Invisible treatment of a severe Class I crowding with multilingual bracket system using new double mushroom archwire technique

This case report presents an invisible lingual bracket orthodontic treatment of a 26.5-year-old adult female patient with Class I severe crowding. The patient did not wish to wear any visible appliances, so she was treated with lingual brackets with four second premolar extraction. The lingual brackets and wires used in this case illustrate atypical biomechanics of tooth movement. The Fujita lingual bracket used in this treatment provides unique form and function. It consists of three main slots: occlusal, horizontal, and vertical. The archwires designed for use with this bracket are unique in form, named the mushroom archwire. We placed two main mushroom archwires into the two main slots, occlusal and horizontal slots, simultaneously. We refer to this two main mushroom archwire technique as the double mushroom archwire (DMA) technique. DMA technique makes it possible to prevent dysfunctional tooth movement such as excessive retroclination of incisors and tipping movement of the crowns of canines and premolars. Unwanted uncontrolled tooth movements were minimized by the new DMA technique. The patient was satisfied with her treatment without others noticing her orthodontic appliances. It is possible to achieve bodily movement and apply lingual root torque with the DMA technique. DMA technique has the potential to raise the quality of lingual bracket treatment.