CONFERENCE PROGRAMME

Despite the ongoing ‘digital revolution’ in dentistry and in particular in orthodontics, the principles of comprehensive treatment remain still valid today. Without any doubt, 3D-technology is helpful for acquiring more diagnostic information, for planning treatment and, especially for the interdisciplinary patient, to continuously exchange records and to communicate with the treating dental specialists and the patient. Moreover, temporary anchorage devices have widened the range of orthodontic tooth movement and being able to substitute fixed braces with clear aligner systems will enable the orthodontist to convince the more aesthetically demanding adult or adolescent patient to undergo treatment.

No matter how promising these new technologies may be, they are only tools and cannot substitute traditional principles and proven strategies for comprehensive treatment planning with due respect for the patient’s individual situation and by applying sound biological and biomechanical knowledge. Clinical examples to illustrate this concept will be presented.

Aligners are here to stay! This lecture will discuss the decisions that patients make in choosing an orthodontist and how aligner care has created a mindset shift in the orthodontic practice. A discussion on the trends in aligner delivery care models and the modern practice will be presented. In addition, an overview of the changing landscape of aligner companies and decisions an orthodontist needs to make in transitioning from product to product. Clinical case types for a successful clinical practice will also be presented.

The temporomandibular joint (TMJ) represents a complex articulation system that connects the jaw bones to the cranium. In times of dysfunction, it can be a challenging problem for the dental team. Orthodontists play a role in the diagnosis and management of TMJ disorders as they have an ability to change the occlusion through selective tooth movement. This lecture will describe the current evidence on TMJ disorders and outline new methods in the management of patients who seek treatment in the clinical setting. Some new 3D imaging techniques and clinical treatment outcomes will be presented to the audience. New techniques including 4D jaw tracking will also be described.

This presentation will discuss the current ideas around accelerated tooth movement as it relates to intra-oral device usage on orthodontic patients. Experiences from a variety of clinical trials will be presented and the audience will have an understanding of science versus application.

What is the future for orthodontic retention? Dr. Littlewood will explore the fascinating new technological breakthroughs and new materials that may help us to reduce the amount of unwanted post-treatment changes after orthodontic treatment, as well as looking at biological approaches to reducing relapse and the controversial approach of treating patients without any retainers. He will also discuss how the findings of qualitative research is helping us to better understand ways of getting our patients to wear their removable retainers – something that would be helpful for all clinicians who prescribe removable retainers for their patients.

So far Simon Graf was known for his 3D metal printed orthodontic appliances, but now, as new materials are emerging, he continues to integrate them in the orthodontic workflow.

In the first part, he will focus on 3D metal printed appliances in combination with mini-implants. He will show the appliances from planning to printing, including post-processing, to the insertion in the mouth.

A very important part, insertion guides for mini-implants, will be covered as well.

In the second part, he will talk about direct printed aligners and removable functional appliances. Simon Graf will show some cases with direct printed aligners and functional appliances, and how to plan and produce them.

There will be no new aligner-protocol, but many new approaches for direct printed aligners and its possibilities to include other elements, not just attachments.

This session serves as an educational platform to deliberate on the current essentials and future possibilities in the provision of orthodontic care via the opinions from a panelist of experts from various backgrounds in academia, private practice and healthcare institutions.

The 3 topics for discussion are
The acceptable standard of care in fixed appliance and clear aligner therapy
Artificial intelligence driven orthodontics
Research relevance in clinical orthodontics

The incidence of Sleep disordered breathing (SDB) is on the rise. Snoring may be indicative of a more severe problem like SDB. SDB is associated with multiple morbidities. The role of dentistry is important in identifying and managing patients with OSA. The treatment of SDB often involves combined approach involving ENT and dental. The ENT role involves a comprehensive assessment of the airway. A nocturnal attended sleep study can be done to confirm the severity of OSA. There are multiple ENT causes of OSA in children. The most common cause of pediatric OSA is adenotonsiller hypertrophy. As such the first line treatment of paediatric SDB is adenotonsillectomy (T&A). CPAP is offered for those not amenable to surgery, or when there is relapse of recurrent symptoms. However, it is poorly tolerated in the paediatric population. A dynamic assessment of airway may be needed in complex cases or recurrent cases. There are multiple challenges faced in management of SDB in children. However, early intervention has been shown to reduce the morbidities associated with OSA.

This session will cover the clinical assessment of patients with Obstructive Sleep Apneoa from a dental perspective. The speaker will cover how treatment strategies can be tailor made for CPAP failures to target the primary issue. Strategies being discussed include: oral appliance selection combined with dental ENT experience, orthognathic surgery in skeletally restricted patients, soft tissue ablation in soft tissue hypertrophy and hypoglossal nerve stimulation in poor muscle tone. The speaker will share several case studies of patients who have benefited from a dental-ENT management strategy to illustrate the above treatment strategies.

Obstructive Sleep Apnea (OSA) has been gaining prominence in the last 30 years as a chronic medical condition with multiple serious health implications. There are a large variety of surgical procedures that are performed for OSA treatment. Traditional orthognathic surgery has been used to treat Obstructive Sleep Apnea for the last 25 years. To date, the Maxillomandibular Advancement (MMA) is one of the most efficacious surgical procedures to manage OSA. Several modifications to the basic orthognathic design and adjunctive procedures have been used to improve the success rate and manage the potential complications.

Orthodontic therapy is an important part of most MMA procedures. A good understanding of the different demands of this group of patients and collaborative partnership between the surgeon and the orthodontist is crucial. Appropriate orthodontic planning and preparation will aid in achieving timely and predictable surgery and good overall results.

Respiration and breathing is essential to life. Accordingly, airway management recently gained attention in the clinical orthodontics field. It has been claimed that in cases of transverse problems maxillary expansion not only increases the dental arch dimension but also nasal airway volume. Either surgical or nonsurgical maxillary expansion has been suggested as favorable to nasal airway enhancement. However, several points have to be empirically examined to advocate the actual effect of maxillary expansion. First of all, the biomechanical aspect of the expander design and related clinical outcome reveals possible limitation of conventional RPE and surgically assisted RPE in terms of airway volume. Therefore, the expander design and expansion protocol have to be clearly understood. Secondly, the conflict between the airway and facial esthetics must be discussed. Major expansion in the zygomatic area leads to unfavorable esthetic outcome in the face. Then the question is whether the zygomatic expansion is desirable for facial esthetics. Thirdly, the airway enhancement must be viewed from both nasal and pharyngeal area. Finally, alternative treatment modality for majority of the skeletal Class III discrepancy exhibiting maxillary deficiency must be suggested. In this regard, induced symphyseal remodeling to replace mandibular setback surgery with effective maxillary expansion using MARPE will be extensively demonstrated and explained.

Do you know how can Oral Health Therapists be seamlessly integrated into your practice’s workflow? This young budding profession can be overlooked and often misunderstood for the roles they are given in the clinic. There is much more that this community of professionals can offer and add value, only if we know how to embrace them and the profession.

Class III Malocclusion could be considered one of the most challenging maxilofacial disorder with a mean prevalence of 5,92% among caucassian and higher values (19%) among some Asian regions.

Class III sequential lower distalisation with Invisalign technique is a minimal invasive (Non-Extractions-TAD´s and Surgery) applied in the lower arch in order to treat Class III Malocclusions.

Sequential Attachment Placement on lower distalised molars and premolars increases aligner fitness and lower arch anchorage. With Aesthetic Start Motivation Strategy, patients achieve short-term lower anterior aesthetic results keeping high motivation and full time aligner and elastic wear during total treatment time.

Clincheck planification and clinical tracking is the key factor for successful finishing cases together with high patient compliance aligner wear.

During the presentation we will review comprehensive Class III complex malocclusions in teen and adult patients and Class III complex malocclusions combined with vertical discrepancies such as anterior open bite or underbite cases.

Around 60% of Dr. Pérez Varela's patients are adults and a significant percentage of them present with skeletal malocclusions. In fact, 25% percent of them present with transversal and sagittal maxillary hypoplasia. He will present cases with different treatment alternatives including a new protocol with minimally invasive procedures using 3D technology, to develop a bone supported customized expander with bi-cortical engagement and surgical guides to facilitate placement of the TADs.

Orthodontic Appliances are no longer just brackets and wires. Technology has ushered in an era of integrated appliance systems, on both vestibular & lingual surfaces as well as removable aligners, that are slowly gaining global acceptance. Integrated systems, however, are marketed by corporations that have financial considerations that sometimes take precedence over science and clinical common sense. This presentation will present a comparative analysis and an experimental clinical audit of contemporary appliance systems and adjuncts from an independent evidence-based perspective.

Complex malocclusions with non-extraction approach are divided in 4 sections.

• Complex crowding malocclusions: The importance of a digital workflow from clinical and x-ray diagnosis integrated into ClinCheck software. A meticulous selection of space achievers: Expansion, Proclination, IPR and Distalization is mandatory in order to achieve successful final results.
• Anterior Open Bite: The type of mechanics involved in anterior open bite closure. Anterior open bites combination with sagital malocclusions will be displayed.
• Clinical and Radiographic Diagnosis and Prognosis of Impacted Canines, the importance of CBCT for minimal invasive surgical approach and the management of auxiliary techniques in ectopic and impacted canine traction in terms of timesaving of the orthodontic treatment.
• Enhanced finishing: ClinCheck software 3D modifications control as a powerful tool for final teeth position and occlusion.