Article
I've just returned having presented the 7th ‘Art meets Science’ course together with Kevin O'Brien, to 80 enthusiastic Dentists and Orthodontists in Manchester. The course is always very well received, particularly the sections where Kevin dissects the Orthodontic literature in ‘real time’, skilfully separating the ‘wheat from the chaff’. Most of the delegates return home with an understanding of the current ‘state of the art’ workings of many of the currently used clinical techniques.
One area which caused great interest was the various and many discussions surrounding the ‘speeding up’ of orthodontic treatment. All attendees were interested to know the evidence to support the use of techniques such as: corticotomies, piezosurgeries, various light-emitting devices, intra-oral vibrators, as well as the magical brackets and mystical archwires that allowed the bone to develop both rapidly and copiously around the moving teeth, under their special forces. It will come as no great surprise to any of you, that the ‘hard evidence’ to support many of these approaches is sadly lacking.
The way to speed up orthodontic treatment in the 21st century is to do things properly. Diagnose the case correctly, assess the space requirement accurately in mm terms, and select an appropriate approach to deal with that space requirement. Use effective archwires, tie in the teeth completely and don't move to the next wire until the current wire has expressed all of its effect. Use heavy stainless steel working wires for the ‘grunt work’ – OJ and OB reduction and space closure, then drop to lighter wires and elastics for finishing. It isn't rocket science … and never has been. Most significant orthodontic cases can then be treated to a good standard, within an 18–24 month period.
We are reminded, in Rolf Behrents' superb AJODO Christmas editorial, that these spurious claims for ultra-fast treatment are absolutely nothing new.1 Telling and retelling a story, as is so easy over today's social media, just doesn't make it true. There is no secret formula … if there was, each and everyone of us, who care deeply about the results of our orthodontic ministrations, would for sure be using it. As soon as anything changes on this front, rest assured you will hear it here, first! Until then, just keep doing ‘the right thing’.