Pacific Coast Society of Orthodontists Bulletin Winter 2012 - (Page 38)
SUMMARIES
ANNUAL SESSION
Treatment Planning: The Magic Step
D
R. VADEN provided
a very fine lecture
describing a number
Dr. Vaden
of treated cases who were
recalled for records several
decades later. These records
helped the audience members
appreciate concerns about
long-term stability of the
dentition after orthodontic
treatment.
He contends that the orthodontic treatment plan must be
based on the limiting dimensions of the jaw structure, and
that this can be determined by a careful evaluation of the
dentition. One needs to consider the benefit and burden to
the patient not only during orthodontic treatment, but for
his/her lifetime.
When forming a treatment plan, consider the limitations
imposed by the facial structure in all three axes: vertical,
sagittal and transverse. Correlate these limitations with
the patient’s goals for facial esthetics and stability of the
dentition.
Dr. Vaden discussed his retrospective study, published
in AJO-DO in August 2012, of 52 women whose posttreatment
records were taken an average of 24 years after
Presented by Dr. James L. Vaden (Cookville, TN) at the PCSO Annual Session on October 5, 2012.
Summarized by Dr. Gerald Nelson, PCSO Bulletin Editor.
active treatment. Most were treated in the adolescent
dentition and had class II malocclusions. All patients had
some combination of premolar extractions. The long-term
stability of these dentitions was remarkable.
Several of these patients were exhibited in the presentation.
Audience members saw photos of pre-treatment
teenagers with class II and crowding turn into mature
faces with very stable class I dentitions.
He presented brachiocephalic patients in whom the
esthetics of the face were maintained during extraction
treatment. In a class III patient, the goal was to maintain
the relation of the lower incisor to the mandible during
treatment. Such goals favored the patient’s esthetics, but
made for quite a challenge to the orthodontist.
He showed dolichofacial class II patients in whom removal
of MX first premolars and MN second premolars
allowed retraction of the upper incisors while maintaining
lower incisors and improvement of the lip posture.
His take-home message is that the benefit of orthodontic
treatment for the patient must outweigh the burden of
either relapse or forever retention over time. This takes
a treatment plan that is based on facial esthetics and the
skeletal pattern type, and how these factors can limit the
goals for tooth movement. As Dr. Vaden said, “This is
how we out-pace the rabble.”
S
38
P C S O B U L L E T I N • W I N T E R 2 0 1 2
Table of Contents for the Digital Edition of Pacific Coast Society of Orthodontists Bulletin Winter 2012
Incremental Change
What a Time it Was!
Invisalign
AAO Trustee's Report
A need, A dream, A reality: A team approach produces an extraordinary outcome
PRECEDENT Orthodontists on Devices
The Complexities of Successful Herbst Treatment
Dr. Bryan Williams
Presentation Software
Treatment Planning: The Magic Step
Comprehensive Mixed Dentition Approach
Social Media 101 for Orthodontists
Update on Bonding 2012
Create the Future by Looking Back: 100 Years of PCSO
PCSO Business
Component Reports
AAOF Report
PCSO at a Glance
Case Report Pre-Treatment
Case Report Post-Treatment
In Memory
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