644 Reviews and abstracts
November 2004
The sequence of treatment is reduced to 3 stages. Stage I
involves aligning the incisors, closing anterior spaces, and
eliminating overjets, reverse overjets, increased overbites, or
anterior open bites by using .016-in stainless steel wire. The
first stage is usually completed in 6 to 9 months in Class II
patients, or less in Classes I and III patients. Stage II entails
the use of .020-in high tensile stainless steel wire to close any
residual extraction spaces. Center lines are corrected at this
stage and molars derotated, ready to receive the rectangular
wires of the third stage. The time taken is reported to seldom
exceed 3 to 4 months. Stage III entails uprighting and
torquing the roots into correct position by using side-winder
springs working against .0215 ⫻.028-in stainless steel arch-
wires. The 3 stages broadly follow the Begg technique,
although the methods of achieving them are considerably
different. The tip-edge appliance often necessitates the use of
auxiliaries to achieve specific tooth movements; the work-
horse among them is the side-winder, which, when used with
rectangular archwires, generates mesiodistal root movements
and torque. Other auxiliaries are power pins that fit into
vertical slots and are used as hooks to which elastics are
attached. Rotating springs are similarly available as auxilia-
ries to derotate teeth, and, like side-winders, they are avail-
able in either clockwise or counterclockwise versions.
The design and dynamics of the tip-edge bracket are
clearly illustrated and described, as are the various auxiliary
attachments, bonding, and setting-up procedures. The book is
essentially a hands-on practical treatment atlas or manual in
which sequences of treatment of the various types of maloc-
clusions are magnificently illustrated in color on high-gloss
paper. Etiology, diagnosis, and treatment decisions are not
featured in the text because it is assumed that the reader is
familiar with these aspects of treatment. Use of the appliance
requires a steep new learning curve because it is a departure
from traditional edgewise treatment. Clinicians familiar with
both Begg and edgewise techniques might want to consider
using the best of both. There is no doubt that excellent results
can be achieved with this relatively new appliance. The
results shown in the atlas are superb.
Alex Jacobson
Am J Orthod Dentofacial Orthop 2004;126:643-4
0889-5406/$30.00
Copyright © 2004 by the American Association of Orthodontists.
doi:10.1016/j.ajodo.2004.07.012
American Journal of Orthodontics and Dentofacial Orthopedics
ARTICLE REVIEW
Association of malocclusion and
functional occlusion with
temporomandibular disorders (TMD)
in adults: A systematic review of
population-based studies
D. Gesch, O. Bernhardt, and A. Kirbschus
Quintessence International 2004;35:211-21
Because there is little agreement in the literature about
whether associations exist between occlusal factors and tem-
poromandibular disorders (TMD), the authors attempted to
analyze published population-based studies on the relation-
ship of malocclusion and functional occlusion to TMD and its
signs and symptoms. The systematic research of the MED-
LINE and EMBASE databases and manual research produced
349 articles. The titles, abstracts, and the complete texts of the
manual research resulted in 42 articles. Their reference to the
literature produced another 32 articles, making a total of 74
additional articles. Twenty-two studies are described in the
article by the authors. Four relevant, representative, popula-
tion-based studies were found to fulfill the inclusion criteria.
Eighteen studies did not fulfill the inclusion criteria and were
excluded.
In reviewing and evaluating the representative studies,
the authors concluded that there are few associations between
malocclusion and functional occlusal factors and TMD.
Additionally, the factors are not uniform. Occlusal factors
appear to be only a piece of the mosaic in the multifactorial
process of TMD. With regard to practice, the results of these
studies support the view that occlusally related dental treat-
ment, especially irreversible occlusal therapy (ie, occlusal
adjustment, restorative dental treatment, orthodontics, or
orthognatic treatment), as direct treatment of TMD should be
used with caution. The efficacy of such treatment is not
predictable.
Alex Jacobson
Am J Orthod Dentofacial Orthop 2004;126:644
0889-5406/$30.00
Copyright © 2004 by the American Association of Orthodontists.
doi:10.1016/j.ajodo.2004.07.002