Paolo Manzo

Efficiency of class II no compliance treatment

The II class malocclusion no extractive nor surgical treatment with fixed appliance is usually affected by a wide elastics phase that normally requires a deep involvement of the patient that must cooperate with orthodontist to achieve the goal.
If the patient’s collaboration is not reliable the treatment result could be partial and unsuccessful.
Nowadays there’s the chance to work with no compliance systems that allow to correct the class II without patient’s work and so reducing the therapy time and the stress for both doctor and patient.
For this reasons these systems are spreading also in lingual technique.
The advantages and disadvantages of the no compliance compared with compliance tools will be examined during the lecture.

Nizan Kucukkeles

How to achieve good results  in Borderline Class II adults

Skeletal Class II is usually characterized by mandibular retrusion and the gold standard for treatment is orthognathic surgery but borderline Class II cases can also be treated with some other protocols such as growth modification in adolescents and camouflage treatment in adults. In adults camouflage protocols comprise nonextraction  (molar distalization ) and extraction (upper and /or lower premolars ) protocols. The factors dictating the best protocol depends on; severity of malocclusion, patient’s age, dentofacial pattern, treatment expectations. In this lecture, these treatment protocols will be presented together with case samples, pros and cons of these protocols will be discussed in the light of the scientific evidence.

Sergio A. Cardiel Rios

“When it is really worth to move the teeth in orthodontics”… Think about stability 

The essence of all orthodontic treatment is space management. Indeed, we use available space or we create enough space to correct any kind of malocclusions.

Some clinical considerations are discussed in order to provide esthetic, functional, healthy and long term results.

Letizia Perillo

Early treatment of Class III Malocclusion: a controversial topic.

Dento-skeletal Class III malocclusion in growing children is one of the most challenging and controversial problems in orthodontics due to the difficulty in maintaining long-term stability.
Class III are disharmonies of the middle and/or lower third of the face, sometimes involving the cranial base too,characterized by negative overjet and concave profile and developing into malformations in the most severe cases.
Ideally, a better diagnosis and predictable prognosis are required to set up an individualized treatment plan and an early therapeutic approach has been widely approved by many authors mainly during the last decades.
The key-point rationale has been to intervene for both aesthetic and psychological reasons while decreasing the severity of the adverse Class III dento-skeletal relationship after growth is completed. Several therapeutic alternatives have been developed to treat Class III dento-skeletal disharmony at an early stage, although long-term data are still few in the available literature.
Thus, this presentation will focus on short and long-term outcomes in hypo- and hyper-divergent children specifically treated with the SEC III protocols, composed by Splints, class III Elastics, and Chincup, in comparison to controls. The efficacy and benefits of early treatment in developing Class III malocclusion will be analyzed and the importance of the ideal timing will be also discussed.

Roland Kmeid

Success with conventional and modern systems – 30 years of experience and scientific researches, case comparison

The straight wire appliance, also termed the pre-adjusted edgewise appliance, was originally described by Larry Andrews in 1976. Over the following three decades this system revolutionized fixed orthodontic appliance treatment, due to the detail of design in the brackets and the associated reduction in archwire bending required by the orthodontist. The appliance is termed the straight wire appliance because of the minimal amount of archwire bending required. But are all straight wire appliances the same? And is it really a straight road?
Self-ligating brackets have been gaining popularity over the past several decades. Various advantages for these systems have been claimed. The development of the Edgelokappliance by Wildman in 1972 and the development of the SPEED appliance by Hanson in 1980 marked the start of modern self-ligating appliances. Since then several active and passive self-ligating systems have been developed.
Following a brief discussion of passive self-ligation we will make a detailed analysis of some clinical cases in order to compare it to conventional bracket systems.

Vaska Vandevska Radunovic

Treatment options for dental traumas

Traumatic dental injuries are most common among children and adolescents, but can also occur in adults. The prevalence varies between countries, but it seems to be more prevalent in males than females. Incisors are the most often affected teeth in both jaws. These traumas can disturb a perfectly normal occlusion, or complicate an already present malocclusion. Sometimes a simple non-orthodontic solution is the best treatment option. However, the treatment depends on the type of trauma and its severity. The majority of these cases require orthodontic treatment, either  alone, or in combination with other disciplines. The lecture will give an overview of the possible treatment solutions for dental injuries pertaining to the maxillary incisors.


Kyriacos Jack Toumba

Fluoride Slow-release Glass Devices: Can we prevent white spot lesions in orthodontic therapy?

Originally it was thought that the incorporation of large amounts of fluoride into enamel were responsible for the reduction of enamel solubility. However, it is the activity of the fluoride ion in the oral fluid that is of most importance in reducing the solubility of the enamel rather than a high content of fluoride in enamel. This is now the most widely accepted view of the role of fluoride in the prevention of dental caries. The latest fluoride research is investigating the use of slow-release devices for the long term intra-oral provision of fluoride. Fluoride Slow-Release Glass Devices (FSRGD’s) were developed by the Leeds group back in the 1990’s with the aim of preventing dental caries in young children. A double blind clinical trial over a period of 2 years involving 174 children aged 8yrs living in an inner city area of Leeds using fluoride slow-releasing glass devices showed 67% fewer new carious teeth and 76% fewer new carious surfaces, and are therefore, effective in preventing caries in children. There were 55% fewer new occlusal fissure carious cavities showing that occlusal surfaces were also protected by the fluoride released from the devices. It then became apparent that these devices could be dentally beneficial in other ways. Enamel demineralisation or white spot lesions (WSL’s) are a risk for all patients undergoing fixed appliance orthodontic treatment (FAOT). Therefore we investigated the FSRGD’s that have been shown to clinically prevent dental caries without relying on the patient’s compliance. This double-blind, randomised clinical study allocated patients to FSRGDs or placebo devices threaded onto the orthodontic wire for the duration of FAOT. Cross-polarised digital photographs of maxillary anterior teeth were taken for 40 subjects and assessed by one examiner for presence of WSL’s. Use of FSRGD’s prevented WSL’s on 2.88 times more teeth compared to only use of fluoride in tooth-paste/mouthwash. The ongoing research with FSRGD is focusing on alleviation of dentinal hypersensitivity evidenced by occlusion of dentinal tubules.

Ranko Rajovic

Značaj mlečnih zuba i žvakanja u ukupnom razvoju dece

Često se olako shvata značaj mlečnih zuba. Ima dosta radova koji ukazuju da problem u  zagrižaju može usloviti poremećaj rasta donje i gornje vilice. Nepravilan zagrižaj može da utiče na sile pritiska i osovine tela,  a samim tim na položaj kičme. Nedostatak žvakanja čvrste hrane smanjuje količinu pljuvačke, koja je važna za prirodnu zaštitu zuba i za imunitet. Nedostatak žvakanja čvrste hrane, može da predstavlja problem, jer mišići koji učestvuju u žvakanju utiču na položaj vilice, a samim tim i položaj tela . Rana pojava karijesa i olako vađenje mlečnih zuba takođe mogu da utiču na odstupanja u zagrižaju i menjaju osovine pritiska, a samim tim utiču na posturu tela. Uzimanje čvrste hrane je važno, jer  utiče i na neke kognitivne funkcije. Čvrsta hrana i žvakanje pomaže razvoj pojedinih regija mozga, uključujući hipokampus, region koji je važan za memoriju i  učenje .
Pojedine studije su pokazale da žvakanje aktivira somatozenzone regije korteksta, ali i duboke ragije uključjući deo bazalnih ganglija, talamus i mali mozak

Gabriela Kjurchieva Chuchkova

Multidisciplinary approach in treatment of orthodontic anomalies – art of science, knowledge and skills

The main goal in orthodontic treatment achievement is to established optimal occlusal relationship, functional occlusion, phisiological and estetic harmony of the orofacial structures and facial aperance. The contemporary approach to the complete dental care of patients and the interceptive management of the occlusion undoubtedly implies a good teamwork and cooperation. Most of the irregularities that affect the developing dentition are solved exclusively with an integrated approach, aiming to eliminate etiological factor, to suspend the correction of the malocclusion (easier and faster), prevention of relapces. Orthodontic treatment is integrated in multidisciplinary approach to achieved complete dental care of patients, especially children at the time of active growth and development. In orthodontic therapeutical purposes, starting from the planned extraction of the primary and/or permanent teeth, through early detection of disturbances in eruption path during growth and development of permanent dentition and possibilities to prevent the complication, up to contemporary approach in the treatment of hypodontia, it is necessary to apply adequate diagnostic principles and cooperation of the orthodontists and oral surgeon, inevitably the patients too. In this lecture those problem will be discussed and possible solution will be presented.

Ayse Tuba Altug

Orthodontic and Orthognathic Treatment Modalities of Lateroocclusion and Laterognathie

Diagnosis of dental and skeletal components of occlusal asymmetry is very important for treatment planning. Asymmetrical occlusal relationship can be caused by asymmetric closure in the maxillary, mandibular or both dental arches, functional midline shift (lateroocclusion).
Alternatively, one or both of the two jaws may appear as asymmetrical relative to the overall craniofacial structure (laterognathie). In both cases, we have the opportunity to start laterocclusion-laterognathie treatments at an early age, since the awareness of the asymmetrical image reflected on the patient’s face is very high for the family and the patient. In this presentation, etiological factors and treatment approaches in growing and adult individuals with asymmetric occlusion and/or skeletal relationship will be presented on clinical cases.

Predrag Janosevic

Camouflage of asymmetrical cases. Is there a cookbook?

As clinicians we are forced to deal with asymmetrical orthodontic cases on a daily level. Facial and occlusal asymmetries influence facial beauty and because of that they are imperativ in treatment.
From an etiological perspective asymmetries can be divided into congenital, developmental and acquired. According to structures that are involved dental, skeletal, muscular or functional asymmetries can be distinguished. Fact that asymmetry is often present on the level of different structures in the same person as well as that skeletal asymmetries are usually accomplished with  dental compensation make the treatment position to be more complicated. We should not forget that in the same patients with transversal malocclusion sagittal and vertical problems usually exist too. Precise and detailed diagnosis including functional analysis of the occlusion and identification of functional mandibular deviations is essential in order to have successful therapy. On the basis of all diagnostic information a clear distinction between surgical and camouflage approach should be made. Wrong decisions based on bad diagnosis can be detrimental to post treatment results and stability.
This lecture is designed to answer a question of whether there is a cookbook for camouflage treatment of asymmetrical cases?

Stjepan Spalj

Combined surgical-orthodontic treatment of skeletal malocclusions

Dentofacial deformities tend to affect the person negatively, often contributing to esthetic concern, social discomfort, difficulties swallowing, speech problems, lip posture, breathing problems, and chewing issues. How much does deformity affect self-esteem and how much can surgery affect the increase in self-esteem? Orthodontists in collaboration with surgeons create a common diagnostic, planning, and treatment scheme for use by both clinician groups in the treatment of dentofacial deformities.  The lecture will focus limits of orthodontic camouflage treatment in skeletal malocclusions, patient perspective of dentofacial deformities and reasons for accepting orthognatic surgery.  Treatment outcome will be discussed from both clinician and patient perspective. The experiences and research results of the team from the University Clinic in Rijeka will be presented.

Evgenija Markovic

Tongue Dysfunctions: What is the Role of an Orthodontist?

Genetic factors play an initial role in determining size, shape, and growth of the jaws but later, functional and environmental factors become dominant force in bone formation. Current data allow us to say that oro-facial functions are instruments in developing the face and in establishing occlusion. High resting tongue position stimulates the intermaxillary synchondrosis, and is one of the main factors guiding the maxilla’s growth and consequently, the growth of mandible. The habitual posture of the tongue and tongue movements have a continuous impact on dentition, occlusion, upper and lower jaw and face morphogenesis.
Tongue dysfunctions affect the development of oro-facial complex and cause dentoalveolar and skeletal malocclusions, speech alterations, parodontal detoriation, difficulty in respiration and sleep apnea, growth retardation, and even a cognitive impairment. In the multidisciplinary team, orthodontist has a pivotal role in screening, identification, categorization, and timely treatment of tongue dysfunctions and sequelae. The lecture will focus on the management of tongue dysfunction and oro-facial manifestations from orthodontic perspective.