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Quintessence Publishing: Journals: ORTHODONTICS
ORTHODONTICS
The Art and Practice of Dentofacial Enhancement

Formerly World Journal of Orthodontics

Edited by
Rafi Romano, DMD, MSc (Editor-in-Chief)

ISSN 2160-2999 (print) / ISSN 2160-3006 (online)

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Publication:
Winter 2000
Volume 1 , Issue 2

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Ultralight Forces for Simultaneous Orthodontics and Orthopedics: Part II. Rheodontic Impediments

Barry Mollenhauer, MDSc, BDSc

Pages: 187-194

Aim: To counter those impediments that slow the rapid movement of teeth. That is, to address the reverse side of rheodontics compared to part I. Methods: Many years of searching to routinely maintain optimum response has shown that a checklist must be built up to ascertain the offending impediment or impediments. Results: As stated in the general abstract at the beginning of part I, parafunction is a more common cause of slow treatment, and even cessation of movement altogether, than noncompliance. Despite the small amount of time the teeth are in occlusion each day, applying effective buccal root torque to maxillary posterior teeth and/or the establishment of incisal guidance can have immediate and dramatic effects on restoring optimum tooth movement. There even appears to be an optimum overbite required, which is a positive one that necessitates setting the lower incisor brackets low. This applies especially to open bite cases to allow full closure of the overbite. On the other hand, deep bites should not be corrected to an edge-to-edge relationship during treatment. As well as marked slowing of tooth movement, poor functional occlusion can manifest as canine wear and dehiscence during or after treatment in some mouths. Conclusion: A simple linear approach is not effective for rapid and good orthodontic results. Rather it is necessary to start the rheodontic process by routinely monitoring for slow movement. Then, every instance should be followed immediately by diagnosis from careful examination and history; and sometimes a trial-and-error or diagnosis-therapy approach. Diagnosis of parafunctional impediments is further complicated by a honeymoon period of about 6 months in adolescents, during which occlusal dysfunction does not slow treatment. World J Orthod 2000;1:187-194.

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