cosmetic dentistry - beauty & science

26 I I case report _ orthodontic Figs. 1a–c_Deep bite, prognathism and latero-gnathia: according to clinical evaluation, they can be resolved only through interdisciplinary treatment. cosmeticdentistry 2_2012 _Oral surgery is an important cornerstone in orthodontic treatment of malocclusions. Tooth movement is only possible to a limited extent and always depends on the misalignment of the maxilla and mandible in relation to each other, as well as on deformities of the jaw in relation to the other facial bones. Abnormalities may be congenital or acquired and may affect patients in childhood already. If so, the focus of ortho- dontic treatment is not primarily in the aesthetic correction, but is guided by functional and pro- phylactic concerns. Efficient occlusion and restoration of masti- catory function are decisive factors for tooth preservation and prevention of secondary dis- orders (Figs. 1a–c). Without a doubt, aesthetic improvement,aswellastheassociatedself-con- sciousness, is the main concern of most patients, which can be pursued through surgical correc- tion. _Causes of malocclusion Generally, patients visit an orthodontic prac- tice only after symptoms or significant abnor- malities have already presented. Clinically, this results in late mixed dentition or permanent dentition, which can complicate an accurate mapping of the reasons for this malocclusion. In the literature, the causes of malocclusion and the aetiological structure of the symptoms ofmalocclusioninorthodonticpatientsarecon- troversial issues. No explicit information on the percentage of patients with acquired or congen- ital malocclusions can be found in a study by Schopf (1981) on the exogenous factors that are involved in the development of malocclusion. However, from the assessment of individual pa- tients’ symptoms, all symptoms of malocclusion could be associated with exogenous aetiological factors only in 48 % of patients. Brodmann and Saekel (2001) concluded from Schopf’s report that only 20 % of the anomalies were hereditary and thus could not be affected by prophylactic interventions. Accordingly, 80 % of malocclu- sions could be resolved through prevention and better oral hygiene. This idea is contrary to the results of the German Oral Health Study. In this study, a decrease in childhood caries was ob- served.However,clinicallytheseresultswerenot Aesthetics and function: Orthodontic–surgical collaboration as a key to success Authors_Drs Martin Jaroch & Friedrich Bunz, Germany Fig. 1a Fig. 1b Fig. 1c