Non Ex Factors: 98.5% nonextraction therapy using coordinated arch development

Chapter 1 provides a historical review of extraction therapy in orthodontics before describing the evolution of the coordinated arch development technique of nonextraction treatment. The coordinated arch development technique is a combined orthopedic-orthodontic approach that uses optimum periods of growth and development to produce results with long-term stability. Listed are the 10 criteria of coordinated arch development. Clearly shown and illustrated are the differences between the coordinated arch development philosophy and buccal expansion. The author maintains that extractions in orthodontics should be avoided when possible, although he recognizes that there is certainly a place for extractions during treatment, but only when most of the 10 criteria listed in the text are present.

Chapter 2, “Maxillary arch development,” begins by describing fixed maxillary molar distalization with the Greenfield molar distalization appliance. The next section deals with a removable molar distalizer, or “Cetlin” appliance. Following is a section that describes and illustrates the effects and control of cervical, occipital, combined, and reverse headgear forces as they relate to the functional occlusal plane and direction of growth. A hefty section of the chapter is devoted to describing and illustrating the effects, the clinical indications, and the use of the transpalatal bar. Then come sequential photographs of patients treated by using the described procedures. Everything one needs to know about lip bumpers, including patients showing their use and versatility, is in a separate section of the chapter. Next is a section dealing with intrusion of the maxillary anterior teeth by using various methods with and without torquing. Also described is a sequence of space closure of the maxillary teeth by retraction. The goals of finishing and the procedures of finishing patients are described and accompanied by numerous diagrams and photographs. The final section of the chapter was written by a contributor, Young-Chel Park, who demonstrates how miniscrew application in the form of temporary anchorage devices can be strategically applied for specific nonextraction treatment.

Chapter 3, “Nonextraction case review,” comprises comprehensive records of 48 completed patients. Each includes intraoral, facial, and study-model photographs as well as cephalometric analyses: 516 pages of records! After this are an additional 83 pages of similar records submitted by the Japanese Academy of Nonextraction. Absolute proof of the advantages of not extracting teeth in borderline cases would require reporting long-term results, which are not evident in the text. Presenting long-term results in this particular instance is somewhat unrealistic, since the author spent 4 years gathering and presenting the material in this form. Assessing long-term results in such cases could be a formidable challenge for an aspiring orthodontist or possibly even a team of investigators to undertake. This shortcoming in no way detracts from the value of the book. The editor and 4 contributors have produced a magnificently illustrated and informative 8.5-lb tome that is likely to be of great interest to clinical orthodontists, particularly to experienced practitioners who wish to further refine their clinical skills. It is a substantial contribution to the orthodontic literature.

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Apr 13, 2017 | Posted by in Orthodontics | Comments Off on Non Ex Factors: 98.5% nonextraction therapy using coordinated arch development
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