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!
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

Pacific Coast Society of Orthodontists Bulletin Winter 2012