1. Systematic review of Present clinical reality
Meta analysis on Patient consideration
In Lingual Orthodontic Treatment
Systematic review of Present clinical reality
Introduction
Demand for lingual orthodontic appliances has markedly increased among orthodontic patients seeking esthetic improvement.
Several seminal studies have shown that lingual appliances can provide treatment outcomes comparable to those achieved with labial appliances.
Objective Systematic review of symptomatic considerations of Lingual treatment and its comparative analysis with labial Orthodontics
Inclusion Criteria for Study Participants
Healthy adults or children who sought orthodontic treatment for dental malocclusion.
Both randomized controlled trials (RCTs) and controlled clinical trials (CCTs) were eligible

2. Materials and Methods Data Recording
Study design
Participant information
Intervention type
Follow-up periods
Outcomes
Cochrane Collaboration Tool for Assessing Risk of Bias
Adequate sequence generation;
Allocation concealment;
Blinding;
Management of incomplete outcome data;
Absence of selective reporting; and
Absence of other sources of bias
Meta analysis
For dichotomous data, odds ratios (with 95% CI) were used for statistical pooling;
For continuous data, standardized mean differences were first converted to ORs through the formula of Chinn
I2 statistic greater than 50% was considered a sign of substantial heterogeneity
Meta-regression or subgroup analysis to explore the potential heterogeneity
Sensitive Analysis
to evaluate the robustness of the pooled results from the meta-analysis

3. Materials and Methods cont.....1
Search of electronic database & Website i.e Pubmed (604),Embase (314),Web of Science (146),Central (28),clinicalTrail.gov (2) 2
718 articles shortlisted 3
709 articles ruled out due to inclusion criteria 4
9 articles screened with full text for eligibility 5
6 articles included in qualitative analysis 6
4 articles included in quantitative analysis (Meta analysis)

4. Odd’s Ratio (lingual vs labial)
Results
Outcomes in lingual and labial
orthodontic treatment
Odd’s Ratio (lingual vs labial)
95% CI
I 2
Sensitivity Analysis
Overall pain
1.35
10.20–3.93
65%
0.66 (0.28, 1.55)
Tongue
34.64
12.53–69.55 0%
Cheek
0.08
0.02–0.35
Lip
0.11
64%
Eating difficulty
3.59
5.21 (0.83, 32.75)*
Speech difficulty
7.91
3.75–18.95
23.87 (3.00, )
* Significant change from the original estimates

5. Conclusion
Meta analysis revealed that there is no difference in symptomatic consideration of overall pain of short-term in both techniques
However Lingual technique patients are less likely to suffer cheeks problems than tongue difficulties.
Other parameters of caries,treatment duration,hygiene and eating were not conclusive indicates more studies preferably with larger sample and controlled trials