Duration: 52 min 05 sec

By Nikhilesh Ramesh Vaid

Orthodontic Appliances are no longer just brackets and wires. Technology has ushered in an era of integrated appliance systems,on both vestibular & lingual surfaces as well as removable aligners,that are slowly gaining global acceptance. Integrated systems however, are marketed by corporations that have financial considerations that sometimes take precedence over science and clinical commonsense. This presentation will present a comparative analysis and an experimental clinical audit of contemporary appliance systems and adjuncts from an independent evidence based perspective.

Learning Objectives:

• Peruse marketing and advertising claims made by various appliance & adjunct manufacturers.
• Analyze data from experimental designs evaluating appliance performance on efficacy &efficiency parameters.
• Compare different appliance systems evaluated based on standard clinical excellence standpoints.
• Analyze the web presence of Orthodontic information, the role of orthodontic organizations and how we can affect orthodontic care protocols

Duration: 33 min 47 sec

By Young-Gon Kim

Deep learning has led to many breakthroughs in many fields of computer science. Especially, computer vision with deep learning is one of the remarkable tasks such as classification or detection for outstanding performance compared to the existing methods. Medical image can be also analyzed with deep learning by extracting meaningful features for diagnosis (classification or detection of disease) or prognosis (prediction). Applications of CNN (Convolutional neural network) to medicine have improved the performance of computer aided diagnosis. In this program, I would like to introduce to researches related with deep learning-based medical image analysis.

Duration: 45 min 15 sec

By Alfred Griffin

Objective: The objective of this presentation is to 1) discuss the theoretical value of a fully custom fixed orthodontic appliance, and 2) evaluate the limited retrospective data collected to date, specifically the efficiency of LightForce 3D printed orthodontic brackets versus Stock orthodontic brackets as a function of duration of treatment and number of appointments to completion.
Methods: Records of cases utilizing LightForce Custom brackets and cases treated with stock brackets were evaluated from one orthodontic practice. All cases were treated by the same orthodontist. LightForce cases were all those completed up to 3/4/2022 (n=60). Stock bracket cases were all those completed between 1/1/2021 - 12/31/2021 (n=110). Only those cases with upper and lower 1st molar to 1st molar teeth erupted were included (LF 59, Stk 93). Partially erupted canines and premolars were accepted if at least 10% of the crown had erupted. Pre-treatment records of all treated cases were evaluated by a calibrated (PAR, ICON, IOTN) orthodontist and scored on an objective severity scale from 1-5. The investigator had full access to the treatment charts of all treated patients. All cases were evaluated for total treatment time, number of appointments, number of emergency appointments, and type of finishing archwire used.
Results: LightForce case data suggests 30-40% fewer scheduled and total appointments compared to stock bracket cases treated by the same orthodontist during the same time period. When matched for case severity and patient age, LightForce cases took 41% less time to finish than stock brackets. In addition, 70% of the LightForce cases were finished with Cu NiTi archwires versus 70% of stock brackets being finished in TMA or stainless-steel finishing wires.
Conclusions: In a retrospective evaluation of one orthodontic practice, LightForce brackets tended to show improvement in practice efficiency as evaluated by number of appointments to complete the case and duration of treatment time. The increased use of Cu NiTi finishing archwires in LightForce cases compared to stock brackets may indicate a decreased need for finishing bends with the LightForce bracket system. As this technology evolves, the specialty should continue to investigate how the theoretical benefits compare to what is actually realized in clinical practice.

Duration: 51 min 16 sec

By Sunil Kapila

In the current era that necessitates minimizing direct contact with patients and colleagues, virtual treatment planning and consultations are becoming increasingly important in health care delivery. In his presentation, Dr. Kapila will discuss the use of 3D segmented models derived from CBCT in virtual planning orthodontic and interdisciplinary treatments involving restorative, implant, surgical, tooth retrieval and other complex procedures across disciplines. The software platform utilized lends itself to concurrent virtual treatment planning with other providers and virtual consultations with patients- an approach that is highly pertinent in the era of COVID-19. Further, the use of this virtual interdisciplinary platform not only enhances the precision and customization of care but contributes to increased efficiency and outcomes of treatment. These reasons make the 3D virtual interdisciplinary treatment planning approach an important and an increasingly integral part of individualized therapy in complex orthodontic and interdisciplinary care.

Duration: 54 min 45 sec

By Theodore Eliades

3D printing of a variety of apparatuses and appliances with the use of a wide array of printing modes and materials extending from polymers, to ceramic and metal/alloys. Whilst the application of 3D printing has become almost an integral part of orthodontic routine in many parts of the world, there is a notable lack of the performance of 3D printed appliances, their ageing pattern, release of compounds in the oral cavity, biological reactivity as well as fundamental mechanical and physical properties. This lecture reviews the scare evidence on the topic and highlights also various issues arising from the lack of regulatory monitoring of the process of fabricating appliances in the environment of a private orthodontic office, quality control issues as well as precautions, and required safety measures.

Duration: 46 min 21 sec

By Flavio Andres Uribe

In the last decade, acceleration of tooth movement has taken front and center interest among clinical and basic science research. Primarily, the local surgical injury of dentoalveolar complex has been the major target of modulation of this speed. Invasive and minimally-invasive approaches that consist of corticotomies with and without flaps that involve different surgical instruments to induce this localized injury have been evaluated. Although numerous studies have been conducted with contrasting results, overall, the evidence tends to support that a temporary acceleration may be obtained. The impact of these acceleratory effects on the reduction of the overall treatment duration are still unclear.

This lecture will:

• Highlight the current evidence in both clinical and basic science regarding the acceleratory effects of the different invasive and minimally invasive procedures to accelerate the speed of orthodontic tooth movement
• Describe the future potential research fronts involving omics research, such as genomics, proteomics and metabolomics that could give us clues to achieve this acceleration
• Present the results of a basic science project evaluating the effect of piezocision in rats with RNA sequencing

Duration: 34 min 47 sec

By Glenn T. Sameshima

This lecture will present the latest findings and information about external apical root resorption (EARR) caused uniquely by orthodontic tooth movement. Despite years of research and clinical experience, EARR remains an enigma but our current state of knowledge positions us to better manage EARR in our practices. Key questions that will be answered in this presentation: What is our present understandingoftheetiologyofEARR? Whoarethepatientsmostatrisk? Shouldyoustarttreatment for a patient who already has short roots? How does the clinician manage EARR found at progress? How does the clinician manage EARR found at the end of treatment? What is the long-term prognosis for teeth with short roots? The content of this lecture should be of great interest to clinicians, academics, and students.

Duration: 36 min 13 sec

By Martin Antonio V. Reyes

Over the past few decades our efforts to educate our patients in the realm of dentistry has bared good fruits by the fact that more and more adult patients are seeking treatment not just for healthy teeth but also for an improved occlusion and a healthy smile. Relatively new advances the wonderful world of orthodontics particularly in self-ligating braces, clear aligners, TADS, traditional mechanics, and orthognathic surgery to name a few, are just some of the factors that have led to an increased curiosity and need to improve one’s occlusion in the post adolescent years.
One particular problem that occurs when our patient’s age is the occurrence of wear and tear of the dentition bringing about a host of problems such as unfavorable tooth movement, poor contacts and loss of bone support which will be the focus of this lecture. This 30-minute presentation will share some multi-disciplinary guidelines in diagnosing and planning orthodontic treatment for patients with history of localized and generalized alveolar bone loss. It will also present some evidence-based guidelines on the management of periodontally compromised dentition applying specific periodontal and orthodontic mechano therapy principles on a few clinical cases.

Duration: 30 min 40 sec

By Shintaro Okashita

The patient was found to have a Micrognathism (mandibular retraction disorder) and was suspected to have progressive mandibular resorption (PCR), in which the mandibular head is resorbed and no joint exists. In this report, we describe two cases of patients with PCR who underwent orthognathic treatment using a combination of anterior mandibular advancement and genioplasty.
Case 1: 16-year-old female. Her chief complaint was maxillary prognathism and inability to bite with her front teeth. She had a severe mandibular retraction with ANB 13.0°, FMA 45.7°, and Pog to MacNamara -25.5.
Case 2: 20-year-old man at the initial examination. His chief complaint was that he could not close his lips. 9.8° ANB, 39.4° FMA, -13.5 Pog to MacNamara, and a severe mandibular retraction.
Treatment results: After preoperative orthodontic correction, Le Fort type I osteotomy was performed on the maxilla, and mandibular branch sagittal segmentation and genio-plasty were performed on the mandible. To flatten the advanced occlusal plane of the mandible, the surgical plan included maxillary decompression and counter-clockwise rotation of the mandible. Postoperative orthodontic treatment was performed to obtain a normal occlusion and improve their profile. Both cases have maintained a relatively stable occlusion for more than 2 years after surgery.
Discussion and Conclusion: In both cases, the patients had protruding anterior teeth, open bite, and severe plexus. Despite these conditions, the patient was able to eat as well as a normal person despite some inconvenience, suggesting that the mandibular head is not an essential organ for masticatory movement. PCR is classified as an intractable disease in Japan, but instead of diagnosing mandibular head resorption itself as a disease, we should focus on masticatory dysfunction caused by this disease or its cause.

Duration: 28 min 16 sec

By Yoon Jeong Choi

There have been controversies regarding the relation between malocclusion and temporomandibular disorder (TMD). Previous studies reported that specific malocclusion does not seem to cause TMD. However, Class II malocclusion with anterior open bite is frequently observed in TMD patients, which implies TMD may cause clockwise rotation of the mandible and subsequent changes. Therefore, orthodontists must be cautious about the possibility of hidden TMD patients when treating Class II malocclusion with anterior open bite.
For correction of anterior open bite combined with TMD, this talk will present diagnosis of the malocclusion, orthodontic strategy for treatment, monitoring of the changes, and consideration of the muscular factors. A decision on a surgical or non-surgical approach should be made based on an accurate diagnosis, and each method needs a different orthodontic strategy. During orthodontic treatment, orthodontists should detect early favorable or unfavorable changes and the relevance of TMD. Furthermore, it is required for orthodontists to consider muscular factors to obtain predictable and stable outcomes.

Duration: 32 min 17 sec

By Ji-Woon Park

Temporomandibular disorders (TMD) is a common form of orofacial pain which involves the temporomandibular joints, masticatory muscles, and associated structures. It is known to affect approximately 33% of the adult population when considering at least one related symptom as the criteria, while 3.6-7% seek treatment due the severity of their TMD symptoms. It is generally more common in women with a peak prevalence around the age of 20-40 years which somewhat overlaps with the major patient group seeking orthodontic treatment. It is second only to toothache as the cause of orofacial pain. While symptoms are mild and self-limiting in most patients, a chronic type of TMD with persistent pain and a higher level of comorbidities such as psychological, autonomic, and sleep disturbances may develop. The etiology of TMD is known to be multifactorial including biologic, behavioral, and psychological factors however, the underlying mechanism is yet to be fully elucidated. Due to the lack of full understanding involving its pathophysiology the current diagnostic and treatment process for TMD is centered on verifying symptoms through patient interviews, palpation of surrounding muscle and joint, and imaging of associated structures leading to symptomatic treatment rather than pathophysiology-driven therapy. Conventional treatment includes controlling of contributing factors based on cognitive behavioral therapy, physical therapy such as thermal, electric, and laser stimulation, and also oral appliance therapy. Invasive treatment should not be considered as first line approaches in most cases since non-invasive treatment results in sufficient symptom relief in the majority of patients in the long-term experiencing improvement in both pain and function.
Pharmacological treatment is a well-accepted approach for TMD patients that has been applied for many years. Commonly used and also effective agents include analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), antidepressants, anticonvulsants, muscle relaxants, benzodiazepine, and corticosteroids. Such medication influences TMD symptoms by directly reducing pain and in some cases by controlling comorbid symptoms such as mood disorders and sleep disturbance. Recently, chronic systemic inflammation has been proposed as the underlying mechanism of pain chronicity in several pain conditions and a few studies have also suggested the possibility of immune disturbance in
TMD patients. The control of systemic inflammation could be another mechanism in affecting TMD symptoms through medication.
TMD is a complex disorder accompanied by various comorbidities and multiple factors may influence its long-term prognosis and treatment response. Based on such characteristics, individual aspects of the disease should be considered when selecting pharmacologic treatment for TMD which will lead to personalized treatment with increased efficiency. Orthodontic treatment related issues could be one of such factors to be included in the treatment planning process for TMD patients.
Therefore, in this lecture general points to consider in the pharmacologic treatment of TMD patients will be handled in a comprehensive manner, later moving on to more detailed description on individual factors to consider when selecting specific agents and also special thoughts on issues related to orthodontic treatment.

Duration: 27 min 25 sec

By Geraldine Lee

With the increase in demand for aesthetic removable orthodontic solutions, intraoral scanners and digital workflows have been gaining popularity in clinics everywhere. Clinicians are now able to increase their clinic offering with in-house clear aligners and differentiate themselves from the rest.
Dr Geraldine will take you through the process of planning, designing, and fabricating clear aligners for simple cases within your dental clinic. She will discuss the importance of proper case selection, how to take digital impressions and create instant treatment simulations, and fabrication of the clear aligners in-house. The biomechanics of moving teeth will be discussed, as well as what to look out for when planning a treatment strategy using clear aligners.

Duration: 33 min 42 sec

By Ashley Trevor Smith

This lecture outlines the advantages of using digital systems for the diagnosis and treatment planning in Orthodontics. The main improvement in the field of Orthodontics in recent years is the incorporation of the Cone Beam CT (CBCT) Each patient has an optimum arch shape and crown torque.
CBCT shows us the design limits for each patient yet there are many common features to all patients. Digital orthodontics allows the astute Orthodontist to diagnose and digitally design the best orthodontic result for each patient (taking into consideration optimum tooth position, function and aesthetics with full knowledge of the boney limits).
At my practice (Toowoomba Orthodontists) we treat all final phase cases with either fully customized braces (Insignia) or aligners (Spark). We have treated over 5000 Insignia cases and 1000 Spark cases. Both these systems have the advantage of using either library or actual CBCT roots.

Duration: 24 min 31 sec

By Chairat Charoemratrote

Most of the facial asymmetry usually presented with mandibular asymmetry. Mandibular asymmetry is mostly related to maxillary deficiency. Malposition of the maxillary teeth could be a cause of premature contact and lead to anterior or posterior cross bite with mandibular asymmetry. Loss of permanent maxillary teeth could cause arch collapsing with subsequently limited function of the affected side with asymmetry appearance. The presentation will focus on the cause of mandibular asymmetry from occlusal interference with malposition of the maxillary teeth. Disclusion by means of bite plane in appropriate location with orthodontic tooth movement to improve the mandibular asymmetry will be presented.

Duration: 27 min 30 sec

By Sung Wan Kim

Pediatric OSA is a kind of sleep-disordered breathing caused by upper airway obstruction, but is totally different from adult OSA in terms of the cause, clinical presentation and treatment. The most common cause of pediatric OSA is adenotonsillar hypertrophy. In most cases, symptoms related to pediatric OSA could be resolved by adenotonsillectomy, but incomplete results are often noted after surgery. This is because the underlying causes of pediatric OSA are complex. Such factors as obesity, anatomical and neuromuscular factors, and hypotonic neuromuscular disease are also involved. Especially, anatomical and craniofacial features assessed during orthodontic exams such as macroglossia, midface hypoplasia, mandibular and maxillary retrognathia, maxillary constriction, short cranial base length, increased total and lower anterior facial heights, and a more anterior and inferior position of the hyoid bone are often associated with persistent symptoms of pediatric OSA after adenotonsillectomy. If small maxilla and/or mandible predisposed children with persistent symptoms, ENT doctors can refer those patients to orthodontists for dental or orthodontic approaches such as maxillomandibular advancement, rapid maxillary expansion, and distraction osteogenesis. On the other way, as dentists often look into children's mouths, they can play an active role in screening potential pediatric OSA and identifying those with enlarged tonsils and referring them to ENT for sleep assessment and soft tissue surgeries. And nasal obstruction can be found in many pediatric SDB patients which is the most frequent cause of mouth breathing resulted in airway obstruction and also the cause of failure in orthodontic treatment after adenotonsillectomy. The causes of nasal obstruction are variable such as allergic rhinitis, nasal polyposis, and septal deviation etc. ENT doctors are able to define and deal with the cause of nasal obstruction. Orthodontist can help the patients with high palatal arch with expansion technique resulted in relief of nasal obstruction. Therefore, both ENT doctors and orthodontist have beautiful collaboration in the pediatric patients with OSA. During the overall screening and treatment process for pediatric OSA, ENT doctors and orthodontists should collaborate as a transdisciplinary team for successful management of pediatric OSA.

Duration: 26 min 35 sec

By Ali Darendeliler

In recent years, increasing interest has developed in sleep related breathing disorders such as snoring and obstructive sleep apnoea (OSA). Nasal Continuous Positive Airway Pressure (CPAP) is sometimes the treatment of choice, but its cumbersome nature makes tolerance and compliance less than optimal. This gives rise to the need for other alternatives such as oral appliances that may be equally effective, but more tolerable. Mandibular Advancement Splints (MAS) were found successful in 63% of OSA patients. Tongue Stabilizing Device (TSD) has also showed promising results in the management of OSA. However preventing and intercepting OSA in children and adults would be the ideal approach and may potentially avoid lifelong management of sleep related issues. Dr Darendeliler will discuss different types of orthodontic and orthopedic treatment approaches, their effectiveness, their short and long term effects and clinical management.

Duration: 36 min 46 sec

By Hong He

Mouth breathing is one of the most common clinical manifestations of pediatric SDB. Children whose mouth breathing remains untreated may develop long, narrow faces, high palatal vaults, dental malocclusion, gummy smiles etc. because of orofacial muscle imbalance. SDB in children has been associated with a variety of comorbidities, including failure to thrive, hypertension, attention deficit disorder, enuresis etc. Orthodontists who have the knowledge of SDB can play an important role in the early diagnosis and treatment of pediatric SDB. It is recommended that the orthodontist perform a clinical risk assessment for SDB. Orthodontists may be involved in the treatment of pediatric SDB by correcting the underlying dental and skeletal deformities. When making the orthodontic treatment plan, orthodontists should account for children’s upper airway condition.

Duration: 27 min 09 sec

By Sandra Khong Tai

In this presentation, Sandra Khong Tai will discuss how to treat orthognathic surgery cases with clear aligners. Case selection criteria for a surgery first approach by using a surgical simulation in the digital treatment planning software will be discussed, together with appointment sequencing, post-surgery fixation and a comprehensive surgical protocol. Collaboration with the oral surgeon for orthognathic surgical planning for surgery first cases will be outlined in a step by step detailed protocol.

Duration: 32 min 36 sec

By Hwi-Dong Jung

Obstructive sleep apnea syndrome (OSAS), the number of which has increased, is diagnosed by several methods including polysomnography. To address time and cost issues from the existing tools, computational fluid dynamics (CFD) has been used for the upper airway geometry obtained from computed tomography (CT) data. A patient with sleep apnea suffers from considerable pressure drop owing to the narrow shape of the airway, which is the main indicator of OSAS. To address the time and cost issues exhibited by the existing diagnosis methods, this study presents computational fluid dynamics (CFD) and machine learning approaches that are derived from the upper airway morphology with automatic segmentation by deep learning.
Our team develops CFD models of the upper airway to increase the quantity of airway model data and simulates them to obtain the aerodynamic features to predict the severity of sleep apnea. In order to overcome the high computational time costs, this study uses a machine-learning algorithm. We use multivariate Gaussian process regression to enable fast predictions of aerodynamic features of unknown patients. Unlike existing regression methods, multivariate Gaussian regression considers the correlation between outputs, and the algorithm can reduce the computational costs of CFD. Additionally, we use the support vector machine algorithm to classify the patients as normal or moderate OSAS.
Recently we developed an advanced OSAS diagnosis method, which was based on upper airway morphology with automatic segmentation using deep learning was developed using CFD and machine learning approaches. By auto segmentation algorithm, we can remove excessive labor and spent time to extract the morphological factors of the upper airway. Furthermore, using regression and classification models, we could obtain immediate flow characteristics and subsequent patient diagnosis results. These processes are fully automatic. Therefore, this will help clinicians by making real-time diagnosis convenient and possible.

Duration: 23 min 42 sec

By Yoon-Ji Kim

Orthodontic diagnosis is a primary step to orthodontic treatment. After the acquisition of patients' anatomical and biological information, a problem list is generated and a treatment plan is established. After diagnosis, the patient’s dental model may be used to simulate the orthodontic treatment by separating each tooth from the arch and rearranging them in the desired position, which will serve as a visual treatment objective. Traditionally, this task has been performed using plaster casts, dissecting each tooth from the plaster model and repositioning them using dental wax. Although this process provides the orthodontist insight into the possibilities and limitations of treatment, creating a diagnostic setup model from a dental plaster model is tedious and time-consuming.
Since the advent of intraoral scanners, instead of using the dental plaster model, intraoral scan data can be manipulated to perform digital tooth setup. After acquiring the full arch scan data of patients, teeth are segmented and repositioned to the desired position using the 3D CAD software. It is more efficient, as it eliminates the process of making plaster models, and it has been reported as effective and accurate as the conventional method. However, there is still much work required in the digital space to perform the virtual setup, such as tooth segmentation, setting the occlusal plane, and adjusting the tip, torque, and rotation of each tooth.
This presentation summarizes the latest artificial intelligence technologies introduced for the automation of digital setup procedures and provides a brief review of the automated setup softwares in the market.

Duration: 27 min 29 sec

By N. Rangarajan Krishnaswamy

In the past, the focus in orthodontics has been on correcting the anterior-posterior skeletal and dental
Nathamuni Rangarajan Krishnaswamy
relationships. Not surprisingly, the current and widely used system of Angle’s classification focuses primarily on the sagittal with very little focus on transverse or vertical dimension problems. It took decades before pioneering orthodontists highlighted the importance of vertical facial dimension. Distortions in vertical proportions has a greater negative impact on facial aesthetics as compared to sagittal and transverse dimension problems. The vertical facial pattern gets established early in life and needs therapeutic intervention.
Although the vertical dimension lends itself to mechanical control alteration in vertical pattern itself is difficult and instability following treatment is a veracious issue. The various options for controlling vertical dimension for enhancing facial esthetics will be discussed in this presentation.

Duration: 33 min 41 sec

By Eddie Hsiang-Hua Lai

Excessive gingival display is an aesthetic concern for patients and a challenge for clinicians. An accurate diagnosis is essential in order to provide effective treatment. The aim of the presentation is to fill a gap in the current literature by providing clinicians with an overview and a stepwise approach to assessing gingival excess, as well as reviewing possible treatment. An examination should be initiated extra-orally to distinguish contributing skeletal factors. The relationships of four aesthetic parameters (LIPG): lip length (L), incisal lines (I), tooth proportions (P), and gingival lines (G), should be examined individually to determine other possible causes of gingival excess. Contributing factors may include a short or hypermobile upper lip, dentoalveolar extrusion, or altered passive eruption. Further investigation to identify patients who might benefit from orthognathic surgery, orthodontic treatment alone, lip repositioning or botulinum injection, or aesthetic crown lengthening procedures, should be conducted to reconfirm a diagnosis and provide the optimal treatment. Clinicians can have a dental blueprint for anterior tooth reconstruction and are able to provide comprehensive treatment in co- operation with other disciplines. By understanding the principles of an aesthetic smile line, the aetiology of an excessive gingival display and treatment concepts, clinicians are able to provide alternative treatments to avoid extensive surgical procedures while achieving acceptable outcomes.

Duration: 30 min 37 sec

By Doan Quoc Huy

The open bite patterns I often encounter usually have horizontal and vertical abnormalities in the posterior teeth area, which may stem from the functional abnormalities of the facial neuromuscular system, cheek, tongue, lips, etc. Those differences lead to a series of erroneous deviations in teeth, alveolar, maxillary system from the posterior teeth area to the anterior teeth area.
Besides finding the cause and related factors, once the treatment of an open bite case starts, the posterior teeth area is always my first priority to examine and adjust. The direction of movement is always in the order of horizontal, vertical and then anteroposterior dimension.
Finally, the ultimate goals in orthodontic treatment I aim for are enhancing the facial aesthetic, maintaining the functional masticatory system, stabilizing the final result and a proper procedure for both dentists and patients.

Duration: 29 min 35 sec

By Seong-Min Bae

Problems in the transverse dimension can be challenging to manage, especially in adult patients. Several etiologic factors that cause adult transverse discrepancies are true excess or deficient maxillary or mandibular transverse growth, ectopic tooth eruption, soft tissue imbalance (example: prolonged digit sucking), asymmetric mandibular growth,etc.
Considering factors when formulating a diagnosis and treatment plan for adult patients with transverse discrepancies are magnitude of transverse discrepancy, facial symmetry or asymmetry with lateral CR-CO shift, whether the transverse discrepancy is absolute or relative transverse discrepancy due to AP discrepancy, magnitude of buccal corridors and magnitude of transverse dental compensations.
Treatment options for adult transverse discrepancies are multiple maxillary osteotomy, SARPE, MARPE and dental expansion. Dental expansion includes translating maxillary posterior teeth buccally with fixed appliance with or without Quadhelix or TPA is available in thick periodontal biotype patients for expansion of transverse maxillary first molar about 3~5mm.
Recently, as skeletal lateral expansion using orthodontic microscrews has been popularized, I have found that the curve of Wilson is removed or, in severe cases, reversed due to unnecessary skeletal expansion and often over-application. In addition, excessive maxillary expansion and compensatory mandibular excessive dental arch expansion are taking place. In addition, there was a question as to whether the old principle of orthodontic treatment to prevent orthodontic relapse, “maintenance of lower intermolar width”, is still effective.
Therefore, I would like to share the experience of long-term observation of treatment cases using dental expansion and molar distalization using MIA (Micro-Implant Anchorage) in cases with transverse discrepancy with or without dental crowding.

Duration: 59 min 05 sec

By Sang-Min Lee

Class III malocclusion is one of the most difficult malocclusions to treat for the orthodontist. Although the form of malocclusion appears from an early age, only the maxilla can be protracted to a certain degree; the mandible growth cannot easily be suppressed and only the vertical direction of the growth can be slightly changed. Even such orthopedic treatments are only effective under the ages of 10, when the circummaxillary sutures can be disarticulated. The cause of the malocclusion cannot be fully understood, and resolving the few known causes (e.g., heredity, rhinitis, etc.) is often very difficult. Even after the orthopedic treatment, these unblocked causes can lead to an unfavorable growth pattern for as long as the patient’s growth persists. Moreover, due to the cephalocaudal gradient law of growth, which states an increased, latter growth farther away from the head, treatment is inevitably prolonged as the mandible growth occurs until a later stage.
In the early stages of Class III malocclusion treatment, not only is it important to improve the morphology of the malocclusion, but relieving the factors causing the malocclusion is critical. If the underlying cause cannot be resolved, the overall prognosis would be very poor due to the subsequent unfavorable growth pattern no matter how effective the early treatment was.
Another important treatment goal to take into consideration along with the successful improvement of causative factors is to prolong the orthopedic effects until a later age. As previously described, it is often impossible to completely eliminate the underlying cause of the malocclusion – therefore, the treatment outcome depends on how long the orthopedic treatment can compensate for unfavorable growth. Recently developed skeletal-anchored appliances that delivers the orthopedic forces directly to the maxilla are utilized today in many forms to achieve this goal.
This presentation will discuss methods to alleviate the causative factors that can be applied in early treatment of class III malocclusion, and also address various ways to prolong the application of orthopedic forces until the later stage of growth.

Duration: 31 min 40 sec

By Hyo-Won Ahn

Class II orthopedics with functional appliances has been established as a primary treatment modality for growth modification since 1930s. Although, some updated evidence on the treatment effects of functional appliances has shown skeptical aspects regarding long term response and predictability of mandibular growth. The goal of functional orthopedics in the treatment of skeletal Class II is to provide normal functional environment inducing advancement of tongue, enlargement of the constricted upper airway, and favorable muscle response which would ultimately stimulate mandibular growth. It is impossible to expect mandibular growth beyond genetic potential by growth modification, however it is critical to eliminate any epigenetic factors which would exacerbate skeletal discrepancy. Understanding the mandibular growth rate and morphologic changes is essential for determination of timing of functional orthopedics. Up to now, it is well known that the timing of successful Class II growth modification is pubertal growth spurt. Most previous studies have focused on the age of patients in preadolescent, adolescent, and post adolescent based on puberty, and there has been no studies on functional orthopedics in early childhood or infancy. In this presentation, the greater potential of mandibular growth in infants and early childhood is highlighted and it will be further discussed whether this period can be considered as a window of opportunity for early treatment.

Learning objective:

• Understand the pattern of mandibular growth from birth to post-adolescent
• The possibility of Class II functional orthopedics at a younger age before puberty

Duration: 24 min 28 sec

By Do-Keun Kim

Treatment of skeletal hyperdivergent Class II malocclusion is challenging for clinicians, especially in growing patients. Although vertical and sagittal skeletal relationships of Class II subjects tend to improve with growth, prediction of facial growth is more difficult in patients with hyperdivergent skeletal patterns due to higher probability of unfavorable growth. Traditional treatment approaches include use of high-pull headgear and/or functional appliances for orthopedic effects, such as inhibition of maxillary forward-downward growth and enhancement of mandibular forward growth, along with dental effects. However, the optimal timing of treatment according to the vertical skeletal pattern remains controversial. There is limited evidence on long-term skeletal effects of conventional appliances followed by fixed orthodontic treatment with or without extractions in adolescents. Moreover, treatment effects of conventional approaches heavily depend on patients’ compliance, and often require prolonged use of appliances to control vertical growth during fixed treatment and retention as well. Mini-implants, non-compliant appliances, are also a possible treatment option in growing patients by controlling vertical eruptions of molars, though only few studies have reported treatment results and long-term stability.
Therefore, the purpose of this presentation is to examine long-term effects of conventional Class II treatment in adolescents with the hyperdivergent growth pattern, and to compare post-treatment changes between patients with different treatment responses through statistical analysis of a pilot study. Furthermore, I would like to discuss the effectiveness of mini-implants by reviewing the clinical cases.

Duration: 30 min 06 sec

By Jin-Hyoung Cho

When we meet growing children for orthodontic treatment in clinical practice, it is common to find difficult cases about sagittal or vertical or horizontal skeletal disharmony, but there are also some cases with congenital missing of multiple permanent teeth. It is not easy to induce and maintain the normal growth and development of the jaw or alveolar bone in the case of a young patient with 2 or 3 or more tooth missing. In addition, it is a well-known fact that it is very difficult to make a decision in the clinic when the residual primary teeth are extracted due to poor prognosis due to caries or severe inflammation, or when ankyloses are occurred.
Therefore, I would like to share the diagnosis and treatment plan establishment that can achieve functional and esthetics in consideration of the future adult and middle-aged growth of a growing patient who is accompanied by multiple permanent tooth missing and who has had loss of or ankyloses of the primary teeth. In fact, clinicians' approaches to multiple tooth missing often establish a treatment plan considering the crown space. However, in this lecture, the treatment plan decision taking into account the development of the alveolar and jaw bones as well as the space required for the crown when the child becomes an adult will be discussed with cases.

Duration: 30 min 37 sec

- Jihoon Kim (Korea)
- Jae-nam Lee (Korea)
- Ji-woo Jang (Korea)
- Song E Park (Korea)
- Ha-Eun Moon (Korea)
- Hyeji Shin (Korea)
- Tzu-Hang Hsu (Taiwan)

Duration: 55 min 26 sec

- Ignatia Wulandari (Indonesia)
- Joo-Yeong Lee (Korea)
- Seung Eun Baek (Korea)
- Seung-Cheol Song (Korea)
- Song-Ha Kim (Korea)
- Tae-Hoon Kim (Korea)

Duration: 47 min 21 sec

- Ahhyeon Kim (Korea)
- ATSUHIRO INOUE (Japan)
- Eun-Jeong Jeon (Korea)
- Ho-yeon Sim (Korea)
- Hye-Min Kim (Korea)
- Hyeong-Yoon Choi (Korea)
- Jun Hyeong Bae (Korea)

Duration: 54 min 47 sec

- Seunghyun Kang (Korea)
- Yoon-Kyo Oh (Korea)
- Tae-Gyun Kim (Korea)
- Yeong jae Jeon (Korea)
- Viet Hoang (Vietnam)
- Young-Soo Seo (Korea)

Duration: 48 min 20 sec

- Rama Raji Sankaranarayanan (India)
- Hyunseung Hong (Korea)
- Yuki Sagawa (Japan)
- Livia Yonathan (Indonesia)
- Soyeon Park (Korea)
- Jae-Woo Kim (Korea)
- Harsha.L (India)

Duration: 52 min 35 sec

- Aerin Choi (Korea)
- Elliott Schwartz (USA)
- Eun kyu Won (Korea)
- HUI SHAN BOO (Malaysia)
- Jo Yeon Hwang (Korea)
- JIA QI (Japan)

Duration: 48 min 01 sec

- Chaehee oh (Korea)
- Amanda Israel (USA)
- Sewoong Oh (Korea)
- Judy Nguyen (USA)
- Yi-Ting Li (Taiwan)
- JUHWAN PARK (Korea)

Duration: 47 min 41 sec

- Sohee Moon (USA)
- Niranjan Acharya (Nepal)
- Do-Gil Kim (Korea)
- Ji-Ae Park (Korea)
- Emin Hartunian (USA)
- Hyein Woo (Korea)

Duration: 47 min 48 sec

Duration: 24 min 51 sec