How to minimize
errors and complications

In this presentation, we will show some failures in the use of standard techniques and we will discuss how it is possible to avoid side effects and make the therapy outcomes more predictable, with the use of a rational and individualized mechanics. This different approach, based on the deep knowledge of orthodontic biomechanics, ultimately raises the limits of orthodontic therapy and allows for the controlled treatment of very complex cases.
You will learn:
1. The basic concepts of statically indeterminate mechanics;
2. Burstone’s 6 geometries;
3. The role of friction in dental movement determination;
4. How inconsistencies are generated using a continuous archwire;
5. The “Force Driven” mechanics as an alternative to “Shape Driven”;
6. Force System and Dental Movement;
7. Anchorage Analysis;
8. Mechanics Design Examples for Statically determinate Appliances with Clinical Cases.

About the lecturer:

Creator of the software T3do and DMA for Orthodontic treatment planning and mechanics design.

Dr. Fiorelli obtained his medical, dental, and orthodontic postgraduate degrees at the University of Siena in Italy.

He has also co-published with Prof. Birte Melsen the “Biomechanics in Orthodontics” multimedia software.

His main professional interests are orthodontic biomechanics, use of computers within the orthodontic practice, segmented arch technique and adult orthodontic treatment.

If orthodontic treatment is to be of benefit to a patient, the advantages it offers should outweigh any possible damage it may cause.
Signs Indicating for Orthodontic treatment:
• Facial imbalance or asymmetry;
• Oral habits dysfunctions;
• Crowding, misplaced, or blocked-out teeth;
• Open bites and deep bites;
• Protruding teeth and facial unbalance;
• Retrusion of the chin in Class II.
An attractive smile is a wonderful asset. It contributes to self-esteem, self-confidence and self-image. But we must evaluate the Risks and the Benefices before to take a decision for the patient and family. Risks increase the possible failures and relapse. Risks on Facial balance:
• Flatten faces with extractions protrusion of the face on non-extraction treatment;
• Anchorage lost;
• Temporomandibular injuries. Risks on teeth and periodont:
• Enamel decalcification and fracture;
• Pulp Vitality, Root resorption;
• Uncontrolled periodontitis;
• Uncontrolled oral hygiene.
So, acknowledgement of failure is important but an orthodontic specialist should have the possibility to treat their patients with a minimum of risks with: сlear and strong diagnosis for treatment decision.
• Respect of the limits of the denture: transversal, vertical and sagittal;
• Do not tip labialy the anterior teeth;
• Overcorrect the overbite;
• Overcorrect the class II discrepancy;
• Maintain arch form and arch width;
• Maintain vertical dimension;
• Think about ROOT, not only Crown;
• BONDING.
• High degree of control during the therapy orthodontic and/or orthopedics including the Ortho-surgical association.
Orthodontics is not only a bracket slot!
The Edgewise concept is based on analysis and strategy with the management of the denture to obtain the best functional occlusion that protect TMJ.
The orthodontic treatment is the service rendered to the patient first !Occlusal management depends on the position of the teeth before the treatment and the movements planned according the objectives.There are two parameters for tooth movement: the force in the wire and the force received by the tooth. The bracket, just transmits the force. So whatever the bracket slot is, in shape and size, the only important thing, is the result of the force system that will move the tooth and group of teeth.
The patients should be aware that stability cannot be guaranteed, and that maintenance depends on his compliance. It seems to be a widespread myth that orthodontic results remains stable. Despite this poor situation, we have some arguments for treating malocclusions with an effective stability.

About the lecturer:

DDS-MS in Orthodontics Paris VII.

President French orthodontic Society

Intl. Member American Association of Orthodontists and WFO

French Board of Orthodontics

Member of orthodontics communities of France, Switzerland, Italy, Romania, Europe.

President Intl. Tweed Foundation for orthodontic research.

Specialization in dentofacial orthopedics.

Diploma in orthodontist Switzerland and France.

Honorary Professor Bucarest and Cluj Univ, Romania.

President European College of Orthodontics Intl. Member American Association of Orthodontists and WFO.

Instructor at the Tweed Intl. Course in Tucson AZ.

Edgewise course in Naples-Milan-Rome IT, Bucarest RO, Bruxelles UCB, Alexandria Egypt, Kiev, Moscow, Seoul, Morroco, Alger, Tunis.

1. Genetic origin vs epigenetic and environmental origin;
2. Symptomatic treatment vs root cause treatment;
3. Focused on sagittal dimension vs focused on vertical dimension;
4. Cephalometric esthetic analysis vs cephalometric functional analysis;
5. Lower incisor centered treatment vs upper incisor centered treatment;
6. Anterior discrepancy vs posterior discrepancy;
7. Premolar extraction vs 3rd molar extraction;
8. Orthognathic surgery vs very little orthognathic surgery;
9. Heavy force vs light force;
10. Mechanical vs biological;
11. Aesthetic vs functional and aesthetic;
12. Tooth centered treatment vs joint centered treatment;
13. Static occlusion vs dynamic occlusion;
14. No reconstruction of occlusal plane vs reconstruction of occlusal plane;
15. Bruxism: abnormal function vs bruxism: normal function;
16. Orthodontic treatment without considering bruxism vs orthodontic treatment with considering bruxism;
17. Longer treatment time vs short treatment time;
18. Often have built-in instability vs very stable;
19. Routine orthodontic treatment vs individualized orthodontic treatment;
20. Mainly antero-posterior tooth movement vs 3 dimensional tooth movement;

About the lecturer:

DDS, PhD

Head of the Kooalldam Dental Clinic, Incheon, Korea.

Thesis defense at the orthodontic school Kanagawa dental University (KDU), Japan.

Adjunct Professor, Seoul National University Dental College (SNUDC), Korea

Professor, Korea University Graduate School of Clinical Dentistry, Korea.

Curator of educational programs, Korean Academy of Orthodontics.

Class II malocclusion does not self-correct in growing patients. The Class II skeletal pattern is established early and remains until puberty if no orthodontic intervention is performed. To this date, several authors have discussed the relationship of the initial malocclusion characteristics with the effectiveness of orthodontic treatment and the stability of the corrections obtained.
Normally, orthodontic treatment takes a long time and uses complex techniques, usually achieving good results; however, these results may be lost in varying degrees after the removal of appliances and retainers. Orthodontic relapse includes crowding or spacing of teeth, and loss of overbite, overjet correction, and loss of Class II molar relationship correction.
Orthodontic changes of the position of the first permanent molars have a great tendency to relapse. Some authors affirm the with time, in adults, changes that occur in molar relationship are always towards Class II relation. The changes are of small magnitude and independent of the type of initial malocclusion and the type of treatment. Other authors suggest that, in the long-term, there is relapse in molar relationship and that changes in incisor position and intercuspation of the posterior teeth are statistically significant.
The real problem is that we don’t have clear the real etiology of a Cl II malocclusion. Only if we have the understanding of the morphologic characteristics of a malocclusion can we know what needs to be changed in order to treat our patients, growing and adults, from a full Cl II molar relationship, to a stable Cl I, correcting also the skeletal Cl II.
Some of the common mistakes in treating a Cl II is wrong diagnosis, high pull headgear, premolar extractions and the use of Cl II elastics.

About the lecturer:

Orthodontics and Facial Orhtopedics Specialist.

PhD in Medical Sciences (Orthodontics and Facial Orhtopedics).

Member of the orthodontic society in Brazil, member of the World Orthodontics Federation.

Graduated as a dentist in 1995 at the the prestigious School of Dentistry of Piracicaba - UNICAMP, which is acknowledged as one of the best in Brazil and renowned for its excellence at both undergraduate and postgraduate levels in Latin America.

Went on to post graduate in the Faculty of Dentistry at the University of Sao Paulo - FOUSP / FUNDECTO.

Have been in private orthodontic practice since 2000, as well as being a course coordinator, instructor, and clinical professor for a mini-residency program in UPS as well as other Universities, including in other countries.

After some 10 years in practice, she decided that she wished to treat her son (a braquifacial skeletal Cl III without a face mask) as well as raise the level of excellence of her treatment and enrolled in various programs around the world in this pursuit. This journey led her to the courses in the USA, Taiwan, Korea, Germany, Colombia as well as the ones conducted by Professors Sadao Sato, Japan, and Rudolf Slavicek, Vienna, both giants in their respective disciplines.

She has lectured extensively all over the world, in private venues, International Orthodontic Meetings as well as at the prestigious Vienna School of Interdisciplinary Dentistry (VieSID), Vienna School of Medicine, where she is an instructor.

In her private practice in Brazil she has become renowned for treating the most difficult of malocclusions and disorders of the Craniomandibular system and is testimony to the dictum that we should be practising as Physicians of Occlusal Medicine of the Craniomandibular System.

She is proficient in GEAW (Gummetal edgewise archwire) technique which enable her to treat very complex malocclusions, many of which, most would have believed would have required surgery, as well as extra-alveolar TADs and MOPS (micro-osteoperforation) for bone remodeling and modeling.

Malocclusions are of skeletal and/or dento-alveolar origin. Growth of the craniofacial skeleton is mainly under genetically control, but early dento-alveolar corrections can facilitate the utilization of growth and compensate for most skeletal deviations. In relations to adult patients application of intra-and inter-arch force systems orthodontic appliances generate dental and dento-alveolar changes that are often unpredictable. Before treating a malocclusion the problems to be solved have to be identified and the exact tooth movements needed to solve the problem have to be defined. Only one line of action of the active force can generate the desirable displacement. This force can, however, be generated by several appliances. Every treatment is carried out in phases and it is crucial to differentiate between the active and the reactive unit in each stage of treatment. The treatment goal can only be maintained when it is compatible with normal function.
Based on the lecture the doctor will be able to:
1) Work up a detailed problem list for any malocclusion;
2) Divide the treatment into phases;
3) Define the line of action needed to generate a specific tooth movement.
Several appliances may, on the other hand generate the same line of action of the force In order to obtain a maintainable correction malocclusion the problem must be localized. Only when the deviation is identified the needed tooth-movements can be determined. For each well defined tooth-movement there is only one correct force system. The shortest distance between two points is a straight line This force system can, on the other hand be obtained by many appliances. can be defined and corresponding appliance generated. For each tooth movement defined in thee planes of space only one line of action of the force system is correct.

About the lecturer:

Ex-President of European Orthodontic Society.

Received her Dental Degree in 1964 from Aarhus University in Aarhus, Denmark.

She has made significant contributions in the field of orthodontics.

Published about 350 papers in scientific journals on topics related to Anchorage (orthodontics) and adult orthodontics.