CONTENTS

Editor’s Choice

David L. Turpin, Editor-in-Chief

The enigma of facial beauty:Esthetics, proportions, deformity, andcontroversyFarhad B. Naini, James P. Moss, and Daljit S. Gill

What do you say to a patient whose primary reasonfor an examination is to explore appearance-alteringtreatment? You might conclude that he or she presentsa considerable clinical challenge. Based on personalexperience, I know that the outcome is not alwayshelpful to the patient’s self-worth. On the other hand, iftreatment can significantly improve a patient’s qualityof life, one could very well argue that the patient shouldmake the ultimate informed decision. Where do youstand on the subject of contemporary facial beauty?

Most of us live in a world where a media-fueledobsession with so-called perfect appearance is almost anorm, an attitude that is at best unhelpful to many andat worst detrimental. Yet, withholding treatment from aperson with a facial deformity because the problem iswith society’s attitudes would be simplistic and possi-bly unethical. This study of the face and our ability toalter dentofacial form will fascinate you, as the topichas fascinated mankind for thousands of years.

Class III surgical-orthodontictreatment: A cephalometric studyChris Johnston, Donald Burden, David Kennedy, NigelHarradine, and Mike Stevenson

The timing of this article on Class III surgical-orthodontic treatment is interesting because other re-cent studies have reported relatively poor long-termstability for these patients. Just how stable is thesurgical correction of Class III malocclusion, nowthought to comprise nearly 20% of the patients comingfor orthognathic procedures?

Overall, surgical treatment in this study was suc-cessful in correcting overjet to the ideal range. Bimax-illary surgery was used for 75% of the patients, whohad more severe skeletal and dental discrepancies than

Am J Orthod Dentofacial Orthop 2006;130:11A0889-5406/$32.00Copyright © 2006 by the American Association of Orthodontists.

doi:10.1016/j.ajodo.2006.07.010

those treated with single-jaw procedures. However,bimaxillary surgery had 3.4 times the odds of fullycorrecting the ANB angulations than single-jaw sur-gery. Incomplete incisor decompensation proved to bethe greatest deterrent to achieving ideal skeletal out-comes. Particular attention should be paid to patientswith retroclined mandibular incisors or proclined max-illary incisors at the start of treatment.

Nonextraction treatment of an openbite with microscrew implantanchorageHyo-Sang Park, Oh-Won Kwon, and Jae-Hyun Sung

I have seen the preferred method of correctinganterior open bite change regularly over the past 40years. I was initially taught to refer these patients to aspeech therapist familiar with the elimination of tonguethrust. Then I learned to obtain more direct results byusing a crib with spurs to enforce immediate compli-ance by the tongue. Of course, fixed appliances withvarious combinations of vertical elastics were usedmore often than any orthodontist wanted to admit. Thenmaxillary surgery to impact the posterior portion of themaxilla achieved success and was thought to be thefinal answer. With the advent of rigid screw fixation insurgery, it became possible to close open bites withmandibular surgery alone, and this is now seen bymany as a good solution. Despite our best intentionswith these techniques, long-term stability of open-biteclosure is no better than 80%. With increasing time outof appliances, too many corrected bites tend to openafter retention is stopped.

Clinicians who have survived this 40-year tran-sition in treatment modalities will be especiallyinterested in this excellent case report, which showsanother method for closing anterior open bites. Tominimize relapse, this patient’s posterior teeth wereintruded to an overcorrected vertical position. Evenwith notable success, the authors stress the need todevelop a proper retention protocol for molar intru-sion when treating open bite problems. Muscle ex-ercises should be prescribed, and it might even behelpful to maintain the microscrew implants for a

while after treatment.

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