10 years have passed since the official inauguration of Japan Lingual Orthodontic Association and we will have this big event at the start of its 11th years. The number of the members of the society now exceed 150. Environment of lingual orthodontics is becoming better and better and many adult patients now show great interest in having lingual treatment. It is a great honor as well as pleasure for me as a current President of the society to see it under such circumstances.
Our group has 4 pillars of activity.
1. Annual 1 day meeting in spring and evening seminar in autumn
2. Annual publication “The Journal of Japan Lingual orthodontic Association (JJLOA)”
3. Holding the Lingual seminar
4. Presentation in the annual meeting of the Japan Orthodontic Association
In these 10 years the organization of our society have changed gradually. The first President, Dr. Hito Koyata established the foundation of society, and made progress the international position. The next president, Dr. Yasunori Mori had held the 2nd Gorman seminar, and the 1st and 2nd Fillion seminar, as well as the publishing the book “The Lingual Technique of Dr. Jack Gorman”. The third President is me, I must make effort to coordinate the organization. Fortunately, we have many young people as new comer. So I have the belief in the success of this 10 year anniversary international congress and the development of our society.

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One of the treatment key in the lingual orthodontic treatment is molar distalization.
In the correction of class II malocclusion in which an adult orthodontic treatment has been treated previously, it is generally necessary to distalize the posterior molar depending on extraction.
I will show several later cases and discuss my latest lingual treatment in the molar distalization.

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Case report 1: Treatment of mandibular prognathism with functional anterior shift of the mandible using a lingual appliance.
Age at initial visit: 23y 2m
Diagnosis and treatment decision:
The case was diagnosed as an Angle Class III malocclusion with skeletal mandibular prognathism and functional anterior shift of the mandible. Non-extraction treatment to improve overbite and overjet relationship by tipping the upper anterior teeth labially and extruding the lower anterior teeth. A decision was made to create space for the missing upper left lateral incisor and to build up the small upper right lateral incisor with composite resin for establishment of a functional occlusion, which was the first priority. The upper left lateral incisor will be restored with either an implant or a conventional bridge in the future.
Active treatment time: 23 months
Results and discussion: The profile remained almost unchanged. The overbite and overjet relationship was improved as a result of labial tipping of the upper anterior teeth and lingual tipping of the lower anterior teeth. This may be attributed to the effects of up and down elastics and the lingual appliance which kept the tongue away from the teeth. Despite non-extraction treatment, the mandible did not rotate clock wise, and CPI showed less than 1mm of CO-CR discrepancy. This may be because the upper functional cusps were successfully controlled with the lingual appliance to provide adequate vertical control.
Case report 2: Treatment of maxillary protrusion with an anterior open bite tendency using a lingual appliance.
Age at intial visit: 29y 5m
Diagnosis and treatment decision:
The case was diagnosed as a crowded Angle Class I malocclusion with maxillary protrusion. A decision was made to extract four first bicuspids in order to eliminate crowding and improve the overbite and facial profile by retraction of the upper and lower anterior teeth, and to use a palatal bar and a highpull headgear for maxillary anchorage.
Active treatment time: 28 months
Results and discussion: Despite the dolicofacial pattern, the upper and lower anterior teeth were successfully intruded with maximum anchorage, and retracted with good control of their labiolingual inclinations. This may be because the distance between the point of force application and the center of resistance of each tooth is smaller with a lingual appliance, which reduces the molars was achieved with the help of a headgear and a palatal bar, resulting in counterclockwise rotation of the mandible and allowing the chin to come forward. These changes led to the improvement of the overbite and overjet relationship and facial profile.

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The case was the Angle Cl. II malocclusion with crowdings, most frequently seen in the treatment of Japanese patients. As a beginner, I treated the case by lingual only for maxilla (mandible by labial). This is an adult case with a TMD problem and a missing molar, a typical case often seen in treating adults. Discussions are focused on problem areas I had in managing active treatment time and periodontal issue. (“Half lingual” is the special term in JLOA, meaning the treatment by lingual appliance in the upper arch, labial appliance in the lower arch; Editor)

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