CONTENTS

Editor’s Choice

David L. Turpin, Editor-in-Chief

ABO certification in the age ofevidence and enhancementMarc B. Ackerman, Daniel J. Rinchuse, andDonald J. Rinchuse

The American Board of Orthodontics (ABO) phaseIII certification examination was originally constructedand recently modified to measure a candidate’s basicknowledge of and ability to practice orthodontics.Recent modifications to the testing process have metwith success, in that the percentage of board-certifiedclinicians has risen to 35%, an all time high for ourspecialty. But will this certification process stand thetest of time? Is there evidence to support the outcomemeasures currently used by the ABO?

The goals of this article were to question the ABO’sconcept of ideal occlusion, to challenge the core con-cepts of its phase III certification process, and torecommend an alternative paradigm predicated on apatient-centered, evidence-based clinical practicemodel. Although it might be time to encourage a morerealistic view of patient variability than allowed bycurrent ABO standards, this article is somewhat vagueabout how this can be accomplished. How can the ABOmeasure the improvement in a treated patient withoutcomparing with an established standard? If an applicantpresents a series of cases completed to another stan-dard, how would that be any more evidence-based?

I hope that this well-constructed article will bringgreater respect to our certifying board by encouraginglong-term self-introspection.

Perceptions of dental professionalsand laypersons to altered dentalesthetics: Asymmetric and symmetricsituationsVincent O. Kokich, Vincent G. Kokich, andH. Asuman Kiyak

When was the last time you completed treatment foran adult patient only to notice that a lateral incisor wasshorter or narrower than the contralateral tooth? Will the

Am J Orthod Dentofacial Orthop 2006;130:10A0889-5406/$32.00Copyright © 2006 by the American Association of Orthodontists.

doi:10.1016/j.ajodo.2006.06.004

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patient notice this difference? Do these asymmetric alter-ations in tooth shape and alignment affect the perceptionof anterior dental attractiveness?

The purpose of this study was to determine theperceptions of laypersons and dental professionals tominor variations in anterior tooth size and alignment aswell as their relationship to the teeth and the supportinggingiva.

In general, these researchers found that asymmetricalterations tend to make teeth less attractive, not only tothe dental professional but also to the lay public. Accord-ing to an earlier study by these authors, this was notnecessarily true for symmetric differences. Although sym-metric alterations might appear unattractive to dentalprofessionals, the lay public was less likely to recognizesome of them. So, should clinicians correct every devia-tion in the name of better esthetics? To this question, theauthors offer these concluding remarks. “Alter toothposition and restore with caution.”

Correction of a canted occlusal planewith miniscrews in a patient withfacial asymmetryYoung Jin Jeon, Yang Hee Kim, Woo Sung Son, andMark G. Hans

Adult patients with asymmetry of the mandible fre-quently have secondary maxillary asymmetry, complicat-ing the plan of treatment. As a result, LeFort I osteotomycombined with mandibular bilateral sagittal split osteot-omy is the accepted method for correcting occlusal planecanting in these patients with facial asymmetry. Is thereany way to reduce the need for this much surgery?

In this case report from Korea, the authors describe theperfect solution. The 22-year-old patient’s chief com-plaints were facial asymmetry and mandibular progna-thism. His mandible was shifted to the right according tothe cant of the maxillary occlusal plane, resulting in theunilateral extrusion of the maxillary left premolars andmolars. The eventual treatment plan included intrusion ofthe teeth on the left side of the maxilla, thereby avoidinga more aggressive LeFort I surgical approach. Correctionof the occlusal plane canting was successfully managedwith miniscrews for skeletal anchorage, leading to reso-lution of the facial asymmetry. Excellent documentation

of the treatment mechanics makes this an interesting read.