Gelb 4/7 position in non-extraction expansive orthodontics

A little history – the Fathers of Gnathology, Drs. Stallard, Stuart and McCollum followed Bonwill’s mechanical occlusion theory and translated the movement of the jaw to an articulator in 1930. They developed a jaw position called Centric Relation, which was the most retruded superior postion of the jaw joint.

These men were revered at the time and are still in the USC Dental Hall of Fame. Around the same time, Tweed had just graduated from Angie’s School of Orthodontics and rejected non-extraction theory as producing faces that were too protrusive. He began extracting permanent bicuspids to “flatten” profiles and supposedly give more stable results (Figure 3). Ron Roth and Robert Williams took the CR concept to orthodontics in ensuing years. Over the next 25 years, the Gnathologists and Tweed orthodontists each contributed to a more retruded jaw position with fewer teeth (Figure 3). This jaw position was taught and utilized in American dentistry from 1930-1995.

To dentists like Bill Farrar, Barney Jankelson, and Harold Gelb, this made no sense. The condyle wars in the 1970s pitted gnathologists from Pankey, Dawson, and SOS against Gelb, Farrar, Jankelson, and Witzig. Witzig taught the European school of functional orthodontics popularized by Schwartz and Frankel which used the Gelb 4/7 position in non-extraction expansive orthodontics. There was a landmark legal case involving a 4 bicuspid extraction patient who ended up requiring TMJ surgery following extraction orthodontics. Witzig was the expert witness and the patient ended up receiving over a million dollars, which was a huge settlement at the time. Dawson realized in the 1980s along with the glossary of prosthodontic terms that the gnathologists had no biologic or physiologic evidence for a retruded centric position. They followed Gelb, but in more conservative anterior superior position (Figure 4).

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Dentistry will now start to understand that jaw position is dependent on the development of the maxilla and mandible. Most maxillas (82% ) are underdeveloped and iatrogenically retruded by dentists and orthodontists as taught by major dental schools and orthodontic programs in the country. We can now understand the folly of Stuart, Stallard, and McCollum, perpetuated by Peter K. Thomas, Pankey, and Dawson in restoring a jaw in the most reproducible retruded nonphysiologic iatrogenic position. Even more harmful was the extraction of permanent teeth during orthodontics, which closed airways and retruded jaws. It is now time for the professionals to become aware of the benefits of the Gel-B Bite Balance Breathing System and AIRWAY CENTRIC ™ appliances.
http://ww1.prweb.com/prfiles/2012/12/03/10199255/Gelb_ebook_AirwayCentricDentistry_FINAL-11-12-12.pdf