Biomechanics and Esthetic Strategies in Clinical Orthodontics

396 Pages·2005·154.3 MB·English

by  Ravindra Nanda

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BIOMECHANICS AND ESTHETIC STRATEGIES IN CLINICAL ORTHODONTICS
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Clinical orthodontics is an ever-changing field. Standard safety precautions must be followed, but as new research
and clinical experience broaden our knowledge, changes in treatment and drug therapy may become necessary or
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ISBN-13: 978-0-7216-0196-0
ISBN-IO: 0-7216-0196-0
Executive Editor: Penny Rudolph
Senior Developmental Editor: Jaime Pendill
Publishing Services Manager: Karen Edwards
Senior Designer: Kathi Gosche
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2
..
In memory of Dr Surender Kumar Nanda
A wondeiful husband, father, brother, educator, philosopher, mentor, and friend,
Whose life was dedicated to the advancement of practice and science of orthodontics.
He continually sought truth in what is good and helping others reach their full potential.
Our profession will forever be grateful for his contributions.
CONTRIBUTORS
Frank H. Chang, DDS University of California at San Francisco
Department of Orthodontics San Francisco, California
School of Dentistry
National Taiwan University Sunil Kapila, DDS, MS, PhD
Taipei, Taiwan Professor and Chair
Department of Orthodontics and Pediatric Dentistry
Jenny Z. Chang, DDS School of Dentistry
Department of Orthodontics University of Michigan
School of Dentistry Ann Arbor, Michigan
National Taiwan University
Taipei, Taiwan Robert G. Keirn, DDS, EdD
Associate Dean, Advanced Studies
R. Scott Conley, DMD University of Southern California
Assistant Professor School of Dentistry
Division of Orthodontics Editor, Journal of Clinical Orthodontics
Vanderbilt University Medical Center Associate Professor
Nashville, Tennessee University of Southern California
Rossier School of Education
Tarisai C. Dandajena, DDS, MS Los Angeles, California
PhD Fellow
Department of Cell Biology Ahrnet Keles, DDS, DMSc
Research Fellow Associate Research Investigator
Department of Orthodontics The Forsyth Institute
College of Medicine and College of Dentistry Boston, Massachusetts
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma Gregory J. King, DMD, DMSc
Professor and Chairman
Nejat Erverdi, DDS, PhD Department of Orthodontics
Professor and Chairman School of Dentistry
Department of Orthodontics University of Washington
Marmara University Seattle, Washington
Istanbul, Turkey
Vincent G. Kokich, DDS, MSD
John C. Huang, DMD, DMedSc Professor
Assistant Professor Department of Orthodontics
Director of Curriculum School of Dentistry
Division of Orthodontics University of Washington
School of Dentistry Seattle, Washington
viii • Contributors
Vincent O. Kokich, DMD, '\'ISO Jill Bennett Nevin
Affiliate Assistant Professor Doctoral Candidate
Department of Orthodontics Annenberg School for Communication
School of Dentistry University of Southern California
University of Washington Los Angeles, California
Seattle, Washington
Junji Sugawara, DDS, PhD
Andrc\\ Kuhlberg, DMD, MDS Associate Professor
Assistant Professor Department of Orthodontics and Dentofacial Orthopedics
Department of Orthodontics Tohoku University
School of Dental Medicine Sendai, Japan
University of Connecticut Health Center
Farmington, Connecticut Flavio Andrcs Uribe, DDS, MDS
Assistant Professor
Han ~ I Legan, DDS Department of Orthodontics
Professor and Director School of Dental Medicine
Division of Orthodontics University of Connecticut Health Center
Vanderbilt University Medical Center Farmington, Connecticut
Nashville, Tennessee
Bjf)rn U. Zachrisson, DDS, MSD, PhD
Ram 'i Nanda, DDS, "'IS, PhD Professor
Professor and Endowed Chair Department of Orthodontics
Department of Orthodontics University of Oslo
College of Dentistry Oslo, Norway
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma
Ravindra 1IoI"anda BDS, "'IDS, PhD
UConn Orthodontic Alumni Endowed
Chair
Professor and Head
School of Dental Medicine
University of Connecticut Health Center
Farmington, Connecticut
Within the past two decades, interest in esthetics from Class II treatment methodologies. This book devotes three
orthodontists, medical professionals, and the general chapters to the subject of Class III malocclusion by Drs
population has increased dramatically and continues to rise. Sugawara and Chang. The contemporary subject of skeletal
While esthetics can be very subjective and variable between implants and absolute anchorage is covered in two chapters
different ethnicities, specific characteristics of attractive by Drs Erverdi, Keles, and Sugawara. Drs Legan and
people can be defined. These characteristics should be Conley address biomechanical considerations in surgical
considered during diagnosis, treatment planning, and orthodontics. Drs Kokich and Kokich Jr discuss the
design of mechanics to correct dentofacial malocclusions. important role of periodontics and restorative dentistry in
For the first time, an orthodontic textbook combines two the esthetic outcome of orthodontic cases. My colleagues,
very important aspects of orthodontic treatment: esthetics Drs Kuhlberg and Uribe, have made excellent contributions
and biomechanics. Biomechanics is the most important in coauthoring seven chapters with me.
aspect of the design of an orthodontic appliance, and this This book takes a sequential approach to diagnosis and
book highlights how the esthetic objectives of orthodontic treatment planning with emphasis on esthetic objectives,
treatment can be successfully achieved with biomechani combined with occlusion as well as functional esthetics.
cally based orthodontic appliances. This book describes It gives numerous case reports using hundreds of color
the design of simple appliances which can be easily illustrations of varying malocclusions and appliances.
incorporated in any prevailing orthodontic technique and Furthermore, this book encompasses the expertise of some
philosophy. of the most eminent clinicians and scientists in the field
This book complements our book, "Biomechanics in of contemporary orthodontics. The esthetic parameters and
Clinical Orthodontics", published in 1996. It expands on biomechanically designed appliances presented here can be
and updates two chapters from this book, and adds 16 new applied to achieve predictable results.
chapters. It draws on the expertise of authors who are consid Orthodontic residents, faculty, and private practitioners
ered leaders in their field. The topics range from diagnosis alike will find useful information on the most important
and treatment planning to biomechanic principles and aspects in orthodontics. After 3 years of continuous work,
finishing of various malocclusions. I am very delighted and proud to present you with this
Drs Huang, King, and Kapila discuss the state of the textbook. I am very grateful to all the contributors and
art in biologic mechanisms of tooth movement. Dr Keirn hope that the orthodontic community enjoys reading this
discusses the social psychology of facial esthetics, an textbook as much as we have enjoyed writing it.
important subject that has probably never been this com
Ravindra Nanda
prehensively discussed before in the orthodontic literature.
December 2004
Dr Zachrisson succinctly describes how a carefully
Farmington, CT
designed treatment can enhance esthetic results. Drs Ram
Nanda and Dandajena give a critical report on various
First of all, I want to thank my fellow contributors for I also want to express my gratitude to more than 125
taking time out of their busy schedules to write some of alumni for their unselfish support. I want to take this
the best reading in orthodontics. Their expertise is highly opportunity to acknowledge and thank them for their
appreciated. financial support in establishing the UConn Orthodontic
My heartfelt thanks to my colleague, Dr Flavio Uribe, Alumni! Ravi Nanda chair in Orthodontics. It is quite an
for helping me throughout the process in developing this honor and no teacher can ask for more.
book. Working closely with him ensures me that our profes r also want to recognize Penny Rudolph, Executive
sion has excellent young talent who will provide a bright Editor at Elsevier, who felt it was worthwhile to have a
future for all those in our field. Dr Andy Kuhlberg did follow-up book to Biomechanics in Clinical Orthodontics.
a superb job in contributing to three chapters. His skillful Also, my sincere thanks to Jaime Pendill, Senior Develop
computer artwork appears in more than 10 chapters. mental Editor at Elsevier, for constantly pushing me and
My special thanks to Dr Erin Kazmierski-Furno, my my co-authors to finish this project on time.
chief resident, who never said no to any request. She spent Lastly, special thanks to my wife, Catherine, for
innumerable hours scanning hundreds of photographs and supporting me at every stage to complete this project.
helping me compile illustrations for this book.
My personal thanks to Perry Haque, Lindsay Brehm,
and Paul Blanchette for their help at various levels during Ravindra Nanda
the last few years.
CHAPTER 1
Principles of Biomechanics 1
A. Kuhlberg and Ravindra Nanda
CHAPTER 2
Biologic Mechanisms in Orthodontic Tooth Movement 17
JC Huang, G. King, and S. Kapila
CHAPTER 3
Individualized Orthodontic Diagnosis 38
F Uribe and Ravindra Nanda
CHAPTER 4
Individualized Orthodontic Treatment Planning 74
Ravindra Nanda and F Uribe
CHAPTER 5
Social Psychology of Facial Appearance 94
.J. Bennett Nevin and R. Keirn
CHAPTER 6
Esthetics in Tooth Display and Smile Design 110
B. Zachrisson
xii • Contents
CHAPTER 7 ..
Management of Deep Overbite Malocclusion 131
Ravindra Nanda and A. Kuhlberg
CHAPTER 8
Management of Open Bite Malocclusion 156
F Uribe and Ravindra Nanda
CHAPTER 9
Biomechanic Strategies for Nonextraction Class II
Malocclusions 177
Ram Nanda, T C. Dandajena, and Ravindra Nanda
CHAPTER 10
Biomechanic Basis of Extraction Space Closure 194
Ravindra Nanda, F Uribe, and A. Kuhlberg
CHAPTER 11
Clinical Practice Guidelines for Developing Class III
Malocclusion 211
J Sugawara
CHAPTER 12
Treatment Strategies for Developing Class III Patients 243
FH. Chang and 1.Z.Chang
CHAPTER 13
Biomechanical Aspects of a Modified Protraction Headgear 264
Ravindra Nanda
CHAPTER 14
Orthodontic Anchorage and Skeletal Implants 278
N Erverdi, A. Keles, and R. Nanda
CHAPTER 15
A Bioefficient Skeletal Anchorage System 295
J Sugawara
Contents • xiii
CHAPTER 16
Biomechanical Factors in Surgical Orthodontics 310
H. Legan and S. Conley
CHAPTER 17
Biomechanic Strategies for Optimal Finishing 330
F. Uribe and Ravindra Nanda
CHAPTER 18
Interrelationship of Orthodontics with Periodontics and Restorative
Dentistry 348
v Kokich and V Kokich
Index 373