Melsen - Adult Orthodontics

List of Contributors

Delfino Allais MSc

Certified Specialist in Orthodontics

Private Practice

Torino, Italy

Dorthe Arenholt Bindslev DDS, PHD

Associate Professor, Certified Specialist in Orthodontics

School of Dentistry

Aarhus University

Aarhus, Denmark

Vittorio Cacciafesta DDS, MSc, PhD

Certified Specialist in Orthodontics

Private Practice

Milano, Italy

and

Assistant Clinical Professor

Department of Orthodontics

University of Pavia

Pavia, Italy

Pablo Echarri DDS

President of the Scientific Committee of Catalonian Dental Association (COEC)

and

President of the Ibero-American Society of Lingual Orthodontics (SIAOL)

and

Visiting Professor of Master in Orthodontics at the University of Sevilla

Barcelona, Spain

Giorgio Fiorelli MD, DDS

Specialist in Orthodontics

Orthodontic Department

University of Siena

and

School of Specialization/Postgraduate Master Course

Siena, Italy

Carmen Giudice DDS

Postgraduate Resident

Department of Orthodontics

University of Pavia

Pavia, Italy

Jaume Janer DDS, MD

Postgraduate in Orthodontics

Certified Specialist in Orthodontics

Private Practice

Barcelona, Spain

Sonil Kalia B.D.S., L.D.S.R.C.S., MOrth.R.D.C MSc

Specialist in Orthodontics (private practice)

Visiting Assistant Clinical Professor

Orthodontic Department

Aarhus, Denmark

Marco Antnio Masioli PhD, MSc

Professor of Dentistry

Federal University of Esprito Santo (UFES)

Brazil

Dimitrios Mavreas DDS, MS, Dr Dent

Private Practice

Chalandri, Greece

Birte Melsen DDS, Dr Odont

Professor, Head of Department

School of Dentistry

Aarhus University

Aarhus, Denmark

Rainer-Reginald Miethke Prof em Dr med Dent

Senior Consultant in Orthodontics

Dental Department

Hamad Medical Corporation

Doha, Qatar

Francesco Milano DDS

Certified Specialist in Orthodontics

Private Practice

Bologna, Italy

Laura Guerra Milano DDS

Certified Specialist in Orthodontics

Private Practice

Bologna, Italy

Sheldon Peck DDS, MScD

Adjunct Professor of Orthodontics

School of Dentistry

University of North Carolina

Chapel Hill, North Carolina, USA

and formerly

Clinical Professor of Developmental Biology

Harvard School of Dental Medicine

Boston, Massachusetts, USA

Yves Samama DDS

Certified Specialist

Private Practice

Paris

and

Former Assistant Professor

Paris Descarte University

France

M Francesca Sfondrini DDS

Certified Specialist in Orthodontics

Assistant Clinical Professor

Department of Orthodontics

University of Pavia

Pavia, Italy

Peter Svensson DDS, PhD, Dr Odont

Professor

Department of Clinical Oral Physiology

MINDLab, Center of Functionally Integrative Neuroscience

Aarhus University Hospital

School of Dentistry

Aarhus University

Aarhus, Denmark

Carlalberta Verna DDS, PhD

Associate Professor

and

Certified Specialist in Orthodontics

School of Dentistry

Aarhus University

Aarhus, Denmark

Introduction: More than a Century of Progress in Adult Orthodontic Treatment

Orthodontics for adults is not new. A hundred years ago and earlier, orthodontics was considered a division of prosthetics in the minds of most dentists. The problems related to the common loss of permanent teeth from uncontrolled caries were among the most frequent chief complaints of adult patients evaluated for orthodontia. Unwitting extraction of posterior teeth during youth allowed adjacent teeth to tip into the spaces over time. Often, orthodontic uprighting of tipped teeth in adult patients was performed by the same doctor who afterward prepared the teeth as anchor units for fixed or removable dental prostheses.

We are fortunate to have details of an adult orthodontic treatment performed by Edward H. Angle, MD, DDS (18551930), the man acknowledged worldwide as the first specialist in orthodontics. In addition to his skill at creating ingenious tooth-regulating appliances, Angle was a bold and talented clinician. In 1901 a 38-year-old woman, Mrs. A, came to him from Louisville, Kentucky, referred by her dentist. She was from a leading Kentucky family and she traveled the 400 kilometers to Dr. Angles office in St. Louis, Missouri, because of his reputation as the worlds best clinical orthodontist.

Mrs. As four permanent first molars, all healthy, were sacrificed at nine years of age by a dentist who said this course of action would prevent the development of malocclusion of the other teeth. She came to Dr. Angle three decades later with severe tipping of the mandibular molars into the extraction sites (Fig. 0.1a,b). In the maxillary dental arch, complete closure of the first molar sites had occurred with associated retroclination of the anterior teeth and loss of lip support. Furthermore, Angle reported that not only have the remaining teeth been rendered almost useless for mastication, but in recent years there has been chronic pericementitis, resulting from wrongly directed force from the molars in their tipped and abnormal positions (Angle 1903, 1907).