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Quintessence Publishing: Journals: 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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Spring 2007
Volume 8 , Issue 1

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Editorial: It’s the Details that Count!

T.M. Graber, DMD, MSD, PhD, Odont Dr hc, DSc, ScD, MD, FRCS

The question often arises, “What is the difference between a good (pedestrian) orthodontist and a great one (a leader)?” Having been in the business of treating patients for over 60 years, and having looked at the cases that didn’t work out as well as I wanted, I truly believe, after considerable hindsight diagnosis, that the causes of less than achievable optimum are often minor factors, problems not caught in time, or treated cases that had inadequate retention, or technical deficiencies. Our tendency has been to follow “systems” developed by leading clinicians, and not knowing when and where to vary our mechanotherapy or treatment rationale. I conduct a Socratic Seminar each week with the orthodontic residents, where I try to show these cases, hoping to save them from making the same mistakes, or at least making them aware of what can go wrong.

For the March 2007 issue of the WJO, we have gathered a number of manuscripts that will help reduce our less-than-optimal treatment results. The lead selection by Samir Bishara and associates at the University of Iowa deals with a gnawing (literally) problem of bracket and attachment bonding. They compared shear bond strengths of several bonding materials. Read and profit thereby!

With all the publicity, good and bad, on clear aligners, use and misuse, the article by Drs Kim and Echarri of Korea and Spain, respectively, will be a welcome contribution. The conclusions of the authors apply for the most part to a similar appliance, ie, Invisalign. It is not the tool, but how, why, when, for how long, and in which cases of adult orthodontics this is a suitable approach.

Still concerned with facial esthetics and the ability to achieve optimum treatment results, Drs Mauro and Monica Merli and associates of Remini, Italy, report preliminary results of treatment with gradual repositioning of the anterior mandibular segment, using distraction osteogenesis in patients with tooth crowding and unfavorable anteroposterior relationship of tooth to skeletal base. Preliminary results are encouraging, but more cases must be treated and observed for a longer time posttreatment.

Enhancing our materia technica knowledge is the article by El-Sheikh, Godfrey, Manosudpraset, and Viwattantipa from Libya and Thailand discussing the force-deflection characteristics and fatigue-resistant spring action, via an in vitro study. This methodology can be applied to other materia technica.

Drs Sayinsu, Isik, and Ulgen, of the Yeditepe University of Istanbul, Turkey, assess 3 different molar distalization appliances from the skeletal and soft tissue change standpoint. Read and see which produces the best results and under which circumstances. Mark Hans of Case Western University and Drs Teng, Liao, Chen, and Yang of Taiwan provide a provocative evidence-based approach to treatment of open bite and deep bite with case reports. Read, analyze, and apply. We need more international teamwork! The World Board of Orthodontics case report by Drs Sayinsu and Isik from Turkey again uses the value of interspecialty teamwork (orthodontics and surgery) in the treatment of a severe mandibular laterognathie with bimaxillary protrusion. Too many orthodontists still attempt skeletal correction alone.

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