Postmortems in posttreatment adjustment

Abstract

Proper mechanotherapy is important, but it is not the magic wand that produces ideal occlusions forever more. 23 This headlong rush with efficient tooth-moving appliances and mass-extraction techniques to complete orthodontic correction in less and less time may be taking us in the wrong direction. I am confident that, with our dependence on pattern and growth and development, we must turn to a longer period of orthodontic management in many cases. This has been one of our faults. We just do not see these patients long enough. The concept of treating the malocclusion once and then considering it finished is unphysiologic. Other abnormalities of the body are seldom handled in this manner. Thus, the philosophy of a longer period of orthodontic management and responsibility, with two or three shorter periods of orthodontic mechanotherapy, makes sense to me. This seems particularly true when one considers that we are concerned with the dominance of the morphogenetic pattern, the general health picture, the endocrine balance, the growth and developmental pattern, treatment timing, and the role of muscle function and habits, both normal and abnormal. There is one inescapable conclusion from this “reveling in realism”: Unless we recognize and discuss the problems and limitations of orthodontic treatment among ourselves, unless we present the limitations and disadvantages of a particular technique as well as the recommendations for its use, and unless we keep our patients under observation longer and observe the status of the stomatognathic system in its biologic continuum, we cannot expect a realistic and objective appreciation of our efforts by the public or by most general dentists.