Evidence Based Clinical Orthodontics – a Contradiction?
Evidence based orthodontics: an introduction
Evidence based orthodontics has a bad reputation among clinicians. This is mainly due to a misunderstanding of what making decisions according to evidence based principles means. This introduction will guide you through this process by analyzing typical clinical questions from daily orthodontic practice.
Orthodontics, occlusion and gnathology: evidence based vs. experience based views
Orthodontic treatment has a tremendous influence on static and dynamic occlusion. But which occlusion is correct and will provide the patient with an optimal functional environment? Numerous occlusion concepts have been introduced in the past, have been altered or even deserted. Many of these were only based on anecdotal and empirical evidence but lacking scientific evidence. This lecture tries to answer the following questions:
-Are occlusion and condyle position really a primary cause of TMD?
-Is there a scientifically proven concept of occlusion?
-Is orthodontic treatment a predisposing or preventive factor for the development of TMD?
-Is extraction treatment a potential hazard?
Selfligating brackets: basics, biology, biomechanics and business
The first ligature free brackets were introduced in 1935. During the following decades numerous designs were patented but hardly ever reached production status. In recent years, however, self-ligating brackets are in the focus of interest. All major orthodontic companies market their own designs. According to the sales promotional material, each company has the bracket system that may solve all clinical difficulties. This lecture will present a critical overview, based on clinical cases and scientific analyses, of the most frequently used self-ligating bracket systems on the market and point out the discrepancy between companies' promises and scientific proof.
External apical root resorptions are among the most frequent unwanted side effects of orthodontic tooth movement that may be minimized, but not completely prevented. A sound knowledge of possible influential factors is essential. The three main questions that will be addressed are:
-Can risk patients be identified before the start of treatment?
-What should be done if root resorption occurs during treatment?
-What happens long term with teeth that develop root resorption during treatment?
Orthodontics and periodontics: on the close contact of 2 dental specialities
Orthodontic tooth movement implies adaptation of the alveolar bone and the neighbouring tissues. Orthodontics may thereby support periodontal treatment but can also aggravate the periodontal situation, in case of uncontrolled tooth movement combined with an inflamed periodontium. In order to deliver the best possible service to the patient each orthodontist must have a sound knowledge of physiologic and pathologic periodontal conditions. The increasing number of adults seeking orthodontic treatment implies that periodontist and orthodontist need to work in ever closer cooperation.
-Orthodontic tissue regeneration: where are the limits?
-Long term effects of perio-ortho treatment
New treatment concepts: the re-invention of the wheel?
The duplication of knowledge takes place in shorter and shorter intervals. Evolutions and revolutions are announced at an almost monthly basis, partly in scientific contributions, partly by companies. Treatment concepts and philosophies that seem new and revolutionary are introduced. As a consequence it is very difficult, if not impossible to keep an overall view of our specialty. Publications by the founders of modern orthodontics in the early 20th century, however, may show us that many ideas have been around for ages. This lecture will critically review new developments in orthodontics and compare these with (almost) forgotten knowledge from times past.