Seminars in Orthodontics

VOL 14, NO 4 DECEMBER 2008

Introduction

wo distinguished specialties in dentistry, namely orthodontics and periodontics, particularly regard the health of the paradental tissues as paramount. To the orthodontist, these tissues contain the cells that enable him or her to move teeth to new positions in the dental arch and perhaps alter the form of the alveolus itself. To periodontists, restoring and maintaining the health of these tissues against the ravages of chronic and acute infection is their declared mission. Focusing on the same tissues, the two specialties overlap biologically, inadvertently, and to the sensitive orthodontist, most benecially. In about 1986 Coenraad F. A. Moorrees wrote presciently: . . . . Only when (the) fundamental question in bone physiology is better understood can appliances for optimal tooth movement in orthodontics be achieved. The 21st century is answering that question with breathtaking speed, challenging biomechanics to meet mechanobiologics. Every clinician in each specialty should applaud that development. Since Moorrees writing, the emphasis of 21st century biology is on molecular mechanisms and cellular genetics. Signicantly, with the aid of these nascent sciences, the mechanotransduction process has been revealed with increasing detail, explaining how a mechanical force is translated into cascades of biological reactions and promising the dentofacial orthopedist a wealth of knowledge to engineer both alterations in physiologic form and protection from disease. This developing body of knowledge is of interest to the periodontist, who is engaged in a formidable battle against harmful microorganisms, highly destructive to the periodontal tissues, as well as to the alveolus and other organs, indeed even as distant as the heart and systemic

2008 Published by Elsevier Inc. doi:10.1053/j.sodo.2008.07.001

vasculature. The periodontist in particular is keenly aware of the intimate associations between paradental tissues, cells, and systemic diseases whether evoked through genetics, epigenetics, or environmental factors. All these disciplines can affect the outcome of periodontal and orthodontic therapy. Moreover, it seems that controlled injury to the alveolar bone actually increases the velocity of tooth movement and enhances long-term stability. It remains to be seen exactly how mainstream orthodontics will adopt these principles for mechanical and surgical procedures. Such an enhancement of didactic power will increase the awareness of more rened principles that dene both accomplishments and failures, but, above all, it will lead to better diagnostic and therapeutic procedures. It is important to remember that science marches on despite what individual styles of practice we may prefer. This issue of Seminars in Orthodontics attempts to bring that science to the clinical realm with contributions from a variety of sources that relate to the foundational integrity and dynamics of orthodontic and dentofacial orthopedic therapy. The rst article denes salient issues that are relevant to the practicing orthodontist. Drs. Palomo and Bissada merge the young with the old, the enthusiastic visions of the new generation with the staid and steady wisdom of experience. The clinical protocols of Dr. Michael O. Williams demonstrate how dening the alveolus as the focus of study might bring knowledge of novel orthopedic manipulation to prior generations of orthodontic literature. Dr. William Mihram shares his prosthodontic perspective, derived from a decade of interdisciplinary university teaching, which demonstrates to his fellow specialists exactly how appliance therapy can alter pathologic alveolar topography to minimize the amount of osseous surgery that may be needed in complex cases. The biochemical basis of his work is explained by Drs. Masella and Chung and the con227

Seminars in Orthodontics, Vol 14, No 4 (December), 2008: pp 227-228

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N.C. Murphy, and N.F. Bissada

cept is taken further by Drs. M. Thomas and William M. Wilcko with their demonstrations of tooth movement through healing periodontal tissue, with and without bone grafts. Our objective is to synthesize recent advances in the specialties of orthodontics and periodontics with the hope that dentofacial orthopedic art will rest secure on the rmament of evidencebased science. It is a compelling biologic ratio-

nale that will allow the clinician a more forceful justication for the clinical art of practice. We hope that such a spirit of collegial enterprise will disclose even more novel methods of collaborative care in this Century of the Biologist. Neal C. Murphy Nabil F. Bissada Guest Editors