Description

Book Synopsis

The complete reference work covering the increasingly prominent area of adult orthodontics

Written by renowned contributors from the orthodontic community and compiled by world-class editors, Adult Orthodontics, 2nd Edition is an authoritative resource on the subject of adult orthodontics, marrying together clinical guidance with a thorough evaluation of the evidence base. Sample topics discussed within the book include:

  • Context for adult orthodontics, including patient demographics and aetiology
  • Treatment planning considerations, including patient case profiles, initial outcomes and longer-term expectations
  • Interdisciplinary and multidisciplinary approaches, including the links between adult orthodontics and periodontics, prosthetics, and temporomandibular disorders

This book is an invaluable resource for professionals providing orthodontic treatment to adults and those dealing with orthodontics as part of the interd

Trade Review

"The contents are clear, concise and well structured. In total, there are 21 chapters, which cover the full scope of adult orthodontic treatment, with a particular focus on clinical challenges which are unique for the adult patient. Each chapter is succinct and well written, with a structured flow which allows the reader to digest the subjects being discussed. The fundamental areas of adult orthodontics covered include diagnosis, aetiology, interdisciplinary versus multidisciplinary treatments, anchorage, treatment planning and post-treatment maintenance."
- Zohaib S. Khan, Specialist in Orthdontics, St Helens, UK, Published in British Dental Journal (Nov 23)

"... this newly updated and expanded edition of Adult Orthodontics is an authoritative resource on the subject of adult orthodontics, blending together clinical guidance with a thorough evaluation of the evidence base.... An invaluable and comprehensive instructional and informational resource for professionals providing orthodontic treatment to adults and those dealing with orthodontics as part of the interdisciplinary management of the adult dentition, Adult Orthodontics is especially recommended as a core addition to personal, professional, and academic library Dentistry/Orthodontics collections."
Library Bookwatch, January 2023, Midwest Book Reviews

"Adult Orthodontics is an authoritative resource, written and edited by experts in the field, combining clinical guidance with a thorough evaluation of the evidence base. Diagnostic issues and problems are clearly defined, and solutions and limitations elucidated using case studies...an invaluable reference for professionals providing orthodontic treatment to adults"
- Peter Folly, British Dental Association, Published in BDJ Team (July 22)



Table of Contents

List of Contributors xiii

About the Companion Website xv

Introduction xvii

Introduction: More than a Century of Progress in Adult Orthodontic Treatment xix

1 Potential Adult Orthodontic Patients – Who Are They? 1
Birte Melsen

Introduction 1

Who are the patients? 1

How do the patients express their needs? 6

The first visit 7

Communicating with the patient 9

Summary 10

References 10

2 Diagnosis: Chief Complaint and Problem List 12
Birte Melsen, Marco A. Masioli

Introduction 12

Workup of a problem list – the interview and chief complaint 12

General health 15

Clinical examination 16

Extraoral examination 17

Extraoral photographs 19

Function of the masticatory system 22

Intraoral analysis – oral health 23

Evaluation of dental casts – arch form 24

Occlusal analysis 24

Space analysis 26

Cephalometric analysis 26

Final problem list 27

Indication for treatment 28

The presentation of the problem list – the tip of the iceberg 29

Concluding remarks 33

References 33

3 Aetiology 35
Birte Melsen

Introduction 35

Biological background 35

Aetiology of malocclusions in adults 41

Age-related changes in the skeleton 42

Age-related changes in the craniofacial skeleton 46

Age-related changes in the local environment 47

Consequences of deterioration of the dentition 48

Case reports 49

Conclusion 52

References 52

4 Interdisciplinary versus Multidisciplinary Treatments 54
Birte Melsen

Interdisciplinary or multidisciplinary treatments 54

Establishment of an interdisciplinary team 56

Treatment sequence 59

Essential and optional treatment procedures 59

Interaction during treatment 62

Post-orthodontic treatment 62

Patient satisfaction 62

Examples of interdisciplinary cases 63

References 63

5 Treatment Planning: The 3D VTO 65
Birte Melsen, Giorgio Fiorelli

Determining the treatment goal using the occlusogram 65

Production of an occlusogram: manual procedure and general concepts 66

Responding to patients’ needs 76

Orthodontic treatment: art or science? 78

References 78

6 Tissue Reaction 79
Carlalberta Verna, Birte Melsen

Orthopaedic effects 79

Orthodontic effects in adult patients 80

References 97

7 Appliance Design 101
Birte Melsen, Delfino Allais, Giorgio Fiorelli

Introduction 101

Treatment goal definition 101

Anchorage evaluation 110

Sequencing the treatment into phases 110

Appliance selection and design 112

Conclusion 138

References 138

8 Anchorage Problems 141
Birte Melsen, Carlalberta Verna

Introduction 141

Definition 142

Classification of anchorage 142

Intramaxillary anchorage 142

Differential anchorage 146

Soft-tissue anchorage 147

Free anchorage 147

Intermaxillary anchorage 151

Occlusion 155

Differential timing of force application 156

Conclusion 156

Extraoral anchorage 156

Skeletal anchorage 156

Prosthodontic implants 157

Temporary anchorage devices 157

Palatal implants 159

Palatal mini-implants with abutments, optimal insertion sites and possible mechanics 159

Implant placement and adaption of the mechanics 159

Clinical applications for palatal mini-implants 163

Conclusion 163

Onplant 163

Retromolar implants 163

Immediately loadable devices 164

Zygoma ligature 164

Miniplates 164

Mini-implants 164

Material 166

Design of the intraosseous parts 166

Design of the transmucosal parts 168

Design of the head of the mini-implant 168

The screwdriver 168

Insertion site 168

Insertion 170

Antibiotics 171

Load transfer 171

Tissue reaction to loading 172

Loading 173

Orthodontic mechanics 173

Alternative application of TADs used as anchorage 173

Indications 174

Complications 175

What happens if the screw touches a root? 175

Failures 176

Problems related to the mini-implant and solutions 176

Problems related to the insertion procedure 176

Problems related to the patient 176

Future of TADs 176

References 177

9 Bonding Problems Related to Adult Reconstructed Dentitions 181
Vittorio Cacciafesta

Introduction 181

Brackets 182

The Basis of the Bonding Clinical Procedure 189

Banding 205

Auxiliary Attachments and Aesthetic Buttons 209

Anchorage Needs and Reinforcement 210

Bonded Retainers 211

References 212

10 Material-Related Adverse Reactions in Orthodontics 216
Dorthe Arenholt Bindslev, Gottfried Schmalz

Introduction 216

Fixed appliances 216

Removable appliances 227

Miscellaneous materials 230

Concluding remarks 230

References 231

11 Patients with Periodontal Problems 235
Birte Melsen

Prevalence of periodontal disease 235

Malocclusion and periodontal disease 235

Orthodontics and periodontal disease 236

Indications for orthodontic treatment in periodontally involved patients 239

Treatment of patients with flared and extruded upper incisors 242

Tissue reaction to intrusion of teeth with horizontal bone loss 247

Treatment of patients with vertical bone defects 250

What are the periodontal limits for orthodontic tooth movement? 254

Sequence of treatment in periodontally involved patients 258

Conclusion regarding influence of orthodontic treatment on periodontal status 260

References 262

12 A Systematic Approach to the Orthodontic Treatment of Periodontally Involved Anterior Teeth 265
Jaume Janer

Single tooth gingival recession 265

Progressive spacing of incisors 269

Case reports 275

Management of periodontally involved teeth 276

References 290

13 Interdisciplinary Collaboration between Orthodontics and Periodontics 293
Francesco Milano, Laura Guerra Milano

Introduction 293

Periodontal diagnosis 294

History taking and clinical and radiographic examination 294

Screening for periodontal disease 294

Local factors predisposing to periodontal therapy 296

Timing of ortho–perio treatment 297

Periodontal therapy 298

Surgical therapy 298

Mucogingival and aesthetic surgery 300

Regenerative surgical therapy 312

Supportive periodontal treatment 312

Ortho–perio and multidisciplinary clinical cases 313

Conclusion 319

Acknowledgements 319

References 321

14 Prosthetically Guided Orthodontic Strategies 323
Arturo Imbelloni, Cesare Luzi

Introduction 323

Interdisciplinary treatment planning: orthodontics in periodontal prosthesis 324

Prosthodontic indications for orthodontic therapy 325

Pre-prosthodontic orthodontics 325

Role of temporisation in interdisciplinary treatment 343

Prosthodontic finalisation 345

References 346

15 Patients with Temporomandibular Joint (TMJ) Problems 348
Birte Melsen

Orthodontics and dysfunction 348

Controversy in the literature regarding TMD and occlusion 350

Treatment and TMD 351

Treatment of clicking joints 352

Orthodontic treatment of patients with TMD 352

Organisation of the treatment 358

Conclusion 358

References 360

16 Patients with Temporomandibular Disorders 362
Peter Svensson, Fernando G. Exposto

Introduction 362

Classification and epidemiology 362

Diagnostic procedures 363

Risk factors and aetiology 367

Pathophysiology 368

Management 371

Summary 373

References 374

17 Clear Aligners and Their Role in Orthodontics 379
Sonil Kalia, Reginald Mietke, Birte Melsen

History of aligners 379

Difference between aligner treatments and conventional orthodontic treatments 380

What types of patients are seeking aligner treatments? 380

Pre-treatment considerations 380

What has to be evaluated before the aligners are produced? 381

Force-driven or displacement-driven aligners? 381

Invisalign® 381

Orthocaps® 385

Studies on treatment efficacy and efficiency of aligner 389

What role will the aligners play in the future? 390

Conclusion 391

References 391

18 Progressive Slenderising Technique 392
Dr Pablo Echarri, Emma Vila Mancho

Definition and objectives 392

Anthropological justification of slenderising 393

Influence of slenderising on dental plaque, caries and periodontal disease 393

Indications 394

Contraindications 397

Advantages of slenderising 399

How much enamel can be stripped? 399

Special considerations 401

Instrumentation for slenderising 401

Progressive slenderising technique 404

Slenderising with aligners 407

The design and planning of the slenderising and preventing risks in slenderising 411

Stripping and Bolton index 412

How much enamel can be worn out? 417

Facial and dental midlines 418

Teeth size 418

Design and planning of the stripping 418

Progressive stripping technique 419

Case reports 421

References 421

19 Post-Treatment Maintenance 423
Birte Melsen, Sonil Kalia

Stability 423

Biological maintenance 424

Mechanical maintenance – retention 426

Intermaxillary retention 431

Active retention plates 434

Latest technology in retainers fabrication (bonded and vacuum-formed) 434

Virtual removal of fixed appliances and or attachments to fabricate retainers 434

Retention after aligner orthodontic treatments 435

Future developments 435

Conclusion 435

References 436

20 Treatment Duration: Can It be Shortened? 438
Sabarinath Prasad, Mauro Farella, Birte Melsen

Introduction 438

Adjuncts to accelerate tooth movements 438

Treatment-related factors 441

Conclusions 444

References 444

21 What are the Limits of Orthodontic Treatment? 446
Birte Melsen

What determines the limits? 446

Reference 447

Index 448

Adult Orthodontics

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    Order before 4pm tomorrow for delivery by Mon 20 Jul 2026.

    A Hardback by Birte Melsen, Cesare Luzi

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      Trusted by thousands of customers. See 2,385+ Customer Reviews

      View other formats and editions of Adult Orthodontics by Birte Melsen

      Publisher: John Wiley and Sons Ltd
      Publication Date: 13/10/2022
      ISBN13: 9781119775775, 978-1119775775
      ISBN10: 1119775779

      Description

      Book Synopsis

      The complete reference work covering the increasingly prominent area of adult orthodontics

      Written by renowned contributors from the orthodontic community and compiled by world-class editors, Adult Orthodontics, 2nd Edition is an authoritative resource on the subject of adult orthodontics, marrying together clinical guidance with a thorough evaluation of the evidence base. Sample topics discussed within the book include:

      • Context for adult orthodontics, including patient demographics and aetiology
      • Treatment planning considerations, including patient case profiles, initial outcomes and longer-term expectations
      • Interdisciplinary and multidisciplinary approaches, including the links between adult orthodontics and periodontics, prosthetics, and temporomandibular disorders

      This book is an invaluable resource for professionals providing orthodontic treatment to adults and those dealing with orthodontics as part of the interd

      Trade Review

      "The contents are clear, concise and well structured. In total, there are 21 chapters, which cover the full scope of adult orthodontic treatment, with a particular focus on clinical challenges which are unique for the adult patient. Each chapter is succinct and well written, with a structured flow which allows the reader to digest the subjects being discussed. The fundamental areas of adult orthodontics covered include diagnosis, aetiology, interdisciplinary versus multidisciplinary treatments, anchorage, treatment planning and post-treatment maintenance."
      - Zohaib S. Khan, Specialist in Orthdontics, St Helens, UK, Published in British Dental Journal (Nov 23)

      "... this newly updated and expanded edition of Adult Orthodontics is an authoritative resource on the subject of adult orthodontics, blending together clinical guidance with a thorough evaluation of the evidence base.... An invaluable and comprehensive instructional and informational resource for professionals providing orthodontic treatment to adults and those dealing with orthodontics as part of the interdisciplinary management of the adult dentition, Adult Orthodontics is especially recommended as a core addition to personal, professional, and academic library Dentistry/Orthodontics collections."
      Library Bookwatch, January 2023, Midwest Book Reviews

      "Adult Orthodontics is an authoritative resource, written and edited by experts in the field, combining clinical guidance with a thorough evaluation of the evidence base. Diagnostic issues and problems are clearly defined, and solutions and limitations elucidated using case studies...an invaluable reference for professionals providing orthodontic treatment to adults"
      - Peter Folly, British Dental Association, Published in BDJ Team (July 22)



      Table of Contents

      List of Contributors xiii

      About the Companion Website xv

      Introduction xvii

      Introduction: More than a Century of Progress in Adult Orthodontic Treatment xix

      1 Potential Adult Orthodontic Patients – Who Are They? 1
      Birte Melsen

      Introduction 1

      Who are the patients? 1

      How do the patients express their needs? 6

      The first visit 7

      Communicating with the patient 9

      Summary 10

      References 10

      2 Diagnosis: Chief Complaint and Problem List 12
      Birte Melsen, Marco A. Masioli

      Introduction 12

      Workup of a problem list – the interview and chief complaint 12

      General health 15

      Clinical examination 16

      Extraoral examination 17

      Extraoral photographs 19

      Function of the masticatory system 22

      Intraoral analysis – oral health 23

      Evaluation of dental casts – arch form 24

      Occlusal analysis 24

      Space analysis 26

      Cephalometric analysis 26

      Final problem list 27

      Indication for treatment 28

      The presentation of the problem list – the tip of the iceberg 29

      Concluding remarks 33

      References 33

      3 Aetiology 35
      Birte Melsen

      Introduction 35

      Biological background 35

      Aetiology of malocclusions in adults 41

      Age-related changes in the skeleton 42

      Age-related changes in the craniofacial skeleton 46

      Age-related changes in the local environment 47

      Consequences of deterioration of the dentition 48

      Case reports 49

      Conclusion 52

      References 52

      4 Interdisciplinary versus Multidisciplinary Treatments 54
      Birte Melsen

      Interdisciplinary or multidisciplinary treatments 54

      Establishment of an interdisciplinary team 56

      Treatment sequence 59

      Essential and optional treatment procedures 59

      Interaction during treatment 62

      Post-orthodontic treatment 62

      Patient satisfaction 62

      Examples of interdisciplinary cases 63

      References 63

      5 Treatment Planning: The 3D VTO 65
      Birte Melsen, Giorgio Fiorelli

      Determining the treatment goal using the occlusogram 65

      Production of an occlusogram: manual procedure and general concepts 66

      Responding to patients’ needs 76

      Orthodontic treatment: art or science? 78

      References 78

      6 Tissue Reaction 79
      Carlalberta Verna, Birte Melsen

      Orthopaedic effects 79

      Orthodontic effects in adult patients 80

      References 97

      7 Appliance Design 101
      Birte Melsen, Delfino Allais, Giorgio Fiorelli

      Introduction 101

      Treatment goal definition 101

      Anchorage evaluation 110

      Sequencing the treatment into phases 110

      Appliance selection and design 112

      Conclusion 138

      References 138

      8 Anchorage Problems 141
      Birte Melsen, Carlalberta Verna

      Introduction 141

      Definition 142

      Classification of anchorage 142

      Intramaxillary anchorage 142

      Differential anchorage 146

      Soft-tissue anchorage 147

      Free anchorage 147

      Intermaxillary anchorage 151

      Occlusion 155

      Differential timing of force application 156

      Conclusion 156

      Extraoral anchorage 156

      Skeletal anchorage 156

      Prosthodontic implants 157

      Temporary anchorage devices 157

      Palatal implants 159

      Palatal mini-implants with abutments, optimal insertion sites and possible mechanics 159

      Implant placement and adaption of the mechanics 159

      Clinical applications for palatal mini-implants 163

      Conclusion 163

      Onplant 163

      Retromolar implants 163

      Immediately loadable devices 164

      Zygoma ligature 164

      Miniplates 164

      Mini-implants 164

      Material 166

      Design of the intraosseous parts 166

      Design of the transmucosal parts 168

      Design of the head of the mini-implant 168

      The screwdriver 168

      Insertion site 168

      Insertion 170

      Antibiotics 171

      Load transfer 171

      Tissue reaction to loading 172

      Loading 173

      Orthodontic mechanics 173

      Alternative application of TADs used as anchorage 173

      Indications 174

      Complications 175

      What happens if the screw touches a root? 175

      Failures 176

      Problems related to the mini-implant and solutions 176

      Problems related to the insertion procedure 176

      Problems related to the patient 176

      Future of TADs 176

      References 177

      9 Bonding Problems Related to Adult Reconstructed Dentitions 181
      Vittorio Cacciafesta

      Introduction 181

      Brackets 182

      The Basis of the Bonding Clinical Procedure 189

      Banding 205

      Auxiliary Attachments and Aesthetic Buttons 209

      Anchorage Needs and Reinforcement 210

      Bonded Retainers 211

      References 212

      10 Material-Related Adverse Reactions in Orthodontics 216
      Dorthe Arenholt Bindslev, Gottfried Schmalz

      Introduction 216

      Fixed appliances 216

      Removable appliances 227

      Miscellaneous materials 230

      Concluding remarks 230

      References 231

      11 Patients with Periodontal Problems 235
      Birte Melsen

      Prevalence of periodontal disease 235

      Malocclusion and periodontal disease 235

      Orthodontics and periodontal disease 236

      Indications for orthodontic treatment in periodontally involved patients 239

      Treatment of patients with flared and extruded upper incisors 242

      Tissue reaction to intrusion of teeth with horizontal bone loss 247

      Treatment of patients with vertical bone defects 250

      What are the periodontal limits for orthodontic tooth movement? 254

      Sequence of treatment in periodontally involved patients 258

      Conclusion regarding influence of orthodontic treatment on periodontal status 260

      References 262

      12 A Systematic Approach to the Orthodontic Treatment of Periodontally Involved Anterior Teeth 265
      Jaume Janer

      Single tooth gingival recession 265

      Progressive spacing of incisors 269

      Case reports 275

      Management of periodontally involved teeth 276

      References 290

      13 Interdisciplinary Collaboration between Orthodontics and Periodontics 293
      Francesco Milano, Laura Guerra Milano

      Introduction 293

      Periodontal diagnosis 294

      History taking and clinical and radiographic examination 294

      Screening for periodontal disease 294

      Local factors predisposing to periodontal therapy 296

      Timing of ortho–perio treatment 297

      Periodontal therapy 298

      Surgical therapy 298

      Mucogingival and aesthetic surgery 300

      Regenerative surgical therapy 312

      Supportive periodontal treatment 312

      Ortho–perio and multidisciplinary clinical cases 313

      Conclusion 319

      Acknowledgements 319

      References 321

      14 Prosthetically Guided Orthodontic Strategies 323
      Arturo Imbelloni, Cesare Luzi

      Introduction 323

      Interdisciplinary treatment planning: orthodontics in periodontal prosthesis 324

      Prosthodontic indications for orthodontic therapy 325

      Pre-prosthodontic orthodontics 325

      Role of temporisation in interdisciplinary treatment 343

      Prosthodontic finalisation 345

      References 346

      15 Patients with Temporomandibular Joint (TMJ) Problems 348
      Birte Melsen

      Orthodontics and dysfunction 348

      Controversy in the literature regarding TMD and occlusion 350

      Treatment and TMD 351

      Treatment of clicking joints 352

      Orthodontic treatment of patients with TMD 352

      Organisation of the treatment 358

      Conclusion 358

      References 360

      16 Patients with Temporomandibular Disorders 362
      Peter Svensson, Fernando G. Exposto

      Introduction 362

      Classification and epidemiology 362

      Diagnostic procedures 363

      Risk factors and aetiology 367

      Pathophysiology 368

      Management 371

      Summary 373

      References 374

      17 Clear Aligners and Their Role in Orthodontics 379
      Sonil Kalia, Reginald Mietke, Birte Melsen

      History of aligners 379

      Difference between aligner treatments and conventional orthodontic treatments 380

      What types of patients are seeking aligner treatments? 380

      Pre-treatment considerations 380

      What has to be evaluated before the aligners are produced? 381

      Force-driven or displacement-driven aligners? 381

      Invisalign® 381

      Orthocaps® 385

      Studies on treatment efficacy and efficiency of aligner 389

      What role will the aligners play in the future? 390

      Conclusion 391

      References 391

      18 Progressive Slenderising Technique 392
      Dr Pablo Echarri, Emma Vila Mancho

      Definition and objectives 392

      Anthropological justification of slenderising 393

      Influence of slenderising on dental plaque, caries and periodontal disease 393

      Indications 394

      Contraindications 397

      Advantages of slenderising 399

      How much enamel can be stripped? 399

      Special considerations 401

      Instrumentation for slenderising 401

      Progressive slenderising technique 404

      Slenderising with aligners 407

      The design and planning of the slenderising and preventing risks in slenderising 411

      Stripping and Bolton index 412

      How much enamel can be worn out? 417

      Facial and dental midlines 418

      Teeth size 418

      Design and planning of the stripping 418

      Progressive stripping technique 419

      Case reports 421

      References 421

      19 Post-Treatment Maintenance 423
      Birte Melsen, Sonil Kalia

      Stability 423

      Biological maintenance 424

      Mechanical maintenance – retention 426

      Intermaxillary retention 431

      Active retention plates 434

      Latest technology in retainers fabrication (bonded and vacuum-formed) 434

      Virtual removal of fixed appliances and or attachments to fabricate retainers 434

      Retention after aligner orthodontic treatments 435

      Future developments 435

      Conclusion 435

      References 436

      20 Treatment Duration: Can It be Shortened? 438
      Sabarinath Prasad, Mauro Farella, Birte Melsen

      Introduction 438

      Adjuncts to accelerate tooth movements 438

      Treatment-related factors 441

      Conclusions 444

      References 444

      21 What are the Limits of Orthodontic Treatment? 446
      Birte Melsen

      What determines the limits? 446

      Reference 447

      Index 448

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