With the increase in use of lingual appliances a more accurate assessment is needed of exactly where the brackets are being placed. This study was undertaken in order to see if it makes any difference who places the brackets. Three groups of participants were selected. One, the commercial laboratory which offers a bracket placement service. Two, clinicians experienced with the lingual appliance, and three, clinicians with no clinical experience with the appliance.

Four sets of patient models were selected from eighty cases Ormco used in the original development of their lingual bonded appliance. These were duplicated and the four sets were sent to each of the participants for bracket placement.

The teeth were sectioned from the models and were photographed using a custom jig and thirty five millimeter camera equipted (sic) with a 1:1 macro lens. The photographs were traced and measurements taken with respect to height and angulation and then underwent statistical analysis. Only two height measurements had results with significance at the p<0.05 level. The maxillary lateral incisors and the mandibular first premolars had better placement by the commercial laboratory.

The rest of the height and angular measurements showed no significant differences. In taking the mean absolute differences of the height placements a ranking of the placements was noted with the commercial laboratory first, experienced clinicians second and, inexperienced clinicians third. The mean absolute differences of the angular placements gave a ranking of experienced clinicians first, commercial laboratory second and, inexperienced clinicians third.

In evaluating the time to set up cases, again no statistically significant differences were found among groups. There was a range of thirty-one to seventy-four minutes per case with a mean set up time of fifty-two minutes.

LLU Discipline





Graduate School

First Advisor

Larry W. Will

Second Advisor

Arthur J. Morgan

Third Advisor

Joseph M. Caruso

Fourth Advisor

Norman S. Carter

Degree Name

Master of Science (MS)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Orthodontic Appliances



Page Count

iii; 44

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives