This electronic book is appropriately entitled Biomechanics in orthodontics . It is a comprehensive, 667–Web-page book, written by Birte Melsen and Giorgio Fiorelli, that is well illustrated and includes over 200 Flash animations and videos.
Sold as a subscription, this e-book is constantly updated by the authors so that, upon log in, the reader always has access to the most current content—a significant advantage over conventional textbooks. Reading about biomechanics is a daunting task, since the concepts are somewhat hard to grasp in a static environment, but the animations and feedback in this interactive medium greatly increase the comprehension of the interactions between force application and tooth movement.
Twenty highly referenced chapters on biomechanics, ranging from physics to treatment planning, are used to explain all the biomechanical concepts that are developed in the e-book. A nice feature is that each reference is hyperlinked, and the respective abstracts are readily accessible on the publisher’s site for immediate consultation.
The first 5 chapters cover the basic force systems used in orthodontics. All definitions are clearly explained and illustrated or animated, making this review useful as a refresher course. The most important principles, such as forces, force systems, and mechanics of tooth movements, are presented in a logical manner from simple to complex, and relevant references are provided to reinforce and validate the scientific bases of the didactic content. Short quizzes are also offered to allow the participants to test and practice the material presented. These 5 chapters are the backbone of the book and are alone worth the price to any orthodontist wishing to fully understand the mechanics of tooth movement.
The following chapters present more complex biomechanical concepts. The segmented arch technique and the rationale for using loops in orthodontic wires vs the use of the straight wire system are well explained and should be of great interest for the orthodontist looking for maximum efficiency and outcome for any type of orthodontic movement. Many postgraduate curriculums have reduced the amount of time allocated to teaching in-depth biomechanical principles. The introduction of the use of the straight wire at the first bonding appointment and sliding mechanics seem to have become the preferred approach to orthodontic care. Orthodontic biomechanical principles introduced by many clinicians and perfected by Dr Burstone are extensively presented in this e-book. It demonstrates that this in-depth knowledge is still relevant and should be an integral part of any modern orthodontic residency curriculum.
The extensively explained segmented arch technique addresses several complex procedures such as space closures and vertical control of malocclusions. Different types of loops are described, and their indications as well as mode of activation are well illustrated. The advantages of using specific loop configuration over others for a specific tooth movement are all explained and simulated with short videos.
A whole chapter is devoted to cantilevers. Cantilever mechanics is of great interest because its efficiency and capacity to precisely move a single tooth or segments of a dental arch in the 3 planes of space with light forces applied in the correct direction are invaluable, especially in adult orthodontics. The use of these cantilevers in molar uprighting, control of occlusal plane cants, and differential intrusion or extrusion mechanics is abundantly illustrated.
In the second part of the book, the undesirable side effects of oversimplified orthodontic techniques are illustrated and explained. Remedial mechanics to overcome these undesirable effects are also addressed with numerous illustrations and animations.
The last part of the e-book relates more to treatment planning, and over 100 clinical situations are presented. An introduction to 2-dimensional and 3-dimensional occlusograms is provided. It allows the reader to design the most appropriate force system for a given clinical situation. Animated short videos describing the proper use of the correct mechanical setup for a specific situation reinforce the knowledge acquired in preceding chapters and add relevant clinical applications to this e-book.
What could be improved? First, the interface could be somewhat improved by filling in more of the blank spaces of several pages. Fewer mouse clicks should also be considered with mouseovers and more “modern” navigation. Some pages could be grouped together to make the reading experience even more enjoyable.
Despite these minor shortcomings, the main point is that the content is extremely useful and well presented in a logical manner for the seasoned clinical practitioner and the future orthodontist alike. The short videos explaining the effects and side effects of the different mechanical forces are invaluable. More detailed and extended explanations of complicated concepts would be welcomed for the orthodontic resident and the orthodontist not having had the opportunity to benefit from a strong training in biomechanics. In some instances, the content is a bit difficult to follow from 1 click to another. The authors are so knowledgeable about biomechanics that they sometimes tended to overlook steps in their explanations, making the material more arduous to follow for the reader.
The occlusogram section is now being revamped to take advantage of 3-dimensional technologies and more up-to-date software.
Incorporating printable exercises with step-by-step corrections especially in the first part of the book would be most welcomed, since mastering these concepts is mandatory to fully benefit from the subsequent chapters. Printable exercises would allow students to better practice and monitor their progress through self-correcting quizzes. A far-fetched wish would be to have Drs Melsen and Fiorelli explain difficult concepts with longer videos, because I was a bit lost sometimes in some of the more technical chapters.
This e-book is highly recommended for any orthodontist who desires to fully understand and master the fundamental biomechanical principles that are the cornerstone of our specialty. It should be used extensively in every orthodontic postgraduate program, since it covers all of the most important biomechanical concepts of modern orthodontics in a well-organized and sequential manner. Some orthodontic program schools may now be relying too much on single simplified techniques and ignoring the immense benefits of mastering in-depth biomechanical orthodontic knowledge. This e-book has truly opened my mind to the importance of acquiring a much broader comprehension and appreciation of the complexity of the optimum force system-tooth movement interactions in orthodontics and not solely to rely only on preprogrammed orthodontic appliances and wire sequencing.
This e-book will absolutely enhance and reinforce the comprehension of simple to complex biomechanical principles for every orthodontist and improve his or her treatment skills dramatically.
One of the main benefits of having spent the time going through this material and applying it in my practice is the vast improvement in the management of several of my patients who were not progressing as planned. This benefit associated with my renewed enthusiasm for biomechanics totally justified once again the price of admission.
I am extremely thankful to Drs Fiorelli and Melsen for their passionate commitment to quality orthodontics and for undertaking such a monumental task. This great reference should be consulted on a regular basis by all orthodontists, because it is the reference for biomechanics and is constantly updated.
This e-book is truly international and is offered in English, Italian, Spanish, Portuguese, and Bosnian/Serbian/Croatian. Chinese and French versions are in preparation.