Session Overview:
Dr Steven J. Lindauer
Psychosocial Benefits of Orthodontics and Orthognathic Surgery
The objectives of orthodontic treatment usually include aligning the teeth and establishing functional occlusal relationships while positioning the dentition so that it is harmonious with the patient’s existing skeletal and soft tissue components. Orthognathic surgery is desirable or required when skeletal and soft tissue limitations prevent the orthodontist from accomplishing goals that are acceptable to both the practitioner and the patient. While the benefits of orthodontic treatment may include enhanced function and esthetics for individual patients, scientific evidence documenting improvement in quality of life remains elusive. However, for patients undergoing combined treatment of orthodontics and orthognathic surgery, the evidence is more compelling. This presentation will examine the existing literature and original research on the psychosocial and functional benefits of orthodontic treatment alone compared to combined treatment with orthognathic surgical procedures.
Orthodontic Management of Deep Overbite
Deep overbite is a common characteristic of malocclusion that must be addressed to achieve the goals of establishing Class I occlusion with good intercuspation and proper overjet. Despite its high prevalence, deep bite alone is not usually the primary motivator for patients to seek orthodontic care but it must be addressed to meet the high standards that both orthodontists and their patients demand. Excessive overbite can be corrected by true intrusion of maxillary or mandibular incisors, relative intrusion, or by opening the bite to allow eruption of posterior teeth. While more than one mechanism may be used to contribute to overbite correction during treatment, orthodontists should intentionally plan how they will address deep bite correction for each patient individually, based on relevant diagnostic information and on their knowledge of the effects of the mechanics they choose to use. Utilizing the so-called “side-effects” of deep bite correction mechanics advantageously can improve treatment efficiency, shorten the duration of treatment, and lead to better patient outcomes.
Recognising and Avoiding Unintentional Surprises during Orthodontic Treatment
Every orthodontist has undoubtedly, at some point, been surprised by the unintended consequences of placing a straight wire into the brackets of crooked teeth. These mishaps may sometimes be labeled as unavoidable, due to individual patient variations or habits, or just bad luck, but they are almost always the consequences of fundamental biomechanics that should (or could) have been recognized from the start. While orthodontists are generally good at correcting unexpected tooth movements, recognizing the most common causes of accidental tooth movement (usually, in the wrong direction) can help in avoiding these incidents and improve treatment efficiency and outcome. This presentation will demonstrate many of these situations (collected from 30 years of experience teaching postgraduate residents) and discuss and demonstrate ways that they can be identified easily and avoided. (My following presentation will present how to correct these mishaps)
Management of Openbite and Cants of the Occlusal Plane
Openbite is often referred to as one of the least predictable types of malocclusion to correct and one of the hardest to maintain during retention. As the teeth erupt and the mixed dentition transitions to the permanent dentition, many openbites self-correct but some remain due to persistent habits or vertical growth tendencies. As in correction of deep overbite, treatment of openbite should be directed toward correcting the cause. Depending on the initial presentation, this may involve erupting maxillary and/or mandibular anterior teeth, retracting and uprighting anterior teeth (often requiring extractions), intruding posterior teeth, or by combining orthodontic treatment with orthognathic surgery. Some of the same types of mechanics used to correct deep overbite and openbite can also be useful for correcting cants of the occlusal plane that may be present on initial exam or that may make surprise appearances during treatment due to unintended mechanical side effects. Examples of how this can be done, including how simple mechanics can be used to correct other untoward developments during treatment, will be presented.
Prof Marie Cornelis
Bone anchored maxillary protraction: Where are we now?
In the last decade, growing patients with Class III malocclusion have been increasingly treated with bone-anchored maxillary protraction. Several protocols have been described, but they can generally be divided into two categories: 1) intermaxillary elastics are engaged on skeletal anchorage devices and on a facemask, with miniplates only in the maxilla and 2) class III elastics are engaged between skeletal anchorage in both maxilla and mandible, without the use of a facemask. The lecture will detail the different protocols used, and focus on the evidence available, comparing the clinical outcomes obtained with bone anchored maxillary protraction, with and without facemask.
Dr Mithran Goonewardene
Sleep Disordered Breathing and Orthodontics
Dental practitioners appear to be increasingly involved in management of children with crowding and sleep disordered breathing, with the latter often emphasized as the primary driver in recommending treatment with a combination of expansion and mandibular repositioning devices. Dr Goonewardene will present an evidence-based approach to the complex issues related to diagnosis and management of sleep disordered breathing in children with special emphasis on the efficacy of new procedures for treatment.
Clinicians have progressively engaged the realms of computer science in diagnosis and treatment planning that now extends to accurate techniques to guide the jaws into the desired positions intraoperatively. Drs Goonewardene and Allan will present an update of contemporary methods currently used to accurately reposition the jaws to the desired positions and the implications that these procedures have on the surgery first technique. Moreover the outcomes of both single jaw mandibular advancement and two jaw surgical repositioning for management of Class II and Class III malocclusion will be shown.
Dr Sanjivan Kandasamy
TMD, Orthodontics & Surgery: Evidence Based Clinical Considerations
There is no doubt the dental profession has been intrigued and confused at the same time about the subject of temporomandibular disorders (TMDs) over the last 80 years. Even today, the dental profession is still divided over what they are and how to deal with them. During this time, nearly every discipline in dentistry has played some role in the development of this field. Unfortunately, a significant amount of this information has been based on personal opinion, experience-based philosophies, or poorly conducted research. Each dental specialty has been responsible for contributing to the concepts of the etiology and management of TMDs with their own professional bias. Advances in research from diverse fields, including neurophysiology, pain pathophysiology, genetics, endocrinology, behavioral sciences, and psychology, have significantly altered our understanding of TMDs and how they should be managed. This lecture will deal with the current evidence-based understanding of TMD and the biopsychosocial medical model for the diagnosis and treatment of TMDs before, during and after orthodontic and orthognathic surgical treatment.
Dr Sarah Lawrence
ALIGN AND SLICE: aligner treatment combined with orthognathic surgery
This lecture will discuss our journey over the last decade using orthodontic clear aligners combined with orthognathic surgery for surgical correction of malocclusions. A review of the protocols, planning and set up of cases for surgical correction as well as finishing of these cases will be given.
A/Prof Paul Schneider
Autotransplantation
Autotransplantation of teeth has been discussed for many years, but is not widely used. This presentation will show cases that have been successful and those not so. Recent literature will be reviewed to determine indications, techniques and general management tips for more predictable outcomes.
Prof Michael Woods
35 years of orthodontics and orthognathic surgery – a view in hindsight
Michael Woods has spent much of his professional career managing surgical patients, teaching orthodontic and surgical trainees about this work, measuring the effects of such treatment, responding to changes in treatment devices and procedures, as well as documenting and reporting post-treatment changes in the dentofacial structures, themselves. Alongside this, he has built a considerable body of work related to the mandibular muscles and the clinical implications of different underlying vertical facial patterns. In this presentation, he will review the diagnostic and treatment developments of the past 35 years and present his own recently published findings on the range of dentofacial changes occurring in patients during the post-treatment decade.
Dr. Alex Yusupov
Advances in digital treatment planning
The 3D digital tools in orthodontics are advancing at a rapid pace. In the last 10 years, our ability to plan cases with the assistance of 3D simulations have opened up new avenues of treatment, treatment staging and improved efficiencies in delivering successful outcomes. In this presentation, Dr Yusupov will discuss and illustrate the benefits of 3D technology in treatment of complex surgical patients.
Dr Sven Jensen
Modern techniques for the management of individuals with cleft lip and/or palate
Orofacial clefts are the most common congenital malformation of the craniofacial region, globally. Orofacial clefts encompass cleft lip with or without cleft palate (CL±P) and isolated cleft palate (CP). Global prevalence of orofacial clefts range from 0.6 to 2.6 per 1000 live births and is dependent on ethnicity, genetics, and environmental factors. Children may have concomitant syndromes, genetic disorders, or a familial history and require management by a multidisciplinary team which is important for the final esthetic, functional, and psychological outcomes. The orthodontic management of children with CL±P has changed minimally over the past 30 years but recent technological advancements have the ability to improve the treatment process and results for these individuals.
Dr Haylea Blundell
Predictability of overbite control with the Invisalign appliance
Dr Ray Lam
Pulp blood flow and sensibility in healthy and traumatized teeth during maxillary expansion
Rapid maxillary expansion is a common treatment modality in orthodontics since Angell’s first description in the 1860s. We know that the most opportunity time for predictable expansion also coincides the time that patients are at most risk of sustaining trauma to the dentition. It is interesting to speculate the impact of these highly impressive forces during expansion on pulp blood flow, especially on teeth with compromise. Furthermore, would transferring these forces directly to the bony maxilla using mini-implants as anchors reduce the burden on the dentition? This presentation outlines research investigating changes in pulp blood flow and pulp sensibility in healthy and traumatized teeth during maxillary expansion.
Dr Tony Weir
Clear Aligner Therapy Has Turned 25! Is it “Grownup”?
Now in clinical use for 25 years, has Clear Aligner Therapy (CAT) matured into a reliable, comprehensive mainstream system able to stand alongside traditional fixed appliance therapy? This lecture will highlight the most recent research to attempt to answer the question whether CAT has indeed “grown up” and deserving of the honour and responsibility of being used for patient care. Pulp blood flow and sensibility in healthy and traumatized teeth during maxillary expansion
View the completed 2-day program here