Informationen aus Orthodontie & Kieferorthopädie 2004; 36(2): 99-114
DOI: 10.1055/s-2004-822764
Originalarbeit

© Georg Thieme Verlag

Mythen und Missverständnisse bei Diagnostik und Behandlung von Erwachsenen

Myths and Misonceptions of Adult Diagnosis and TreatmentD. R. Musich1
  • 1Department of Orthodontics, University of Pennsylvania, School of Dental Medicine, USA
    Department of Orthodontics, University of Illinois, Chicago School of Dentistry, USA
Further Information

Publication History

Publication Date:
30 June 2004 (online)

Zusammenfassung

Umfragen zeigen, dass etwa 20 % aller kieferorthopädischer Therapien inzwischen bei Erwachsenen durchgeführt werden. In den Vereinigten Staaten hat der Baby-Boom etwa 80 Millionen Erwachsene hervorgebracht, von denen viele potenzielle Patienten sind. Zwar ist klar, dass sich einige der wissenschaftlich begründeten Prinzipien der kieferorthopädischen Therapie auch auf den erwachsenen Patienten übertragen lassen. Auf der anderen Seite trifft man inzwischen jedoch in diesem Bereich auf viele Mythen und Missverständnisse, welche die Therapie von Erwachsenen und die erreichten Behandlungsresultate negativ beeinflussen können. Im vorliegenden Beitrag werden vier dieser Mythen besprochen und der klinischen Realität nach den Erfahrungen des Verf. gegenübergestellt. Wenn diese praktischen Erfahrungen konsequent umgesetzt werden, lässt sich eine kieferorthopädische Therapie auch bei Erwachsenen in der überwiegenden Mehrzahl der Fälle mit Erfolg durchführen.

Abstract

Orthodontic practice surveys indicate that adult patients account for about 20 % of the patients in orthodontic treatment. In the USA, the “baby boom” generation has about 80 million adults, many of whom may be candidates for orthodontic treatment. While it is evident that some of the basic scientific principles of orthodontics still apply to the adult patient, many myths and misconceptions have developed that may interfere with optimal treatment outcomes. Four myths are discussed, and then presented with the clinical reality as experienced by the author; the clinical realities, if applied, will allow successful outcomes for the majority of adult cases treated orthodontically.

Literatur

  • 1 Musich D R. Assessment and description of the treatment needs of adult patients evaluated for orthodontic therapy: characteristics of the solo provider group (I).  Int J Adult Orthodon Orthognath Surg. 1986;  1 55-67
  • 2 Musich D R. Assessment and description of the treatment needs of adult patients evaluated for orthodontic therapy. II. Characteristics of the dual provider group.  Int J Adult Orthodon Orthognath Surg. 1986;  1 101-117
  • 3 Musich D R. Assessment and description of the treatment needs of adult patients evaluated for orthodontic therapy. III. Characteristics of the multiple provider group.  Int J Adult Orthodon Orthognath Surg. 1986;  1 251-274
  • 4 Goldstein M C, Burns M H, Yurfest P. Esthetic orthodontic appliances for the adult.  Dent Clin North Am. 1989;  33 183-193
  • 5 Grant D A, Stern I B, Everett F G. Periodontics: In Tradition of Orban and Gottlieb. 5th ed., Mosby, St. Louis 1979
  • 6 Huser M C, Baehni P C, Lang R. Effects of orthodontic bands on microbiologic and clinical parameters.  Am J Orthod Denofacial Orthop. 1990;  97 213-218
  • 7 Zachrisson B U, Brobakken B O. Clinical comparison of direct versus indirect bonding with different bracket types and adhesives.  Am J Orthod. 1978;  74 62-78
  • 8 Ainamo J. Relationship between malalignment of the teeth and periodontal disease.  Scand J Dent Res. 1972;  80 104-110
  • 9 Okeson J P. Management of Temporomandibular Disorders and Occlusion. 5th ed., Mosby, St. Louis 2003
  • 10 Roth R H. Functional occlusion for the orthodontist. Part III.  J Clin Orthod. 1981;  15 182-198
  • 11 Williamson E H. JCO Interviews: Dr. Eugene Williamson on occlusion and TMJ dysfunction. Interview by S. Brandt.  J Clin Orthod. 1981;  15 333-350
  • 12 Bell W H, Proffit W R, White R P. Surgical Correction of Dentofacial Deformities. W. B. Saunders, Philadelphia 1980
  • 13 Proffit W R, White R P. Surgical-Orthodontics Treatment. Mosby, St. Louis 1991
  • 14 Amsterdam M. Periodontal prosthesis. Twenty-five years in retrospect.  Alpha-Omegan. 1974;  67 8-52
  • 15 Miller G, Vanardsall R. Initial preparation for periodontal therapy. In: Goldman HM, Cohen DW (eds). Periodontal Therapy. 6th ed., Mosby, St. Louis 1980
  • 16 Ingber J S. Forced eruption: alteration of soft tissue cosmetic deformities.  Int J Periodontics Restorative Dent. 1989;  9 416-425
  • 17 Polson A M, Heijl L C. Occlusion and periodontal disease.  Dent Clin North Am. 1980;  24 783-795
  • 18 Lindegard B, Lindegard L, Carlson M, Larsson S. Need and demand for orthodontic treatment.  Tandlaegebladet. 1971;  75 1198-1210
  • 19 Andrews L F. The six keys to normal occlusion.  Am J Orthod. 1972;  62 296-309
  • 20 Casko J S, Vaden J L, Kokich V G, Damone J, James R D, Cangialosi T J, Riolo M L, Owens S E, Bills E D. Objective grading system for dental casts and panoramic radiographs. American Board of Orthodontics.  Am J Orthod Dentofacial Orthop. 1998;  114 589-599
  • 21 Ackerman J L. The challenge of adult orthodontics.  J Clin Orthod. 1978;  12 43-47
  • 22 Ahrens D G, Shapira Y, Kuftinec M M. An approach to rotational relapse.  Am J Orthod. 1981;  80 83-91
  • 23 Williamson E H. Occlusion: understanding or misunderstanding.  Angle Orthod. 1976;  46 86-93
  • 24 Williamson E H. Occlusal concepts in orthodontic diagnosis and treatment. In: Johnston LE (ed). New Vistas in Orthodontics. Lea & Febiger, Philadelphia 1985
  • 25 Jacobson A. Planning for orthognathic surgery - art or science?.  Int J Adult Orthodon Orthognath Surg. 1990;  5 217-224
  • 26 Proffit W R, Phillips C, Tulloch J F, Medland P H. Surgical versus orthodontic correction of skeletal Class II malocclusion in adolescents: effects and indications.  Int J Adult Orthodon Orthognath Surg. 1992;  7 209-220
  • 27 Kiyak H A, Bell R. Psychological considerations in surgery and orthodontics. In: Proffit WR, White RP (eds). Surgical Orthodontic Treatment (Year Book). Mosby, St. Louis 1991; 71-95
  • 28 Broder H L, Phillips C, Kaminetzky S. Issues in Decision Making: Should I Have Orthognathic Surgery?. In: Sadowski PL (ed). Seminars In Orthodontics: Psychologic Issues Related to Orthodontic Treatment and Patient Compliance 2000; 6: 249-258
  • 29 Koury M E, Epker B N. The aged face: the facial manifestations of aging.  Int J Adult Orthodon Orthognath Surg. 1991;  6 81-95
  • 30 Cassidy D W, Herbosa E G, Rotskoff K S, Johnston L E. A comparison of surgery and orthodontics in borderline adults with Class II, division 1malocclusions.  Am J Orthod Dentofacial Orthop. 1993;  104 455-470
  • 31 Creekmore T D. Where teeth should be positioned in the face and jaws and how to get them there.  J Clin Orthod. 1997;  31 586-608
  • 32 Alexander R G, Sinclair P M, Goates L J. Differential diagnosis and treatment planning for the adult nonsurgical orthodontic patient.  Am J Orthod. 1986;  89 95-112
  • 33 Peck S, Peck L, Kataja M. The gingival smile line.  Angle Orthod. 1992;  62 91-100
  • 34 Peck S, Peck H. The aesthetically pleasing face: an orthodontic myth.  Trans Eur Orthod Soc. 1971;  47 175-184
  • 35 Garber D A. Problems of the high lip line - the gummy smile. In: Bell WH (ed). Modern Practice in Orthognathic and Reconstructive Surgery. W. B. Saunders, Philadelphia 1992; 252-261
  • 36 Janzen E K. A balanced smile - a most important treatment objective.  Am J Orthod. 1977;  72 359-372
  • 37 McNamara J A, Ellis E. Cephalometric analysis of untreated adults with ideal facial and occlusal relationships.  Int J Adult Orthodon Orthognath Surg. 1988;  3 221-231
  • 38 Williams K R, Bentley J E. Survey findings on dental fees. A comparison from 1982-93.  J Am Dent Assoc. 1994;  125 1260-1262
  • 39 Graber T M. Postmortems in posttreatment adjustment.  Am J Orthod. 1966;  52 331-352
  • 40 Little R M, Wallen T R, Riedel R A. Stability and relapse of mandibular anterior alignment - first premolar extraction cases treated by traditional edgewise orthodontics.  Am J Orthod. 1981;  80 349-365
  • 41 Reitan K. Principles of retention and avoidance of posttreatment relapse.  Am J Orthod. 1969;  55 776-790
  • 42 Boese L R. Fibrotomy and reproximation without lower retention, 9 years in retrospect.  Angle Orthod. 1980;  50 88-97
  • 43 Jerrold L. Informed consent and orthodontics.  Am J Orthod Dentofacial Orthop. 1988;  93 251-258
  • 44 Lanigan D T, Hey J H, West R A. Major vascular complications of orthognathic surgery: hemorrhage associated with Le Fort I osteotomies.  J Oral Maxillofac Surg. 1990;  48 561-573
  • 45 Weed L L. Medical Records, Medical Education, and Patient Care: The Problem Oriented Record as a Basic Tool. Case Western Reserve Press, Cleveland 1969
  • 46 Sarver D M, Proffit W R, Ackerman J L. Diagnosis and treatment planning in orthodontics. In: Graber TM, Vanarsdall RL (eds). Orthodontics: Current Principles and Techniques. 3rd ed., Mosby, St. Louis 2000; 3-109
  • 47 Miller G, Vanardsall R. Initial preparation for periodontal therapy. In: Goldman HM, Cohen DW (eds). Periodontal Therapy. 6th ed., Mosby, St. Louis 1980
  • 48 Musich D R. Problem oriented record. In: Graber TM, Swain BF (eds). Current Orthodontic Concepts and Techniques. 2nd ed., W. B. Saunders, Philadelphia 1975
  • 49 Gottlieb E L, Nelson A H, Vogels D S. 2001 JCO Orthodontic Practice Study. Part 1 Trends.  J Clin Orthod. 2001;  35 623-631
  • 50 Steiner C C. The use of cephalometrics as an aid to planning and assessing orthodontic treatment.  Am J Orthod. 1960;  46 721-735
  • 51 Jacobson A. The proportionate emplate as a diagnostic aid.  Am J Orthod. 1979;  75 156-172
  • 52 Johnston L E. Template analysis.  J Clin Orthod. 1987;  21 585-590
  • 53 Musich D R. Orthodontic Aspects of orthodontic surgery. In: Graber TM, Vanarsdall RL (eds). Orthodontics: Current Principles and Techniques. 3rd ed., Mosby, St. Louis 2000; 940-952
  • 54 American Academy of Periodontists . Tobacco use and the periodontal patient.  J Periodontol. 1996;  67 51-56

Dr. David R. Musich

1701 E. Woodfield Road 500

USA-Schaumburg IL 60173-5166

Phone: +1(8 47)5- 17-13 33

Fax: +1(8 47)5- 17-75 94

Email: drm4drmltd@aol.com

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