Page 44 - DP Vol 22 No 1

ORTHODONTICS

MANAGEMENT OF ANTERIOR CROSSBITE &

LOWER ANTERIOR CROWDING USING THE

BRAVA APPLIANCE: A CASE REPORT

Gurkeerat Singh, Jyoti Yadav, Lalfakzuali, Armaan Kaur

INTRODUCTION form. The lower incisors are typically the most affected teeth. This may
Lingual orthodontic appliances have progressively advanced due also sometimes cause anterior crossbite which is an abnormality in
to developments in digital dentistry and CAD/CAM technologies. the sagittal direction of one or more maxillary anterior teeth against
These appliances provide key benefits, including superior esthetics the mandibular teeth. It may lead to aesthetic problems, incisal wear,
and refined biomechanical control relative to labial systems. In 2017, caries, gingivitis, and labial bone or gingival recession. Two case
Mehdi Peikar introduced the Brius™ appliance, a novel lingual system reports are presented which will discuss the treatment of anterior
intended to optimize treatment efficiency by reducing side effects crossbite and lower anterior crowding using the Brava appliance. The
commonly associated with round-tripping and variable force delivery. patient was treated exclusively using the Brava Lingual Orthodontic
The Brava appliance is a digitally customized system that uses flexible System due to its esthetic design, independent biomechanics, and
arms attached to a personalized base to achieve independent tooth capacity for precise, digitally planned tooth movements, particularly
movement. Its discreet design and high precision make it an excellent suitable for adult patients. A 3D digital scan of both the arches was
option for adults seeking efficient and aesthetic orthodontic treatment. obtained and submitted to Brius Technologies for treatment planning.
Dental crowding is characterized by a discrepancy between tooth Customized biomechanical arms were digitally designed to achieve
size and arch space, leading to malocclusion. This imbalance results individualized tooth movements.
from inadequate coordination between tooth dimensions and arch

CASE REPORT - 1
A 19-year-old male presented for an initial orthodontic
consultation with the chief complaint of crowding in
the upper and lower anterior teeth. The patient was in
good general health with no history of systemic disease
or trauma. Extraoral examination (Figures 1a to 1c)
revealed a straight facial profile, competent lips, and no
noticeable facial asymmetry. Temporomandibular joint
evaluation showed no signs of dysfunction. Intraoral
examination demonstrated a Super Class I molar and
canine relationship bilaterally with a tendency towards
Class III (Figures 2a to 2e), with an anterior crossbite
involving tooth 11 positioned palatal to the mandibular Fig 1a-c: Pre-treatment extraoral photographs

Fig 2a: Pre-treatment intraoral buccal view Fig 2b: Pre-treatment intraoral frontal view Fig 2c: Pre-treatment intraoral buccal view
(right) (left)

44 Dental Practice I January-February 2026 I Vol 22 No 1