Annual Scientific Congress of the Korean Association of Orthodontists
PASSION FOR A LONG JOURNEY :
Nature vs Nurture
November 5(Thu) - 6(Fri), 2020
Precongress: November 1(Sun) / VOD: November 7(Sat) - 8(Sun)
TAD driven orthopedic treatment of growing patients and adults using dentition as a tool
Dr. Cheol-Ho Paik
Dr. Cheol-Ho Paik is a private practitioner at the SAI orthodontic clinic in the center of Seoul, Korea. He is also a clinical part-time faculty in the department of orthodontics, dental college of Seoul National University. He graduated the dental college of Seoul National University and received orthodontic training and PhD degree at the Dept. of Orthodontics of the dental college of Tsurumi University in Yokohama, Japan. He is a member of Southern California component of Angle Society and was a visitig faculty of Dept. of Orthodontics at UCLA and UCSF. His main interest is in the field of TADs with numerous publications and lectures on this topic. He is the first author of the textbook 'Orthodontic Miniscrew Implants' published from Mosby/Elsevier and 'Tissue-friendly strategic orthodontic treatment and orthodontic mini-screw implants' published from Japan Quintessence Publishing.
A couple of decades have passed since the name of the journal was changed from 'American Journal of Orthodontics' to 'American Journal of Orthodontics and Dentofacial Orthopedics'. However, ironically, orthodontists have started to avoid the orthopedic approach and stick to aligning the dentition alone ever since. I would like to describe the active role of orthopedic treatment in growing patients and adults with both Class II high angle cases with receding chin and the Class III maxillary deficient cases. The introduction of TADs in the field of orthodontics further emphasizes the role of orthopedics even for adult patients. Hence, the phrase, 'adult orthopedic treatment' may be justifiable.
Class II high angle growing patients with receding chin can be treated with molar intrusion throughout the phase 1 and phase 2 treatment using TPA, Teusher appliance and high pull headgear. Adult patients with vertical excess and receding chin can be treated by reducing the mandibular plane angle using a TAD driven 'double arch intrusion'. For a patient with maxillary deficiency, the maxillary incisal display can be increased by TAD driven intrusion of the mandibular incisors along with the downward and forward orthopedic protraction of the maxilla. The full-time orthopedic solution, which is a night-time face mask combining with day-time Class III mechanics between the rapid palatal expander (or MARPE) and the lower lip bumper after reinforcing the lower molars with lingual arch, makes orthopedics possible even for adult class III patients.
With the help of TAD, it appears to be the era Dr Ricketts spoke about in his statement, "Orthodontics is the profession where one enhances the facial esthetics using a dentition as a tool" has finally arrived. In this presentation, I would like to present a variety of orthopedic cases with and without TADs, both in growing patients and adults.
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