World Federation of Orthodontists guidelines for postgraduate orthodontic education.

Advanced dental education programs in orthodontics and dentofacial orthopedics require an extensive and comprehensive evidence-based experience, which must be representative of the current didactic and technical advancements. Over the past 25 years, the World Federation of Orthodontists (WFO) has placed emphasis in the support for the recognized orthodontic specialty training programs in every region of the world. In its early years, the WFO developed general principles for specialty education that culminated in the first comprehensive curriculum recommendations, i.e., the WFO Guidelines for Postgraduate Orthodontic Education, which was published in February 2009. In view of the significant changes in the specialty of orthodontics, the WFO has revised and updated its previous document to reflect the expanded scope and demands of current orthodontic education and practice. The members of the task force participated in a thorough revision of the guidelines and created a new document that takes into consideration the didactic, clinical, and the appropriate physical facilities to provide clinical care, study, and research areas. Although it is recognized that there will be variations in teaching and faculty assets, as well as facilities, access to materials, and equipment, the aim of the WFO Educational Guidelines is to provide the minimum program requirements necessary to provide orthodontic specialty residents the educational experience that prepares them to deliver the best level of orthodontic treatment for their patients. It is recommended that these guidelines be used universally by orthodontic specialty program educators and related educational, scientific, and administrative institutions to evaluate and compare their curriculum to a world standard.

American Board of Orthodontics: Time for change.

The American Board of Orthodontics (ABO) works to certify orthodontists in a fair, reliable, and valid manner. The process must examine an orthodontist's knowledge, abilities, and critical thinking skills to ensure that each certified orthodontist has the expertise to provide the highest level of patient care. Many medical specialty boards and 4 American Dental Association specialty boards use scenario-based testing for board certification. Changing to a scenario-based clinical examination will allow the ABO to test more orthodontists. The new process will not result in an easier examination; standards will not be lowered. It will offer an improved testing method that will be fair, valid, and reliable for the specialty of orthodontics while increasing accessibility and complementing residency curricula. The ABO's written examination will remain as it is.

Common errors observed at the American Board of Orthodontics clinical examination.

The American Board of Orthodontics has developed tools to help examinees select patients to be used for the Board examination. The Case Management Form can be used to evaluate aspects of a patient's treatment that cannot be measured by other tools. The Case Management Form is a structured treatment-neutral assessment of orthodontic objectives and outcomes associated with a patient's treatment. Despite the availability of this form, examiners continue to see problems, including lack of attention to finishing details, inappropriate treatment objectives, excessive proclination of mandibular incisors due to treatment mechanics, excessive expansion of mandibular intercanine width, closing skeletal open bite with extrusion of anterior teeth leading to excessive gingival display, and failure to recognize the importance of controlling the eruption or extrusion of molars during treatment. In addition, some examinees exhibit a lack of understanding of proper cephalometric tracing and superimposition techniques, which lead to improper interpretation of cephalometric data and treatment outcomes.

A retrospective study of Class II mixed-dentition treatment.

OBJECTIVE: To consider the effectiveness of early treatment using one mixed-dentition approach to the correction of moderate and severe Class II malocclusions. MATERIALS AND METHODS: Three groups of Class II subjects were included in this retrospective study: an early treatment (EarlyTx) group that first presented at age 7 to 9.5 years (n = 54), a late treatment (LateTx) group whose first orthodontic visit occurred between ages 12 and 15 (n = 58), and an untreated Class II (UnTx) group to assess the pretreatment comparability of the two treated groups (n = 51). Thirteen conventional cephalometric measurements were reported for each group and Class II molar severity was measured on the study casts of the EarlyTx and LateTx groups. RESULTS: Successful Class II correction was observed in approximately three quarters of both the EarlyTx group and the LateTx group at the end of treatment. EarlyTx patients had fewer permanent teeth extracted than did the LateTx patients (5.6% vs 37.9%, P < .001) and spent less time in full-bonded appliance therapy in the permanent dentition than did LateTx patients (1.7 ± 0.8 vs 2.6 ± 0.7years, P < .001). When supervision time is included, the EarlyTx group had longer total treatment time and averaged more visits than did the LateTx group (53.1 ± 18. 8 vs 33.7 ± 8.3, P < .0001). Fifty-five percent of the LateTx extraction cases involved removal of the maxillary first premolars only and were finished in a Class II molar relationship. CONCLUSION: EarlyTx comprehensive mixed-dentition treatment was an effective modality for early correction of Class II malocclusions.

Evaluation of posttreatment stability after orthodontic treatment in the mixed and permanent dentitions.

OBJECTIVE: To investigate posttreatment changes in the maxillary and mandibular arches in patients who underwent orthodontic treatment during the mixed and permanent dentitions. MATERIALS AND METHODS: The sample was collected retrospectively from three private practices and consisted of 42 patients who were at least 10 years out of orthodontic treatment. The longitudinal records of study casts and cephalometric radiographs were analyzed to quantify posttreatment changes. RESULTS: Minimal changes in maxillary and mandibular irregularity occurred after an average of 16.98 years from completion of treatment. More than 10 years posttreatment, approximately 81% of the maxillary anterior teeth and 88% of the mandibular anterior teeth showed clinically acceptable incisor alignment (<3.5 mm). Mandibular fixed retainers greatly aided in maintaining the stability of the mandibular incisor alignment. However, posttreatment changes in maxillary incisor irregularity did not appear to be influenced by the presence of a mandibular fixed retainer. When compared with longitudinal changes observed in untreated subjects, the increase in incisor irregularity resembled a pattern similar to the regression line of untreated subjects and seems to be entirely age related. Arch width and arch depth was consistently decreased after treatment, but the magnitude of change was minimal at about 1 mm. No associations were found between any of the cephalometric measurements and changes in incisor irregularities. CONCLUSIONS: Orthodontic treatment stability can be achieved and mandibular fixed retention appears to be a valuable contributor, especially in patients with further growth expected.

Certification renewal process of the American Board of Orthodontics.

The American Board of Orthodontics was established in 1929 and is the oldest specialty board in dentistry. Its goal is to protect the public by ensuring competency through the certification of eligible orthodontists. Originally, applicants for certification submitted a thesis, 5 case reports, and a set of casts with appliances. Once granted, the certification never expired. Requirements have changed over the years. In 1950, 15 cases were required, and then 10 in 1987. The Board has continued to refine and improve the certification process. In 1998, certification became time limited, and a renewal process was initiated. The Board continues to improve the recertification process.

Orthodontic treatment in the early mixed dentition: is this the optimum time to start care?

The age at which children should start orthodontic treatment has been debated amongst orthodontists for many decades. Orthodontists can agree on what is a quality orthodontic result, but disagree as to how and when to best obtain this result Some orthodontists contend that starting treatment in the primary dentition is the most effective means of orthodontic care. Other orthodontists would prefer to begin in the early or late mixed dentition. Still others would rather postpone treatment until the permanent dentition at approximately age 12. This article will evaluate the pros and cons of initiating treatment at different ages.