ripano Médica; 2010
Echarri P, editor. New approach in lingual orthodontics. Madrid (España):Ripano Médica; 2010
Echarri P. Microimplants and lingual orthodontics. In: Romano R, editor, Geron S, Echarri P,
associate editors. Lingual & esthetic orthodontics. London (United Kingdom):Quintessence
Publishing; 2011.
SCIENTIFIC ARTICLES
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Echarri P. Técnica de posicionamiento de brackets linguales Class System. Revista Iberoamericana
de Ortodoncia 1997;16:1-17.
6.Echarri P. Carillas linguales de porcelana como retención permanente en casos de mordida
profunda. Ortod Clin 1998;1(1):3-13.
Echarri P, Baca A. Ortodoncia lingual. Determinación de la forma del arco. Revista Iberoamericana
de Ortodoncia 1998;17:1-8.
Echarri P. Procedimiento para el posicionamiento de brackets en Ortodoncia Lingual. (Parte I).
Ortod Clin 1998; 1(2):69-77.
Echarri P. Procedimiento para el posicionamiento de brackets en ortodoncia lingual. (Parte II).
Ortod Clin 1998;1(3):107-17.
Echarri P. Segmental lingual orthodontics in preprosthetic cases. J Clin Orthod 1998;32:716-9.
Echarri P. Ortodoncia lingual. Puesta al día del procedimiento clínico de cementado indirecto.
(Parte III). Ortod Clin 1999;2(1):28-36.
Echarri P. 15 claves para optimizar los tratamientos de ortodoncia lingual. Cúspide 1999;(2):6-10.
Echarri P. Técnica lingual (Parte IV). Preparación de la boca en 10 pasos. Ortod Clin 1999;2(2):7481.
Echarri P. Ortodoncia lingual. V parte. Tratamiento con extracciones. Ortod Clin 2000;3(1):22-31.
Echarri P. Ortodoncia lingual. VI-A parte. Tratamiento sin extracciones. Ortod Clin 2000;3(2):8693.
Echarri P. Ortodoncia lingual. VI-B parte. Tratamiento sin extracciones. Ortod Clin 2000;3(3):13242.
Echarri P. Ortodoncia lingual. VII parte. Terminación de casos. Ortod Clin 2000;3(4):206-12.
Echarri P. Ortodoncia lingual. VIII-A parte. Materiales e instrumental utilizados y confort del
paciente. Ortod Clin 2001;4(1):40-8.
CUSTOM-MADE LINGUAL ORTHODONTICS3
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CLO 3
Echarri P. Ortodoncia lingual VIII-B parte. Materiales e instrumental utilizados y confort del
paciente. Ortod Clin 2001; 4(2): 95-102.
Baca A, Echarri P. Ortodoncia lingual. 10 años de experiencia en el posicionamiento indirecto de
brackets. Ortod Clin 2001;4(3):142-50.
Echarri P. Posibilidades terapéuticas de la ortodoncia lingual. Profesión Dental 2001;4:40-3.
Echarri P. Introducción a la ortodoncia lingual. Cúspide 2001 noviembre;(5):4-14.
Echarri P. Sagittal and vertical control in lingual orthodontics. J Lingual Orthod 2002;2:48-56.
Echarri P. Comparación de los tratamientos ortodóncicos realizados con ortodoncia vestibular y
con ortodoncia lingual. Rev Esp Ortod 2002;32:207-32.
Echarri P. How to obtain the maximum benefits from the lingual archwires. J Japan Ling Orthod
Association (JJLOA) 2002;13:2-13.
Echarri P. Comparison between sliding and loops mechanics. Its influence on torque and vertical
problems. Virtual J Lingual News 2003 marzo; 1(2):[9]. Disponible en www.lingualnews.com
Echarri P. Lingual Orthodontics. Bracket set-up using Model Checker, Slot Machine, and CRC
Ready Made Core Trays. Korean J Lingual Orthod 2003; 2: 58-71.
Echarri P. Lingual Orthodontics: An up-date of the bracket positioning and bonding procedures. J
Orthod Society and Research of Thailand 2003;3:1-14
Echarri P. Corrección de la mordida profunda anterior y de la mordida abierta anterior con técnica
de arcos dobles y con brackets vestibulares y linguales. Ortod Esp 2003;43:240-51.
Echarri P. Quince nuevas claves para el éxito en ortodoncia lingual. Maxillaris 2004;62:46-54.
Echarri P. Utilización de los arcos linguales. Maxillaris 2004;64:150-164.
Echarri P. Comparación del cierre de espacio con diferentes mecánicas de deslizamiento en
ortodoncia lingual. Rev Esp Ortod 2004;34(2):139-47.
Echarri P. Ortodoncia lingual y cirugía ortognática. Cúspide 2004 sept;(9):10-5.
Tsuruta M, Hong RK, Echarri P. Método de ajuste indirecto de arcos en técnica lingual. Ortod Clin
2006;9(1):18-20.
Echarri P. Lingual Technique Indirect Bonding: Double Transfer Tray Technique. World J Orthod
2006; 7(2):154-8.
Echarri P. Revisiting the History of Lingual Orthodontics: A basis for the future. Semin Orthod
2006; 12(3):153-9.
Echarri P. Lingual Orthodontics: Patient Selection and Diagnostic Considerations. Semin Orthod
2006; 12(3):160-6.
Echarri P. Cirugía ortognática, ortodoncia lingual y microimplantes. Monografías Clínicas en
Ortodoncia 2007;26(3):41-7.
Echarri P. Ortodoncia y microimplantes. Técnica SARDAC. Rev Chil Ortod 2007;24(1):24-35.
Echarri P. Manejo de anclaje en Ortodoncia Lingual. Rev Chil Ortod 2008;25(1):69-78
Echarri P, Carrasco A. Influencia de los microimplantes en la ortodoncia lingual. Casos con
extracciones. Ortodoncia (Revista de la SAO) 2008;71(144):8-13.
Echarri P, Carrasco A. Influencia de los microimplantes en la ortodoncia lingual. Casos sin
extracciones y maloclusiones verticales. Ortodoncia (Revista de la SAO) 2009;72(145):8-13.
Echarri P. Linguale Orthodontie nach Maß. Kieferorthop Nachrichten 2010;10:1-6.
Echarri P. Linguale Orthodontie nach Maß. Kieferorthop Nachrichten (Supplement) 2010;12:3740.
110.Echarri P. How microimplants have changed the lingual orthodontics. Lecture at 106th AAO
Annual Session, May 3rd, 2010, Washington, EEUU.
Echarri P. Cementado indirecto en la técnica CLO3. Odontología actual 2011;2(2):3-6
Echarri P. In drei Schritten zum Erfolg. Kieferorthop Nachrichten 2013;4;6-7.
Echarri P, Schendell C. Kein Schleifen und Trimmen mehr. Kieferorthop Nachrichten 2013;5;13-5.
Echarri P, Loidl H. Biomecánica en la técnica CLO3 (Custom-made Lingual Orthodontics in 3 Steps
– Ortodoncia Lingual Personalizada en 3 pasos). Dental Tribune 2013;8(3):16-8.
Echarri P, Schendel C. Einfach und präzise. Kieferorthop Nachrichten 2013;6;14-16
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