This is a major new work dedicated to the increasingly prominent area of adult orthodontics. Written by renowned contributors from the orthodontic community and beyond, and compiled by a world-class editor, it provides an authoritative resource on the subject, marrying together clinical guidance with a thorough evaluation of the evidence base. The opening chapters provide the context for adult orthodontics, including patient demographics and aetiology, and the book goes on to detail treatment planning considerations, including patient case profiles, suggesting initial outcomes and longer term expectations. Interdisciplinary and multidisciplinary approaches are discussed, including the links between adult orthodontics and periodontics, prosthetics and temporomandibular disorders. The book is accompanied by a website containing further examples of case studies and a wealth of clinical images. Set to become the gold standard resource on the subject, this book will be invaluable to all those providing orthodontic treatment to adults and those dealing with orthodontics as part of the inter-disciplinary management of the adult dentition.
KEY FEATURES A major new work on an expanding area of orthodontic treatment Covers patient demographics, aetiology, treatment planning and maintenance issues Includes case studies, suggesting realistic and optimal short and long term outcomes Highly illustrated with full colour clinical photos Accompanied by a website with further material: www.wiley.com/go/melsen
Birte Melsen is Professor and Head of the Department of Orthodontics; School of Dentistry, Aarhus University in Aarhus, Denmark. She has authored more than 360 publications in the fields of growth, with her recent professional interests focusing primarily on the fields of skeletal anchorage, virtual imaging and adult orthodontic treatment.
List of Contributors xi Introduction: More than a Century of Progress in Adult Orthodontic Treatment xiii 1 Potential Adult Orthodontic Patients Who Are They? 1 Birte Melsen Introduction 1 Who are the patients? 1 How do the patients express their needs? 6 The first visit 7 Communicating with the patient 9 Summary 10 References 10 2 Diagnosis: Chief Complaint and Problem List 12 Birte Melsen, Marco A Masioli Introduction 12 Work-up of a problem list the interview chief complaint 12 General health 14 Clinical examination 16 Extraoral examination 16 Extraoral photographs 19 Function of the masticatory system 23 Intraoral analysis oral health 23 Evaluation of dental casts arch form 24 Occlusal analysis 24 Space analysis 26 Cephalometric analysis 26 Final problem list 27 Indication for treatment 28 The presentation of the problem list the tip of the iceberg 29 Concluding remarks 33 References 33 3 Aetiology 35 Birte Melsen Introduction 35 Biological background 35 Aetiology of malocclusions in adults 41 Age-related changes in the skeleton 42 Age-related changes in the craniofacial skeleton 46 Age-related changes in the local environment 46 Consequences of deterioration of the dentition 48 Case reports 49 Conclusion 50 References 52 4 Interdisciplinary Versus Multidisciplinary Treatments 54 Birte Melsen Interdisciplinary or multidisciplinary treatments 54 Establishment of an interdisciplinary team 56 Treatment sequence 58 Essential and optional treatment procedures 59 Interaction during treatment 61 Post-orthodontic treatment 62 Patient satisfaction 62 Examples of interdisciplinary cases 63 References 63 5 Treatment Planning: The 3D VTO 64 Birte Melsen, Giorgio Fiorelli Determining the treatment goal 64 Producing an occlusogram 64 Combining the occlusogram with the head fi lm 69 The computerized occlusogram 72 Responding to patients needs 73 Orthodontic treatment: Art or science? 73 References 76 6 Tissue Reaction 77 Carlalberta Verna, Birte Melsen Orthopaedic effects 77 Orthodontic effects in adult patients 78 References 95 7 Appliance Design 99 Birte Melsen, Giorgio Fiorelli, Delfi no Allais, Dimitrios Mavreas Introduction 99 Defi nition of the necessary force system 100 Anchorage evaluation 101 Sequencing the treatment into phases 103 Appliance selection and design 105 Sliding mechanics 108 Segmented mechanics 112 Conclusion 128 References 129 8 Anchorage Problems 132 Birte Melsen, Carlalberta Verna Introduction 132 Definition 132 Classification of anchorage 132 Intramaxillary anchorage 133 Soft tissue anchorage 136 Free anchorage 137 Intermaxillary anchorage 142 Occlusion 143 Differential timing of force application 144 Extraoral anchorage 144 Skeletal anchorage 145 References 160 9 Bonding Problems Related to Adult Rehabilitated Dentitions 163 Vittorio Cacciafesta, M Francesca Sfondrini, Carmen Giudice Introduction 163 Brackets 163 Basics of bonding 168 Bonding to crowns and restorations 178 Debonding 179 Reconditioning of stainless steel attachments 180 Banding 181 Auxiliary attachments 185 References 185 10 Material-related Adverse Reactions in Orthodontics 188 Dorthe Arenholt Bindslev Introduction 188 Fixed appliances 188 Bonding and banding materials 194 Removable appliances 197 Miscellaneous materials 199 Concluding remarks 200 References 200 11 Patients with Periodontal Problems 205 Birte Melsen Prevalence of periodontal disease 205 Malocclusion and periodontal disease 205 Orthodontics and periodontal disease 206 Indications for orthodontic treatment in periodontally involved patients 209 Treatment of patients with flared and extruded upper incisors 212 Tissue reaction to intrusion of teeth with horizontal bone loss 214 Treatment of patients with vertical bone defects 220 What are the periodontal limits for orthodontic tooth movement? 221 Sequence of treatment in periodontally involved patients 227 Conclusion regarding Infl uence of orthodontic treatment on periodontal status 227 References 231 12 A Systematic Approach to the Orthodontic Treatment of Periodontally Involved Anterior Teeth 234 Jaume Janer Single tooth gingival recession 234 Progressive spacing of incisors 238 Case reports 241 Management of periodontally involved teeth 245 References 258 13 Interdisciplinary Collaboration Between Orthodontics and Periodontics 261 Francesco Milano, Laura Guerra Milano Introduction 261 Periodontal diagnosis 262 History taking, clinical and radiographic examination 262 Screening for periodontal disease 262 Local factors predisposing to periodontal therapy 264 Timing of ortho-perio treatment 264 Periodontal therapy 265 Surgical therapy 271 Mucogingival and aesthetic surgery 272 Regenerative surgical therapy 281 Supportive periodontal treatment 282 Ortho-perio and multidisciplinary clinical cases 282 Conclusion 284 Acknowledgements 284 References 288 14 The Link Between Orthodontics and Prosthetics 291 Yves Samama Introduction 291 Edentulousness and space management: the mesiodistal dimension 291 The vertical dimension 301 Orthodontics, periodontal disease and prosthetic splinting 303 Conclusion 307 Acknowledgements 308 References 308 15 Patients with Temporomandibular Joint (TMJ) Problems 310 Birte Melsen Orthodontics and dysfunction 310 Controversy in the literature regarding TMD and occlusion 312 Treatment and TMD 313 Treatment of clicking joints 314 Orthodontic treatment of patients with TMD 314 Organization of the treatment 320 Conclusion 320 References 323 16 Patients with Temporomandibular Disorders 324 Peter Svensson Introduction 324 Classification and epidemiology 324 Diagnostic procedures 326 Risk factors and etiology 329 Pathophysiology 329 Management 332 Summary 335 References 335 17 Invisalign(R): as Many Answers as Questions 339 Rainer-Reginald Miethke Is Invisalign(R) new? 339 How does Invisalign work? 339 What are the pre-treatment considerations? 340 How does the Invisalign System differ from conventional orthodontics? 341 What characterizes patients seeking Invisalign treatment? 341 What is the most favourable approach to resolving crowding in Invisalign patients? 341 How can the alternatives to IER be evaluated? 342 What are the problems related to resolution of crowding? 342 When are extractions indicated? 342 Does an Invisalign treatment plan differ from a regular orthodontic treatment plan? 344 How does one take an adequate impression for the Invisalign System? 344 What is required to be evaluated in ClinCheck(R)? 345 What material are aligners made of? 347 What are aligner attachments? 347 How are attachments fabricated on the teeth? 348 What has to be controlled after insertion of aligners? 348 What are the consequences of good or poor aligner fi t? 349 What if an aligner is lost? 350 What can be done if a severe discrepancy between ClinCheck(R) and the clinical situation becomes evident during treatment? 350 What can be done if a slight discrepancy between ClinCheck(R) and the clinical situation becomes evident at the end of treatment? 350 How can complications during treatment with the Invisalign system be avoided? 350 References 353 18 Progressive Slenderizing Technique 354 Pablo Echarri Definition and objectives 354 Anthropological justification of slenderizing 354 Influence of slenderizing on dental plaque, caries and periodontal disease 355 Indications 355 Contraindications 360 Advantages of slenderizing 360 How much enamel can be stripped? 361 Special considerations 362 Instrumentation for slenderizing 362 Progressive slenderizing technique 366 Case reports 369 References 369 19 Post-treatment Maintenance 370 Birte Melsen, Sonil Kalia Stability? 370 Biological maintenance 371 Mechanical maintenance retention 372 Intermaxillary retention 378 Active retention plates 380 Conclusion 380 References 380 20 What are the Limits of Orthodontic Treatment? 382 Birte Melsen What determines the limits? 382 Reference 383 Index 385 Visit the supporting companion website for this book: www.wiley.com/go/melsen