1988 Article regarding root resorption

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.655.8358&rep=rep1&type=pdf

TAD - intrusion of the posterior maxillary molars - mild to moderate open bite cases

Recently, the minimally invasive placement of TADs (temporary anchorage devices) has allowed orthodontists to treat some of these patients without orthognathic surgery through intrusion of the posterior maxillary molars. While TADs are not a substitute for surgery in all cases, they do provide a treatment alternative for specific mild-to-moderate open bite cases without other skeletal malformations.

http://www.dentistryiq.com/articles/2015/07/temporary-anchorage-device-use-in-the-treatment-of-anterior-open-bite.html

In 1-2% of patients, however, obvious root shortening occurs during routine orthodontic treatment. These patients are just more genetically susceptible to root resorption. I have even noticed that root shortening runs in families (after noticing resorption in two children from the same family I looked at the mom’s records and found the same thing). This genetic predisposition is important and should be communicated to your orthodontist if you are aware that it has been noticed in your family.
Are there things an orthodontist can do to cause or prevent root resorption? Some have theorized that root resorption happens if the teeth are moved too quickly or too slowly. Teeth that are moved too quickly may be subject to too much force they say. However, in my cases where I’ve seen resorption I’ve used exactly the same amount of force for exactly the same amount of time as everyone else. Braces that are on longer logically have more time to cause a problem. Having said that, I’ve seen transfer cases that have had braces on for more than 5 years with no signs of root change. There really is neither documented cause of nor protocol to follow to prevent this shortening.

So what can be done about root shortening during treatment? About the only thing we can do as orthodontists is monitor our patients during treatment using routine x-rays. These should be taken at least annually as long as the braces are on. If root shortening is noticed, it should be pointed out and discussed with the patient and their family. Depending upon the amount of shortening, treatment may be continued as normal, the treatment time shortened (stopping after spaces close for example), or the braces immediately removed. It is generally believed however that a tooth can lose up to half of its root length and never have a problem. In my 21 years of private practice, not a single tooth has been lost to root resorption.

Unfortunately there is nothing you can do to “re-grow” the length of the roots. All we can do in cases like this is to educate the patients, stabilize the teeth (passive bonded lingual retainers), and encourage mouth guard wear for any activities that may threaten the teeth. As I’m sure you’ve read in my article, some patients are just predisposed to root shortening and some aren’t. The only thing the orthodontist could have done differently is recognize the shortening earlier (i.e. 6 to 12 months in) and change the treatment goals (like leaving some uncorrected overjet). Luckily the shortening usually stops once the orthodontic movement stops, so it shouldn’t get any worse.
http://www.gregjorgensen.com/blog/2013/03/do-braces-make-the-roots-of-your-teeth-shorter/

miniscrew - time needed longer, dispose to more root resorption.

But the time needed for the greater amount of maxillary en-masse anterior retraction with miniscrew anchorage is longer and might dispose the patient to more apical root resorption.

http://www.ncbi.nlm.nih.gov/pubmed/20152676

self-treatment orthodontics

http://jawpain-tmjtreatment.com/

When a child is growing up, consuming foods like beef and lamb livers as often as possible, along with organic (grass fed) ghee and fermented cod liver oil on a daily basis will ensure prominent cheekbones, wide dental arches built upon long jaw-bones with enough room to accomodate wisdom teeth, and teeth that are impervious to cavities. If orthodontic work should be deemed necessary for some odd reason, one must choose an orthodontist who refuses extractions and seeks to widen the arches in order to deal with tooth crowding.

...

 So I searched high-and-low for an orthodontist who:

->Rejected the idea of extractions and embraced the idea of expanding the arches.

->Embraced the idea of biologically-compatible "lightwire" forces that are incorporated into self-ligating bracket systems.

WHAT NOT TO DO...

Most orthodontists these days are pretty awful. Many of them learned their craft from a paint-by-numbers course that was created by an idiot. Naturally said idiot who created it doesn't want to turn around to the orthodontic community after years of mutilating the population and admit he was wrong. So the evil perpetuates itself. Some examples of idiocy/evil include:

->A palate cannot be expanded without surgery once one is an adult (yes it can because bones remodel and furthermore sutures never fuse until advanced age due to over-calcification).

->Using elastics to tie the upper and lower teeth together will "level" a smile because they act on the sphenoid bone (scientifically impossible as the sphenoid bone can only be acted upon directly with endo-nasal balloon therapy or the modern-day equivalent known as NCR). Forcing the smile to level with rubber bands without addressing the sphenoid bone directly creates a smile like Drew Barrymore has - NOT the most downloaded woman on the internet. ;)

Most orthodontists are so out-of-touch with their own bodies, that even if they embrace an "out-of-the-box" technology like the A.L.F. device which uses biologically-compatible, lightwire forces they follow it up with old-school braces and then wonder why they produce unsatisfactory results. Seriously, I know several adults who wore braces for like 4 years and then one day their orthodontist just gave up and admitted defeat.

Then there are the oral surgeons who love to do palatal expansion surgeries for $20,000 a pop. They even want to do a surgery to bring the maxilla forward. It is all unnecessary. As I said earlier, the effects of palatal expansion can be accomplished in the majority of cases with self-ligating braces by an orthodontist who believes in expanding your dental arches. Palatal expansion in a child using a rapid palatal expander (RPE) is possible due to the suture still being very loose, but palatal expansion with an RPE or surgery at any age always produces a 2D smile that looks stupid UNLESS dental arch expansion is targeted with biologically-intelligent braces by an orthodontist who believes in expanding your dental arches.

MY JOURNEY IN THE VALLEY OF ORTHODONTICS

So I found two orthodontists in the tri-state area (California may be better for this sort of quest) who were open to what I wanted to accomplish and went to work with one of them. After about 1 year I was getting depressed as hell because my orthodontist was NOT working on expanding of my arches for that "10-tooth smile" and idiotically focusing on "leveling" my smile (a-la Drew Barrymore) by running elastics between my upper and lower teeth to "close my bite." After injuring the periodontal ligament on one of my teeth with this asshatery my gum receded and I have constant nerve pain due to its' exposure. Thank god I have a high pain tolerance and can live with it. Luckily at this point I stumbled upon this "face pulling" technique through aforementioned mutual friend and decided to give it a try. Not only does it "close the bite" naturally without any of that stupid elastics crap, but it gives you massive cheekbones without surgery, cures TMJ permanently, gives you a beautiful maxilla and jawline, and is the "3rd dimension in the NCR experience." Basically what it does is it clears the roadblock one can encounter after a few years of NCR and allow for the sphenoid bone to "swing freely" again. Oh yeah... and it opens up your pelvis! Meow!

I also changed my orthodontist. I am completing my treatment with the amazing David H. Seligman DMD 212.988.8235 who understands what I'm trying to do. He is all about bone remodelling, trained under the inventor of the Damon system, and has access to the latest custom brackets that are engineered for each individual tooth. He "gets it" and so he's awesome. :)

Here are two resources for removable orthodontics, both located in Germany and Germans (my ancestors) are the masters of engineering and craftsmanship:

http://www.sanfte-zahnklammern.de/

http://www.kfo-soehngen.de/kfo_fachlabor_gisbert_soehngen_spangen.html

Now before you say "But I don't live in Germany" I'll say "Contact them anyway." Trust me, contact them no matter what chatter is in your head. ;) We limit ourselves all the time with negative thoughts. You have nothing to lose by going forward despite the defeatist chatter. If I had to do it all again, I would go with removable plates instead braces. But I also had the thought "But I don't live in Germany." Where there's a will, there's a way!

BTW, if anyone needs a regular dentist in NYC who does the finest dental work, shoot me an email and I will tell you whom I go to. She'll always work to save the tooth and doesn't drill when not needed, doesn't kill the root to make money doing root canals, etc. Does the finest implant work as well.

MY RESULTS

Your maxilla will come forward without surgery. As it comes forward, the bones around your condiles will rotate and your jaw will become loose and drop forward. Therefore, you will not be pulling JUST the maxilla forwards and end up looking like an inbred retard. Not only your maxilla will come forward but YOUR ENTIRE FACE WILL! Especially your cheekbones, so if you don't have cheekbones, you will get them with this technique. Your whole face will come forward and your jaw will follow along getting rid of TMJ forever! Below are my results...

 Dentists and orthodontists focus on teeth too much and ignore the skull which is the most important. Underbites come about because the skull doesn't develop properly. So the child has an underbite. Sometimes during delivery, the doctor applies forceps and deforms the child's head. Sometimes babies get dropped and nobody wants to admit this. The result is that the face gets squashed. So you have an underbite. The rest of the face needs to catch up. The solution is face-pulling! But of course all those idiot orthos try and jam the jaw back in. Stupid.

CONCLUSION

So that's about it. I've told you what you need to know to solve your trigeminal neuralgia, jaw pain, TMJ, cluster headaches, poor posture, jammed pelvis, etc., etc., etc... all in 30 minutes a day! You will notice results in 1 week. In 3 months you will be a different person. The ride will be rough because your entire psyche will be changing for the better. But it is only 30 minutes a day and the equipment costs less then $50! Assuming you have braces of course, otherwise you will need a custom retainer made and that will be the main cost and is dependent on who makes it for you. Print out those pictures of that custom retainer above and show it to a dental lab or an orthodontist - just don't show him this website or he will get pissed off because orthodontists have big egos and don't like their treatment paradigm threatened. Also, oral surgeons won't be too happy that such a cheap solution supplants a $20,000 surgery. How will they be able to afford that Mercedes SL63 AMG now?

If you are a parent with young children, please don't let an orthodontist destroy their future! I get emails all the time from adults whose lives were destroyed by childhood orthodontics. Lucky for them they find this site! If you remember anything, remember this and stick to it as if your child's future happiness depended on it:

UNDER NO CIRCUMSTANCES ALLOW TOOTH EXTRACTIONS IN A CHILD!!! GO FOR EXPANSION OF ARCHES AND LENGTHENING OF JAWBONES VIA PROPER NUTRITION AND GENTLE ORTHODONTICS IF NEEDED!!!

Here is an Australian "60 Minutes" interview on why extractions suck:http://sixtyminutes.ninemsn.com.au/article/259072/straight-talk

Basically, do not allow the usage of anything that resembles a torture device on your child. This includes braces, reverse headgear, etc. Your child is still growing, and you want the growth to be as natural as possible so if you want to do any "orthodontics" on your child to assist the natural process, then use only removable plates or myofacial trainers or such. If you are an adult, then go for Damon braces if needed. Adults are no longer growing, so more extreme measures are needed. But children should not be fucked with. Would you let a dental professional sexually molest your child? No? So then why would you let them abuse your child with painful, beauty-destroying orthodontics?

However, your main weapon is nutrition! Even if you are an adult! Follow in the footsteps of the great dentist, Weston A. Price by giving your child 1 tablespoon of each of these every day:

http://pureformulas.com/cod-liver-oil-q-liquid-8-fl-oz-96-svgsbottle-by-premier-research-labs.html?CAWELAID=532166621 (link disconnected because product has been discontinued)

http://livesuperfoods.com/x-factor-high-vitamin-butter-oil.html

In addition, eating 1 grass-fed beef or lamb liver 1x per week will give them nutrition through the roof.

If you have kids, put the above into them on a daily basis as soon as they can eat. They'll never get cavities again! You should be eating the same thing yourself!!! If you are planning to make a baby, both you and your wife should be eating this sort of diet starting 1 year before you make the baby. Make sure to load up on iodine before you get pregnant so your baby will be as smart as possible. If the baby is a boy, the mother should CONSIDER taking Indonesian Tongkat Ali in 50:1 extract or 100:1 extract while pregnant because the amount of testosterone the fetus is exposed to in the womb will determine his testosterone "set-points" as an adult. It will also make sure he comes out with a really large penis! Why wouldn't you want the most powerful child possible? Make sure he/she is tall, strong, beautiful, healthy... Nobody puts any thought into what they create anymore. They make children out of spite and just to have someone to boss around. If you give your child a shitty physical vehicle, what sort of suffering are you creating for it?

Here are some other useful links:

http://www.icnr.com/

http://www.facefocused.com/indexb.html

http://www.facialbeauty.org/homepage.html

http://www.westonaprice.org/

FINAL WORDS

Don't get me in any trouble, because I just want to help all those people who are suffering in this world. In China they say that "your face is your fortune" and everybody deserves the good fortune to be beautiful. =^_^= To reiterate, I don't want to vex the dental community who won't take kindly to my challenging their paradigms. Sadly, many tenets of their paradigms are flat out wrong: sutures are NOT fused past a certain age. The spehenoid bone CANNOT be acted upon via elastics strapped between the upper and lower brackets. Pulling the face forward as explained on this website will NOT give you an overbite.

Do you want to chat with me?  email me!

Also, I did a radio interview on Rumor Mill News: http://jawpain-tmjtreatment.com/rumormillnewsfacialremodelling.mp3

BTW, check out my website on NeuroCranial Restructuring!

TMJ The Great Controversy

TMJ The Great Controversy (starts at page 27 of the PDF file which is page 519)

http://www.cda.org/portals/0/journal/journal_082014.pdf

(Description of the Airway Centric philosophy starts at page 59 of the PDF file (p. 551))

t. Focusing on the relative position of the condylar head in the fossa to an idealized position within the fossa misses on two counts:
■ Morphological changes of the condyles — bending, breaking, flattening and other compensatory changes make the position of such a condyle different from an undamaged condyle within the same fossa.1
■ Anatomical appearance shows the current condition of the structures that have resulted in response to the forces over time. It is akin to looking at the rearview mirror. Physiologic parameters — such as electrocardiogram (EKG), apnea–hypopnea index (AHI) and EMG give current data on the function of the organism. Function changes the form just as oral breathing changes maxillary shape.

manipulating patients into centric relation, making splints in that position

The early dentists who attempted to help TMD patients through occlusal therapy include the following:

Nathan A. Shore (1914-1984)  Spent 40 years focusing on “TMJ Syndrome”, NYC

Harold Gelb, NYC, did much to popularize “TMJ” from the 60’s thru the 80’s.  He had several controversial methods, including putting condyles in what he called the “4/7 position” and building a “Gelb splint” which did not follow the principles of occlusion.

In the early 70’s several dentists who had been trained in gnathology began eliminating the more esoteric methods (i.e., tripodized occlusion) and making it more user-friendly for clinicians.  I call it gnathology-lite.  They include:  Peter Dawson, Henry Tanner, Niles Guichet, Peter Neff, Bob Lee, and Terry Tanaka.  They perpetuated the concept of treating TMD through focusing on the occlusion, although Dr. Tanaka has done much to advance our understanding of the TMJ with excellent anatomical research via cadaver studies.

Barney Jankelson, a Seattle dentist, invented a jaw tracking device in the early 70’s.  He incorporated the use of TENS on the jaw muscles, and claimed that this method proved where the jaw “belongs.”  He then advocated rebuilding the occlusion to this “scientific” position, which almost always resulted in opening the bite.  His mantra was “If you can measure it, it’s a fact; if you can’t, it’s an opinion.”  He is considered the father of electrodiagnostics and neuromuscular dentistry.

Dr. George Goodheart, D.C., 1918-2008, Detroit, Michigan.  In 1964 Goodheart developed applied kinesiology—a method of “testing” the body in ways that “diagnosed” any physiologic or medical condition the patient may have.  For dentists, this technique was popularized by George Eversole, who had studied with Goodheart.  Many dentists interested in TMD took weekend courses from Eversole in the 1980’s.  Applied Kinesiology is widely used by chiropractors today.

Bill Farrar (pronounced “fair-ah”), Montgomery, AL, 1924-1985.  Bill Farrar, along with an oral surgeon, Bill McCarty, “discovered” the internal derangement of the jaw joint.  Prior to Farrar, the biomechanical function of the joint was poorly understood.  In 1979, Farrar began lecturing on his discoveries, which transformed our understanding of this condition.  He introduced (along with others) transcranial x-rays to study condylar position.  He introduced disc re-capturing and jaw unlocking techniques.  He used a pull-forward appliance on many of his patients to prevent their jaws from locking again.

o Review:  The underlying philosophy regarding appropriate condylar/mandibular position for TMD patients divides these experts into two basic camps:

Centric Relation/ Ideal occlusion

                      Gnathology,

Restorative occlusionists

Anterior Condylar Repositioning

                        Kinesiologists

                        Gelb

                        Jankelson

                        Farrar

We will revisit when and where to employ condylar repositioning later on.  Farrar was erroneously interpreted as saying that you had to hold the condyle forward forever.  He never said that.  However, he is the one most responsible for “phase II” dentistry on TMD patients.  More accurately, Farrar (along with Gelb, Jankelson, kinesiology) is used as an excuse by too many dentists to perform phase II dentistry  (orthodontics and/or extensive crownwork) on TMD patients.

The lite gnathologists, who I will now call the occlusionists, especially Dawson and Guichet, were adamant that Farrar was wrong about what caused jaw clicking and the need for provisional condylar repositioning.  They dismissed kinesiology, Gelb, and Jankelson out-of-hand as little more than quacks. 

#6  The claims of so-called experts in the field

By the early 1980’s, it became the battle of the gurus with egos, primarily between the occlusionists and Bill Farrar.  The occlusionists ganged up on Bill Farrar.  He was telling us that attempting to put TMD patients in centric relation was iatrogenic.  He was bringing their jaw forward to recapture their disc, or at least reduce joint capsulitis. The occlusionists regarded this as heresy.  However, Farrar was unflappable at conferences in which he was attacked.  I was privileged to be with him every year until he died in 1985 of emphysema.  He was only on the TMD national stage for 6 years, but he made a huge impact on TMD treatment throughout the world. 

Over 900 dentists traveled to Farrar’s small Montgomery AL office from 16 foreign countries and 46 states.  He taught 79 courses in Montgomery between 1980 and 1985.  He published numerous articles in American and European dental journals over a 25 year period.  He worked in his office until he died.

“My time is short, I will fight and I am not bitter. I have accomplished much of what I wanted to do. It has been exciting…Criticism on a professional level is actually beneficial, because it stimulates us to re-think and re-test our viewpoints and concepts.  We must not accept old ideas not based on scientific fact.”

--Bill Farrar

“Dr. Farrar considered his patients his primary teachers. His clinical findings encouraged him, even drove him, to scientific contributions. He possessed a mind that did not allow intermissions and a heart that reached out to his patients.”  

--Dr. Jack Haden

In his final days, Farrar was heard to say, “Medical science has not yet been able to attach a prognosis of doom on man’s spirit nor to predict the physical strength it can harness. I ask only to contribute to life as long as I live it.”

Bottom Line:  Bill Farrar caused a huge paradigm shift in the world of TMD.  More than any other before or since.  Those who profess expertise in this field are standing on the shoulders of Bill Farrar, whether they know it or not.  For more on Dr. Farrar, see Jack Haden’s guest editorial in the Journal of Craniomandibular Practice, Oct, 2008, found here:  FarrarHadenCranioArticle.pdf

For those of us who grew up in the world of gnathological occlusion, we could see the writing on the wall.  We realized within a year of Farrar’s 1979 revelations that the days of manipulating patients into centric relation, making splints in that position and subsequently equilibrating them into this position was not the answer for TMD patients.  If the disc is dislocated, as it is in the majority of TMD patients, there is no such thing as “centric relation.”  The most you can hope to accomplish is identify an “adapted centric position” (Dawson’s term).

Also, by the late 1970’s we had some excellent clinicians who were leading the way in looking at more than just occlusion in evaluating and treating these patients.  They include:

All three organizations support the use of splints, although they use them for different purposes and have different beliefs about the mechanism of how a splint works.