Orthodontic Treatment of Impacted Teeth. Adrian Becker

person to fabricate, place and activate a suitable and efficient auxiliary to apply a directional force of optimal magnitude and range of movement and to do so at the time of actual surgery.

It is not fair to expect oral surgeons to be aware of how the different attachment locations may affect the orthodontic or periodontic prognosis; nor should they be expected to be sufficiently experienced with the bonding technique to do it themselves. Bonding is not a procedure that oral surgeons routinely carry out. The presence of the orthodontist allows for bonding to be performed efficiently, while the surgeon and the nursing attendant maintain haemostasis and the necessary dry field.

      Some surgeons may take exception to the presence of the orthodontist at the exposure and may even use expressions like ‘even the lowliest oral surgeon can place a bracket’ or that it is ‘a waste of time’ [52]. It will then be quite apparent that the oral surgeon had sorely missed the point and had not understood the wider context of ensuring quality care and overall treatment success.

      The ultimate responsibility for the success of the case rests firmly on the shoulders of the orthodontist, from the initiation of orthodontic treatment up to the point where the impacted tooth is brought into full alignment and, almost invariably, until the overall malocclusion is resolved. It would be irresponsible to abrogate the management of this crucial stage of the treatment to another party, when there is force to be applied to the newly exposed impacted tooth and where so much is at stake that will affect the future of the case. If, as has been advocated by many orthodontists and surgeons alike, orthodontists absent themselves and leave surgeons to make orthodontic decisions for which they are not equipped, they will be endangering the outcome and inviting legal proceedings, from which the orthodontist involved will not be immune.

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