CHAPTER 3: CONCEPT OF MODERN ORTHODONTICS OF THE 21st CENTURY

The goal of modern orthodontics of the 21st century: With the 21st century the concept of orthodontic changed and putting the following important points in consideration: 1. Orthodontic practice is running under the umbrella of evidence base orthodontics. The best evidence can inform, but can never replace, individual clinical expertise because it is this expertise which decides whether the evidence applies to the individual patient and, if so, how it should be integrated into a clinical decision Harrison E Jayne 2. We are not either occlusionist or cosmetologists but we are professional orthodontists aiming to establish well balanced aesthetic long term stable functional occlusion within the stomatognathic system. Ackerman et al 3. Creation of the best accepted normal occlusion but not on the expenses of function, long stability and healthy stomatognathic system Ackerman et al 4. Too much concern on creation and establishment of the best balanced functional occlusion, dental and facial aesthetics, long-term stability and maintenance of the treatment outcome (be free from the dogma of detailed ideal occlusion) Proffit 5. Orthodontics changed from the occlusion concept to functional aesthetic concept Ackerman et al 6. Respecting patients psychosomatic norm Elisha Richardson, Abdel-Kader 7. We are treating patients subconsciously up to our psychosomatic norm Peck and Peck 8. We are not the sole decision maker; we have to be autonomist and not paternalist Ackerman, Proffit 9. The miracle of internet technology and global information Peck 10. Orthodontics is now a day running with the miracle of Digital Era Peck Proffit summarizes the concept of modern orthodontics in the following statement: In the early 21st century, orthodontics differs from what was done previously in three important ways: 1. There is more emphasis now on dental and facial appearance. This reflects a greater awareness that parents and patients seek treatment largely because of concern about facial appearance, and that psychosocial problems related to appearance can have major effects on an individual's quality of life. The advent of orthognathic surgery has made it possible to correct facial disproportions that previously were not treatable, and the development of computer imaging methods that allow the orthodontist to share facial concerns with patients in a way that was not possible until recently.

2. Patients now expect and are granted a greater degree of involvement in planning treatment. No longer is it appropriate for the paternalistic doctor to simply tell patients what treatment they should have. Now patients are given the opportunity to participate in selecting among treatment options-a process that is facilitated by computer imaging methods; and Orthodontics now is offered much more frequently to older patients as part of a multidisciplinary treatment plan involving other dental and medical specialties. The goal is not necessarily the best possible dental occlusion or facial esthetics but the best chance for long-term maintenance of the dentition. This increased emphasis on treatment coordinated with other dentists has the effect of integrating orthodontics back into the mainstream of dentistry, from which Angles teachings had tended to separate i