2009 AAO Meeting (Boston) Early Treatment Outcomes

Research studies into the overall treatment outcomes for orthodontic patients has been reviewed with the following conclusions:

1. Early orthodontic treatment does not provide any better treatment outcomes. Therefore, there are no distinct treatment advantages of early treatment.

2. Prolonged Phase I (Early) and Phase II treatment leads to patient "burn out" with less patient compliance resulting in inadequate oral hygiene care and orthodontic therapy over time.

3. When treatment efficiency as assessed, combining Phase I & Phase II therapy less efficient when compared to Phase II treatment alone with its corresponding shorter overall treatment time.

4. In reviewing orthodontic retention for Phase I patients, there are more retention problems in the younger patients as reported by Wheeler (AJO 2002) and Weislander (AJO 1993).

5. A clinical analysis of the "Best Treatment Time" for patients reveals that the ideal time is between the ages of 10-13 immediately following the exfoliation of the E's and in conjunction with the eruption of the 12-year molar teeth.

2009 AAO Meeting (Boston) Skeletal Changes Associated With Early Treatment

Various research studies has been used to assess the effect of "Extraction Treatment" on skeletal changes to the facial profiles and overall "looks". McNamara (AJO 1985), Panchez (AJO 1985), Bacetti (AJO 2000), and Faltin (AL 2003) reported that "Extraction Treatment" protocols are not effective or even recommended for achieving skeletal changes. Additionally, extraction therapy does not cause any negative effects to the facial profile, and therefore, the unsubstantiated belief of altered profile changes was proven to be false.

2009 AAO Meeting (Boston) Phase I & Phase II Treatment

Three randomized clinical trials were conducted at the University of North Carolina (Dr. Tulloch), the University of Florida (Dr. Wheeler), and the United Kingdom (Dr. O'Brien) to assess the clinical effectiveness of Phase I & Phase II therapy versus Phase II treatment by itself. Although these studies have evaluated many facets of orthodontic treatment outcomes, the overall conclusion of all three RCT's was that there is no clinically significant differences between Phase I therapy when combines with Phase II therapy versus Phase II treatment by itself. The only statistically significant difference was related to the overall treatment time, and the Phase II treatment was approximately seventeen (17) months shorter than the combined therapy of a Phase I and Phase II approach.