Adrian BECKER, Professor Emeritus at Hadassa University in Jerusalem, was one of the renowned guest speakers at the recent Journées de l'Orthodontie. He brilliantly led the post-congress course on impacted teeth.
He is the author of a reference work on the subject, entitled "Orthodontic Treatment of Impacted Teeth". The third version, published by Wiley-Blackwel in 2012, is remarkable in more ways than one.
The management of impacted maxillary canines is, of course, of paramount importance. The author emphasizes the value of three-dimensional imaging, particularly in cases of root proximities with neighboring incisors: depending on the extent of resorptions observed, he considers whether or not to undertake orthodontic traction, taking care to remove the danger as quickly as possible
.
A fascinating discussion ensued on the pros and cons of the various surgical protocols. Adrian Becker, for his part, favors a minima surgery with repositioning of the flap to promote optimal healing of the gingiva. The quality of the periodontal results obtained with this technique
known as "closed surgery" can be appreciated through the presentation of numerous clinical cases.
But the author doesn't limit himself to canines: all teeth are examined with a fine-tooth comb. An entire chapter is devoted to maxillary impacted central incisors, whose roots may be dilacerated as a result of early childhood trauma. Rarely has the subject been treated with such rigor and precision, whether in terms of etiopathogeny, diagnosis or treatment.
Multiple inclusions are also discussed, in the context of local pathologies - cysts - or general pathologies - cleidocranial dysplasia.
Professor Becker teaches us to be patient and to break down movements: the results obtained in the end are truly impressive.
Finally, an entire chapter is devoted to the causes of failure. Particular attention is paid to anchoring management.
From this point of view, mini-screws and
mini-plates offer interesting prospects, particularly for the most complex cases.
In 446 pages, the author passes on over 40 years' experience in the field of impacted teeth.
His teaching is rich and dense, illustrated by a vast iconography and supported by a recent and relevant literature review. Adrian Becker runs a website devoted to all the problems posed by impacted teeth. The site is aimed not only at orthodontists worldwide, but also at
patients and their parents seeking information on this subject.
www.dr-adrianbecker.com
Arnaud Costi
