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The Concept of a New Dental Disease: Orthodontosis and Orthodontitis

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The Concept of a New Dental Disease: Orthodontosis and Orthodontitis Journal of Dental Health, Oral Disorders & Therapy The Concept of a New Dental Disease: Orthodontosis and Orthodontitis Abstract Research Article Introduction: Angle’s 110 year old classification of malocclusion lacks verifiable Volume 1 Issue 5 - 2014 scientific validity, and lacks substantiation on whether ideal occlusion significantly 1 2 locationimproves of oral bone function in the horizontal or provides dimension. significant benefits in oral or general health. We Anthony D Viazis , Evangelos Viazis and propose a new orthodontic classification based on evaluating the position of roots and Tom C Pagonis3* Materials and Methods: Thousands of completed orthodontic cases, with an 1Orthodontist, Private Practice, USA 2Private Practice, Greece 3Department of Restorative Dentistry and Biomaterials overwhelming majority treated non-extraction were subjected to photographic and of Sciences, Harvard School of Dental Medicine, USA radiographic evaluation. Based upon this we propose new orthodontic classifications *Corresponding author: in the horizontal dimension caused by the displaced root(s) of the tooth, typically palatallya. Orthodontosis, or lingually. defined as the non-inflammatory deficiency of the alveolar bone Tom C Pagonis, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA, Tel: +1617-432-5846; Fax: +1617-432- b.Discussion: Orthodontitis To date, defined a link as betweenexcess soft malocclusions tissue manifestation and periodontal and chronic condition inflammation. remains 0901;Received: Email: August 24, 2014 | Published: September 30, 2014 and treated accordingly based on their own individual genetic and morphologic appearanceunclear and rather controversial. than an arbitraryWith this ideal. new classification patients will be diagnosed Conclusion: is proposed for malpositioned teeth based on the clinical morphology, appearance A new orthodontic classification namely Orthodontosis and Orthodontitis orthodonticand contour therapeuticof the alveolar modalities. bone and ridge. This new classification, as a replacement of or as a supplement to traditional classifications may lead to more non- extraction Keywords: Orthodontitis; Orthodontosis; Dentistry; Orthodontics; Periodontics; Braces Abbreviations Class II sub-division. An editorial published in the American Journal of Orthodontics in 2009 [5] stated that, although the concept of ideal occlusion has taken precedence as the ultimate PAR: Peer Assessment Rating; IOTN: Index of Orthodontic goal in clinical orthodontics for some 110 years and serves as an Treatment Need; OHP: Oral Health Promotion; TBI: Tooth Bone adopted arbitrary method convention and clinical gold standard, Interface; OTM: Orthodontic Tooth Movement; PDL: Periodontal LigamentIntroduction it has no verifiable scientific validity, and that no one has yet A critical prerequisite for orthodontic treatment is the function.demonstrated Rinchuse that andideal Rinchuse occlusion [6] provides also question significant the arbitrary benefits in oral or general health, or that it significantly improves oral understanding of and classification of malocclusion. Currently functional mandibular position in order to achieve a morphologic classic qualitative methods such as Angle [1] and more nature of this classification that suggests a change in a stable, there are several classifications of malocclusion which include occlusion that conforms to an arbitrary ideal. It is estimated that the teeth are in contact for less than 20 contemporary quantitative methods and indices such as Peer minutes per day [7]. Why then should a dentist base his/her [2]assessment has remarkably rating (PAR) endured and theIndex test of oforthodontic time and treatmentcontinues diagnosis of a patient’s malpositioned teeth on the occlusion toneed be (IOTN).utilized Firstas the developed main language in 1899, of Angle’smalocclusion classification among and not on the alveolar bone that is a constant 24 hours a day? orthodontic specialists. Yet, there continues to be an emerging Why shouldn’t the same principles that apply to the evaluation of the bone and roots in the vertical dimension utilized in the orbody III. ofGraverly literature and that Johnson exposes [3] showedthe lack poor of evidence diagnostic for inter- this horizontal dimension? Clinical observations after two decades providerconventional reliability classification while Siegel’sof malocclusion survey study in Class [4] 1 among (ideal), 34 II offield orthodontics of Periodontics practice also leadsapply usto theto proposefield of orthodontics the establishment in the chairpersons of Orthodontics Departments in the U.S. showed that fewer than 65% were in agreement on the meaning of a clinical morphology and appearance of the alveolar bone and of a new classification for malpositioned teeth based on the Submit Manuscript | http://medcraveonline.com J Dent Health Oral Disord Ther 2014, 1(5): 00030 Copyright: The Concept of a New Dental Disease: Orthodontosis and Orthodontitis 2/5 2014 Viazis et al. orthodontic thinking and more in line with the current accepted theoriesridge. This found classification in the periodontal is a paradigm literature shift fromand the the specialty traditional of Periodontics.Materials and Methods Thousands of completed orthodontic cases, with an of two decades of clinical practice utilizing a system of braces Figure 1: overwhelming majority treated non-extraction over a span ideal occlusion. Localized orthodontosis replaces the old term of class I were subjected to photographic and radiographic evaluation. Clinicalthat upright observation the roots leads from us theto proposebeginning the of establishment treatment [8-21] of a morphology of the alveolar bone and ridge: new classification for malpositioned teeth based on the clinical Localized orthodontosis This term replaces the old Angle term of Class I ideal occlusion. This condition typically has an overbite/overjet relation of 2-3mm which is adequate for anterior guidance. Orthodontosis horizontal dimension caused by the displaced root(s) of the tooth, is the non-inflammatory deficiency of the alveolar bone in the Figure 2: of the alveolar bone. Brackets applied initially only on teeth with orthodontosis uprighttypically then palatally the alveolar or lingually. bone isThis restored results and in excessthe Orthodontitis soft tissue (theand chronicgingivitis inflammation from malpositioned called Orthodontitis. teeth) is alleviated Once the ( root is 1-5). Figure Premaxillary orthodontosis This term replaces the old Angle term of Class II malocclusion. ofThese the typesupper of anterior cases typically teeth did demonstrate not erupt flaredto their upper full anteriorupright teeth and a premaxilla that seems underdeveloped as the roots alleviatepotential. thisAs acondition result, the and overbite/overjet restore the alveolar relation boneis excessive. to the levelUpper it interproximalshould have always reduction had. Ifmolar the patient to molar also can demonstrates easily help Figure 3: Orthodontosis in the right mandibular premolar area. mandibular retrognathia, then a surgical procedure may also be dimension caused by the displaced root(s) of the tooth, typically indicated ( 6). palatallyOrthodontosis or lingually. is the deficiency of alveolar bone in the horizontal MandibularFigure orthodontosis This term replaces the old Angle term of Class Ill malocclusion. These types of cases typically demonstrate minimal overbite/ overjet with retro lined lower incisors or negative overjet (underbite). Apart from a slight maxillary deficiency, these cases molarshow excesscan alleviate alveolar this bone condition and/or for basal up to bone three formation lower anterior with teethretro inlined underbite incisors. relation. Lower If moreinterproximal teeth are inreduction anterior molarcrossbite to then a surgical procedure may also be indicated ( 7). Discussion Figure Periodontic orthodontic interrelationships Generally, treatment planning of orthodontic care is based Figure 4: primarily on the premise of improvements of function, dental incisor have orthodontosis. The canine tooth should be bracketed and facial esthetics and general dental health. Yet, a link between after the lateral The maxillary and premolar right rootspremolars have upand righted maxillary in order right forlateral the malocclusions and periodontal condition remains unclear and alveolar bone to be restored beforehand. Citation: Viazis AD, Viazis TC Ther 1(5): 00030. DOI: 10.15406/jdhodt.2014.01.00030 E, Pagonis (2014) The Concept of a New Dental Disease: Orthodontosis and Orthodontitis. J Dent Health Oral Disord Copyright: The Concept of a New Dental Disease: Orthodontosis and Orthodontitis 3/5 2014 Viazis et al. is consistent with differences found in the microbial composition of sub gingival plaque of malpositioned Vs non-malpositioned teeth. While several factors contribute to the microbial colonization of dental plaque including pH, temperature and caused by malpositioned teeth facilitate the accumulation of plaqueosmotic andpressure its microbial [24-28], constituents physical barriers [29]. Chungto self-cleansing et al. [30] concluded that compared to non-malpositioned anterior dentition plaque accumulation, a greater number of periodontopathogens in adults, malpositioned anterior dentition exhibited greater Figure 5: premolars is restored after their roots orthoerupted in their upright present in sub gingival plaque
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