Orthognatodontics in clinical practice

Chapter I
General aspects. - Embryology. - Craniofacial growth. - ossification. - Stomatognathic growth. - Forecast of growth. - Diagnosis and treatment plan. - Study of family members and patients. Models in plaster, orthopantomography and teleradiography. - Importance of the radiological study. Importance of clinical observation combined with radiological. - Data obtainable from the radiological study and the models. Changes that occur from deciduous occlusion to permanent. Relationship between deciduous and the corresponding pieces not yet rasted. Relationship between teeth and arcade. - Classification of malocclusions. - Cefalometric analysis. - Telerradiography. What data to take from a layout?. Posteroanterior radiography. - Orthognatodontics and aesthetics. Clinical evaluation Mixed (clinical-radiographic-photographic) evaluation. Discussion. Conclusions. - Biomechanics. Displacement of the teeth. - Dental movements. Tipping-uprighting. Torque. Interaction wire-attaches according to Burstone. - Anchor. - Wires. Metallurgical characteristics. - Why orthognatodontics? When to start a treatment?. - Prevention in orthognatodontics. - Interceptive orthodontics (schematic summary). - Myofunctional exercises. - Fixed therapy and mobile therapy. - What kind of "mobile" therapy? - What kind of "fixed" therapy? 10 orthognatodontics in clinical practice. - Fixed orthodontic techniques. Edgewise classic. Tweed. Alexander. Straight Wire (Andrews). Begg. Bioprogresiva. Segmented arc. Common features of the Ataches. Self Ligating - Low Friction. - Aesthetic techniques. Aesthetic attachments. - Transparent dental alignment templates. - Elastic.

Chapter II
Class I. - Introduction. - The expansion in orthognatodontics. Maxilla superior. - What kind of expansion?. Fast expansion. Slow expansion. Ultrallete expansion. Until what age is it possible to expand the maxilla superior?. - Maxilla lower. Expansion on the transverse plane. The expansion to earn space. The limits of the denture. Where is the truth?. - Clinical cases. - Beyond the limits naturally: biprotrusions. - Extract or not extract? - Recovery of the distal space. - Non-Compliance Aparatology for the distalization of higher molars. - Clinical cases. Lip Bumper. Palatine bar. Conclusions. - Summary: treatment with extraction or not. - Non-conservative orthognathomontic treatments, what teeth should be extracted? The third molars. The first molars. The second molars. Conclusions. - Clinical cases. Extractions flattened the profile, true or false?. Stripping. - Two final cases with opposite characteristics. Sectoral treatments.

Chapter III
Class II. - Class II. - Treatment. Functional devices. Andresen activator. The Fränkel function regulator. Functional plate of Cervera (PCF). Bimler. Bionator. Kinetor. Sander's devices. Twin Block. RV1 and RV2. The Herbst apparatus. - Extraoral traction. Biomechanical effects of extrasoral tractions. Orthodontic use. Orthopedic application (forces indicatively greater than 300 g). Extraoral tractions combined with activators. Resistance centers. Can extraoral tractions cause incidents?. - The fixed orthodontic devices in the conservative treatment of class II. And then, treatment of class II in one or two phases?. Conclusions. Considerations on class II in patients who finish growth. The different approaches of class II. The treatment of adults. The limits of mandibular progress. - Treatment of class II with four extractions. Two cases of class II with problems in the temporomandibular joint. Orthodontics and Gnatology. - Treatment of class II with two extractions. Classic scheme and unusual variants. TEMPORTATION OF THE TEMPOROMANDIBULAR JUST (ATM). - Clinical cases. Conclusions.

Chapter IV
Class III. - Description and Ethiopathogenesis. Maxilla superior. Maxilla lower. Treatment. Functional devices. Mentonera. Posteroanterior traction. - Clinical cases. At the end of growth. Indicative cephalometric values of a surgical class III (according to Ricketts). Fixed orthognathodontic treatment. Discussion and conclusions.

Chapter V
Common aspects for the three classes. - Serious extractions. - Anomalies of number of teeth with special reference to agenesis. - Problems (and errors) in orthognathodontics with special reference to rizolysis. - The vertical dimension in orthognatodontics. - Increased vertical dimension. The open bites. Clinical and radiological signs. Etiopatogénesis. - Functional problems. Respiratory problems. The treatment. Treatment of skeletal hyperdiversity. Treatment of dysfunctions. - Clinical cases. - Decreased vertical dimension. The deep bites. Indications for treatment and technical possibilities. - Clinical cases. - The containment. Removable containment. Fixed containment Discussion. - Diatemas. - Clinical cases. - Inclusions (with special reference to higher canines). Superior canines. Palatine inclusions: Clinical case. Vestibular inclusions: Clinical case. - Failures: Clinical cases. Importance of clinical observation: clinical case. Iatrogenic inclusions: clinical case. Possible damage related to inclusion. What are the limits of disinclusion?. Other inclusions: clinical case. Transpositions: Clinical cases.

Chapter VI
Relations with other disciplines. - orthognathodontics and periodontics. Predodontic operating protocols. The intrusion of dental pieces with scarce periodontal support. Extrusion, a valid aid in periodontal and prosthetic therapy. Gingival retractions. Need to consolidate the results. What are the limits?. Conclusions. - orthognatodontics and prosthesis. Orthodontic techniques. - Preprotemic orthognathodontics and antiprothetic orthognathodontics. Incisors. Dogs. Premolar and molars. The Uprighting of the Molars. - Clinical cases. - Orthodontics - Implantology. Preimplant orthodontics. Orthodontics postimplantar. - Clinical cases. - Miniimplants. Surgical procedure of the insertion and removal of mini-implements. - Orthognatodontics and temporomandibular articulation: relationship between orthodontics and gnatology. TEMPOROMONIBULAR ARTICLION (ATM): Anatomical, functional and pathological aspects. Therapy. - What are the relationships between temporomandibular and orthognathic joint? - The orthognatodontics is one of the main causes of ID or on the contrary is an irreplaceable. Therapeutic instrument in ability to eliminate an ID?. Personal observations Transversal evaluation Vertical evaluation - Clinical cases. Criteria for the evaluation of diagnostic modalities. The role of electronic devices in the diagnosis of temporomandibular problems. - The role of occlusal analysis in the diagnosis of temporomandibular problems. Conclusions. Synthesis. Complex cases

Chapter VII
Introduction to orthognathic surgery. 1st part: orthognathodontic surgery of maxillary malformations. - Evaluation of malformation characteristics. - Planning and realization of the intervention. - osteotomy according to Le Fort (I). - Sagittal osteotomy according to Epker. - Genioplasty. - Clinical case. 2nd part: At present, what should be the collaboration between orthodontist, implantoprotector and maxillofacial surgeon in clinical practice? - Four clinical cases.

Chapter VIII
Notions of forensic dentistry in the orthodontic area. - Clinical documentation. - Insurance policy. - Informed consent.

Chapter IX
Notions of clinical photography for the orthodontist. - Introduction. - The compact machine. - The SLR machine. - Diaphragm. - focal length and field angle. - Focus. - Depth of field. - Memory cards and resolutions. - Useful accessories. - Practical part. Bibliography.