Kieferorthopädie, 04/2024

Molar incisor hypomineralization (MIH) is a structural developmental disorder of the enamel that classically affects the permanent first molars and possibly also the incisors. It is characterized by poor quality of mineralization of the enamel, which leads to white, yellow, or brown discoloration of the affected teeth. Disturbed areas are vulnerable to posteruptive breakdowns, and hypersensitivity may also occur. Children with MIH should therefore be closely monitored. Keywords: MIH, diagnosis, MIH-TNI, Würzburg concept, therapy

The different treatment strategies for managing agenesis of permanent teeth depend on the individual skeletal and dental relationships, the practitioner‘s experience, and the latest developments in ­dental technologies. Simple and efficient biomechanical solutions and long-term observations are demonstrated using two treatment examples with orthodontic space closure for bilateral agenesis of maxillary lateral incisors and mandibular second premolars. Keywords: agenesis, orthodontic space closure, biomechanics, long-term retention

This article describes two options for the digital planning and fabrication of indirect transfer splints. The digital development in orthodontics today enables new ways of working, especially in the field of indirect bonding. A distinction can be made between the semidigital method, which combines digital bracket planning with the conventional thermoforming method, and the fully digital method, in which the transfer splints are 3D printed. Both methods have advantages and disadvantages in terms of bracket transfer accuracy. However, a clear workflow is crucial in order to optimize the benefits of these technologies. Continuous development and customization based on individual patient needs and the latest findings in the scientific literature are necessary to further develop these promising possibilities. Keywords: 3D printing, digital workflow, digital orthodontics, indirect bonding, IDB

Advancing digitalization and technologic progress have brought about a revolutionary change in orthodontics. However, even though algorithms and automated processes are increasingly coming to the fore, it should not be forgotten that even the most sophisticated treatment equipment cannot function without adequate patient cooperation. However, young people today are facing new challenges. In particular, the increasing use of social media has eroded the persistence and patience of young people for lengthy processes. This change often has an impact on cooperation during orthodontic treatment. Inadequate adherence is also a growing problem in other medical specialties. In 2003, the World Health Organization published a report in which experts from various disciplines analyzed the reasons for inadequate adherence to long-term treatment. This review summarizes this report in an orthodontic context. It crystallizes the importance of good communication between practitioners and patients in order to promote understanding, motivation, and active cooperation. After all, despite all digital progress, even today it is impossible to achieve a perfect treatment result without adequate adherence. Keywords: cooperation, adherence, compliance, communication

After more than 30 years in private practice and countless hours of study, course attendance, and professional exchange across disciplines, the author is still faced with the odd surprise in everyday clinical practice. Experience and routine certainly help, but the technologic developments of the last 20 years particularly challenge our expertise and our complex technical work on a daily basis. In addition, there have been profound changes in human communication: Social media facilitates and accelerates the exchange of experiences between patients; influencers are the new experts; and half-knowledge and industrial simplification undermine our professional expertise. ”You never stop learning” is the author‘s mantra. She advocates healthy self-criticism, learning from your own mistakes, and remaining open to everything new, all while focusing on what works in your own hands in your daily work. Keywords: CAD/CAM, lingual technology, virtual setup, finishing, bracket positioning, bracket individualization, customized multibracket appliance, robots, indirect bonding technology, 3D printing

With the help of a suction device with an integrated bite block and flexible cheek wing to control the tongue space, the reattachment of a buccal or lingual bracket can be carried out relatively easily ­without clinical assistance after familiarization with the device. Keywords: suction device with bite block, bonding failure

Increasing digitalization in orthodontics enables the design of time-efficient workflows in orthodontic practice. This article presents a combined digital and conventional workflow by which fixed retainers and retention splints can be inserted together in just one appointment after completion of active orthodontic treatment. Keywords: retention, fixed retainers, retention splint, digital workflow

Teeth that are to be moved orthodontically are characterized by two distinct sites: the point of force application (usually the bracket or tooth crown) and the center of resistance. Force systems can be determined or constructed at both sites. What can you use these for? Are there advantages to one or the other perspective? Does this also have practical benefits for the clinician? The following article will get to the bottom of these questions. Keywords: force system at bracket, force system at center of resistance, point of force application, center of resistance, rigid body, parallel force displacement, moment of force