Lingual braces in Paris-Neuilly: invisible braces from the designer of the Harmony system

Why this practice for lingual braces

Lingual braces have existed since the 1970s, but few orthodontists offered them for a long time: standard brackets, designed for the front of the teeth, fitted poorly on inner surfaces whose shape varies from tooth to tooth and person to person. The answer came from digital design, manufacturing each bracket and wire for a given patient.

That is what the Harmony system does. Designed by Dr Patrick C. Curiel in 2008 and distributed worldwide since 2011 with American Orthodontics, it was the first fully customised self-ligating lingual system and has been the subject of 17 patents. Dr Curiel has trained orthodontists in the technique in Japan, Austria, the United States, China and across Europe, and has published in the American Journal of Orthodontics and Dentofacial Orthopedics.

For a patient this means thin brackets that interfere little with the tongue, a predictable appliance, and a practitioner who has met most of the situations lingual treatment can raise. Dr Curiel’s training and career are on his profile page.

How custom lingual braces work

The principle is the same as with conventional braces: brackets bonded to the teeth, joined by a wire whose shape guides the movement. The differences lie in the position and in the manufacturing.

1. Digital impression. An intra-oral scanner replaces impression paste. A 3D model of both arches is obtained in a few minutes.
2. Design of the target. On the model, the teeth are placed in the final position the treatment is meant to reach, and the appliance is designed from that position.
3. Individual manufacturing. Each bracket is made to fit the inner surface of one specific tooth; the wires are bent by robot to the shape of your final arch.
4. Indirect bonding. The brackets arrive in a transfer tray and are bonded in a single visit, with a precision hand placement cannot match.
5. Adjustments. Every 6 to 8 weeks the wire is changed or adjusted. The self-ligating clip, with no elastic or wire ligature, shortens these visits.
6. Retention. When the braces are removed, a thin wire bonded behind the teeth and a night-time retainer stabilise the result.

Who lingual braces suit

Lingual braces are chosen first by adults and teenagers who do not want their treatment to show, but their value is not only cosmetic.

• Crowding and overlapping, including relapse after treatment in childhood.
• Spaces to close (diastemas, missing teeth) and extraction cases, where a fixed appliance keeps the advantage.
• Deep bite and open bite: vertical control is a recognised strength of the lingual technique.
• Preparation for crowns, bridges or implants, in coordination with your dentist.
• Jaw discrepancies in adults, alone or in preparation for orthognathic surgery.

The limits are few: very short teeth that leave little room for brackets, unstabilised gum disease, and hygiene that cannot be maintained. The assessment identifies them and another technique is then proposed.

Advantages and limitations, stated plainly

Lingual, aligners or ceramic braces: a comparison

Indicative ranges for a complete adult treatment in the Paris region; only the written quote issued after the assessment is binding.

Clear aligners are described on the Invisalign in Neuilly-sur-Seine page.

Duration and cost of lingual treatment

A simple realignment of the front teeth takes 6 to 9 months; a complete correction of the bite, with or without extractions, 12 to 24 months. The duration is written in the quote and is met in most cases, provided adjustment visits are kept.

At the practice, a complete adult lingual treatment most often costs between €6,000 and €9,000, paid in stages; this covers design and manufacture of the appliance, bonding, all adjustment visits, removal and the first retainers. Adult orthodontics is not reimbursed by French public health insurance; many mutuelles and international insurers pay part of the cost (see fees and insurance). The written quote prevails over these indicative figures.

Treatment pathway if you travel from abroad or from central Paris

Lingual treatment requires an adjustment visit every 6 to 8 weeks. Some patients travel from abroad or from the other side of Paris; this is how their care is organised. In-person visits remain necessary throughout.

1. Assessment (1 visit)

   Examination, radiographs, photographs and digital impression. Diagnosis, options and written quote.

2. Design (3 to 5 weeks)

   Planning of the final tooth position, validation by Dr Curiel, manufacture of the individual brackets and wires. No visit is needed.

3. Bonding (1 visit, about 1 h 30)

   Indirect bonding of the brackets and first wire, with hygiene and adaptation advice. Patients from abroad may wish to stay a day or two for a check.

4. Follow-up (every 6 to 8 weeks)

   Wire changes and adjustments, 20 to 40 minutes. Where availability allows, visits can be placed at the start or end of the day for patients coming from further afield. Questions between visits can be sent by email.

5. Removal and retention

   Removal of the brackets, polishing, bonded retention wire and night-time retainer. Checks at 3, 6 and 12 months.

Access from Porte Maillot or La Défense is described on the practice and access page; booking is explained under book an appointment at the practice.

Frequently asked questions about lingual braces