OHI-S Complex Orthodontic Cases. Braces, TADs, MARPE, Aligners

Kerolos Alhakeem and Omar Fawzi Chawshli examine the mechanics and planning decisions behind complex orthodontic treatment in this OHI-S course. The lessons connect extraction and space-management decisions with anteroposterior and vertical control, then consider hybrid aligner mechanics and digital workflows for palatal miniscrews and MARPE. Clinical cases cover open bite, deep bite, gummy smile, missing teeth, and challenging anchorage problems. The listed program contains five lessons plus two additional clinical lessons, totaling 6 hours 13 minutes in English. It is intended for orthodontic clinicians with an interest in advanced biomechanics, with the complete lesson-by-lesson topics retained below.

Faculty: Kerolos Alhakeem presents Lessons 1–5; Omar Fawzi Chawshli presents Lessons 6–7.

Topics

Lesson 1. Orthodontic Space Management and Extraction Decision

• Orthodontic camouflage and anteroposterior problems: definitions and space management

• Strategies for space management in the dental arch

• The extraction vs. non-extraction dilemma

• Statistics on extraction therapy and reasons for the global decrease in extractions

• Evidence-based medicine (EBM) in the orthodontic decision-making process

• Facial aesthetics and soft tissue-centered treatment planning

• Clinical case presentations and methodology

• Detailed case analysis: proclined anterior teeth with an anterior open bite

Lesson 2. The Anteroposterior Dimension in Complex Orthodontic Case Management

• Orthodontic camouflage and anteroposterior problems: definitions and space management

• Strategies for space management in the dental arch

• The extraction vs. non-extraction dilemma

• Statistics on extraction therapy and reasons for the global decrease in extractions

• Evidence-based medicine (EBM) in the orthodontic decision-making process

• Facial aesthetics and soft tissue-centered treatment planning

• Clinical case presentations and methodology

• Detailed case analysis: proclined anterior teeth with an anterior open bite

• Biomechanics: the drawbridge effect in vertical control

• Detailed case analysis: missing upper canines and reverse bite (anterior crossbite)

• Evaluation of gingival tissue: the Seibert and Lindhe classifications

• Detailed case analysis: congenitally missing lateral incisors and spacing

• Biomechanical dilemmas: space closure vs. space opening

• Analyzing the negative sequelae and risks of various treatment pathways

• Management and prevention of “black triangles” (loss of interdental papilla)

• Detailed case analysis: congenitally missing upper central incisor

• Treating growing patients: clinical nuances, growth prediction, and interceptive case analysis

• Detailed case analysis: overjet management and its effect on the soft-tissue profile

• Detailed case analysis: severe incisor proclination

• Molar distalization: the clinical efficiency of Temporary Anchorage Devices (TADs)

• Detailed case analysis: miniscrew-supported maxillary molar distalization

• Palatal anchorage concepts and mechanics

• Detailed case analysis: unilateral molar distalization

• Detailed case analysis: management of a transposed canine

• Simplified criteria for clinical decision-making

Lesson 3. The Vertical Dimension in Complex Orthodontic Case Management

• The vertical control problem in orthodontics

• The 3 domains of vertical control

• Anterior vertical control: incisor intrusion and extrusion mechanics

• Poster vertical control: molar intrusion and extrusion mechanics

• Mandibular rotation and skeletal vertical control

• Establishing a definitive vertical diagnostic framework

• Systematic diagnostic scheme for the evaluation of a gummy smile

• Assessment of gingival display at rest and during smiling

• Clinical assessment of upper lip length and mobility

• Evaluation of incisor width, height, and periodontal probing depth

• Determining upper incisor position in relation to the upper lip

• Assessment of the Curve of Spee (COS) and root parallelism

• Biomechanical scenarios: mesially tipped posterior segments

• Biomechanical scenarios: mesially tipped posterior segments combined with distally tipped anterior segments

• Fundamental biomechanical principles of vertical movement

• True vertical vs. relative vertical control mechanics

• Detailed clinical case analysis: anterior gummy smile with over-erupted upper incisors

• Detailed clinical case analysis: anterior gummy smile associated with maxillary excess

• Detailed clinical case analysis: anterior gummy smile associated with Vertical Maxillary Excess (VME) and protrusion

• Detailed clinical case analysis: anterior gummy smile with incisor extrusion, an increased Curve of Spee, and a deep bite

• Detailed clinical case analysis: deep bite management via an increased Curve of Spee and lower anterior intrusion

• Detailed clinical case analysis: deep bite management via an increased Curve of Spee and lower posterior intrusion

• Detailed clinical case analysis: open bite with average incisor inclination, decreased incisor exposure, and a tongue-thrust habit

• Detailed clinical case analysis: reduced incisal display – anterior open bite vertical control utilizing TAD mechanics

• Detailed clinical case analysis: increased Lower Anterior Facial Height (LAFH) and anterior open bite corrected via posterior intrusion

• Detailed clinical case analysis: over-erupted molar management using TAD-supported single molar intrusion

• Detailed clinical case analysis: occlusal plane canting correction utilizing TADs

• A simplified, systematic criteria for vertical decision-making

Lesson 4. Hybrid Aligner Mechanics in Orthodontic Treatment

• Mechanical principles: how clear aligners move teeth

• The biomechanical concepts behind aligners: force delivery mechanisms

• Comparative analysis: clear aligners vs. fixed appliances

• Open vs. closed orthodontic systems and strategies for space gaining

• The clinical role of aligner attachments

• The tracking and engagement dilemma in aligner therapy

• Determining the force vectors and active push surfaces of an aligner

• Biomechanics of buccolingual tipping

• The 3 fundamental pillars of success in clear aligner therapy

• Aligner manufacturing: types of polymers

• Material science: physical characteristics of thermoplastic polymers

• Aligner biomechanics as dictated by material properties

• Evaluating movement type predictability

• Clinical efficacy: how effective are aligners at true tooth movement?

• Biomechanics of mesiodistal tipping

• What aligners can and cannot achieve

• Clinical guidelines for software overcorrection

• How to improve aligner predictability

• Hybrid mechanics: the synergy of buttons and elastics

• Strategic placement of elastic attachments for maximum efficiency

• Class 2 management: anchorage control in bilateral Class 2 Division 1 malocclusions (clinical case)

• Class 2 management: midline shift correction in unilateral Class 2 Division 1 malocclusions (clinical case)

• Class 3 management: anchorage control and mechanics in reverse overjet/anterior crossbite (clinical case)

• High-angle cases: managing vertical discrepancies, extrusion, and settling protocols (clinical case)

• The push-pull dynamic: mastering advanced directional forces (clinical case)

• Biomechanical limitations of rotational movements in aligner therapy

• Hybrid derotation techniques: integrating minitubes and sectional NiTi wires (clinical case)

Lesson 5. Digital Workflow for Palatal Miniscrew Appliances and MARPE

• The clinical and logistical benefits of transitioning to a digital orthodontic workflow

• Limitations of the conventional analog approach

• Complication analysis: a clinical case of incorrect palatal miniscrew positioning and its consequences

• Digital problem-solving: clinical challenges resolved by a completely digital workflow

• Limitations of maxillary expansion

• Architectural anatomy of the facial skeleton

• Identifying structures of resistance against skeletal maxillary expansion

• Biomechanical comparison: skeletal vs. conventional tooth-borne anchorage

• Midpalatal suture maturation: classification and the clinical decision-making hierarchy

• Comprehensive analysis of the stages of midpalatal suture maturation

• Clinical relevance of maturation stages: establishing age-appropriate treatment pathways

• Crucial intraoral clinical examination prior to skeletal expansion

• Diagnostic matrices for crowding cases

• Assessing and diagnosing functional mandibular shifts

• Utilizing the WALA Ridge for mandibular arch form diagnostics

• Classification of Miniscrew-Assisted Rapid Palatal Expansion (MARPE)

• Biomechanical differences: bone-borne (BB) vs. tooth-bone-borne (TBB) appliances

• Finite element analysis: stress distribution and displacement patterns of different palatal expanders

• The “TAD-First” vs. “TAD-Last” fabrication protocol

• Biomechanical stability: monocortical vs. bicortical skeletal anchorage

• Anatomical guidelines and safe zones for miniscrew insertion in palatal sites

• Core components and architecture of the digital orthodontic workflow

• Advanced imaging: segmentation, orientation, and fusion of cephalometric and CBCT data

• Three-dimensional anatomical evaluation and virtual placement of palatal TADs

• CAD/CAM software design for 3D-printed surgical guides

• Clinical protocol: placing palatal TADs using a 3D-printed surgical guide

• Laboratory and chairside protocols for bonding the skeletal appliance

• Comprehensive, step-by-step clinical case analyses and troubleshooting

Lesson 6. Open Bite Treatment: Etiology, Mechanics, and Evidence-Based Strategies

• Classification of open bite etiologies: skeletal vs. dental

• Evidence-based treatment strategies for open bite correction

• Design and management of habit-breaking appliances

• Biomechanics of molar intrusion: foundational mechanics

• Utilizing Temporary Anchorage Devices (TADs) for molar intrusion: buccal vs. palatal configurations

• Strategic clinical placement of Transpalatal Arches (TPAs) and lingual arches

• Clinical applications of posterior bite turbos

• Introduction and comprehensive analysis of open bite clinical cases

Lesson 7. Vertical Plane Malocclusion: Diagnosis and Management

• Classification of open bite etiologies: skeletal vs. dental

• Evidence-based treatment strategies for open bite correction

• Design and management of habit-breaking appliances

• Biomechanics of molar intrusion: foundational mechanics

• Utilizing Temporary Anchorage Devices (TADs) for molar intrusion: buccal vs. palatal configurations

• Strategic clinical placement of Transpalatal Arches (TPAs) and lingual arches

• Clinical applications of posterior bite turbos

• Introduction and comprehensive analysis of open bite clinical cases

• Biomechanical protocols for the incisor extrusion strategy

• Practical methods for incisor extrusion: V-bends, extrusion arches, and vertical elastics

• Interdisciplinary management: comprehensive case analysis of a cleft palate patient with a severe open bite

• Mechanics, rotational effects, and vectors of short Class 2 and Class 3 elastics

• Utilizing bite raisers to open the occlusion and manage vertical discrepancies

• Biomechanics and extraction protocols for open bite correction

• Mechanics of space closure in open bite cases: maximizing the drawbridge effect

• Strategic bonding of the second molar: clinical efficiency and vertical implications

• Classification of deep bite etiologies: skeletal vs. dental

• Comprehensive treatment planning and strategies for deep bite correction

• Absolute and relative extrusion of posterior teeth: anterior bite plates, bite bumpers, bite turbos, cervical headgear, and Class 2 elastics

• Controlling the intentional flaring of anterior teeth

• True intrusion of incisors utilizing anterior TADs

• Soft-tissue diagnostics: evaluating interlabial gap, smile line, lip length, and the incisor-gingival relationship

• Skeletal considerations in vertical diagnosis

• Clinical application of anterior bite turbos

• Introduction and comprehensive analysis of deep bite clinical cases

• Advanced mechanics of Temporary Anchorage Devices (TADs) in vertical correction

• Evaluating the rotational and vertical effects of short Class 2 and Class 3 elastics

• Biomechanics of intrusion: managing the Reverse Curve of Spee (RCS) archwire

• Mechanical principles of segmental intrusion arches

• Analysis and execution of Burstone’s 6 principles of true intrusion

• Appliance engineering for incisor intrusion: utility intrusion arches and Burstone’s segmental mechanics

• Gummy smile: architectural correlation with open and deep bites, clinical case introduction

• Advanced anchorage setups: combining anterior TADs with posterior TADs for total arch vertical control

• Introduction and comprehensive analysis of complex gummy smile cases

• Occlusal plane canting: definition and clinical presentation

• Introduction and comprehensive analysis of occlusal plane canting correction cases

• The reciprocal effect of sagittal mechanics on the vertical dimension

• Comprehensive clinical case analysis: Class III malocclusion corrected via en-masse retraction using Infrazygomatic Crest (IZC) screws

Training scope: Recorded education does not replace formal orthodontic training, hands-on instruction, supervised clinical experience, or the imaging and surgical competencies required for these procedures.

File scope: This purchase covers the educational files offered by MedicalAmboss. Event attendance, publisher-platform access, accounts, memberships, apps, and publisher-hosted extras are not included.