Gimcracks, Geegaws and Gimmicks: Distinctions in Search of a Difference

In today’s orthodontic marketplace, a wide variety of Class II treatments jostle for attention, each promising new, improved, and more salable techniques. A pledge to “work with growth” is a common, assuasive rationale. Unfortunately, both for the clinician and the patient, our attempts to grow bone have come to naught and now boil down to making use of whatever the individual pattern of mandibular growth has in store. To this end, all treatments must in some way control the movement of teeth. Therein lies the rub. The canard that people like faces that are stuffed full of teeth commonly leads to an over-reliance on non-extraction treatments and the various “advances” that have served to ratchet the dentition ever more forward. Just as all roads are said to lead to Rome; all roads that lead to well treated Class II malocclusions (that is, results achieved without “blowing” mandibular anchorage) must take a variety of routes to and through the upper dentition. Fixed or functional, early or late, the details are surprisingly similar.

Learning Objectives:

• Recognize the similarity among the various contemporary Class II treatments.
• Identify treatments whose advertised mode of action is at odds with common sense and contemporary concepts of craniofacial biology.
• Distinguish between practice management decisions and biological imperatives encountered in planning the treatment of Class II malocclusions.