AREO International Congress 2024

Prepared for EOS 2024 is presented for the first time at the AREO 2024 International Congress. Totally original and new and has never been talked about in orthodontics! Come, see, be surprised and amazed by Alberto Julio Canabez Berthet & Domingo Martín Salvador.

Prepared for EOS 2024 is presented for the first time at the AREO 2024 International Congress. Totally original and new and has never been talked about in orthodontics! Come, see, be surprised and amazed by Alberto Julio Canabez Berthet & Domingo Martín Salvador.

During the workshop we will talk not about aligners but rather about orthodontics. We will stress on our unique diagnostic protocol and demonstrate why it should be vertical first if you want to obtain function and esthetics. The key to success is all about diagnosis. 

This workshop navigates beyond aligners, unveiling the transformative power of a vertically-oriented diagnostic framework in orthodontics.

The ultimate desire of patients seeking orthodontic treatment is the excellent dental and facial esthetics. The orthodontist is a team player in the dental esthetic team, he should be able and is responsible to cooperate with other dental professionals to deliver the best aesthetic results. The treatment results are always superior when there is close communication and planning in various cases requiring the contribution of several disciplines. 

Some strategies important in comprehensive treatment planning will be presented identifying the most common aesthetic finishing factors that can enhance any complimentary dental work. Examples illustrating the difference between multidisciplinary and interdisciplinary treatment will be presented with emphasis on the significance of early consultation with the orthodontist, the patient, and any other dental professional. 

Intended Learning Outcomes: 

• Stress the significance of prior treatment planning before starting any intervention.
• Illustrate the difference between multidisciplinary and interdisciplinary case planning.
• Show examples of comprehensive cases treated in multidisciplinary and interdisciplinary ways.

Managing transposition cases has always been a significant challenge in clinical practice due to the unpredictability and complexity involved. However, despite the challenges, correcting transposed teeth can yield great rewards for both patients and orthodontic professionals. 

This lecture aims to provide a brief overview of the existing literature on transposition management and present clinical cases that highlight the difficulties and excitement encountered during treatment. The supporting biomechanical principles will also be illustrated. By the end of this lecture, attendees will have gained knowledge and skills necessary to effectively manage transposition cases using efficient and simplified techniques. 

Transposing teeth can yield great rewards for both patients and orthodontic professionals when approached with careful planning. 

Learning Objectives: Recognize the relative difficulty of different transposed teeth. Develop guidelines for utilizing different approaches in managing transposition demonstrate how to apply alternative treatment plans when managing with some of the most difficult impactions and transposition.

Traditional rapid palatal expansion methods are known to have side effects, including tooth tipping, a decrease in the thickness of the buccal bone, and a decrease in the height of the bone near the gums, which can result in receding gums. 

The new methods used the mini-screw as a bone anchorage.  We used 15 classical implants and  15 thread length, thread pitch and diameter, thus turns implant surface design, insertion mode, as well as the correlations of these features with stability mini implant. They were  analized two types of rate stability mini implants by measuring the tensile force with a traction machine and the kind of tensions that occur during orthodontic request. The insertion angle of the TADs  can be optimized with a proper evaluation of palate bone morphology, preferably through the use of CBCT scans. 

The most reliable types of orthodontic mini-implants are cylindrical-conical screw-type , with the optimal size of between 8-10 millimeters, one step thread ranging from 0.75 mm 0.80. Using orthodontic implants as temporary anchorage devices (TDA) has revolutionized the biomechanical orthodontic treatment planning, eliminating the problem of losing orthodontic anchorage.  

Key words : CBCT, MARPE, mini-screw, orthodontics, expansion

The use of mini-implants in orthodontics has already secured a well-established place in the daily practice of specialized practitioners. These devices are safe, easy to use, and have a significant impact on clinical practice, which is why many consider them revolutionary for orthodontics.

In the context of digitalization, the possibilities for planning and implementing guided mini-implant insertions open up new opportunities for optimizing and personalizing the orthodontic treatment plan and workflow with them.

With the help of digital technologies, skeletal anchorage can be seamlessly integrated with various orthodontic appliances: from aligners to traditional fixed appliances, expanders, or strictly customized constructions for specific cases.

With the increased demand toward a better facial esthetics, orthognathic surgery has become a key factor in orthodontic treatment planning. Using surgical approach leads sometimes to an abuse if the clinician doesn’t take into consideration some guidelines that could be applied in borderline cases. 

This presentation will try to clarify these guidelines and trace the border between surgery and orthodontics through complex clinical cases management.

Interdisciplinary treatment plans are increasingly common in the practice of everyday dentistry. Cooperation between different dental specialties can offer patients more correct, less invasive, and more aesthetic results. This presentation shows step by step how to design and the stages of the plans multidisciplinary treatment, as well as the motivation behind each stage in this process, which most often it can involve specialties such as periodontology, orthodontics, implantology, minimally invasive prosthetics, and orthognathic surgery.

The maxilla is extremely important in smile aesthetics.  Its correct spatial position and adequate transverse width are among the most important quality components in achieving facial harmony and aesthetics. In adult and adolescent patients, when maxillary sutures are very complicated or closed, there are two possible treatments for the skeletally narrow and/or retruded maxilla: rapid surgically assisted palatal expansion (SARPE) and segmented osteotomy. The ability to intervene on all these components without the need for surgery is an important assist for the orthodontist. In this presentation, using a group of both adolescent and adult patients, we will show how, using three-dimensional MAPA GPS, it is possible to intervene on all these components with high predictability without relying on surgery.

For several treatments the interdisciplinary evaluation contains the success key of the dental and orthodontic therapy. 

A high percentage of subjects diagnosed and planned for an orthodontic treatment need to be treated also for dental shape, size and number discrepancies or for a gummy smile and/or periodontal disease or discrepancy like altered passive eruption. For these patients an interdisciplinary approach starting from a collegial diagnosis and treatment plan is mandatory. Thus for these patients is by merging the orthodontic point of view with the esthetic and functional direct or indirect rehabilitation options and with surgery and periodontal therapy, that it is possible to settle a comprehensive and efficient treatment plan achieving an effective and customized therapy. 

The management of the esthetic areas requires a wide point of view and an integrated approach in order to achieve excellent and proper results accordingly with the patient needs and wishes with different specialists collaborating in order to plan the functional and esthetic rehabilitation.

From the beginning of the orthodontic treatment to its end, managing the space on the arches is a real test. Static analysis can give some suggestions.

With the use of some clinical examples of various types of malocclusions , the steps for planning and guided application of mini screws in the palatal vault will be teached. 

The protocol for applying both miniscrews and orthodontic appliance in one session will be also taught (One Visit Protocol).

In addition, each participant will perform a hands-on section where, using work models, he or she will be able to replicate step by step all the steps in the application of the mini-screws. Small tricks will also be taught to help overcome any doubts and uncertainties.

Facial asymmetries can be assigned to very different causes. These can be functional or dental asymmetries as well as hemifacial microsomia affecting all components of one side, morphologic asymmetries of the mandible like hemimandibular elongation or hemimandibular hyperplasia, asymmetries due to temporo-mandibular joint disorders, cleft lip and palate and asymmetries due to syndromatic diseases. 

In this presentation, the different asymmetries of the mandible with special respect to the hemimandibular elongation and hemimandibular hyperplasia, their characteristics and progress are depicted. 

Diagnostic tools like classical radiography and scintigraphy and a scheme for differential diagnosis of functional, dental and skeletal mandibular asymmetries are given and some treatment proposals are made as a function of the severity of the underlying skeletal asymmetry. Different mechanics and their side effects for purely orthodontic compensation like asymmetric torque of the buccal segments, transverse, frontal and asymmetric sagittal forces, Tweed-mechanics and their combination are explained. The possibilities and limits of such compensations are presented by some clinical cases.

Patients affected by missing teeth in the esthetic zone due to agenesis or transpositions, impacted or retained teeth, tooth malformations such as dilaceration or enamel dysplasia, and the entire range of dental trauma may sometimes require unusual treatment approaches. 

The therapeutic challenge in these patients is to select 1. the most appropriate orthodontic strategy without the need for extremely sophisticated mechanics, 2. to keep treatment time within acceptable limits for not risking iatrogenic damages, e.g. major root resorptions and 3. to avoid the necessity for a future extensive implanto-prosthodontic rehabilitation whenever feasible. 

Simple, but efficient treatment strategies for clinical patients with missing teeth in the upper AND in the lower esthetic zone will be presented to explain the pros and cons of space closure and space opening.

Orthodontists make every possible effort to create full smiles, and non-extraction treatments are becoming increasingly popular among patients. However, dental arch dimensional changes tend to relapse, and this instability is one of the main reasons why non-extraction treatment remains an open question. Key factors guiding the choice between extraction and non-extraction are the amount of crowding and aesthetic concerns, and non-extraction treatment is therefore often indicated in patients with moderate, and sometimes severe, crowding who could benefit from increased lip support. 

This presentation focuses on the rationale for non-extraction treatment and its long-term stability. We compared data from dental casts and lateral cephalograms of patients consecutively treated with a trans-palatal arch in the upper arch and a lip bumper in the lower arch during the mixed dentition stage followed by fixed appliances in the permanent dentition with those of an untreated matched control sample, both during treatment and at long-term follow-up. Arch widths, perimeters, and lengths as well as crowding and incisor proclination were evaluated. In the treated group, upper and lower dimensional changes improved significantly after treatment with trans-palatal arch and lip bumper before the application of braces, whereas only minor increases were recorded after fixed appliance treatment. At long-term follow-up, all the arch widths were slightly decreased, with a 0.4 millimeter increase in crowding, considered clinically irrelevant. However, overall dental arch changes remained stable. The best predictors of relapse and long-term stability were also evaluated.

Does the profound intersection of orthodontics and TMJ  still resonate as a cornerstone in our professional perspective? 

This presentation illuminates the connection between class II malocclusions and TMJ health. 

In Europe and also in Romania class II malocclusion stands as the most prevalent malocclusion. We will dissect the distinctive features of class II cases and delve into effective treatment modalities regarding also TMJ health. Through a meticulous exploration of anatomical, biomechanical and orthodontic constrains, join us in unraveling the key objectives aimed at achieving not only aesthetically pleasing outcomes, but also ensuring long term stability of the temporomandibular joint complex.

The absence of the upper lateral incisor is one of the most common agenesis encountered in the dental office, representing a clinical problem that affects both functionality and aesthetics.

Regardless of the chosen therapeutic approach (closing or opening the space), for the best results, collaboration between doctors with different dental specializations (orthodontist, surgeon, prosthetist, etc.) is necessary.

Aesthetics is becoming more and more frequently the reason for visiting the orthodontic office. Digital dentistry can help us address aesthetic requirements with more predictability and control, facilitating communication between different collaborating doctors, and between doctors and patients alike, offering results that mimic the natural.

Embark on an illuminating journey into the future of dentistry, where the seamless integration of diverse disciplines unfolds in a digital realm. This lecture explores the transformative impact of technology on elevating awareness and enhancing the quality of dental care. Focusing on the groundbreaking synergy between implants and clear aligner treatments, we'll unravel their applications in replacing edentulous areas, managing congenitally missing bicuspids, and providing effective orthodontic anchorage.

Discover the collaborative potential of implantology and clear aligner therapy, where their combined use creates a unified approach to comprehensive patient care. Through illuminating case studies and insights into advanced digital workflows, witness how this multidisciplinary integration shapes the future of dentistry. Embrace a new era where technology and diverse expertise converge to redefine precision, efficiency, and patient satisfaction in dental practice.

We are going through a period in which more and more patients turn to specialists and request aesthetic, comfortable and short-term orthodontic treatments. 

Technological progress and the online environment have made patients as well informed as possible, and they want affordable and fast treatments. Aligners offer us a good treatment option, but what do we do with complex cases? Can we achieve treatment objectives with hybrid tehniques? 

In my presentation I will show several cases where the association between aligners and corticotomies led to a predictable result, shorter treatment time, and successfully achieved therapeutic goals.

Embark on a dynamic three-hour workshop that unravels the intricacies of digital dentistry, spanning advanced imaging, treatment planning, Interproximal Reduction (IPR), and the seamless integration of engagers. This hands-on session equips participants with comprehensive skills, guiding them from digital imaging to the biomechanical planning and practical application of IPR techniques and engagers within the digital workflow.

Highlights:

Digital Imaging Mastery: Explore advanced techniques in digital imaging, including intraoral scanning & learn to interpret and leverage high-quality digital images for precise diagnosis and treatment planning.

Digital Treatment Planning: Navigate through digital treatment planning software to enhance case analysis and visualization. Incorporate 3D virtual models for accurate and efficient treatment plans.

Interproximal Reduction (IPR) Techniques:  Showcase the most advanced IPR techniques in a live demonstration. Provide hands-on practice for participants to master IPR applications.

Engagers Integration:  Integrate biomechanical planning into the digital workflow for optimal engager placement.  Explore best practices for engager placement, removal during treatment, and revisions.

Collaborative Multidisciplinary Approach: Foster collaboration among workshop participants representing various dental specialties. Discuss real-world case studies involving IPR and engagers, engaging in collaborative decision-making processes.

Learning Objectives. By the end of this workshop, participants will: Master advanced digital imaging techniques for comprehensive patient assessment. Competently navigate digital treatment planning software to create precise and tailored treatment plans. Acquire practical skills in advanced Interproximal Reduction (IPR) techniques. Understand the biomechanical planning and integration of engagers into the digital workflow. Develop best practices for engager placement, removal, and management during treatment and revisions.

Join us for this comprehensive workshop to elevate your proficiency in digital dentistry, IPR techniques, and engagers integration, providing valuable insights for enhanced patient care in your practice.

Orthodontic treatment of impacted teeth cannot be a “cookbook”. 

Although the results can be excellent, treatment is complicated, usually long and requires one or several surgical interventions. Manifold reasons can cause failure, such as inaccurate positional diagnosis, missed resorption of adjacent teeth, wrong mechanotherapy, surgical mistakes and more. The risk of failure increases with the severity of impaction. 

In this presentation, several difficult impaction cases will be utilized to illustrate the step-by-step decision-making process which can help the clinician make the most thoughtful treatment decision, highlighting the importance of early diagnosis and timing, gathering of comprehensive pretreatment data, assessing treatment alternatives, weighing the evidence and critically reviewing the decision and its consequences. 

In the treatment of adult patients, we often times face abraded teeth that compromise the esthetics in the frontal area by having shorter crown length, compensatory eruption and a higher exposure of the gingiva. In order to have a pleasing esthetic result in the end of treatment, the interdisciplinary team has to have a clear vision and planning of the final positioning of the gingival margins, together with the desired proportions of the teeth and especially the desired level of the final incisal margins. 

Here plays the orthodontist a key role in generating these three dimensional positions of the abraded teeth in these complex cases and therefore allowing the prosthodontist to be as minimally invasive as possible. The aim of this presentation is to go through the thinking and planning steps in these particular cases using clinical cases to exemplify and discuss different strategies and outcomes.

Treatments with aligners differ in many ways from those with fixed appliances. Sometimes it can be frustrating not to reach our finishing objectives, to which we were accustomed with our conventional treatments. 

What are the essential differences that we must take into account? What factors must we take into consideration? Are you afraid to treat more complex cases because you are not confident of reaching your treatment standards? How to reconcile esthetic and functional objectives? Is it possible to achieve a good finish in a reasonable time, without going on forever with refinements? 

Today we have the most advanced digital tools that allow us to plan in a tremendously precise way. We will look at some of the keys involved in diagnosis, planning, follow-up and finishing, so that finishing well... does not become hell.

Patients’ expectations nowadays have changed, they have become more focused on esthetic outcome, as well as paying more attention to details. 

A beautiful smile and a correct occlusion without improving facial features are not satisfying our patients’ demands anymore. If a skeletal malocclusion is diagnosed, a complete treatment plan must address it. 

The ortho-surgical treatment becomes more complicated when teeth are affected, have an incorrect aspect or are absent, cases in which a multidisciplinary approach is required. The prosthodontist becomes the coordinator of the team by creating clear guidelines for the orthodontic and surgical treatment, through a prediction of the final result. 

This presentation will be looking at the treatment sequence followed in our clinic for patients with skeletal malocclusions, where the orthodontist-surgeon-prosthodontists team is involved from beginning to end.

TBA

The paraclinical investigations currently used for the diagnosis of the dento-maxillary joint can be supplemented by morphological and functional hybrid imaging. The aim of this presentation is to bring into attention the necessity and to understand the importance of paraclinical and clinical investigations availabile. 

Healthcare providers should have possibility and instruments, like guidelines to answer specific questions in day-to-day practice and as an information source for continuing professional education.