Background and method: Almost 20 months of practical application of a new lingual bracket system have revealed some clinically relevant advantages and disadvantages deriving from the original design. Numerous modifications in the design of the bracket bodies and bases have contributed towards further optimization of the appliance. The efficiency of the appliance is discussed, taking five treated cases as examples.
Results and conclusions: The initial demands for low bracket loss rates and simplified rebonding, controlled finishing and enhanced patient comfort have been largely met by the customized design and the flexibility in the manufacture of the new appliance. However, in the triad of orthodontist, patient and appliance that is of such great importance to any orthodontic therapy, any future ideal appliance will still offer no guarantee of a successful treatment outcome.