Japanese-Vietnamese school of orthodontics

At Dorotowska Dental Clinic, we draw knowledge and inspiration from the world's top dental specialists. This is also the case with orthodontics. We believe that in some cases the classical orthodontic approach will not solve in the long term the problem with which the patient comes to us. In short, there are situations when an orthodontist alone is not enough in orthodontic treatment, because a broader, interdisciplinary view of the patient is needed.

Orthognathic, or so-called "Japanese-Vienna" orthodontic school. Japanese-Viennese school of orthodontics, is based on an understanding of the interrelationships and mechanisms occurring in the masticatory organ and the assumption that a prerequisite for effective therapy is to find and eliminate the cause of the problem, not just the effect (such as crooked teeth). This approach grows out of the scientific achievements of Japanese orthodontist Prof. Sadao Sato and the work of Austrian prosthetic dentist Prof. Rudolf Slavick.

The basic premise of this modern theory of dentistry is to move away from thinking about orthodontics in mechanical terms and to treat teeth as part of a larger functional system responsible for, among other things, speaking, swallowing or expressing emotions. According to Prof. Sato's philosophy, an orthodontist must treat his task interdisciplinarily and consider it in the context of neurological, otolaryngological or even orthopedic conditions, while any action he takes must be preceded by precise diagnostic studies. Only then will it be possible to achieve positive, and therefore permanent, treatment results.

The key to successful treatment in the Japanese-Austrian school is knowledge of occlusion (the mechanism of occlusion, or in other words, the relationship of the upper dental arch to the lower), as it is this that allows most complications to be avoided. The causes of malocclusion are recognized in disorders of the development of the maxilla and mandible mainly in the vertical (vertical) dimension, and are largely due to an abnormal plane of occlusion. According to Professor Sato, the key to success is to control the inclination of the plane of occlusion of the upper and lower teeth (the so-called occlusal plane) aimed at achieving an optimal relationship between the maxilla and mandible, which ultimately leads to the correct occlusion of the teeth, which will ensure pain-free work of the muscles and temporomandibular joints in the correct ranges of motion.

The primary method of treatment here is control of the occlusal plane, while its planning is always based on cephalometric analysis and conditionlography. Of great importance is the elimination of crowding of teeth in the posterior segment of the maxilla and mandible resulting most often from the presence of retained "eights". If, during treatment, the orthodontist orders the extraction of "eights" or, in some cases, "sevenths" and thus unloads the crowding in the posterior sections and takes advantage of the possibility of changing the height and angle of the plane of occlusion of the teeth (known as occlusion), this is often enough for successful treatment.

The main treatment tool is the dogged wire (MEAW) technique, which allows control of the occlusal plane in three dimensions, but other premium orthodontic wires are also used, such as. GUMMETAL® - a new beta titanium alloy exhibiting excellent rubber properties.

Orthognathic surgical procedures in the Japanese-Vienna school are actually reserved only for patients with skeletal defects of very high severity. In defects of moderate and low severity, compensatory techniques - appendicular, vertical and joint - are used. In some cases, there is no need for retention after treatment, i.e. mechanical maintenance of the effects of treatment by means of various types of removable braces, caps or wires permanently attached to the teeth. For the patient, this provides an additional benefit. According to Professor Sato, the best retainer is the elimination of the causes of malocclusion and natural and correct occlusion, i.e. contact between the upper and lower teeth.

How does the Japanese approach differ from the traditional one?

In classical orthodontics, the goal of treatment appears to be similar to that of the Japanese school, but is achieved with different methods and assumptions. The basic one is that the mandible should be in a touchdown position (in the so-called central relation) without positioning it in space. The causes of malocclusion are attributed to abnormalities in the development of the maxilla and mandible mainly in the horizontal dimension,and in order to unload crowding, it is quite common to remove premolar teeth. Crowding in the posterior sections of the jaws often remains unloaded. No change in the height of the stenosis and no change in the spatial position of the mandible are used to correct skeletal malocclusion. During the planning of orthodontic treatment, very little use is made of conditionlographic diagnosis.

As for treatment methods, only tooth-align compensation is used, consisting of shifting and changing the angle of the teeth with fixed or removable appliances. In this way, abnormally displaced or inclined teeth can be arranged, but without changing the patient's skeletal class. In practice, this can mean no improvement in facial features, leaving many intra-articular abnormalities, and sometimes not achieving good occlusal contacts in the first skeletal class. Therefore, for minor and moderately severe skeletal malocclusion, the consequence of classical orthodontics is often the need for conservative or prosthetic restoration of the occlusion in all teeth, as well as the need for retention, i.e. mechanical maintenance of the effects of treatment. In addition, some of the abnormalities may remain uncorrected after treatment (e.g., disc displacements and crackles). For defects of moderate to severe severity, the continuation of orthodontic treatment by the classical method is quite often followed by orthognathic surgery.

The implementation of orthodontic interdisciplinary management is not always justified. There are situations in which traditional treatment will be indicated. The basic prerequisite is the absence of temporomandibular disorders (no muscle or joint discomfort) and the correct spatial position of the mandible in relation to the skull. The dentition must be healthy and show no signs of pathological wear. The last condition is to achieve perfect occlusion during orthodontic treatment. This situation usually occurs in young healthy patients with healthy dentition treated by a good orthodontist.

At Dorotowska Dental Clinic, orthodontic and prosthodontic treatment according to the theory of the orthognathic school of orthodontics is provided by students and graduates of the VieSID Curriculum, VieSID Continuum Prosthodontics and VieSID Continuum Orthodontics courses:

Dr. Piotr Jurkowski, specialist in prosthodontics

Orthodontist dr. Aleksandra Dabrowska

Orthodontist dr. Aleksandra Wawrzeńczyk

Dental Prosthodontist dr. Anastasia Skąpska

Dental Prosthodontist dr. Daniel Surowiecki