Adrian Becker - Orthodontic Treatment of Impacted Teeth

My colleagues Dr Monica Barzel, Dr Yocheved ben Bassat, Dr Gabi Engel, Dr Doron Harary, Dr Tom Weinberger and Professor Yerucham Zilberman, and my former graduate students Dr Yossi Abed, Dr Dror Eisenbud, Dr Sylvia Geron, Dr Immanuel Gillis, Dr Raffi Romano and Dr Nir Shpack, have provided me with several of the illustrations included here and I am indebted to them.

I am grateful, too, to Ms Alison Campbell, Commissioning Editor at Martin Dunitz Publishers and to Dr Joanna Battagel, Technical Editor, for their constructive and professional critique of the manuscript, which contributed so much to its ultimate format. I also thank Naomi and Dudley Rogg, of the British Hernia Centre, for the computer and office facilities that they placed at my disposal during my short sabbatical in London in the latter stages of the preparation of the work for publication.

Permission to use illustrations from my own articles that were published in various learned journals was granted by the publishers of those journals or by the owners of the copyright, as follows:

Figure 5.13 was reprinted from Pertz B, Becker A, Chosak A, The repositioning of a traumatically‐intruded mature rooted permanent incisor with a removable appliance. J. Pedodont 1982; 6: 343–354, with kind permission of the Journal of Pedodontics Inc.

Figure 5.4and 5.12were reprinted from Becker A, Stern N, Zelcer Z, Utilization of a dilacerated incisor tooth as its own space maintainer. J Dent 1976; 4: 263–264, with kind permission from Elsevier Science Ltd, The Boulevard, Langford Lane, Kidlington OX5 1GB, UK.

Figures 9.8–9.14 were reprinted from Becker A, Shteyer, A, Bimstein, E, Lustmann, J, Cleidocranial dysplasia: part 2 – a Treatment Protocol for the Orthodontic and Surgical Modality, Am J Orthod Dentofac Orthop 1997; 111: 173–183, with kind permission of Mosby‐Year Book Inc., St Louis, MO, USA.

Figure 6.35 was reprinted from Kornhauser, S, Abed, Y, Harary, D, Becker, A, The resolution of palatally‐impacted canines using palatalocclusal force from a buccal auxiliary, Am J Orthod Dentofac Orthop 1996; 110: 528–534, with kind permission of Mosby‐Year Book Inc., St Louis, MO, USA.

I am very thankful for their cooperation and for their agreement.

Adrian Becker

Jerusalem

In the nine years that have elapsed since the publication of the first edition of this book, much has changed in the field of orthodontics in general and, perhaps even more so, as it relates to the treatment of impacted teeth. The advances in imaging, particularly cone beam computerized tomography, have made accurate positional diagnosis of an impacted tooth virtually foolproof, enabling the application of appropriately directed traction to resolve even the most difficult cases. Temporary orthodontic implants have provided the opportunity to resolve the impaction, in many cases without the need for an orthodontic appliance and before orthopaedic treatment per se is begun. They have opened up a whole new area to exploit for mechanotherapeutic solutions to many of the problems we face.

The first edition was based on the findings of clinical research that was carried out over a long period of time in Jerusalem during the 1980s and 1990s. In much the same way, this second edition documents the findings of ongoing and evidence‐based studies carried out by largely the same small group of clinical investigators, since then. Most of these published articles were the product of an excellent working collaboration with Dr Stella Chaushu, a former student of mine and now Senior Lecturer in the Department of Orthodontics. Her industrious and intellectual qualities have contributed to the output of a large number of valuable published studies in just a few short years.

Under the leadership of Professor Refael Zeltser, chairperson of the Department of Oral and Maxillo‐facial Surgery at the Hebrew University – Hadassah School of Dental Medicine in Jerusalem, a whole generation of young surgeons has grown up who exhibit the ability to appreciate and value the finer points of cooperation with the orthodontist. Dr Eran Regev and Dr Nardi Casap in Jerusalem, Dr Gavriel Chaushu, the chairperson at the parallel department of the Sourasky Hospital in Tel Aviv, and Dr Harvey Samen in private practice, have worked closely with me in the treatment of our patients. Many of these cases are illustrated in the pages of this book. I derive considerable satisfaction from seeing the surgical expertise learned from and handed down by Professors Arye Shteyer and Joshua Lustmann being practised by these highly professional colleagues, on a day‐by‐day basis. Their awareness and perception of the significance of their work in determining the long‐term outcome have helped me to aim for the highest quality results and the well‐being of the patient. They deserve my gratitude.

In the preparation of this book, I have called upon and am grateful for the expertise of a small number of people, who have provided me with authoritative and essential information that has permitted me to make the text more comprehensive and more complete. In particular, I mention Dr James Mah and Dr David Hatcher in California, with regard to cone beam CT imaging and Dr Joe Noar in London, with regard to the use of magnets.

I have given and continue to give courses and lectures on the subject of impacted teeth in many places all over the world which, in the past few years, have been presented in collaboration with Dr Stella Chaushu. It is at these meetings that I come across some of the most interesting and rare material. I am indebted to several individual members of these audiences who frequently approach us during a coffee break, radiograph in hand, with some truly remarkable conditions, several of which have been included in this book, together with appropriate recognition.

My colleagues in the Orthodontic Department in Jerusalem have often become the sounding board for many of the ideas that are presented herein and I am thankful to them for the discussions that we have had. I appreciate their taking the stand of devil’s advocate in these situations, forcing me to justify or to discard. Nevertheless, none of this would ever have been published had I not spent so many years teaching the students on our postgraduate orthodontics specialty course. These future orthodontic standard bearers are privileged to learn from the various individual teaching preferences of mentors who rely on years of experience in practice, particularly when it comes to this bracket or that, this treatment philosophy or that and this orthodontic guru or that. Additionally, they have learned to look for and even demand clinical ideas and treatment policies that have a proven evidence‐based, track record to commend them and to justify their use. I know of no other postgraduate orthodontic course, worldwide, in which the subject of impacted teeth is explicitly taught in a comprehensive and integrative manner, including a designated weekly clinical session. It was this more than any other factor which encouraged me to embark on this mammoth task.

The future of our profession and the long‐term superior care of the even younger generation of our patients is in the hands of these aspiring orthodontists. I am grateful to them for having, perhaps unwittingly, cajoled me into writing this text. I hope that it will be a source of information for them as they undertake the challenge of some of the more difficult, unconventional and unusual cases that they will inevitably come across in practice and for which they will be expected to find appropriate therapeutic answers.

I wish to thank the following publishers of two articles, as follows:Several of the illustrations comprising Figure 7.8 were reprinted from the World Journal of Orthodontics. Vol. 5. The Role of Digital Volume Tomography in the Imaging of Impacted Teeth, by Adrian Becker and Stella Chaushu. 2004. with permission from Quintessence Publishing Co, Inc.