Schupp / Haubrich Aligner Orthodontics and Orofacial Orthopedics

2. Auflage 2023
ISBN: 978-3-86867-655-6
Verlag: Quintessenz
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 672 Seiten

This book presents useful tips and strategies on how to integrate aligner orthodontics successfully into clinical practice, whether outsourced or with in-office aligner treatment. This second edition sees the authors review the diagnostic protocols and the biomechanics of aligners before presenting aligner orthodontics protocols. Supported by accompanying case documentation, the discussion of each malocclusion includes information on the associated symptoms, the rationale behind the selected treatment approaches, and the various outcomes achieved. The separation into sections on each malocclusion helps patients and clinicians in deciding whether this system can provide optimal treatment outcomes for a particular clinical situation. This is a practical manual for any clinician interested in the treatment modality of aligner orthodontics.

Autoren/Hrsg.

Schupp, Werner

Haubrich, Julia

Fachgebiete

• Medizin | Veterinärmedizin Medizin | Public Health | Pharmazie | Zahnmedizin Zahnmedizin

Inhaltsverzeichnis

Contents
Chapter 1. Physiology and functional neuroanatomy of the temporomandibular system and musculoskeletal system
Chapter 2. Biomechanical aspects of tooth movement with aligners
Chapter 3. Diagnostics
Chapter 4. Treatment planning and treatment with aligners
Chapter 5. Treatment of different malocclusions with different aligner systems
Chapter 6. Advantages of aligner orthodontics
Chapter 7. Avoid global warming and plastic waste

Leseproben

1
PHYSIOLOGY AND FUNCTIONAL NEUROANATOMY OF THE TEMPOROMANDIBULAR SYSTEM AND MUSCULOSKELETAL SYSTEM
The nervous system, with its peripheral and central portions, is a complex and coherent system which can be divided into individual blocks, communication though inseparable. The central nervous system (CNS) requires information from the periphery to plan the motor activities and functions and be able to control these. Considering the motor cortex in the precentral gyrus and somatotopic representation of the contralateral muscles (homunculus) as well as the sensory portion, a significant proportion of the temporomandibular system (TMS) drops directly into the eye area (Fig 1-1). Many actions are done unconsciously. Most of the information from the TMS is processed in the brain stem, the trunk encephali, consisting of the midbrain (mesencephalon), bridge (pons), and prolonged spinal cord (medulla oblongata). The basal ganglia are an integral part of the motor system, which become highly active already directly after birth.1, 2 Fig 1-1 Motorized primary field of the gyrus precentralis. Graphic: Lovric & Bohr from Boisserée, Schupp, Kraniomandibuläres and Musculoskeletal System, courtesy Quintessence Publishing.2 The function of the basal ganglia
The subcortical basal ganglia are involved in many processes such as perception, learning, memory, attention, motor function and select central inputs and outputs, both of a cognitive and emotional nature, to maintain stability with change, namely allostasis.3–6 For our human survival, its selection of movements and establishment of a corresponding sequence of movements to our current context of events is indispensable.7 The basal ganglia are directly involved in this process. The basal ganglia return on existing patterns of movement and save new movement patterns by repeating the new patterns. The basal ganglia select, sort, and integrate congenital learned movement patterns associated with cognitive and emotional mental information.7 Directed motility controls the flow of directed voluntary movements. The interaction of sensorimotor regions in the nervous system, in compliance with the basal ganglia in voluntary movements, is shown in Figure 1-2.8 The center for purposeful movement is the subcortical motivation area. Further processing takes place simultaneously and is rational in the frontal cortex and emotional in the limbic cortex. There is thus no muscular activity without the influence of the limbic system. Regarding the associative cortex, the advance takes place in the basal ganglia, the nucleus tegmental pedunculopontine informs among others the cerebellum, but also the cortex, basal ganglia, and thalamus according to an “integrated interface.” The nucleus tegmental pedunculopontine is connected to motor nuclei in the brain stem and spinal cord.9, 10 From the thalamus the information enter into the brain stem and from there via the dorsolateral pathways of the spinal cord to the muscle that performs the idea. An immediate feedback follows as somatosensory information into the cerebellum, the associative, and in the limbic cortex. Fig 1-2 Planning process of directed motility in consideration of the basal ganglia, modified by Rettig.8 Immediate feedback from the muscle follows as somatosensory information into the cerebellum and into associative and limbic cortec (black arrows). The basal ganglia receive their input from the sensory organs, from the muscles, tendons, and other deep somatic tissues, as well as from connective tissues. This information of the cortex is communicated to the basal ganglia via the thalamus. Cortical areas of the orbitofrontal cortex, the anterior cingulate cortex, the lateral prefrontal cortex, and areas of the motor cortex control striatal core areas, which lie in the dorsolateral and ventromedial caudate nucleus, in the putamen and nucleus accumbens, and which are connected to the globus pallidus as a starting region of the basal ganglia area (Fig 1-3). The globus pallidus communicates with the ventral and medial thalamic nuclei, which mediate a rear projection to cortical output structures.11 The basal ganglia decide after receiving this information whether a motor, an emotional, motivational, or cognitive instruction takes place or not. The selection is made according to the criteria of maintaining allostasis. Beyond the direct interconnection in the basal ganglia, the activity is increased in the thalamus, and inhibited via indirect and hyperdirect interconnection in the basal ganglia. The resulting net income determines accordingly whether the stimulation of a motor, emotional–motivational, or cognitive region in the cortex takes place or not. Fig 1-3 Basal ganglia interconnection in detail, Indirect way: inhibiting; Direct way: exciting; Hyperdirect way: inhibiting. mod. Asan15 with courtesy of Damir del Monte (www.damirdelmonte.de) (cortex, limbic cortex, cortical areas, basal ganglia, and thalamus are connected underneath in three loops: 1. Direct, exciting way; 2. Indirect, inhibitory way, 3. Hyperdirect, inhibitory way, formatio reticularis = spinal cord). Without the involvement of the basal ganglia, the motor cortex areas cannot trigger or control any voluntary movement. The basal ganglia prepare any directed motility and control it. This is where the implementation of the cortical motion planning into specific exercise programs happens. These exercise programs control the development of power, direction, and speed of a movement sequence. A further function of the basal ganglia is the emotional and motivational influence of action preparation and action selection on limbic shares. Under the influence of the limbic system, the process of selection of action, inhibiting unwanted and finally the activation of desired action sequences is carried out here.12–14 The basal ganglia are positioned exclusively subcortically. The cortex radiate fibers into the basal ganglia from widely distributed areas. From here, they go through the thalamus back to the cortex, resulting in a bowing movement – which is why they are called “loops.” Cortical areas, the basal ganglia, and the thalamus are thus connected in the form of loops together. Complex conscious planning, unconscious and involuntary motor experience, and emotional aspects draw circles on parallel tracks between cortex, basal ganglia, thalamus, and cortex. This parallel processed information produces an activation, which is the basis of voluntary movement. According to their different functions, the fibers are divided into five separate tracks, which are grouped into two systems12: The motoric dorsal lap The limbic ventral lap The basal ganglia consist of (mod. according to Asan12,15): Striatum Striatum dorsale Nucleus caudatus (main part) Putamen (main part) Striatum ventrale Nucleus caudatus (ventral) Nucleus accumbens Putamen (ventral) Pallidum Pallidum laterale (dorsal, ventral) Pallidum mediale (dorsal, ventral) Associated nuclei Nucleus subthalamicus Substantia nigra In the basal ganglia interconnection, three routes can be distinguished: direct, exciting way the indirect, inhibitory way the hyperdirect, inhibitory way The direct, exciting path projects by GABAergic neurons (inhibiting) go from the striatum to the globus pallidus medial, as well as into the substantia nigra pars reticularis. From there, the forwarding occurs via GABAergic neurons into the thalamic nuclei. The concatenation of two inhibitory neurons leads to a disinhibition, which is an excitation of thalamic nuclei. The indirect, inhibiting path of the striatum projects to the external, lateral pallidum segment, which inhibits the subthalamic nucleus with GABAergic neurons. The subthalamic nucleus acts via neurotransmitter glutamate excitation to the pallidum media, which thereby inhibits movement impulses in the thalamic nuclei.8, 12 The hyperdirect, inhibiting pathway acts via the striatum, pallidum laterale, and nucleus subthalamicus to the medial pallidum. The nucleus accumbens (Fig 1-2) includes afferents to the limbic system, making an integrative interface between the basal ganglia and limbic system. It plays an important role in pleasurable and motivational states and therefore is considered an antagonist of the amygdala, which processes mainly negative key stimulus.12 The striatum and the subthalamic nucleus, as two separate structures, give input into the basal ganglia. Both play a role in motor control, but also in cognitive function.16 The cognitive loop runs from the prefrontal cortex to the nucleus caudatus and from there parallel to the motor loop over the substantia nigra, globus pallidus, and anteroventral thalamic nuclei back to the prefrontal cortex.17 The efferent connection of the basal ganglia occurs via globus pallidus and substantia nigra with structures, which initiate movements as well as physiological and cognitive processes. Typically, an inhibitory effect takes place. The basal ganglia thus inhibit...

Über Autor(innen)

Dr. Schupp graduated in dentistry in 1985 from the University of Münster and continued his studies here as a postgraduate student of orthodontics under the direction of Prof. Dr. U. Ehmer. Collaboration in the orthodontic private practice of Dr. D.E. Toll followed and since 1990, he has been in private practice as an orthodontics specialist in Cologne, Germany. In his office, over 6000 patients have been treated with aligner orthodontics. He is certified in Manual Medicine and Osteopathy for Orthodontics. Dr. Schupp is a founding member and past president of the German Board of Orthodontics and Orofacial Orthopedics, and a board member of the German Society of Aligner Orthodontics (DGAO). He is also the founder and editor-in-chief of the Journal of Aligner Orthodontics (JAO) and an advisory board member for the periodical Manuelle Medizin. He has published various articles concerning orthodontics, function, and pain therapy. He has written the books Funktionslehre in der Kieferorthopädie and Kraniomandibuläres und muskuloskelletales System, as well as the first edition of Aligner Orthodontics, published in 2016 (Quintessence Publishing) and translated in several languages. Dr. Schupp is also visiting professor at the Capital University, Beijing, China.

Dr. Haubrich studied dentistry at the University of Freiburg (Albert Ludwigs Universität) graduating in 2001. After working as a general dentist, she began her postgraduate studies in orthodontics in the private practice of Dr. Werner Schupp from 2003 to 2005, continuing her studies at the University of Berlin (Charité Universität) under the direction of Prof. Dr. R.R. Miethke. Since becoming a certified specialist of orthodontics in 2007, she has been collaborating with Dr. Werner Schupp and Dr. Bahareh Wymar in a private practice in Cologne, Germany. She is co-author of the book Funktionslehre in der Kieferorthopädie (2012), and has published several articles concerning orthodontic aligner therapy in children, function and pain therapy published in national and international journals. She is associate editor of the Journal of Aligner Orthodontics (JAO) and lecturer for the University of Vienna, Austria. Dr. Haubrich is a clinical speaker for Align Technology since 2005, and is a board member and Conference President of the German Society of Aligner Orthodontics (Deutsche Gesellschaft für Aligner Orthodontie, DGAO).