Orthotown September 2020 - 10
embrace progress
Cosmetic Orthodontics
by Dan Grob, DDS, MS, editorial director, Orthotown magazine
Is all orthodontic treatment cosmetic? Is
it possible to have an excellent orthodontic
result and not have the optimum cosmetic
benefit?
Ouch! Is this any way to open an article
in an orthodontic magazine? Well, let's be
honest: Sometimes-because of circumstances beyond our control, or systemic bias
and standard operating procedures within
the industry-we look at the results of our
best efforts and come to the conclusion
that the patient could look better if a
different approach or no approach had been
undertaken.
We are not alone.
In my previous, short-lived life, my
prosthodontic experience presented the
same dichotomy or choice. Other dental
specialties also often force practitioners to
decide between mechanical stability (based
on engineering principles, geometry and
force vectors) and aesthetic demands (based
on rather vague concepts and appearance
concerns).
I'll never forget the mother of one of my
young patients asking if anything could be
done for her maxillary lateral incisor. The
brief history is that periodontal involvement
of this tooth resulted in severe bone loss. The
periodontist was pounding his chest over his
ability to "save" the tooth. It looked terrible!
There were, of course, huge dark triangles,
and gingival contours were uneven. We
ultimately decided to remove and replace
for ultimate cosmetics, not just the "ideal"
of saving the tooth.
To illustrate the choices we have in
delivering aesthetics, let's draw on a couple
10
of classic articles published by leaders in
their respective fields.
Prosthodontics
Dr. Earl Pound was probably one of the
most famous complete-denture researchers
and practitioners in his day. The name
may not be familiar to many Orthotown
members, but understand that just like our
time when message boards are filled with
heated discussions regarding placement of
teeth in orthodontic treatment-basically,
extraction versus non-extraction-the era of
complete dentures had a similar predicament:
Either place the teeth over the bone or
somewhere out in space.
Many of Pound's concepts and thoughts
appear in the article "An Introduction to
Denture Simplification" (Journal of Prosthetic
Dentistry, Vol. 27, p. 570).
SEPTEMBER 2020 // orthotown.com
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Orthotown September 2020
Table of Contents for the Digital Edition of Orthotown September 2020
Orthotown September 2020 - Cover1
Orthotown September 2020 - Cover2
Orthotown September 2020 - 1
Orthotown September 2020 - 2
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