Presurgical orthodontics for facial asymmetry

As with the treatment of all facial deformities, orthodontic pre-surgical preparation for facial asymmetry should aim at correcting severe occlusal discrepancies not solely on the basis of a narrow occlusal analysis but also in a way that will not disturb the proposed surgical protocol. In addition, facial asymmetries require specific adjustments, difficult to derive and to apply because of their inherent atypical morphological orientation of both alveolar and basal bony support. Three treated cases illustrate different solutions to problems posed by pathological torque: this torque must be considered with respect to proposed surgical changes, within the framework of their limitations and their possible contra-indications.     

Epigenetic orthodontics: facial and airway development

It is the purpose of this article to introduce a functional orthopedic/orthodontic appliance, the Homeoblock (Figure 1), which, when worn at night (3 p.m. to 8 a.m.), alters oral function and produces a gene environmental interaction that results in an epigenetic response, namely, the expression of unexpressed genes in adult patients. The results of the case studies presented are evaluated using state-of-the-art, three-dimensional technologies: cone beam computerized tomography combined with Dolphin and Analyze 10.0 software (Mayo Clinic). The results, in so-called non-growing adult patients, can only be attributed to gene expression.     

Three-dimensional surface imaging: limitations and considerations from the anthropometric perspective

The use of three-dimensional (3D) surface imaging for clinical measurement purposes has increased considerably as the technology has become more affordable. Like any measurement technique, 3D surface-based anthropometry is subject to a number of limitations and methodological caveats and thus should not be applied without sufficient consideration of its potential strengths and weaknesses. In this brief report, the authors consider 3D surface imaging from the anthropometric perspective, specifically focusing on issues related to the capture of reliable quantitative information from the head and face.     

Cone-beam CT: applications in orthodontics

Radiographic images have always been an important part of orthodontic diagnosis and treatment planning. We have been limited by the two-dimensional nature of these radiographs as we pursue tooth movement in a three-dimensional fashion. This article shows the current and future uses and advantages of cone-beam CT in the practice of orthodontics. The use of this technology in the near future will change the way records are taken and treatment is rendered. With this added diagnostic knowledge, orthodontic treatment will assuredly become not only more high tech but also higher quality.     

Computer applications in orthodontics

The most valuable contribution of computers in orthodontics is to the forecast of growth from serial cephalograms. In order to establish a sound basis it is necessary to evaluate and record the outcome of treatment over a prolonged period. The evolution of a management information service requires that information from all sources shall be recorded in a uniform manner, not only by the individual orthodontist, but both nationally and internationally. The orthodontist will become a member of an oral health management team having all relevant information readily available.     

A review of the clinical applications of elastic tractions in orthodontics

Intermaxillary elastic traction to correct various malocclusions was first introduced in 1892 by Calvin Case. The types of elastics are distinguished according to their material, force production, and mode of application. All elastics vary in their characteristics presenting both advantages and disadvantages. Their composition plays an important role in their behavior when worn. The biomechanics of intermaxillary elastics determine their indications and contraindications.     

Quality control in orthodontics: risk/benefit considerations

The literature concerning risk/benefit appraisal for orthodontic treatment is reviewed with respect to factors which influence dental health, social psychological well-being and the harmful effects of orthodontic treatment. There is little evidence to suggest that the absence of malocclusion is associated with a measurably higher self-esteem and life fulfillment, or with major advantages for dental health, except for a limited number of traits. With regard to treatment, small risks of iatrogenic harm exist, while the effects of partial or total failure of treatment, and the lack of long-term stability of results should not be underestimated.     

More than lip service: facial esthetics in orthodontics.

BACKGROUND: Current trends in orthodontic care emphasize alternatives to the extraction of premolars, despite a lack of support from the refereed literature for many of the nonextraction treatments. DESCRIPTION OF THE SITUATION: Anecdotal reports published in non-peer-reviewed journals have called into question the esthetic effects of extraction treatment. As calls for evidence-based treatments increase throughout dentistry, reports on the effects--both positive and negative--of different orthodontic options have appeared in growing numbers. CLINICAL IMPLICATIONS: Given the results of a variety of reports in the peer-reviewed literature, it may be concluded that orthodontic treatment involving extractions can produce improved esthetics for many patients who have some combination of crowding and protrusion. However, careful diagnosis followed by evidence-based treatment decisions should be the accepted clinical norm as the specialty of orthodontics embarks on its second century.     

Three-dimensional cone beam computerized tomography in orthodontics

There has been an escalating interest in three-dimensional imaging devices over the last decade. Orthodontists are beginning to appreciate the advantages that the third dimension gives to clinical diagnosis, treatment planning and patient education. This article focuses on the cutting edge technology of cone beam CT, which utilizes conventional X-ray technology and computerized volumetric reconstruction to reproduce a three-dimensional image. A variety of applications and range of issues associated with this technology will be discussed.