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the Complete Review
the complete review - medicine

Removable Orthodontic Appliances

K.G. Isaacson, J.D. Muir, R.T. Reed

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To purchase Removable Orthodontic Appliances

Title: Removable Orthodontic Appliances
Authors: K.G. Isaacson, J.D. Muir, R.T. Reed
Genre: Textbook
Written: 2002
Length: 119 pages
Availability: Removable Orthodontic Appliances - US
Removable Orthodontic Appliances - UK
Removable Orthodontic Appliances - Canada
  • Includes a CD-ROM illustrating clinical cases and basic laboratory procedures
  • Includes dozens of drawings
  • Removable Orthodontic Appliances is: "a combination two previous books: Orthodontic Treatment with Removable Appliances by Houston and Isaacson and Tooth Movement with Removable Appliances by Muir and Reed".

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Our Assessment:

-- : thorough overview of removable orthodontic appliances and their use

See our review for fuller assessment.

Review Summaries
Source Rating Date Reviewer
European J. of Orthodontics . 8/2004 Timo Peltomäki
Journal of Orthodontics . 9/2004 .

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The complete review's Review:

       The use of removable orthodontic appliances was always more popular in Europe than the United States, but even there the use of fixed appliances (using (generally metal) bands and brackets) has largely become the primary method of treatment. Nevertheless, as the authors of Removable Orthodontic Appliances point out, removable appliances are often an effective means of addressing many patients' needs, and in some cases have considerable advantages over fixed appliances. This book offers an introduction to the devices, and covers the principles behind how they function, as well their design and use.
       The most familiar removable device is the retainer, specifically the Hawley or Begg device. Its function, however, is retention -- keeping teeth in their place after the desired tooth-movement has been achieved. Retainers are discussed in this book, too, but the main focus is on removable devices that are used in promoting the desired changes. (Functional appliances are also removable, but different enough in their use and function to warrant separate coverage and are not discussed at any length in this book.)
       The main drawback of removable orthodontic appliances is that they can only apply a tipping force (whereas fixed appliances can also apply a rotating force); this means they are not suitable for the complete treatment of some cases (specifically, serious class II and III cases). Among the big advantages of removable orthodontic appliances is in the area of anchorage (since the palatal area is also used for this), significant since fixed appliances must generally rely on adjacent teeth. (As the authors note, the use of removable appliances generally involves the upper arch; lower arch treatment with them is limited by difficulties with retention and bulk, as well as the limited space available for active components on the appliances themselves.)

       Removable Orthodontic Appliances begins with a brief general introduction, and then discusses the 'Biomechanics of tooth movement'. The third chapter discusses the various active components that can be utilized, and how they function and are integrated into devices, including a variety of springs, bows, and screws.
       The next three chapters survey 'Appliance retention', 'The baseplate', and 'Anchorage', discussing the factors that should be taken into consideration in designing the device, both generally (going so far as to note: "Removable appliances should ideally be fitted within 2 weeks of the impression being taken") and also in tailoring it to the individual case. Anchorage issues, in particular, must be closely monitored from visit to visit, and as the authors point out: "if space is critical it may be wise to plan for extraoral anchorage from the start." Clearly, the use of extraoral anchorage -- headgear, which in the case of removable appliances cannot be cervical (since the pull must be upwards so as not to displace the appliance) -- allows for much greater flexibility in treatment, as headgear can be used as the sole source of anchorage or to reinforce intraoral anchorage, as well as -- as extraoral traction -- be an active component for tooth movement.
       Chapters seven through nine are devoted to the three major classes of malocclusion (I through III), and the use of removable appliances in treating them. In the case of Class I malocclusions removable appliances are particularly useful for space maintenance, as well as in treating local tooth displacements. (As the authors point out, Class II and III cases with similar issues can be treated with similar devices.) In Class II cases, removable devices can be effective in a variety of division 1 cases (though generally not in division 2 cases), while there are only some mild Class III cases where removable appliances are appropriate. The authors show a variety of treatment plans and the design of appropriate appliances, and offer specific points to note regarding many of these cases.
       It is for these chapters that the CD-ROM that comes with the book is of particular use. The chapters themselves are filed with line drawings of the devices and their function, but the CD-ROM offers full colour photographs of more than two dozens actual patient-cases, focussing largely on the actual tooth movement achieved, clearly illustrating what can be achieved.
       Chapter 10 covers 'Chairside management' involving removable appliances. Points to note includes the emphasis on full-time wear, even (or rather: especially) during meals, which contrasts with the widespread tolerance in the US of patients removing retainers when eating.
       Chapter 11 covers 'Retainers', and a final chapter usefully if very briefly addresses 'Problem cases'. Finally, there are three appendices. The first covers 'Laboratory procedures', and again the CD-ROM offers useful additional illustrations (walking the reader through the making of a retainer, for example). The second offers 'Instructions for wearing your removable appliance', the basics for patients -- though in fact the authors are more helpful in addressing possible patient concerns and issues elsewhere in the text. Lastly, there is a quick guide to 'Recommended wire diameters' for both clasps and active components.

       Removable Orthodontic Appliances is an excellent basic resource for students, orthodontists, and dental practitioners, giving a good, broad overview of what can be accomplished with removable appliances and what is involved in putting them to effective use. Their advantages over fixed appliances -- most obviously for space maintenance, but also in many cases where anchorage is an issue -- mean that there will always be cases where it is preferable to use them, and so some familiarity with their use is essential to anyone practising orthodontics. Success with them in other cases -- including but not limited to retraction and palatal expansion -- suggests their use is often worth considering, either in conjunction with or as an alternative to fixed appliance treatment.
       The book also gives a good idea of what is involved in using removable appliances in orthodontic treatment, from their design and fabrication to what practitioners should be particularly alert to, as well as some of the patient issues involved in their use. This is a thorough introduction to the subject, and certainly recommended for all those who may have occasion to consider using removable appliances in their practise (as, presumably, anyone involved in orthodontic practise at some time should).

       Removable Orthodontic Appliances is a book for the student and professional. Richly illustrated and clearly explained, the interested layperson likely can follow most of what is presented here, but the subject-area covered is a relatively limited one, and there is probably relatively little additional information of interest that patients or parents of patients did not obtain either from their treating orthodontist or other, more general texts.

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Other books of interest under review:

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About the Authors:

       K.G. Isaacson, J.D. Muir, and R.T. Reed are consultant orthodontists in England.

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© 2004-2021 the complete review

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