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By Dr. Khaled Abouseada, BDS, MS, Orthod. cert. A smile is a primal instinct which we acquire when we are born. A beautiful genuine smile has tremendous psychological and emotional benefits specifically brightening the mood of both your own and of those around you. Orthodontic is truly a blessing as it is the dental practice that shapes a per- fect attractive smile on people's faces and straightens not just the human teeth but also the whole being throwing light on the importance of their chance to live content- ly. It is with immense contentment and an- ticipation that in this edition of Dental-Tri- bune Middle East and Africa, I announce the creation of the remarkably vital sec- tion, Dental Orthodontic, which is part of the Dental Tribune International Publish- ing Group, composed of the leading den- tal trade publishers around the world. Its combined portfolio includes more than 100 trade publications that reach over 650,000 dentists in more than 90 countries in 25 lan- guages. The orthodontist is the artist who with his great knowledge, creates an outstanding balance and harmony between the teeth and face structure. People who suffer from dental flaws such as improper bite, crooked teeth, protruding teeth, misaligned teeth and spaces between teeth, tend to lose their confidence which result in frustration and avoidance of criticism and socializing. The recognizably golden role of the orthodon- tist helps to restore self-esteem and en- hance their being. Our section's focal objective will be encapsu- lating the accumulated information into an easily digestible manner . The real change in the approach of using information as a tool will be the mission we set for ourselves to give doctors access to the data they need most in the way they expect to find it. In broader sense, our team will be providing a common platform and a melting pot for ideas from diverse areas, updates about new product launches, orthodontic events, ethics in orthodontic principles of medical prac- tices, residents' journal review, original ar- ticles, clinical corner, techno bites, book re- views, continuing education and interviews with the pioneer doctors in the world . All the above features will be intended to ex- plain and lay open current problems of com- mon interest to all orthodontists involved. The section will also potentially present in- structive and exceptionally well-document- ed case reports pertinent to the goals and readership of the journal along with concise reviews of the important features of each re- ported condition. We expect such an approach to stimulate further research on orthodontic matters. We intend to publish special issues on se- lected topics providing adequate scope for presentation and discussion of controver- sial ideas, well-founded conjectures and comments on published work. High sci- entific standards will be the top priority of this section of the journal to increase the awareness of the readers to important is- sues in emerging fields and materials pro- cessed by orthodontists. The basic foundation has been laid to make readers more interactive, encourage pro- ductive debates enabling us to add more aspects so that this section can best serve you. We would appreciate receiving sur- veys on your opinions on activities, re- searches you value as well as thoughts on compelling subjects. We would thus devel- op our orthodontic section as a direct re- sult of your input. We also have tremendous work to do be- yond today's launch which revolves around offering an open-access academic and sci- entific forum for the all doctors facing diffi- cult cases and also assisting general practi- tioners to solve simple and moderate orth- odontic cases. To this end, and to ensure rapid publica- tion of significant results, every effort will be taken to ensure efficient communica- tion between authors, editors and readers and continuous improvement of this sec- tion will be our definite preference and its growth will be our distinct mission which we hope it would be envisaged to meet your needs. Yours faithfully, Dr. Khaled Abouseada Consultant Orthodontist khaledseada@yahoo.com DTMEA introduces 'Ortho Tribune' section By Dr. Khaled Abouseada T his case report describes the non- surgical, non-extraction treatment of a 24 years-old male with a skel- etal Class III malocclusion, a prog- nathic mandible and retrusive maxilla. He was initially classified as needing orthog- nathic surgery, but he and his parents wanted to avoid that. The Class III mal- occlusion was corrected by non-extraction orthodontic treatment with fixed appliance only. Class I molar and canine relation- ships were achieved, and the facial profile improved substantially. Class III malocclusions are usually growth- related discrepancies that often become more severe until growth is complete.1 Fa- cial changes can influence a patient’s self- confidence and interpersonal relation- ships.2, 3 In adults orthognathic surgery is the most effective treatment.4 Correction of Class III without surgery can be challeng- ing .3,5 Therefore the purpose of this article was to describe the nonsurgical treatment of a patient with Class III dental and skele- tal relationship. Diagnosisandetiology The patient was male, aged 24 years and 5 months, whose chief complain was the overlapped upper anterior teeth. He had class III canine and molar relationships on both sides, 3 mm negative overjet, 5 mm negative overbite, bilateral cross bite with both maxillary and mandibular midline co- incident to the midsagittal plane, unilateral posterior cross bite at the area of the right premolars, upper dental arch had about 5 mm crowding and lower dental arch had 3 mm spacing (Fig 1). Cephalometrically, there was a Class III jaw relationship and increase vertical facial height (fig 2). He was in good health and his medical history showed no contraindications to orthodon- tic therapy. Treatmentobjectives Treatment objectives included correction of the posterior and anterior crossbites, im- provement of dentoalveolar and maxillo- mandibular relationships, improvement of facial esthetics and establishment of a sta- ble occlusion and better smile. Treatmentalternatives Three treatment options were suggested to the patient. The first alternative consisted of combined surgical and orthodontic treat- ment with a high LeFort procedure and mandibular osteotomy to improve skeletal and facial appearance. The second consisted of maxillary expan- sion and extraction of the mandibular first premolars with the maxillary second pre- molars. Tis would correct the Class III den- tal relationship, but it also involves retrac- tion of mandibular incisors without pro- trusion of the maxillary incisors; this was thought to be unsatisfactory for this pa- tient’s retruded maxilla. The other treatment alternative was a non- extraction orthodontic approach with max- illary expansion and protraction of up- per anterior segment. The patient did not want orthognathic surgery or teeth extrac- tions. Therefore, he chose this non-extrac- tion orthodontic treatment. Treatmentprogress Treatment began with placement of fixed posterior composite bite plane at the area of second molars both sides, fixed pre- adjusted appliances (0.022 in slots) were placed on maxillary teeth, leveling and alignment progressed up to rectangular 0.019x0.025 stainless steel arch wire with posterior stops for the wire and extension a head from anterior teeth then ligated to them, this initial phase of treatment lasts for 5 months (Fig 3). After, fixed appliances were placed on mandibular teeth and Class III elastics were used for 3 months to aid in correcting the anterior cross bite (Fig4). The second molars were not included in brack- eting to prevent molar extrusion; this could have caused more downward mandibular rotation. After correction of the crossbite and creation of a class I occlusion, detailing and finishing were undertaken. The total active treatment time was 11 months. Pa- Non- extraction treatment of adult skeletal Class III malocclusion Fig 1. Extraoral and intraoral photographs with radigraphs before treatment.The profile view shows deficiency in ma Fig 2. Pretreatment cephalometric tracing and measurements. Fig 3. Progress 1 after 5 months from starting treatment and just before bonding the lower arch. 13DENTAL ORTHO TRIBUNEDENTAL TRIBUNE Middle East & Africa Edition | Jan-Feb 2013