ORTHODONTIC TREATMENT OF ADULTS: WHERE IS THE LIMIT?

COURSE OUTLINE

Adult Orthodontics

• Introduction and history
• Adolescent vs adult orthodontics
• Age and anatomic limitations
• Periodontal ligament modifications
• Bone modifications
• Local modifications
• Biological reactions of periodontal tissues to orthodontic forces
• The biological response of the adult patient

Treatment goals

• General
• Specific
• Multidisciplinary treatment plan

Soft tissues

• Esthetics of the maxillary anterior group
• Excess problems
• Defect problems
• Loss of interdental papilla
• Labial movement of mandibular incisors

Periodontal disease

Create the Vision

• Diagnostic Wax-up
• How to make a Multidisciplinary treatment planning

Class II Borderline malocclusions

• Deep bite management
• Labial movement of mandibular incisors and implant space opening
• Orthognathic Surgical procedures

Pre-prosthetic management of Molar uprighting

• The use of double cantilevers
• The Sander uprighting spring

Anchorage systems

• Optimal level of forces and moments for each type of tooth movement
• Active and reactive units
• Activation and deactivation forces
• Extraoral anchorage systems

Intraoral anchorage systems

• Fiber-reinforced composites
• The Iron-cross
• Occlusion
• Ankylosed teeth
• Teeth to be extracted: “free anchorage”

Extradental anchorage systems

• Osseointegrated implants
• Onplants
• Miniplates
• Zygoma wires
• Miniscrews

Orthodontics movement of periodontally involved teeth

Orthodontic movement through infrabony defects

Management of interproximal craters

Management of one-two-three wall defects

Orthodontic movement through edentulous areas

• Protraction of maxillary and mandibular molars: where is the limit?
• How to develop an implant site by orthodontic tooth movement and new bone formation

Intrusion vs Extrusion of teeth with compromised periodontium

Orthodontic treatment of adult patients with severely compromised periodontium

• Biomechanical and interdisciplinary planning
• Anchorage demands
• The use of long Power Arms
• When and how to treat dental recessions in ortho patients?
• Orthodontic Management of gingival recessions with Lingual Root Torque

Retention protocols

Conclusions