**First chapter: Introductory chapter - Innovations in Orthodontics written by Belma IŞIK ASLAN & Fatma Deniz UZUNER**

**Second chapter: 'Ceramic Brackets Revisited' written by Elekdag-Türk S. and Abulkbash H.** This chapter provides information about aesthetic brackets. This comprehensive review covers the physical properties as well as rebonding and debonding of polycrystalline and monocrystalline ceramic brackets. Furthermore, this review aims to present the advantages and disadvantages as well as the refinements of these brackets since their introduction in the late 1980s.

and Sagittal Split Ramus osteotomies. He mainly emphasizes the use of piezoelectric sur‐ gery rather than rotary instruments, and how surgical saws supply bloodless and neuro sen‐ sorial deficits free operations. The chapter ends with the future of orthognathic surgery and

**Ninth chapter: 'Ortho-surgical Management of Severe Vertical Maxillary Excess (Gummy Smile)' written by Saleh F. and Al Hamadi W.** In this chapter, the authors review the treat‐ ment alternatives for excessive gingival display. They present clinical cases. The authors em‐ phasize the orthosurgical treatment of severe vertical maxillary excess as the optimal solution to restore facial balance and harmony, an attractive smile, and patient satisfaction. **Tenth chapter: 'Surgery First Approach' written by Gülşen A.** This chapter focuses on the advantages and treatment plan of SFA. The author provides information about the time for orthodontic bonding and force application in detail. The reasons of relapse in SFA are em‐

**Eleventh chapter: 'Orthodontics in Relation to Alveolar Bone Grafting in Patients with CLP' written by Uzel A.** In this chapter, the current orthodontic approaches in relation to alveolar bone grafting (ABG) in cleft patients are discussed. The factors for success of the graft are defined. The periodontal health of the surrounding graft tissues, the experience and ability of the surgeon, the timing of surgery, and orthodontic management of the cleft area before and after grafting are underlined. The chapter carries on with the treatment se‐ quencing for pre-graft orthodontics, post-graft stabilization, and post-graft orthodontics. The chapter ends with the explanation of unfavorable conditions including wide alveolar

**Twelfth chapter:** '**Contemporary Treatment Approaches to Obstructive Sleep Apnea Syn‐ drome' written by Oğuz H.T.** This chapter presents the current information about etiology, diagnostic tools, treatment alternatives of obstructive sleep apnea, and introduces dental sleep medicine to orthodontists. This chapter starts with the diagnosis and classification of Obstructive Sleep Apnea Syndrome and continues with epidemiology and etiology of this syndrome according to contemporary literature. Detailed information about the treatment

We would like to thank all the authors and Ms. Dolores Kuzelj and all the staff who took a

**Assoc. Professor Belma Işik Aslan and Assoc. Professor Fatma Deniz Uzuner**

Department of Orthodontics

Turkey

Preface IX

Gazi University, Faculty of Dentistry

cleft, late one grafting/prolonged orthodontic treatment, and unstable premaxilla.

options is given. The role of orthodontist is stressed in the chapter.

related technologic developments.

phasized at the end of the chapter.

role in the production of this project.

**Third chapter: 'Accelerated Orthodontics' written by Patil A.K. and Maan A.S.** In this chapter, the authors summarize the methods of accelerated tooth movements by means of pharmacological, surgical, and physical methods. The pharmacological agents (prostaglan‐ din E2 and E1, 1,25-dihydroxycholecalciferol, parathyroid hormones etc.) that act as biomo‐ dulators for increased orthodontic tooth movement are discussed. Surgical methods are categorized as periodontally accelerated osteogenic orthodontics, piezocision, and micro-os‐ teoperforations. Physical methods such as the vibratory stimulus, low level laser therapy, and low-intensity pulsed ultrasound are defined. A novel device, AcceleDent, is described as an example for vibratory stimulus.

**Fourth chapter: 'The Role of Cytokines in Orthodontic Tooth Movement' written by Vu‐ jacic A**. This chapter focuses on existing knowledge about the roles and dynamics of the change in three cytokines (*IL -1β, IL-б,* and *TNF*) simultaneously during the early stage of orthodontic tooth movement. Detailed information about orthodontic tooth movement and biological mechanisms of reshaping the mechanic-sensitive dental tissue is provided. The chapter discusses the benefit of pharmacological modulation of the tooth movement, espe‐ cially the aspect that leads the acceleration of the process of tooth movement in the connec‐ tion with the local application of cytokines.

**Fifth chapter: 'Advances in Orthodontic Tooth Movement: Gene Therapy and Molecular Biology Aspect' written by Atsawasuwan P., Shirazi S.** This chapter starts with general in‐ formation about the biology of tooth movement. Detailed information about the molecular mechanism of orthodontic tooth movement is presented. The authors discuss how advances in gene therapy and molecular biology technology will shape the future of orthodontic treat‐ ment. The authors also emphasize the future genetic manipulation of tooth movement.

**Sixth chapter: 'Micro-osteoperforations' written by Bolat E.** This chapter discusses microosteoperforations (MOPs), which is a recent, reliable, repeatable, and minimally invasive method to stimulate alveolar bone remodeling without the disadvantages of surgery; such as the requirement of corticotomies, cuts in cortical bone, raising split-thickness flap, and decorticating the bone. Informative details about the biological basis of orthodontic tooth movement, accelerated tooth movement techniques, and application methods are men‐ tioned. The author describes the advantages, disadvantages, effects, and possible side effects of micro-osteoperforations based on recently published literature.

**Seventh chapter**: '**Stability of Diastema Closure after Orthodontic Treatment' written by Carruitero M.J., Janson G.** This chapter seeks to evaluate the recurrence of upper interincis‐ al diastemas, the factors associated with the relapse and stability, some treatment proposals, and considerations for retention. The chapter starts with the definition and epidemiology of diastemas and carries on with the development of diastemas related to the development of occlusions. The readers can benefit from practical strategies that can be applied in clinical practice to provide stability.

**Eight chapter:** '**Current Approaches in Orthognathic Surgery' written by ATAÇ S. M.** This chapter provides information about commonly used orthognathic surgery techniques to solve deformity problems of the facial skeleton. In this comprehensive chapter, the author shared his personal experience and some technical details concerning Le fort I osteotomy

and Sagittal Split Ramus osteotomies. He mainly emphasizes the use of piezoelectric sur‐ gery rather than rotary instruments, and how surgical saws supply bloodless and neuro sen‐ sorial deficits free operations. The chapter ends with the future of orthognathic surgery and related technologic developments.

and disadvantages as well as the refinements of these brackets since their introduction in the

**Third chapter: 'Accelerated Orthodontics' written by Patil A.K. and Maan A.S.** In this chapter, the authors summarize the methods of accelerated tooth movements by means of pharmacological, surgical, and physical methods. The pharmacological agents (prostaglan‐ din E2 and E1, 1,25-dihydroxycholecalciferol, parathyroid hormones etc.) that act as biomo‐ dulators for increased orthodontic tooth movement are discussed. Surgical methods are categorized as periodontally accelerated osteogenic orthodontics, piezocision, and micro-os‐ teoperforations. Physical methods such as the vibratory stimulus, low level laser therapy, and low-intensity pulsed ultrasound are defined. A novel device, AcceleDent, is described

**Fourth chapter: 'The Role of Cytokines in Orthodontic Tooth Movement' written by Vu‐ jacic A**. This chapter focuses on existing knowledge about the roles and dynamics of the change in three cytokines (*IL -1β, IL-б,* and *TNF*) simultaneously during the early stage of orthodontic tooth movement. Detailed information about orthodontic tooth movement and biological mechanisms of reshaping the mechanic-sensitive dental tissue is provided. The chapter discusses the benefit of pharmacological modulation of the tooth movement, espe‐ cially the aspect that leads the acceleration of the process of tooth movement in the connec‐

**Fifth chapter: 'Advances in Orthodontic Tooth Movement: Gene Therapy and Molecular Biology Aspect' written by Atsawasuwan P., Shirazi S.** This chapter starts with general in‐ formation about the biology of tooth movement. Detailed information about the molecular mechanism of orthodontic tooth movement is presented. The authors discuss how advances in gene therapy and molecular biology technology will shape the future of orthodontic treat‐ ment. The authors also emphasize the future genetic manipulation of tooth movement.

**Sixth chapter: 'Micro-osteoperforations' written by Bolat E.** This chapter discusses microosteoperforations (MOPs), which is a recent, reliable, repeatable, and minimally invasive method to stimulate alveolar bone remodeling without the disadvantages of surgery; such as the requirement of corticotomies, cuts in cortical bone, raising split-thickness flap, and decorticating the bone. Informative details about the biological basis of orthodontic tooth movement, accelerated tooth movement techniques, and application methods are men‐ tioned. The author describes the advantages, disadvantages, effects, and possible side effects

**Seventh chapter**: '**Stability of Diastema Closure after Orthodontic Treatment' written by Carruitero M.J., Janson G.** This chapter seeks to evaluate the recurrence of upper interincis‐ al diastemas, the factors associated with the relapse and stability, some treatment proposals, and considerations for retention. The chapter starts with the definition and epidemiology of diastemas and carries on with the development of diastemas related to the development of occlusions. The readers can benefit from practical strategies that can be applied in clinical

**Eight chapter:** '**Current Approaches in Orthognathic Surgery' written by ATAÇ S. M.** This chapter provides information about commonly used orthognathic surgery techniques to solve deformity problems of the facial skeleton. In this comprehensive chapter, the author shared his personal experience and some technical details concerning Le fort I osteotomy

of micro-osteoperforations based on recently published literature.

late 1980s.

VIII Preface

as an example for vibratory stimulus.

tion with the local application of cytokines.

practice to provide stability.

**Ninth chapter: 'Ortho-surgical Management of Severe Vertical Maxillary Excess (Gummy Smile)' written by Saleh F. and Al Hamadi W.** In this chapter, the authors review the treat‐ ment alternatives for excessive gingival display. They present clinical cases. The authors em‐ phasize the orthosurgical treatment of severe vertical maxillary excess as the optimal solution to restore facial balance and harmony, an attractive smile, and patient satisfaction.

**Tenth chapter: 'Surgery First Approach' written by Gülşen A.** This chapter focuses on the advantages and treatment plan of SFA. The author provides information about the time for orthodontic bonding and force application in detail. The reasons of relapse in SFA are em‐ phasized at the end of the chapter.

**Eleventh chapter: 'Orthodontics in Relation to Alveolar Bone Grafting in Patients with CLP' written by Uzel A.** In this chapter, the current orthodontic approaches in relation to alveolar bone grafting (ABG) in cleft patients are discussed. The factors for success of the graft are defined. The periodontal health of the surrounding graft tissues, the experience and ability of the surgeon, the timing of surgery, and orthodontic management of the cleft area before and after grafting are underlined. The chapter carries on with the treatment se‐ quencing for pre-graft orthodontics, post-graft stabilization, and post-graft orthodontics. The chapter ends with the explanation of unfavorable conditions including wide alveolar cleft, late one grafting/prolonged orthodontic treatment, and unstable premaxilla.

**Twelfth chapter:** '**Contemporary Treatment Approaches to Obstructive Sleep Apnea Syn‐ drome' written by Oğuz H.T.** This chapter presents the current information about etiology, diagnostic tools, treatment alternatives of obstructive sleep apnea, and introduces dental sleep medicine to orthodontists. This chapter starts with the diagnosis and classification of Obstructive Sleep Apnea Syndrome and continues with epidemiology and etiology of this syndrome according to contemporary literature. Detailed information about the treatment options is given. The role of orthodontist is stressed in the chapter.

We would like to thank all the authors and Ms. Dolores Kuzelj and all the staff who took a role in the production of this project.

> **Assoc. Professor Belma Işik Aslan and Assoc. Professor Fatma Deniz Uzuner** Department of Orthodontics Gazi University, Faculty of Dentistry Turkey

**Chapter 1**

**Provisional chapter**

**Introductory Chapter: Innovations in Orthodontics**

In the present day, orthodontic treatment not only meets the demand for functional harmony in occlusion and the improvement of the esthetic appearance but also should be completed in the most efficient time accepted by the patient and the orthodontist. Living in a fast-paced world leads to a great interest in the techniques decreasing the orthodontic treatment duration.

Various clinical techniques were introduced for accelerated orthodontic tooth movement, including local injection of cellular mediators [1], physical or mechanical stimuli [2], and surgically assisted orthodontics [3, 4]. The rate of orthodontic tooth movement is under the control of molecular mechanisms regulating cellular behavior in the alveolar bone and in the periodontal ligament [5–7]. Therefore, it is essential to identify and control cellular regulators to safely shorten the duration of orthodontic treatment. In addition to the local injection of cellular mediators, with the rise of advanced technology in biomedical engineering and medicine, gene therapy will be a promising method in the future for accelerated tooth movement. The common physical methods used in the present day are vibratory stimulus, low-level laser

For surgically assisted orthodontic techniques, the current surgical methods being practiced are periodontally accelerated osteogenic orthodontics, piezocision, and micro-osteoperforations. Micro-osteoperforations have emerged as a new, minimally invasive, easy-to-use, reproducible, and effective method that eliminates some of the disadvantages of surgery such as the requirement of corticotomies, cuts in cortical bone, raising split-thickness flap, and decorticat-

Today, multidisciplinary treatment procedures are taking more place in orthodontics. The treatment of skeletal discrepancies requires orthognathic surgery in combination with orthodontic treatment to improve malocclusion, function, facial, and smile esthetics. The improvement in

**Introductory Chapter: Innovations in Orthodontics**

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

DOI: 10.5772/intechopen.84694

Belma Işık Aslan and Fatma Deniz Uzuner

Belma Işık Aslan and Fatma Deniz Uzuner

http://dx.doi.org/10.5772/intechopen.84694

**1. Innovations in orthodontics**

therapy, and low-intensity pulsed ultrasound.

ing the bone [7].

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

#### **Introductory Chapter: Innovations in Orthodontics Introductory Chapter: Innovations in Orthodontics**

DOI: 10.5772/intechopen.84694

Belma Işık Aslan and Fatma Deniz Uzuner Belma Işık Aslan and Fatma Deniz Uzuner

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.84694
