Orthodontics: Current Principles and Techniques

Front Cover
Inside Front Cover
Orthodontics: Current Principles and Techniques
Copyright
Dedication
Contributors
Preface
Contents
Part A Foundations of Orthodontics
1 The History of Orthodontics… From an Idea to a Profession
Pre-1900 development of the orthodontic specialty
The professionalization of orthodontics
The American Board of Orthodontics, Albert Ketcham, and early 20th-century appliances
More early 20th-century appliances and the extraction controversy
The cephalometer takes its place in the orthodontic armamentarium
Functional appliances to midcentury
The golden age of orthodontics
Two controversies: early treatment and occlusion
The temporomandibular joint and orthognathic surgery
Surgical adjuncts to orthodontics
Skeletal anchorage
Late 20th-century
2 Craniofacial Growth and Development
Developing a Perspective
Somatic Growth
Differential Development and Maturation
Variation in Rates of Growth during Maturation
Craniofacial Complex
Structural Units
Desmocranium
Chondrocranium
Viscerocraniu
Dentition
Functional Units
Neurocranium
Face
Oral Apparatus
Molecular Basis of Craniofacial Development and Growth
Cranial Vault
Development of the Cranial Vault
Mechanisms of Suture Growth
Postnatal Growth of the Cranial Vault
Cranial Base
Development of the Cranial Base
Mechanism of Synchondrosal Growth
Postnatal Growth of the Cranial Base
Midface/Nasomaxillary Complex
Development of the Midface
Postnatal Growth of the Midface
Mandible
Development of the Mandible
Growth of the Mandibular Condyle
Histomorphology of the Growing Condyle
Articular layer
Growth layer
Age-Related Changes in the Mandibular Condyle
Mechanisms of Condylar Growth
Postnatal Growth of the Mandible
Arch Development, Tooth Migration, and Eruption
Adult Changes in Craniofacial Form
Postnatal Interrelationships During Craniofacial Growth
Significance of Understanding Craniofacial Growth for Orthodontics
References
3 Genetics and Orthodontics
Etiology
Background and basic definitions
Types of genetic effects and modes of inheritance
Monogenic Traits
Autosomal Dominant Traits and Penetrance
Variable Expressivity
Autosomal Recessive Traits
X-Linked Traits and Lyonization (X-Inactivation)
Complex Traits
Nature versus nurture
Heritability and Its Estimation
Use of Family Data to “Predict” Growth
Normal facial growth
Growth Differences During Puberty
Mandibular Prognathism/Class III Malocclusion
Class II Division 2 Malocclusion
Tooth size and agenesis
Dental Crown Morphology
Dental Agenesis
Dental eruption problems
Canine Impaction and/or Displacement
Primary Failure of Eruption
Environmental and genetic influences on bilateral symmetry
Genetic factors and external apical root resorption
Short root anomaly
Personalized-precision orthodontics
Summary
References
4 The Biological Basis for Orthodontics
Introduction
Tooth-supporting tissues
Gingiva
Periodontal Ligament
Root Cementum
Alveolar Bone
Biology of orthodontic tooth movement through bone
Fundamental studies reveal tissue-level bone changes leading to tooth movement
Bone cell modeling activity enables tooth movement through bone
Mechanical orthodontic forces stimulate biochemical cell signals
Local biological mediators of orthodontic tooth movement
Neuropeptides and orthodontic tooth movement
RANK/RANKL/OPG system for control of osteoclastogenesis and tooth movement
Biological control of osteogenesis involved in orthodontic tooth movement
Physical methods aimed at stimulating the biology of orthodontic tooth movement
Injury-Facilitated Acceleration of Tooth Movement
Vibration-Induced Acceleration of Tooth Movement
Laser Irradiation–Induced Acceleration of Tooth Movement
Types of Tooth Movements
Physiologic Tooth Migration
Tipping
Bodily Movement
Rotation
Extrusion
Intrusion
Movements in the Labial/Buccal Direction
Tissue Reactions Seen in Orthodontic Retention and Relapse
Future directions
References
5 Bone Physiology, Metabolism, and Biomechanics in Orthodontic Practice
Osteology
Differential Osteology of the Maxilla and Mandible
Bone physiology
Specific Assessment Methodology
Classification of Bone Tissue
Woven Bone
Lamellar Bone
Composite Bone
Bundle Bone
Skeletal adaptation: remodeling and modeling
Bone Remodeling
Bone Modeling
Cortical bone growth and maturation
Cutting and Filling Cones
Structural and Metabolic Fractions
Bone metabolism
Biomechanics
Sutures
Orthodontic tooth movement
Occlusal Trauma and Root Resorption
Induction of the Tooth Movement Response
Differential Anchorage
Rate of Tooth Movement
Periodontitis and Orthodontics
Endosseous Implants
Current status of miniscrew implants
Osseointegration
Bone-to-Implant Contact
Bone Remodeling
Failure of Miniscrew Implants—Design or Unique Biological Constraints?
Rigidity of Miniscrew Implants
Animal models for studying bone adaptation, remodeling, and modeling
Novel Application of in vivo Micro-CT to Study Bone Adaptation in 3D
Developing a Novel Animal Model for Orthodontic Tooth Movement 188
Expedited tooth movement
Regional Acceleratory Phenomena
Bone Remodeling Rate
Current Evidence of Expedited Tooth Movement from Experimental Studies on Rodents and Canines
Summary
Acknowledgments
References
6 Application of Bioengineering to Clinical Orthodontics
Sign conventions
Biomechanics of tooth movement
Centers of Rotation and Centers of Resistance
Bracket Path and the Required Force System
Optimal Force and Stress
The orthodontic appliance
Active and Reactive Members
Moment-to-Force Ratio
Load-Deflection Rate
Maximal Elastic Moment
Manner of Loading
Mechanical Properties of Metals
Basic Behavior of Alloys
Elastic Limit
Modulus of Elasticity
Shape-Memory Alloys
Ideal Orthodontic Alloys
Wire Cross-Section
Selection of the Proper Wire (Alloy and Cross-Section)
Wire Length
Amount of Wire
Stress Raisers
Sections of Maximal Stress
Direction of Loading
Attachment
Forces from a Continuous Arch
Principles of Spring Design
The Role of Friction
Summary
Acknowledgment
References
7 Clinically Relevant Aspects of Dental Materials Science in Orthodontics
Impact of appliance properties on mechanics
Stainless Steel Brackets
Stiffness
Roughness
Base-Wing Joint
Hardness
Friction
Material Properties and Torque
Titanium Brackets
Ceramic Brackets
Brittleness and Fracture
Ceramics in Wet Environments
Effect of Grain Size
Archwires
Clinical Impact of Nickel-Titanium Archwire Properties
Superelastic and Non-superelastic Nickel-Titanium in Crowding Alleviation
Photocuring and adhesives
Photocuring
Light Intensity
Lamps
Biological Properties of Blue Light and Adhesives
Blue Light Effects
Grinding of Adhesives: Production of Aerosol and Estrogenic Action
Materials for fixed retainers
Properties of Wires and Composite Resins Used for Fixed Retainers
Wires
Composite Resins
Materials used in aligner treatment
Properties Important to Their Clinical Performance
Intraoral Alterations of Orthodontic Aligners
Aspects of Composite Resin Attachments to the Tooth
Summary
Acknowledgments
References
8 The Role of Evidence in Orthodontics
Introduction
The best scientific evidence
Observational Studies
Randomized Controlled Trials
Critical Assessment and Interpretation of Randomized Controlled Trials
1 . Research Question
Systematic Reviews
Applying evidence-based orthodontics in clinical practice
Example
Integrating clinical expertise, the best evidence, and patient preferences/values
Critique of Evidence-Based Orthodontics
The future of evidence-based orthodontics
References
9 Applications of Artificial Intelligence and Big Data Analytics in Orthodontics
Introduction
Applications of artificial intelligence in orthodontics
Automated Cephalometric Analysis
Three-Dimensional Cephalometric Analysis
Orthodontic Treatment Planning
Assessment of Treatment Outcomes
Computer-Aided Design/Computer-Aided Manufacturing/Additive Manufacturing
Classifying and Organizing Data
Remote Treatment Monitoring
Other Orthodontic Applications
Artificial intelligences and genomics
Conclusion
References
Part B Diagnosis and Treatment Planning
10 The Decision-Making Process in Orthodontics
Background Concepts
Quality of Life: The Modern Healthcare Paradigm
Understanding Normal versus Ideal Occlusion
Dental and Skeletal Compensations: Nature’s Way of Camouflaging Discrepancies
Recognizing Orthodontic Problems
Limitations of Orthodontic Treatment
Patient evaluation: the diagnostic process in orthodontics
Overview of the Problem-Oriented Approach
Collection of Interview Data
First Contact
Interview at the First Appointment
Meeting the Patient and Eliciting the Chief Concern
Clinical Evaluation
Facial Proportions and Appearance
Intraoral Examination
Health of hard and soft tissues
Soft tissue function
Jaw function
Diagnostic Records
What Records Are Needed?
Virtual versus physical dental casts
Head orientation for cephalograms
Additional records
Technologic Advances in Diagnosis
Digital photography, videography, and three-dimensional photography
Computer imaging
Cone-beam computed tomography
Intraoral scanning
Analysis of Diagnostic Records
Cast Analysis
Cephalometric Analysis
Development of clinical cephalometrics
Goals of modern cephalometric analysis
Evaluation of Class II malocclusion
Evaluation of Class III malocclusion
Vertical skeletal problems
Vertical dental problems
Classification: Organizing the Database
Angle Classification
Systematic Description: Ackerman-Proffit Classification
Development of the classification scheme
Application of systematic description
Step 1: Evaluation of dentofacial appearance
Step 2: Analysis of the dental alignment and intraarch symmetry
Step 3: Lateral dimensions (Transverse Plane of Space)
Step 4: Anteroposterior dimensions (Sagittal Plane of Space)
Step 5: Vertical dimensions (Vertical Plane of Space)
Summary of Diagnosis
Treatment planning: the problem-oriented approach
Prioritizing the Problem List
Considerations in Evaluating Treatment Possibilities
To Extract or Not to Extract?
Management of crowding or protrusion
Incisor repositioning for camouflage
Visual treatment objectives in the extraction decision
Therapeutic Modifiability
Interaction among potential solutions to problems
Patient cooperation
Presenting the Tentative Treatment Plan, Finalizing It, and Obtaining Informed Consent
The Patient-Parent Conference
Informed Consent
Informed consent sequence
Computer image predictions
Treatment response
The Final Step: The Treatment Plan Details (Mechanotherapy Plan)
Applications of skeletal anchorage
Stereolithographic models and three-dimensional printing
Custom milling of attachments and robotic wire bending
References
11 Psychological Aspects of Diagnosis and Treatment
Patient perceptions
Patients with psychological disorders
Attention-Deficit/Hyperactivity Disorder
Obsessive-Compulsive Disorder
Body Dysmorphic Disorder
Bipolar Disorder
Panic Disorder
Depression
Eating Disorders
Personality Disorders
Difficult” Patients
Patients having orthognathic surgery
Psychological Status and Motivation
Expectations
Satisfaction
Patients with craniofacial deformities
Psychological Issues
Patients with Clefts of the Lip and Palate
Patients with Acquired Deformities
Summary
References
12 Orthodontic Diagnosis and Treatment Planning with Cone-Beam Computed Tomography Imaging
Introduction
Strategies for assessment of radiation dose risk
Factors that Influence Dose and Risk Estimation
Biological Factors
Technical Factors
Receptor technology and field of view
mAs
kVp and beam filtration
Resolution
Clinical indications for the use of cone-beam computed tomography in orthodontics
Tooth Morphology and Relative Position Within the Alveolar Bone
Temporomandibular Joint Health and Disease
Airway Assessment
Skeletal Discrepancies and Craniofacial Anomalies
Image analyses and the use of three-dimensional surface models and superimpositions
Practical Challenges
Image Acquisition Challenges
Segmentation Challenges
Image Registration
Quantitative Measurements
Volume
Three-dimensional linear surface distances in triangular meshes
Closest point measurements
Shape correspondence measurements
Three-dimensional angular measurements
Step-by-Step Open-Source Three-Dimensional Image Analysis Procedures
Acquisition of Three-Dimensional Diagnostic Records
Head orientation
Construction of 3D volumetric files that label with color the anatomic structures of interest
Image registration
Manual approximation of Time 1 and Time 2 scans
Voxel-based registration for longitudinal assessments
Placement of prelabeled landmarks on the segmentations
Generation of three-dimensional surface models from the segmentations with prelabeled landmarks
Quantitative measurements
Three-dimensional linear surface distances in triangular meshes
3D angular measurements
Visual analytics with graphic display of three-dimensional morphologic variability and/or changes over time
Treatment planning with computer-assisted surgery
Surgical Planning and Simulation
Simulation of Soft Tissue Changes
Intraoperative Guidance: Surgical Navigation
Tracking Technology
Final considerations
References
13 Upper Airway, Cranial Morphology, and Sleep Apnea
Introduction
Airway complications have far-reaching effects
Anatomy and growth
Overview
Hyoid Bone Position and Morphologic Features
Relationship of Different Skeletal Patterns to Airway Morphologic Structure
Airway measurements and imaging
Overview
Cone-Beam Computed Tomography
Acoustic Rhinometry
Pharyngometry
Ultrasonography
Influence of orthodontic treatment on the airway
Treatment Including Extractions
Rapid Maxillary Expansion
Functional Orthopedic Appliances
Orthognathic Surgery
Summary of Orthodontic Treatment Effects on the Airway
Sleep-disordered breathing: airway disorders and management
Definitions and Testing Reports
Classifications of Sleep-Disordered Breathing
Obstructive Sleep Apnea
Upper Airway Resistance Syndrome
Central Sleep Apnea Syndrome
Sleep Hypoventilation Syndromes
Epidemiologic Factors
Pathophysiologic Precipitants in Sleep
Clinical Presentations
Physical Risks in Wakefulness
Clinical Prediction of Significant Sleep-Disordered Breathing
Patient-Based Tests and Questionnaires
Friedman Classification
Modified Mallampati Classification
Pediatric Sleep Questionnaire
STOP-Bang Questionnaire
Epworth Sleepiness Scale
Nasal Obstruction Symptom Evaluation Scale
Diagnostic Testing of Obstructive Sleep Apnea
Treatment Modalities
Treatment Options
Lifestyle and Behavior Modification
Positive Airway Pressure
Oral Appliances
Surgical Treatment
Oropharyngeal Exercises
Upper Airway Electrical Neurostimulation
Management for Prevention of Harm
Importance of a multidisciplinary approach
Summary and conclusions
Acknowledgment
References
14 Orthodontic Therapy and the Patient with Temporomandibular Disorders
Introduction
The Concept of Orthopedic Stability
Finding the Musculoskeletal Stable Position
Evaluating the Patient for Temporomandibular Disorders
A Temporomandibular Disorder Screen History
A Temporomandibular Disorder Screen Examination
Muscle Palpation
Temporomandibular Joint Palpation
Range of Mandibular Movement
Occlusal Evaluation
The Clinical Significance of Joint Sounds
Developing the Orthodontic/Temporomandibular Disorder Treatment Plan
Managing Temporomandibular Disorder Symptoms that Arise During Orthodontic Therapy
Summary
References
15 The Orthodontist’s Role and Collaboration in a Cleft Palate–Craniofacial Team
The Team Approach
Orthodontic Treatment and Team Collaboration
Neonates and Infants (Birth to 2 Years of Age)
Presurgical Infant Orthopedics
Primary Alveolar Bone Grafting
Speech Considerations for Infants and Toddlers
Primary Dentition Stage (2 to 6 Years of Age)
Speech Considerations for the Young Child
Mixed Dentition Stage (7 to 12 Years of Age)
Secondary Alveolar Bone Grafting
Early secondary alveolar bone grafting (2 to 6 years of age)
Intermediate or secondary alveolar bone grafting (7 to 15 years of age)
Timing
Interdisciplinary sequencing
Orthodontic considerations associated with secondary alveolar bone grafting
The transverse dimension
Maxillary incisor alignment
Position of the premaxilla in bilateral cleft cases
Eruption of the maxillary canine
Assessing the outcome of secondary alveolar bone grafting
Speech Considerations for Older Children and Young Adolescents
Permanent Dentition Stage
Speech Considerations during Comprehensive Orthodontic Treatment
Skeletofacial Growth Considerations
Orthognathic Surgery
Interdisciplinary treatment planning
Role of the orthodontist
Distraction osteogenesis
Speech considerations AFTER orthognathic surgery
Management of the Missing Lateral Incisor Space
Canine substitution
Fixed partial dentures
Removable partial dentures
Endosseous implants
Current Issues in the Access of Orthodontic Care
Barriers in the Access to Cleft Team Interdisciplinary Coordination and Specialty Care
Barriers from United States Health Insurance Programs
Other Barriers Encountered by Families
References
Part C Orthodontic Treatment
16 Principles of Treatment: Balancing Outcome and Efficiency
Introduction
Balancing risk and benefit
Orthodontic planning and esthetics
Orthodontic planning and dental health
Treatment process, experience, and outcome
Treatment duration and experience: association with outcome
Optimizing efficiency: treatment planning and mechanics
Fixed appliance attachments
Nonsurgical and surgical adjunctive procedures
Short-term” orthodontics
Treatment principles: planning for stability
Conclusion
References
17 Optimizing Orthodontics and Dentofacial Orthopedics
Part A: Patient Management and Motivation for the Child and Adolescent Patient
Behavior guidance
Pain Management
First Impressions
Differences in behavior management between pediatric dentistry and orthodontics
Communication Guidance
Patient at-home responsibilities
Oral Hygiene and Diet
Removable Orthodontic Appliances
Extraoral Appliances
Headgear for Class II Correction
Removable Intraoral Appliances
Orthodontic Appointments
Intraoral Elastics
Removable Retainers
Summary
Part B: Treatment Timing and Mixed Dentition Therapy
The timing of treatment intervention
Modification of Craniofacial Growth
Patient Cooperation
Practice Management
The cervical vertebral maturation method
When to intervene
Treatment of tooth-size and arch-size discrepancy problems
Space Maintenance During the Transition of the Dentition
Transpalatal Arch
Lingual Arch
Serial extraction
Arch expansion
Types of Expansion
Orthodontic Expansion
Passive Expansion
Orthopedic Expansion
Rationale for Early Orthopedic Expansion
Permanent Dentition
Mixed Dentition
Orthopedic Expansion Protocols
Maxillary Adaptations
Mandibular Dental Uprighting, Expansion, and Space Management Appliances
Mandibular Adaptations
The Schwarz Appliance
Lip Bumper
Spontaneous improvement of sagittal malocclusions
Class II Patients
Class III Patients
The treatment of class II malocclusion
Components of Class II Malocclusion
Available Class II Treatment Strategies
Maxillary Distalization
Extraoral Traction
Maxillary Molar Distalization
Pendulum and Pendex Appliances
Mandibular Enhancement: Functional Jaw Orthopedics
Appliance Selection
Herbst Appliance
Mandibular Anterior Repositioning Appliance
Treatment Timing for Class II Malocclusion
Additional Comments Regarding Class II Treatment
Treatment of class III malocclusion
Components of Class III Malocclusion
Available Class III Treatment Strategies
Appliance Selection
The Orthopedic Facial Mask
The Fränkel FR-3 Appliance
The Orthopedic Chin Cup
Bone-anchored miniplates for maxillary protraction
Additional Comments Regarding Class III Treatment
Overview and summary
Final remarks
Acknowledgments
References
18 Standard Edgewise: Tweed-Merrifield Philosophy, Diagnosis, Treatment Planning, and Force Systems
19 Contemporary Straight Wire Biomechanics
Straight wire appliance design and values
Straight wire appliance and self-ligation
Optimal Bracket Placement
Treatment Mechanics
Stage 1: Leveling and Aligning
Stage 2: Working Stage
Arch coordination
Overbite and overjet correction
Closing extraction spaces
Double keyhole loop activation
Niti thermal-activated coil activation
Minimum anchorage
Medium Anchorage
Maximum anchorage
Intermaxillary elastics
Stage 3: Finishing Stage
Future directions
Summary
References
20 Self-Ligating Bracket Biomechanics
The Historical Context of Self-Ligation
Stainless Steel Ligatures
Elastomeric Ligature
Begg Pins
Self-Ligation
Factors that Hindered the Adoption of Self-Ligation
Proposed Core Advantages of Self-Ligating Brackets
Faster Archwire Removal and Ligation
Less or No Chairside Assistance for Ligation
Secure Archwire Engagement
Friction and Self-Ligation
Friction with Active Archwires: Thick, Stiff Wires
Friction with Active Archwires: Thin, Flexible Wires
Friction In Vivo: Occlusal and Masticatory Forces
Secure Ligation and Low Friction as a Combination of Properties
The Clinical Significance of Low Friction
Active Clips and Passive Slides
Thin Aligning Wires Smaller Than 0.018 -Inch in Diameter
Wires Larger Than 0.018 Inch in Diameter
Thick Rectangular Wires
Aging of Spring Clips
Self-Ligation and Treatment Efficiency
Accuracy of Bracket Placement
Initial Alignment
Canine Retraction
Transverse Development
Space Closure
Overall Treatment Duration
Self-Ligation and Patient Comfort
Self-Ligation and Effectiveness of Torque Control
Self-Ligation and The Periodontium
Self-Ligation and Root Resorption
Force Levels with Self-Ligation and Conventional Ligation
Does Self-Ligation Reduce the Need for Extractions?
PRACTICAL CONSIDERATIONS AND CLINICAL TECHNIQUE TIPS
Bracket Type
Practical Tips
Summary
References
21 Lingual Appliance Treatment
Introduction
Customized Treatment Goals and Lingual Appliances
Use of a Target Setup Model System
Accurate Realization of Individual Treatment Goals
Reduced Risk of Decalcification
Main Differences Between Labial and Lingual Techniques
Anatomic Variations of the Lingual Tooth Surfaces
First-Order Compensations
Torque Control
Exposure of Bonding Area
Innovation in Completely Customized Lingual Appliances
Efficient Leveling and Aligning with Lingual Appliances
Aligning Type 1
Aligning Type 2
Aligning Type 3
Summary
Ref erences
22 Clear Aligner Treatment
Introduction
Materials
Attachment design and other features
Software
Biomechanics of clear aligner treatment
Clinical application
References
23 New Frontiers in Fixed Class II Correctors
Introduction
Two-phase treatment with fixed class II correctors
Interarch appliances
Herbst Appliance and Variations: Clinical Use
Herbst Appliance and Variations: Phase 1
Herbst and Variations: Comprehensive Treatment
Mandibular Anterior Repositioning Appliance: Phase 1
Mandibular Anterior Repositioning Appliance: Comprehensive Treatment
Xbow (Crossbow): Phase 1
Xbow (Crossbow): Comprehensive Treatment
Intraarch appliances
Pendulum Appliance: Phase 1
Pendulum Appliance: Comprehensive Treatment
Other Intraoral Distalizers: Phase 1
Distal Jet: Phase 1
Distal Jet: Comprehensive Treatment
Jones Jig: Phase 1
Jones Jig: Comprehensive Treatment
Wilson Arch
Carriere Motion Appliance: Phase 1
Carriere Motion Appliance: Comprehensive Treatment
Jasper Jumper: Phase 1
Jasper Jumper: Comprehensive Treatment
Forsus: Comprehensive Treatment
Temporary anchorage devices anchored or bone-borne noncompliance appliances for molar distalization
Overall Success Rates
Insertion Sites
Loading Force
Effectiveness and Biomechanics
Effectiveness of Different Nontooth/Tissue-Borne Distalization Variations
Biomechanics: Palatal Versus Buccal
Clinical Application
Distal Jet as a Mainframe
Pendulum-Type Distalizers
Conclusion
References
24 Temporary Anchorage Devices
Part A: Biomechanical Considerations with Temporary Anchorage Devices
Characteristics and clinical significance of temporary anchorage devices
Characteristics of temporary anchorage device mechanics
Rigid Anchorage
Intrusive Mechanics
High-Efficiency Mechanics
Clinical significance of temporary anchorage device mechanics
Easy and Simple Anchorage Preparation
Increased Treatment Efficiency
Expansion of the range of orthodontic and orthopedic treatment
Shifting from a Mechanics-Centered Approach
Considerations for temporary anchorage device mechanics
Temporary Anchorage Device Stability
Temporary Anchorage Device Positioning
Load-Bearing Capacity of the Temporary Anchorage Device
Biomechanical Considerations
Biological Considerations
Side effects related to temporary anchorage device mechanics and their management
Clinical and biomechanical applications of temporary anchorage devices
General Principles in Biomechanical Application of Temporary Anchorage Device Mechanics
Diagnosis and Treatment Planning
Selection of a Temporary Anchorage Device System and Insertion Site
Anatomic factors
Biomechanical factors
Clinical factor
Treatment Strategy
Mechanotherapy Design
Monitoring
Molar Intrusion
Decision-making
Local factors
General factors
Factors for stability
Biomechanics
Mechanical efficiency
Three-dimensional control
Treatment Mechanics
Maxillary molar intrusion
Mandibular molar intrusion
Considerations for Stability
Molar Distalization
Decision-making
Required space
Hard tissue conditions
Soft tissue conditions
Biomechanics
Mechanical efficiency
Three-dimensional control
En masse distalization
Molar Protraction
Decision-making
Biomechanics
Anterior Retraction in Extraction Treatment
Decision-making
Biomechanics
Case studies
Prospective Insight
Part B: The Use Of Palatal Mini-Implant Anchorage: Conventional Approaches Versus Computer-Aided Design and Computer-Aided ...
Mini-implants in the anterior palate
Mini-implant Placement
Appliance Installation: Conventional Workflow
Clinical Procedure: Digital Workflow
Clinical Applications of Palatal Mini-implant Anchorage
Upper Molar Distalization
Maxillary Space Closure
Molar Anchorage, En Masse Retraction
Alignment of Impacted Teeth
Molar Intrusion
Rapid Maxillary Expansion
Conventional Versus Digital Techniques?
Conclusion
Part C: Extraalveolar Bone Screw Anchorage Applied to Challenging Malocclusions
Design and applications of orthobonescrews
Mandibular buccal shelf
Sagittal Anchorage: Retraction of the Lower Dentition
Transverse Anchorage: Correction of Scissors Bite
Mandibular Impaction Recovery: Three-Dimensional Lever Arm Anchored with an OrthoBoneScrew
Protraction of Lower Posterior Teeth
Ramus screw
Application of a Ramus Screw to Treat Horizontally Impacted Molars
Infrazygomatic crest bone screw
Maxillary Impaction Recovery: Three-Dimensional Lever Arm Anchored with an OrthoBoneScrew
Combined Incisal and Infrazygomatic Crest Screws for Arch Intrusion
Combined Palatal and Infrazygomatic Crest Screws for Molar Intrusion
Other Applications of Infrazygomatic Crest Screws
Conclusions
Acknowledgment
Part D: Orthopedic Changes With Boneanchored Miniplates and Functional Jaw Orthopedics: Biological Basis and Practice
Growth changes in the maxilla
Class III Orthopedics
Class II Orthopedics
Growth changes in the mandible
Class III Orthopedics
Class II Orthopedics
Gonial Angle Modifications
Modification of Condylar Growth Direction
Orthopedics in cleft patients
Class III orthopedics and mandibular asymmetry
Equilibrium of forces
References
Biomechanical Considerations with Temporary Anchorage Devices
The Use of Palatal Mini-implant Anchorage: Conventional Approaches Versus Computer-Aided Design and Computer-Aided Manufact ...
Extraalveolar Bone Screw Anchorage Applied to Challenging Malocclusions
Orthopedic Changes with Bone-Anchored Miniplates and Functional Jaw Orthopedics: Biological Basis and Practice
25 Maxillary Expansion in Adults
Traditional Tooth-Borne Expansion Appliances
Surgically Assisted Rapid Maxillary Expansion
Evolution of Bone-Borne Expansion Appliance
Maxillary Skeletal Expander
Fundamental Concept of Adult Expansion with Maxillary Skeletal Expander
Expansion Protocols
Midfacial Expansion with Maxillary Skeletal Expander
Midfacial Protraction
Surgically Assisted Maxillary Skeletal Expander
Cortipuncture
Surgery and Microimplant-Assisted Rapid Palatal Expansion (SMARPE)
Future Consideration
Less Invasive Surgical Options
Airway Considerations
Maxillary Skeletal Expander (MSE) Versus SURGERY AND MICROIMPLANT–Assisted Rapid Palatal Expansion (SMARPE) Versus Surgical ...
The Microimplant-Assisted Rapid Palatal Expander and Orthodontics
References
26 Orthodontic–Periodontal Interface
Prevalence of Periodontal Disease and Conditions
Periodontitis in Children and Adolescents
The Problem of Different Case Definitions
Increased Risk for Periodontitis
Periodontal Health and Gingival Diseases and Conditions
Forms of Periodontitis
Periodontal Manifestations of Systemic Diseases and Developmental and Acquired Conditions
Pathologic Tooth Migration Related to Periodontal Disease
Prevalence
Etiology
Treatment of Pathologic Tooth Migration
Gingival Recession
Definition and Classifications
Prevalence
Etiology
Traumatic Occlusion
Gingival Recession and Planning of Orthodontic Treatment
General Findings
Proclination and Protrusion of Incisors
Maxillary Arch Expansion
Extraction Versus Nonextraction
Treatment of Gingival Recession in Orthodontic Patients
Increasing Gingival Thickness in Relation to Orthodontic Tooth Movement
Indications for The Treatment of Gingival Recession in Orthodontically Treated Patients
Timing of Soft Tissue Augmentation in Relation to Orthodontic Treatment
Surgical Treatment of Gingival Recession in Orthodontic Patients
Development of Gingival Recession in the Long-Term Following Orthodontic Treatment
Orthodontic Fixed Retainers and Periodontal Health
Studies Comparing Fixed Retainers to Orthodontically Treated or Untreated Controls Without Retainer
Studies Comparing Fixed to Removable Retainers
Studies Assessing Different Vertical Wire Positions
Other Studies
Studies Assessing Fixed Orthodontic Retainers and Gingival Recession
Conclusions
References
27 Orthodontic Aspects of Orthognathic Surgery
Background
Definition
Prevalence of Dentofacial Deformities
Objectives
Esthetics
Function
Incising Food
Mastication
Deglutition
Trauma
Attrition
Respiration and Sleep Apnea
Temporomandibular Joint Dysfunction
Speech
Drooling
Stability
Effectiveness
Treatment need
Measurable Criteria
Index of Orthodontic Treatment Need
Index of Orthognathic Functional Treatment Need
Facial Attractiveness Research Studies
The patient pathway
The Orthognathic Team
The Clinician’s Role in the Treatment Pathway
Sequencing of Treatment and Coordination of Care
Patient evaluation
Patient Interview
Presenting Complaint
History of Presenting Complaint
Psychosocial History
Perception
Motivation
Expectation(s)
Cooperation
Support Network
Medical History
Suitability for Orthognathic Treatment
Diagnostic Records
Systematic clinical evaluation
Principles
Frontal Facial Evaluation
Vertical Proportions
Transverse Proportions
Facial Height to Width Ratios
Sagittal Midface Assessment in Frontal View
Bilateral Facial Symmetry
Dental Midlines
Buccal Corridors (Negative Space)
Profile Facial Evaluation
Sagittal Position of the Maxilla
Nasolabial Region
Maxillary Incisor Crown Inclination in Profile Smiling View
Sagittal Maxillary Incisor Position
Lip Prominence
Mentolabial Region
Chin Prominence
Submental-Cervical Region
Cephalometric Analysis
Sagittal Skeletal Relationships
Vertical Skeletal Relationships
Incisor Inclinations
Dental-Occlusal Relationships
Treatment planning principles
Preoperative Diagnosis
Vectorial Analysis
Prediction Planning
Model Surgery
Three-Dimensional Virtual Surgical Planning
Multidisciplinary 3D-VSP Meeting: Virtual Diagnosis, Surgical Planning, and Simulation
Virtual diagnosis.
Surgical planning and simulation.
Virtual maxillary osteotomy.
Virtual mandibular osteotomy and/or genioplasty.
Cutting guide and plate positioning and design.
CAD/CAM: Review and Printing of Surgical Cutting Guides, Plates, and Occlusal Splints
Intraoperative Use of Cutting Guides, Plates, and Occlusal Splints
The orthodontist’s role in orthognathic surgery
Preoperative Orthodontics
Alignment
Leveling
Decompensation
Incisor Inclination Preparation
Arch Coordination
Elimination of Occlusal Interferences
Immediate Preoperative Appointment
Intraoperative Orthodontic Requirements
Immediate Postoperative Appointment
Postoperative Orthodontics
Soft tissue effects
Individual Variation in Soft Tissue Response
The Immediate Response to Orthognathic Surgery
Major Soft Tissue Effects of Orthognathic Procedures
Reference Ratios for Soft Tissue to Hard Tissue Movements
Stability
Factors Affecting Postoperative Stability
The Hierarchy of Stability
Considerations in specific situations
Timing of Surgery in Relation to Patient Age
Surgery-First Versus Conventional Surgery
Orthognathic Surgery for Sleep Apnea
Mandible-Only Surgery for Anterior Open Bite Correction
Distraction Osteogenesis
Facial Feminization Surgery
Bimaxillary and Occlusal Plane Rotation
Concomitant Temporomandibular Joint Surgery
Hilotherapy
Adjunctive Treatments
Complications
Conclusion
Acknowledgment
References
Further reading
28 Adult Interdisciplinary Therapy: Diagnosis and Treatment
Current Status of Adult Interdisciplinary Therapy
Adult Patient Demographics
Adult Patient Needs
Developing an Interdisciplinary Team
Goals of Adult Interdisciplinary Therapy
Ideal Orthodontic Treatment Goals and the Adult Patient
Individualized Adult Interdisciplinary Orthodontic Treatment Objectives
Additional Adult Treatment Objectives
Diagnosis of Adult Orthodontic Conditions
Skeletal Differential Diagnosis
Periodontal Differential Diagnosis
Temporomandibular Joint Differential Diagnosis
Clinical Management of The Interdisciplinary Adult Therapy Patient
Biomechanical Considerations
Control of Occlusion
Disarticulation
Selective grinding
Modification of mechanotherapy
Removable appliances
Fixed appliances
Use of temporary anchorage devices
Occlusal control
Periodontal accelerated osteogenic orthodontics
Periodontal Management during the Orthodontic Tooth Movement
Significance of Tooth Mobility
Periodontal Preparation of Adults before Orthodontic Therapy
Smoking cessation
Gingival tissue
Osseous surgery
Inflammation control
Behavioral Management: Orthodontist and Staff Preparation for Adult Interdisciplinary Patient Management
Advanced Continuing Education Courses
Refined Consultation Techniques
Appliance Modifications for Adult Treatment to Reduce Esthetic Concerns
Sequence of Adult Interdisciplinary Therapy
Evaluation of the Skeletal Component of the Malocclusion
Periodontal Preparation
Dentoalveolar Collapse: Orthodontic and Restorative Considerations in The Adult Interdisciplinary Patient
Application of Principles
Concepts for Adult Interdisciplinary Team Patients with Missing Teeth and Dentoalveolar Collapse
Evaluation before Debonding or Debanding
Coordination of Debonding or Debanding with Other Treatment Providers
Stability and Individualized Retention for The Adult Interdisciplinary Patient
Risk Management for The Adult Interdisciplinary Therapy Patient
Treatment Conference Report
Progress Report
Stabilization and Retention Report
Treatment Completion Report
Summary
Acknowledgments
References
Part D Specialized Treatment Considerations
29 Bonding in Orthodontics
Introduction and Historical Perspective
Materials and Devices Used in Orthodontic Bonding
Brackets
Ceramic Brackets
Metal Brackets
Adhesives
Composite Resins
No-mix adhesives
Light-cured adhesives
Primers
Moisture-insensitive primers
Self-etching primers
Cytotoxicity of orthodontic resins
Glass Ionomer Cements
Light Sources
Light-Emitting Diodes
BONDING
Bonding to Enamel
Premedication
Cleaning
Enamel Conditioning
Moisture control
Enamel pretreatment
Conventional acid etching
Laser etching
Sealing and priming
Bonding
Transfer
Positioning
Fitting
Removal of excess
Curing
Bonding to Artificial Tooth Surfaces
Bonding to Porcelain
Bonding to Zirconia
Bonding to Amalgam
Small amalgam filling with surrounding sound enamel
Large amalgam restoration or amalgam only
Bonding to Gold
Bonding to Composite Restoratives
Indirect Bonding
Clinical Procedure
Indirect bonding with composite custom bracket base
Indirect bonding with CAD/CAM-assisted bracket placement and clear transfer tray
Rebonding
Special Considerations for Orthodontic Bonding during COVID-19 Outbreak
Initial Bonding and Rebonding with No Adhesive on Enamel202
Rebonding with Residual Composite on Enamel202
Special Considerations for Orthodontic Bonding During COVID-19 Outbreak
Final Check and Delivery of Care Instructions to Prevent Decalcification and to Decrease Bond Failures
Conclusion
Debonding
Clinical Procedure
Removal of Steel Brackets
Removal of Ceramic Brackets: Enamel Tearouts
Cracks: Fracture Lines
Removal of Residual Adhesive
Amount of Enamel Lost in Debonding
Operator Safety during Debonding
Prevention and Reversal of Decalcification
Microabrasion
Clinical Procedure
Resin Infiltration
Clinical Procedure (Fig. 29.42)
Bonded Retainers
Bonded Fixed Retainer Materials
Bonded Fixed Retainer Adhesives
Periodontal Health with Bonded Fixed Retainers
Bonded Canine-to-Canine Lingual Retainer Bar
Bonding the 3-3 Retainer Bar
Failure Analysis and Long-Term Experience with the 3-3 Retainer Bar
Multistranded Wire Retainers
Bonding the Multistranded Wire Retainer
Direct bonding of multistranded wire retainer
Indirect bonding of multistranded wire retainer
Failure Analysis and Repair
Long-Term Experience with the Multistranded Wire Retainer
Direct-Bonded Labial Retainers
Technical Procedure
Long-Term Results
Other Applications of Bonding
Bonding a Large Acrylic Appliance
Technical Procedures
Permanent dentition
Deciduous or mixed dentition
Occlusal Buildup of Posterior Teeth
Technical Procedure
Conclusion
References
30 Management of Impactions
Teeth normally erupt! (cause)
Is there an impaction? (diagnosis)
Which teeth are the most likely to be affected? (prevalence)
Where is the tooth? (positional diagnosis)
Clinical Examination
Plane Film Radiography
Three-Dimensional Imaging
Assessment of the overall malocclusion (treatment planning)
Resolving the impaction
Rationale for surgical exposure
Surgical options: two approaches
Attachments
Traction mechanisms, their range, and their directional potential
Finishing and the importance of torque correction
Impacted canines that resorb the incisors
Prevalence
Proximity of the Canine Crown
Treatment Priority Protocol
Treatment Priority Protocols for Patients with Canine-Induced Severe Resorption
When Can We Start Orthodontic Movement of the Resorbed Tooth?
Failure—patient-dependent factors
Failure—orthodontist-dependent factors
Failure—surgeon-dependent factors
References
31 Management of Dental Luxation and Avulsion Injuries in the Permanent Dentition
Tissue response to trauma
Root resorption
Pulpal response
Pulp Necrosis
Pulp Canal Obliteration
Alveolar fracture
Management of trauma and immediate sequelae
Concussion and Subluxation
Lateral Displacement
Extrusive Luxation
Intrusive Luxation
Avulsion
Treatment of avulsed permanent teeth with closed apex
Treatment of avulsed permanent teeth with open apex
Prevention
References
32 Autotransplantation of Developing Teeth
Autotransplantation of developing premolars
Selection of a Donor: Orthodontic Considerations
Selection of a Donor: Surgical Considerations
Surgical Procedure
Removal of the Donor Tooth
Preparation of the Recipient Site
Follow-Up
Presurgical and Postsurgical Orthodontics
Reshaping to Incisor Morphology
Transalveolar transplantation
Autotransplantation of developing third molars
Conclusions
References
33 Iatrogenic Effects of Orthodontic Appliances
Prevalence
Detection and Measurement
Transverse Microradiography
Quantitative Light-Induced Fluorescence
Quantitative Light-Induced Fluorescence–Digital
Prevention
Prevention of DL During Orthodontic Treatment
Preventing Loss of Mineral from Enamel (Demineralization)
Promoting the Uptake of Mineral into Enamel (Remineralization)
Reducing plaque.
Mechanical.
Chemical.
Diet.
Placing a barrier to mineral loss.
Increasing the availability of fluoride.
Toothpaste
Mouthrinse, gel, and foam
Varnish
Bonding materials
Elastics
Slow-release devices
Diet
Increasing the availability of calcium and phosphate.
CPP-ACP
Increase salivary flow or increase the pH of saliva
Chewing gum
Treatment of demineralized lesions
Fluoride
Casein Phosphopeptide–Amorphous Calcium Phosphate
Resin Infiltration
Summary
Cause
Risk Factors
Diagnostic Factors
Tooth anatomy.
Demographic factors.
Malocclusion factors.
Protective factors.
Patient medical history and habits.
Treatment Factors
Mechanical factors.
Clear aligners.
Accelerated treatment.
Early treatment.
Rapid maxillary expansion
Extractions.
Treatment duration.
Root apex displacement.
Magnitude of applied force.
Skeletal anchorage devices.
Maxillary surgery.
Management
Imaging
History
Progress Review
What Should Be Done if Root Resorption Is Detected at Progress Review?
Common questions
When Does EARR Start?
When Does EARR Stop?
What Happens to Teeth with Short Roots over the Long Term?
Are There Any Methods to Detect Root Resorption Before It Is Visible on Radiographs?
References
Prevention and Management of Demineralized White Lesions
External Apical Root Resorption
Further readingS
34 Minimally Invasive and Noninvasive Approaches to Accelerate Tooth Movement
Patient and parent perspective on orthodontic treatment duration
Avenues to reduce duration of orthodontic treatment
Optimizing Delivery of the Load System
Altering Biology to Enhance the Rate of Orthodontic Tooth Movement
Objective outcome measures in tooth movement acceleration
Approaches to accelerate the rate of tooth movement
Invasive methods
Distraction Osteogenesis
Periodontal Ligament Distraction Osteogenesis
Dentoalveolar Distraction Osteogenesis
Speedy Surgical Orthodontics
Corticotomy
Periodontally Accelerated Osteogenic Orthodontics
Minimally invasive methods Orthodontic Tooth Movement
Piezocision
Animal Studies
Human Studies
Micro-osteoperforation
Animal Studies
Human Studies
Noninvasive methods
Photobiomodulation
Animal Studies
Human Studies
Mechanical Vibration
Animal Studies
Human Studies
Drugs, hormones, and biologics
Platelet-Rich Plasma
Animal Studies
Human Studies
Vitamin D
Animal Studies
Human Studies
Prostaglandins
Animal Studies
Human Studies
Hormones
Gene Therapy
Conclusion
References
35 Aerosols in Orthodontics
36 Computer-Assisted Orthodontics
Integrating Computer-Aided Design and Computer-Aided Manufacturing Technology with Diagnosis, Treatment Planning, and Thera ...
Evolution of diagnostic media technologies into therapeutics
Early treatment simulation technologies
Integrated Digital Technology Platform: SureSmile Technology
The Starting Point: Digital Diagnostic Model and Do-It-Yourself Simulation Solutions
Digitally-Assisted Indirect Bonding
Digital Indirect Bonding Solutions
Digital Technology–Assisted Indirect Bonding Advantages
SureSmile Indirect Bonding Process
Evolution of digital orthodontic therapeutics
The Traditional Reactive Care Cycle Model
Computer-Assisted Orthodontic Therapy Benefits
Computer-Assisted Customized Prescriptive Care Model
The suresmile fixed appliance process: collaboration of the practice and digital lab
The Therapeutic Model
MACROS: Communicating with the Digital Lab
Plan Construction and Review
Surgical Tools
Qualitative Viewing
Quantitative Viewing
Quality Tools
Wire Design
Clinical Management of SureSmile Wires
Summary of SureSmile Technology Benefits
Additional therapies supported on the suresmile platform
Lingual Fixed Appliance Treatment
In-Office Aligner Treatment
Minor Tooth Movement
Finishing Aligners
Comprehensive Aligner Treatment
Summary
Acknowledgments
References
Part E Orthodontic Retention and Posttreatment Changes
37 Stability, Posttreatment Changes, and Retention
Historical Background
Schools of Thought for Reducing Instability
The Occlusal School
The Apical Base School
The Mandibular Incisor School
The Musculature School
Historical Theories of Retention That Influence Contemporary Practice
Theory 1: Teeth That Have Been Moved Tend to Return to Their Former Position
Theory 2: Elimination of the Cause of the Malocclusion Will Prevent Recurrence
Theory 3: The Malocclusion Should Be Overcorrected
Theory 4: Proper Occlusion Is an Important Factor in Holding Teeth in Their Corrected Positions
Theory 5: Bone and Adjacent Tissues Must Be Allowed to Reorganize Around Newly Positioned Teeth
Theory 6: If The Lower Incisors Are Placed over Basal Bone, They Are More Likely to Remain in Good Alignment
Theory 7: Corrections Carried out During Periods of Growth Are Less Likely to Relapse
Theory 8: Arch Form, Particularly the Mandibular Arch, Cannot Be Altered Permanently with Appliance Therapy
The University of Washington Post-Retention Studies: Key Findings
Post-Retention Changes Are Unpredictable
Arch Length and Width Decrease Over Time, Especially Intercanine Width
Rotations Usually Relapse Toward Initial Positions
Some Cases Display More Favorable Results
Treatment Timing
Early Post-Retention Stability Is Usually a Mirage
Life-Long Retention Is the Best Insurance Policy
Some Good News: Maxillary Teeth Fare Better
Treat to Excellence: Quality Matters
Impact of Key Findings of Post-Retention Registry
Posttreatment Changes
Etiologic Factors of Unwanted Posttreatment Changes
Periodontal and Gingival Fibers
Occlusion, Centric Relation, Temporomandibular Disorder
Growth
Third Molars Do Not Have an Effect
Interarch Stability in the Anteroposterior, Vertical, and Transverse Dimensions
Anteroposterior Stability
Transverse Stability
Vertical Stability
Retention Devices
Hawley-Type Retainers
Clear Plastic Retainers
History of Clear Plastic Retainers
Design of Clear Plastic Retainers
Clear Plastic Retainer Materials and Manufacture
Contraindications for Clear Plastic Retainers
Dangers of Clear Plastic Retainers
Bonded Retainers
History of Fixed Retainers
Indications for Bonded Retainers
Bonded Retainer Material and Design
Adhesives and Bonded Retainers
Problems with Bonded Retainers
Bonded retainer failures
Negative effects on periodontal health
Unwanted tooth movement while bonded retainer is in situ
Adverse effects on general health
Maintenance of Bonded Retainers
Positioners as Retainers
Evidence Comparing Different Types of Retainers
Evidence Comparing Hawley and Clear Plastic Retainers
Evidence Comparing Different Types of Bonded Retainers
Evidence Comparing Removable and Fixed Retainers
Evidence About Dual Retention
Evidence of How Often to Wear Removable Retainers
Summary of Evidence Comparing Different Types of Retainers
Adjunctive Techniques for Reducing Posttreatment Changes
Pericision
Interproximal Reduction
Frenectomy
Novel Approaches for Improving Stability
Developments in Technology Related to Retention
Alternative Removable Retainer Materials
Remote Monitoring of Retention
Biologic Approaches to Reducing Relapse
No Retainers: Testing Who Is Stable
Educating and Motivating Patients at a Population and Patient Level
Responsibilities and Retention
Summary
References
Part F Classic Chapters
38 Interceptive Guidance of Occlusion
39 Functional Appliances
References
40 Treatment of the Face with Biocompatible Orthodontics
Part A Foundations of Orthodontics
1e Orthodontics: From an Idea to a Profession
How the Specialty Has Evolved from 1850 to the Present
Pre-1900 Development of the Orthodontic Specialty
The Professionalization of Orthodontics
Universities Take the Plunge
Orthodontists Get Together: Associations
Organizations Abroad
Periodicals
The Study of Craniofacial Growth
Histologic Studies
The American Board of Orthodontics, Albert Ketcham, and Early Twentieth-Century Appliances
The American Board of Orthodontics and Albert H. Ketcham
The Crib Grows Up
Angle’s Appliances
Mershon Lingual Arch
Labiolingual Appliance
Open-Tube Appliance
Stainless Steel
More Early Twentieth-Century Appliances and the Extraction Controversy
Universal Appliance
Twin Wire
Preformed Bands
Acrylics
Headgear
Extraction Controversy
The Cephalometer Takes its Place in the Orthodontic Armamentarium
Form-Function Relationship
Laminography
Individual Growth
Cephalometrics
Maxillofacial Triangle
Anteroposterior Dysplasia
Downs’ Analysis
ANB Angle
Steiner Analysis
Tweed Triangle
Archial Analysis
Harvold Analysis
McNamara Analysis
Wits Analysis
Ricketts Analysis
Mesh Diagram
Commentary
Functional Appliances to Midcentury
The Monobloc
Myofunctional Therapy
The Activator
The Herbst Appliance
The Bimler Appliance
The Double Plate
The Function Regulator
The Tooth Positioner
The Nuk Sauger
The Bionator and Other Functional Appliances
Classification by Type
The Golden Age of Orthodontics
Orthodontic Education
American Association of Orthodontists Preceptorship Program
The Upswing
The Downswing
Arch-Length Analyses
Second Premolar Extraction
Two Controversies: Early Treatment and Occlusion
Early Treatment Definition
Clinical Period
Academic Period
More Recent Concepts
Occlusion
Fictional Period
Hypothetical Period
Factual Period
The Temporomandibular Joint and Orthognathic Surgery
Neuromuscular Theories
Myofascial Theories
Psychological Theories
Recent Theories
Articulators and Centric Relation
Temporomandibular Joint Prostheses
Orthognathic Surgery to Midcentury
Surgical Adjuncts to Orthodontics
Surgery Matures
Cleft Lip and Palate Treatment
Distraction Osteogenesis
Pioneers
Mandibular Procedures
Skeletal Fixation
Ilizarov’s Influence
Skeletal Anchorage
Types of Implants
Evolution of Skeletal Anchorage
Capabilities and Limitations
Late Twentieth-Century Fixed Appliances
Rotation Control
Preadjusted Brackets
Narrow Slots
Esthetic Brackets
Bonded Brackets
Adhesives Mature
A Brief History of the American Journal of Orthodontics
Martin Dewey 1915–1931
Harvey Carlyle Pollock 1932–1968
B. F. (Tod) Dewel 1968–1978
Wayne G. Watson 1978–1985
Thomas M. Graber 1985–2000 ( Fig. 1.76)
David L. Turpin 2000–2010
Vincent G. Kokich 2010–2013 ( Fig. 1.77)
Rolf G. Behrents 2014–Present
Formation of the World Federation Of Orthodontists
References
Pre-1900 Development of the Orthodontic Specialty
The Professionalization of Orthodontics
The American Board of Orthodontics, Albert Ketcham, and Early 20th-Century Appliances
More Early Twentieth-Century Appliances and the Extraction Controversy
The Cephalometer Takes its Place in the Orthodontic Armamentarium
Functional Appliances to Midcentury
The Golden Age of Orthodontics
Two Controversies: Early Treatment and Occlusion
The Temporomandibular Joint and Orthognathic Surgery
Surgical Adjuncts to Orthodontics
Skeletal Anchorage
Late Twentieth-Century Fixed Appliances
A Brief History of the American Journal of Orthodontics
Formation of the World Federation of Orthodontists
18e Standard Edgewise: Tweed-Merrifield Philosophy, Diagnosis, Treatment Planning, and Force Systems
Historical Perspective
The Angle System
The Edgewise Appliance
Charles H. Tweed
Levern Merrifield
Diagnostic Concepts
Treatment Concepts
Dimensions of the Dentition
Differential Diagnosis
Facial Disharmony
Z Angle
Frankfort Mandibular Incisor Angle
Cranial Disharmony
Skeletal Analysis Values
Frankfort mandibular plane angle
Incisor mandibular plane angle
Sella-nasion-subspinale angle
Sella-nasion-supramentale angle
Subspinale-nasion-supramentale angle
Occlusal plane
Posterior facial height
Anterior facial height
Facial height index
Facial height change ratio
Craniofacial Analysis
Dental Disharmony
Total Dentition Space Analysis
Anterior Space Analysis
Midarch Space Analysis
Posterior Space Analysis
Differential Diagnostic Analysis System
Tweed-Merrifield Edgewise Appliance
Brackets and Tubes
Archwires
First-, Second-, and Third-Order Bends and Their Interaction
First-Order Bends
Second-Order Bends
Third-Order Bends
Auxiliaries
Variations of the Appliance
Treatment with the Tweed-Merrifield Edgewise Appliance
Sequential Appliance Placement
Sequential Tooth Movement
Sequential Mandibular Anchorage Preparation
Directional Force
Timing of Treatment
Steps of Treatment
Denture Preparation
Denture Correction
Sequential Mandibular Anchorage Preparation
Class II Force System
Orthodontic Correction of the Class II Dental Relationship
Denture Completion
Denture Recovery
Summary
References
35e Aerosols in Orthodontics
What is an aerosol?
What happens to aerosol particles and droplets once generated?
What are orthodontic aerosols?
Triple Syringe
Enamel Prophylaxis Before Bonding
Removal of Adhesives
Air Polishing
Ultrasonic Scalers
When do aerosols pose a health risk?
How can we mitigate against orthodontic aerosols?
Non–Aerosol-Generating Procedures
Preprocedural Mouthrinse
Use of Facemasks
High-Volume Evacuation
Ventilation in the Workspace
Use of Face Shield and Protective Eyewear
Extraoral Scavenging Devices
Summary
References
Part F Classic Chapters
38e Interceptive Guidance of Occlusion with Emphasis on Diagnosis
Diagnostic records
Intraoral, Panoral, or Cone-Beam Computed Tomography Images
Cephalometric Radiographs
Facial Photographs
Study Models
Intraoral Photographs
Diagnosis
The Face
Proportional Facial Analysis
The Standard
Alveolodental Protrusion
Class I: Maxillary and mandibular alveolodental protrusion
Class II: Maxillary alveolodental protrusion
Class III
Alveolodental Retrusion
Class I: Maxillary and mandibular alveolodental retrusion
Class II: Mandibular alveolodental retrusion
Prognathism
Class I: Maxillary and mandibular prognathism
Class II: Maxillary prognathism
Retrognathism
Class I: Maxillary and mandibular retrognathism
Class II: Mandibular retrognathism
High angle (hyperdivergent)
Low angle (hypodivergent)
The Teeth
Clinical Analysis
Hereditary crowding
Environmental crowding
Dental Development in the Mixed Dentition
First molars
Incisors
Canines, premolars, and second molars
Total Space Analysis
Conventional Method
Tweed Method
Total Space Analysis
Anterior area
Tooth measurement
Cephalometric correction
Soft tissue modification
Middle area
Tooth measurement
Curve of occlusion
Posterior area
Discussion
Timing of Guided Primary Tooth Removal
Treatment
Class I treatment
Treatment Procedures: Interceptive Guidance and Active Treatment
Serial Extraction in Class I Treatment
Group A: Anterior discrepancy—crowding
Group B: Anterior discrepancy—alveolodental protrusion
Group C: Middle discrepancy—impacted canines
Group D: Enucleation in the mandible
Group E: Enucleation in the maxilla and mandible
Group F: Alternative to enucleation
Group G: Interproximal reduction
Group H: Congenital absence
Maxillary incisors
Mandibular incisors
Premolars
Typical Patient for Class I Serial Extraction
Key measurements for diagnosis and case evaluation
References
Additional Readings
39e Functional Appliances
Origin
Andresen activator
Bite-opening controversy
Head Posture during Sleep
Working Hypotheses
Sagittal Change
Vertical Opening Variations
Mechanisms of class ii correction with functional orthopedics
Class II Correction: A Likely Scenario
Bionator
Construction bite
Anterior Mandibular Posturing
Hamilton Expansion Activator
Fränkel Appliance
Double Plates
Clark Twin Block Appliance
Magnetic Appliances
Stöckli-Teuscher Combined Activator-Headgear Orthopedics
Fixed Functional Appliances
Herbst Appliance
Sagittal Changes
Vertical Changes
Long-Term Posttreatment Changes
Jasper Jumper
Summary
References
40e Treatment of the Face with Biocompatible Orthodontics
The damon system concept
Early observations of damon system treatment
Contemporary orthodontic philosophies
Achieve Facial Harmony via Facially Driven Treatment Planning
Use of Nonextraction Therapy Where Possible and Light-Force Mechanics
Force management
Achieving Extremely Light–Force Mechanics: A Passive Tube
A Look at Sliding Mechanics
Case for Using Extremely Light Forces in Passive Tubes
Computed tomographic scans demonstrate healthy bone structure after treatment with the low-force damon tube system
Case presentations and clinical analyses
Treatment with the Herbst Appliance of Growing Patients with Skeletal Class II Dentition
Clinical Principles for Using the Herbst Appliance
Clinical Application of the Herbst Appliance
Damon system essentials
Damon System Appliance
Damon Standard Prescription
High-Torque and Low-Torque Alternatives to the Damon Standard Prescription
Upper central incisors
Upper lateral incisors
Upper and lower canines
Lower central and lateral incisors
Damon System Archwires and Archwire Sequencing
Light Round Wire Phase
High-Tech Edgewise Phase
Major Mechanics Phase
Finishing Phase
Tieback Usage with the Damon System
Using Elastics with the Damon System
Lingual Retainer Wire and Splint Retainer
Summary
Acknowledgment
References
Index