CONTENTS

Editor’s ChoiceDavid L. Turpin, DDS, MSD, Editor-in-Chief

l

t

nseenap-theery

an’sareore

es?llary4-6asedhorsrtho-ical,ts.atedthe

n 1thehad.ateen

s nott be

ctabil-ver,cial

rna-entears

ter

allseek-the

eenweremet athe

ererootlossftenical

l offterrchax-

ntic1 ofbined

betages ofntlytoryewsatedthetheency

Orthognathic surgery and dentofaciaorthopedics in adult Class II Division1 treatment: Mandibular sagittal spliosteotomy versus Herbst applianceSabine Ruf and Hans Pancherz

Adult patients with skeletal Class II malocclusioand mandibular deficiencies have traditionally boffered 2 treatment options: either a camouflageproach consisting of maxillary extractions to maskunderlying skeletal disharmony or orthognathic surgto lengthen the mandible. Depending on the clinicibackground, mild Class II problems in adultsusually resolved with camouflage treatment and msevere discrepancies by surgery.

But what about the many borderline Class II casIn these patients, you hesitate to extract in the maxiarch, yet the skeletal disharmony might be onlymm, and the patient is reluctant to have surgery. Bon the findings of a large clinical study, these autsuggest that the Herbst appliance might be the opedic tool you are looking for to undertake nonsurgnonextraction treatment in borderline Class II adul

The subjects being compared were 46 adults treby orthognathic surgery and 23 adults treated withHerbst appliance. All patients had Class II Divisiomalocclusions and were treated nonextraction. Atend of treatment, all surgical and Herbst subjectsClass I occlusions with normal overjet and ovebite

The critical question for the authors is: “Whdifferences in treatment outcomes were found betwthe 2 groups after treatment?” If a skeletal change iimportant to the patient, then Herbst treatment migha good option, because the success rate and prediity is as high as for orthognathic surgery. If, howethe patient’s main objective is a greatly improved fa

Am J Orthod Dentofacial Orthop 2004;126:8A0889-5406/$30.00� 0Copyright © 2004 by the American Association of Orthodontists.doi:10.1016/j.ajodo.2004.06.015

8A

profile, then orthognathic surgery is the better altetive. I predict that this study will challenge the currorthognathic standards of treatment planning for yto come.

Emergency orthodontic treatment afthe traumatic intrusive luxation ofmaxillary incisorsStella Chaushu, Joseph Shapira, Ilana Heling, and AdrianBecker

As a clinician, I can remember many phone cfrom general dentists who had been called on a wend to examine a young patient with trauma tomaxillary incisors. If at least 1 anterior tooth had bseverely intruded, more often than not the dentistsinclined to defer treatment until weeks later. Soorthodontists were slow to complain, thinking tha“cooling off” period is recommended to reducepossibility of collateral damage.

This inaction often led to unexpectedly sevcomplications, such as pulp necrosis, inflammatoryresorption, ankylosis, replacement resorption, andof marginal bone support. Treatment alternatives oincluded observation alone and immediate surgreduction and repositioning.

The authors of this article report on a handfupatients having early orthodontic repositioning atraumatic intrusion and review the literature in seaof answers. Altogether, 31 previously traumatized millary incisors were identified and studied. Orthodoextrusive traction per se was successful in 30 of 3the teeth described. The results of the present comsample of treated patients show this method tosuperior to both its alternatives, in terms of percenof teeth lost during the follow-up period. Regardleswhich technique was used, the 2 most frequeencountered complications were external inflammaroot resorption and marginal bone loss. The good nis that the success rate of orthodontically generextrusion of the intruded teeth was high, and thatorthodontic specialist is an important member ofdental trauma team in the early stages of emergtreatment for traumatic injury.

American Journal of Orthodontics and Dentofacial OrthopedicsVolume 126, Number 2

Editor’s choice 9A

Case Report Category 6: Class IIDivision 1 with severe crowdingKyle Childers

Correction of a severe Class IIImalocclusionSeher Gündüz Arslan, Jalan Devecioglu Kama, and SedatBaran

By presenting 2 case reports in differing formats inthis issue, we are emphasizing the format required bythe American Board of Orthodontics (ABO). DrChilders prepared his case for display in an abbreviatedmanner, making it easier for the board directors andothers to evaluate it. All forms used were provided bythe ABO and are available to all candidates qualified tostand for certification. This particular case report waspresented at the AAO 2003 Annual Session in Hawaii.If you are interested in taking Phase III of the ABOexamination in the future, watch for the periodic

publication of cases in this format to better understandwhat will be expected. The last page of the reportincludes the actual discrepancy index completed by DrChilders to evaluate the patient’s initial degree ofdifficulty.

In contrast to this ABO format, take time to read thecase report relating the correction of a severe Class IIImalocclusion as presented by members of the orthodon-tic department in Diyarbakır, Turkey. In this typicalAJO-DO write-up, the authors were challenged toprovide treatment alternatives and to be thorough indescribing the thought processes to diagnose and treatthis patient. They were asked to base treatment deci-sions on the best available evidence as published in theliterature and to appropriately reference their work.This case was selected for its complexity and treatmentoutcome.

We will continue to use this type of presentation formost case reports published throughout the year. Thisformat is also required to compete each year for theCDABO case report of the year, which carries a prizeof $1500.