History of Orthodontics

Orthodontics is the branch of dentistry concerned with the prevention and correction of malocclusions. Appliances for aligning teeth go as far back as the Egyptians. However, the first formal text discussing orthodontics was published in 1879 by Norman Kingsley, titled A Treatise on Oral Deformities as a Branch of Mechanical Surgery. At that time, Kingsley introduced extra-oral force to move teeth.

It wasn’t until 1900 that orthodontics was first declared a specialty by Edward H. Angle, becoming the first dental specialty. He founded the American Association of Orthodontists (AAO), started the first independent school of orthodontics, and originated the classification of malocclusions.1 In the early years, the goals of orthodontic treatment were to attain ideal occlusion without the extraction of teeth. Angle believed that if the teeth were placed in ideal position, good facial esthetics would result. Angle opposed the extraction of teeth; consequently, all of his cases were treated non-extraction.

As time went on, and with the introduction of cephalometrics, a number of orthodontists emphasized the importance of the relationship between the teeth and bones as well as soft tissues. In the 1930s, controversy erupted when Calvin S. Case advocated the use of extraction in treatment.2 Case also recommended the use of retainers to maintain the achieved results.

Today, orthodontists evaluate a number of patient factors to individualize treatment options. Advances in the field including skeletal anchorage, digital radiography, improvements in bracket systems, and aligner therapy have allowed orthodontists to provide patients with more options and better treatment than ever before. Skeletal anchorage provides the opportunity to make dental changes not previously possible. Mini-implants, also referred to as Temporary Anchorage Devices, and mini-plates are used often today to move teeth more predictably (Figure 1) and even to help modify growth patterns. Advances in cone beam computed tomography (CBCT) allows orthodontists to obtain more information about tooth position and the craniofacial complex. CBCT can also be used to plan surgical treatments in adults with skeletal problems to achieve optimum surgical outcomes, occlusal relationships and facial esthetics.

Figure 1.

Images showing mini-implants used to move teeth predictably

A mini-implant in the retromolar pad is being used to distalize the first molar in order to alleviate the premolar crowding.