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In comparison to the straight wire technique the segmental arch approach offers numerous biomechanical and clinical advantages. Three typical examples: controlled tooth movement, en masse space closure and deep overbite correction serve to show the spectrum and the efficiency of the segmented arch technique.
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Our findings indicate a cellular basis for the connective tissue remodeling which takes place during physiologic tooth movement. This cell is the fibroblast which is capable of synthesizing and degrading collagen simultaneously and, utilizing this ability, the orderly control of collagen remodeling within the periodontal ligament is possible. It is suggested that this cellular basis of connective remodeling will have a direct significance for orthodontic tooth movement once control mechanisms have been established.
Transseptal fibers are a part of the gingival group of fibers of the periodontal membrane, and they are very tough and resistant. They form a chain from tooth to tooth which, provided that it remains intact and is sufficiently strong to resist displacing muscular pressures, will preserve the contacts between the teeth throughout the arch. If the continuity of the chain is interrupted, the balance of the forces acting upon the teeth on either side of the break is upset and considerable displacements can occur. Maxillary median diastemas are classified as "simple" or "persistent" according to their etiology, and an operation to clear the upper midline suture of transeptal fibers is described as an essential part of the treatment of persistent upper median diastema.
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A 2-year longitudinal investigation was conducted at five New York City junior high schools on 11- to 13-year-old children starting instrumental music education to determine what tooth movement, if any, resulted from the playing of certain musical instruments. Questionnaires, interviews, oral examinations, and dental casts were used at the start of instrumental study, after one year, and then after a second year. Statistically significant anterior tooth movements occurred in an overwhelming majority of the instrumentalists, while negligible movements were recorded for the controls over this period. As a result of this study, certain recommendations can be made by dentists when they are asked to suggest instruments which are dentally suited for children. In most cases they can suggest more than one instrument which would be of benefit dentally to the individual child, especially in the increase or reduction of overjet and overbite. The playing of the correct musical instrument can serve as an adjunct to the dentist or orthodontist in trying to accomplish certain tooth movements.
A method is presented for the accurate application of the modified 3-3 retainer of multistrand wire described by Zachrisson . This lingual retainer or splint is noninvasive of dental tissue and is reversible. Wire breakage does not appear to occur, and the slightly elastic properties of the wire allow a physiologic mobility of the teeth, which is of advantage in the periodontal patient. The only breakage that may occur is of the composite bond, although this appears to be less than with bonded brackets, but repair is quick and simple. The present method is now offered to add simplicity, speed, and accuracy to the important advantages already enjoyed, widening the scope for employment of this type of retainer to as many as eight or ten teeth in a series and, perhaps more significantly, to the maxillary anterior teeth, even where a deep bite exists. The value of the method is also seen when an active orthodontic appliance is removed and retention or splinting is required within an hour or two, as for the patient who is concurrently undergoing periodontal treatment.
Increasing numbers of adult patients are seeking orthodontic care and some, despite significant skeletal malocclusions, elect not to have combined orthodontic-surgical treatment. The purpose of this article is to outline some of the diagnostic and therapeutic principles that can be used in the adult nonsurgical orthodontic patient. The importance of realistic goal setting in the face of compromised occlusions is emphasized. Diagnosis should include evaluation of all three dimensions and recognize the limitations of therapy in each dimension for the nongrowing patient. Periodontal considerations, extraction decisions, and retention regimens are of vital importance to the achievement and maintenance of an optimum result. Clinical records will demonstrate four commonly seen problems and their resolution.
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