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Orthotropic vs Orthodontic evidence

Practical guidance about Orthotropics.

Scientific Evidence To Support Orthotropics

1. Using the ‘Best Results’ Method to Establish the Potential of Different Orthodontic Techniques. Under review by The British Dental Journal. Introduction. If a method of treatment demonstrates occasional good results but is generally unreliable it will be rejected by most statistical tests. This applies particularly to methods that are highly dependent on patient co-operation such as habit breaking and complying with exercises. By selecting the ‘Best Results’ of such a method and comparing them with the best results achieved by other methods, a special potential of an unreliable technique might be disclosed but caution is required as adverse side effects could remain hidden. Material. Photographs of thirty-two orthodontic results considered to be “excellently treated” by world standards were shown to eighteen judges. Half the cases had been treated by a range of different orthodontic methods and half by a system called ‘Orthotropics®’ which aims to correct growth by changing oral posture. The judges who were ‘blind’ to the methods used were asked to score the aesthetic changes to both the teeth and the face during treatment. No attempt was made to match the cases or measure the changes; the judgements being purely aesthetic. Results. The panel of 6 lay members, 6 dentists and 6 orthodontists found that Orthotropics was significantly more efficacious than the other methods. Conclusion. Orthotropics appears to have good ‘potential’ for improving Facial and/or Dental aesthetics but the risk of harmful side effects remains untested.

2. Orthodontics and Facial Appearance. Natural Methods may be More Effective than Extractions or Train Tracks.

Research on identical twins, published in the World Journal of Orthodontics today, suggests that traditional methods of straightening teeth may not be as effective as some natural methods. “Orthodontic treatment is usually delayed until after growth has stopped” explains Professor John Mew director of the London School of Facial Orthotropics, “by when it may be too late to avoid extractions and ‘Train Tracks”. This research suggests that extractions may be avoided if the growth of the jaws can be corrected, preferably before the age of eight”. Correcting the shape and size of the jaws also improves the appearance of the face.

This research project applied different types of treatment to identical twins and found that after Orthotropics (growth guidance) the facial appearance improved and the teeth stayed straight for longer. Traditional orthodontic methods appeared to cause some damage to the face and the teeth were more likely to re-crowd afterwards.

Abstract. Despite the known influence of orthodontic treatment on facial appearance there have been few comparative studies of the effect of different treatments, and none of these appear to have looked at the long-term consequences. Material. This study compared the effect of Traditional fixed appliances against Orthotropic (growth guidance) treatment without fixed appliances, on a series of twelve identical twins, ten years after treatment. Facial changes were assessed by a panel of ten lay judges. A comparison was also made of the dental changes and an error study undertaken. Results. Most of the Traditionally Treated twins were judged to look less attractive after treatment while most treated by Orthotropics were judged to have improved. There was little difference in the dental results but the traditionally treated cases seemed to relapse after treatment.

The World Journal of Orthodontics, Quintessence Publishing Co Inc, 4350 Chandler Drive, Hanover Park, Illinois, 60133. USA.

3. VERTICAL GROWTH: THE EFFECTS OF TREATMENT AT DIFFERENT AGES WITH DIFFERENT TECHNIQUES. Mew JRC, & Gibbs W. European Orthodontic Conference 2003. Aim of Investigation. The long-term success of orthodontic treatment is heavily dependent on the direction of facial growth. This study compared the direction of growth of five groups of patients who were treated at two different ages by three different techniques. Material and Method. Five groups were taken from the practice records of the second author. 1/ Under 14 years old, non-extraction, treated with straight wire. 2/ Adult, over 16 years old, non-extraction, treated with straight wire. 3/ Under 14 years old, four pre-molar extraction, treated with Begg appliances. 4/ Adult over 16, four pre-molar extraction, treated with Begg appliances. 5/ Under 14, non-extraction, treated with ‘Postural’ appliances (Biobloc). The first 30 consecutive cases in each classification were included provided they had cephalometric records taken immediately prior to treatment and shortly afterwards. The distribution appeared random with the exception there was a higher ratio of class II division 2 in the adult groups. The starting age for the Biobloc group was younger but it was followed until the same age as the other two groups and so was probably comparable. One of the adult groups was younger than the other but no patient in either of the adult groups grew more than 1mm along SN. Definitions. Biobloc appliances encourage forward growth by using ‘semi-rapid’ expansion followed by postural training. The Growth Direction was defined as, “the angle of intersection between gnathion at T1 and T2 and the Frankfort plane”. Measurements. These were tested for error and significance. Results. Early treatment, Non-Extraction treatment, and Postural Training are highly significant factors in reducing vertical growth.

4. The Conversion of Vertical Growth to Horizontal. A prospective pilot study of twelve consecutive patients treated by two different methods. Mew JRC, European Orthodontic Society Gent 2001. Summary. Vertical growths may be a disadvantage for both facial appearance and long term dental stability. This paper reports a pilot study comparing the direction of facial growth following treatment by either fixed retractive appliances or by removable ‘Orthotropic’ appliances designed to reduce vertical growth. To meet ethical objections two different operators each treated a consecutive series of six patients with overjets exceeding ten millimetres. The resultant mean growth direction at Gnathion for the fixed retraction group was 67 degrees while in the Biobloc group it was 46 degrees.

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