Orthotown December 2015 - (Page 42)

clinical orthodontics // feature R O F E S A C THE SOFT-TISSUE S C I T N O D ORTHO The use of neuromodulators and soft-tissue fillers to enhance orthodontic treatment by Scott Frey, DDS, MSD The modern biologic model of orthodontic treatment has revealed soft-tissue elements as the primary drivers of therapeutic outcomes. The periodontium, neuromusculature, airway, temporomandibular joint, and facial contours, as well as their evolution over the life of the patient, all dictate how we must approach treatment as orthodontists.1-7 Therefore, it is essential that we not only cultivate greater understanding of soft-tissue function and esthetics, but that we also equip ourselves with tools that enhance our command over soft-tissue elements. Otherwise, we fall far short of what we can deliver for our patients. Neuromodulators and soft-tissue fillers provide orthodontists with a minimally invasive means of addressing soft-tissue obstacles to orthodontic goals, and thus 42 DECEMBER 2015 // orthotown.com All photos courtesy of Scott Frey have an important role to play in patient care. These tools will continue to expand the envelope of orthodontic changes that are possible without surgery, and will make significant cosmetic and functional enhancements more accessible to a greater number of patients. In this article, we will briefly review the action of injectable neuromodulators and soft-tissue fillers, discuss their clinical value, and present cases to illustrate how their use enhances orthodontic care. This article should serve as a proof of concept, with contemporary references, and I urge the reader to monitor and contribute to progress on this front in orthodontics. Soft-tissue fillers, as their name implies, are used to enhance and augment soft-tissue volume. This capacity holds tremendous value for the orthodontist. How and where the dentition is positioned relative to facial structures plays a definitive role in the establishment of perioral contours.8 Thus, ideal facial contours are a fundamental responsibility of the orthodontist and a principle macroesthetic goal of orthodontic treatment. Traditionally, disharmonies of the soft-tissue envelope beyond the scope of simple tooth movement have been left to surgical correction, or have to be accepted as less than ideal. However, soft-tissue fillers now provide us a means to bridge the gap between surgical intervention and orthodontic therapy. They also empower the clinician to engage in soft-tissue finishing-whereby, dentoskeletal anomalies are confronted by addressing their softtissue manifestations. Let us briefly consider a few examples. http://www.orthotown.com

Table of Contents for the Digital Edition of Orthotown December 2015

Orthotown.com Highlights
Embrace Progress: It’s Always Time for a System
Industry News
Finishing Tips, Tricks and Voodoo
Preserving Anterior Anchorage in Cases of Congenital Missing Laterals
Smooth Running: A Guide to Practice Transitions
Office Visit: Upstate New York Orthodontist Hits a Home Run with Winning Smiles
10 Things Every Orthodontist Needs to Know About HR Management
The Benefi ts of Early Treatment
Accelerated Orthodontic Tooth Movement with Clear-Aligner Therapy
Path to Purchase Research: A Survey Analysis
Poll
The Case for Soft-Tissue Orthodontics
Ad Index

Orthotown December 2015