Orthodontics: Principles and Practice Basavaraj Subhashchandra Phulari
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fm1ORTHODONTICS Principles and Practicefm2
fm3ORTHODONTICS Principles and Practice
SECOND EDITION
Basavaraj Subhashchandra Phulari BDS MDS (Ortho) FRSH FAGE Formerly, Faculty of Department of Orthodontics and Dentofacial Orthopedics Mauras College of Dentistry, Hospital and Oral Research Institute Republic of Mauritius
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Orthodontics: Principles and Practices
First Edition: 2011
Second Edition: 2017
9789385999895
Printed at
fm5Dedicated to
My dear parents (Subhashchandra and Shivalingamma Phulari),
brothers (Sangamesh, Jagadeesh and Manjunath),
My beloved wife Dr Rashmi GS Phulari, MDS (Oral Pathology & Microbiology) and
My dearest sons (Yashas and Vrishank) for their love, support and encouragement
And to
Dear (Late) Chandu who is always in our hearts and thoughts…fm6
fm7Contributors
  • Aakash Shah BDS MDS (Ortho)
  • Professor
  • Department of Orthodontics and Dentofacial Orthopedics
  • Faculty of Dental Sciences
  • Dharmsinh Desai University Nadiad, Gujarat, India
  • Aneshwar Rohanlal Bhagwandass BDS (Manipal), DMD (USA)
  • Private Practioner
  • United States of America
  • Anil Shah BDS Master of ESOLA Academy Vienna University, Austria
  • President, SOLA India
  • Innovate Dental Center
  • Surat, Gujarat, India
  • Basavaraj Subhashchandra Phulari BDS, MDS(Ortho), FRSH, FAGE
  • Formerly, Faculty
  • Department of Orthodontics and Dentofacial Orthopedics
  • Mauras College of Dentistry,
  • Hospital and Oral Research Institute
  • Republic of Mauritius
  • Basti Risi Kino DMD, MDSc, PGDip (PSM)
  • Director of Public Dental Services
  • Ministry of Health and Quality of Life
  • Republic of Mauritius
  • Desi Moodley BDS, PDD-Aesthetic Dent (Stell), MSc Dent Sc (Stell), PhD (UWC)
  • Researcher
  • Oral and Dental Research Institute
  • University of the Western
  • Cape Cape Town, South Africa
  • Frank Tsahannerr Dr Med Dent (Munich University)
  • Implantologist
  • Perchastr.5
  • 82335 Berg am starnberger see, Germany
  • Mark Donald Vernon BChD MFDSRCS (England)
  • Clinical Lecturer
  • The Barts and The London Dental Institute
  • United Kingdom
  • Mohan Vakade MDS (Oral and Maxillofacial Surgery) Master of ESOLA Laser Academy, Vienna University
  • Professor and HOD
  • Department of Oral and Maxillofacial Surgery
  • Vaidik Dental College
  • Daman, Gujarat, India
  • Naresh Thukral BDS Master of ESOLA Academy Vienna University, Austria
  • Founder President, SOLA India
  • Head, Laser Academy and a Faculty
  • Executive Member of Board
  • SOLA-International
  • Ohana Gabriel
  • Dentiste
  • 7 Ar Gombetta
  • 92400, Courbevoie
  • France
  • Poorya Naik BDS MDS (Ortho)
  • Reader
  • Department of Orthodontics and Dentofacial Orthopedics
  • College of Dental Sciences
  • Davangare, Karnataka, India
  • Rashmi GS BDS MDS (Oral Pathology and Microbiology)
  • Professor
  • Department of Oral Pathology and Microbiology
  • Manubhai Patel Dental College and Hospital
  • Vadodara, Gujarat, India
  • Syed Zakaullah BDS MDS (Oral and Maxillofacial Surgery)
  • Professor and Vice Principal
  • Department of Oral and Maxillofacial Surgery
  • Al-Badar Dental College and Hospital
  • Gulbarga, Karnataka, India
  • Valentina Tsipova BDS MDS (Ortho)
  • University of Tartu
  • Estonia
  • Richard Poavin and Brulet Alain
  • Graphic Designer Rich. C.lte'e
  • Route co^tiere-Trou- Aux-Biches
  • i^le Maurice
  • Rue Aristide Briand
  • 78700 conflans Ste, Honorine
  • Francefm8
fm9Preface to Second Edition
Since the first edition of this book was published in 2011, I have received an overwhelming feedback in the form of numerous email messaged and letters. I am extremely grateful for the positive response the book has received from the faculty in the field of Orthodontics and students alike.
The basic format of the book comprising of 49 chapters grouped under 15 sections is retained in the second edition as well. The book continues to give simple and logical narration of difficult orthodontic concepts in a fluid easy-tounderstand language.
Numerous high-quality clinical photographs and skilfully made graphic illustrations throughout the book make it easier for the students to grasp the subject. Few pictures that lacked good resolution have been replaced in the new edition.
Innovative self-explanatory flowcharts and tables along with good pictures have come to be the hallmark of this title. In addition, summary charts given at the end of each chapter as Chapter Overview come handy during revision of the subject in preparation to exams.
Sample questions in both long question and short note formats are given for each chapter to prepare the students for theory examination. Chapter-wise Multiple Choice Questions (MCQs) are also given to aid students in preparation for viva-voce.
All the efforts have been made to present the subject in concise yet all comprehensive manner. It is hoped that the new edition will continue to be appreciated by students and staff alike.
Basavaraj Subhashchandra Phulari
fm10Preface to First Edition
The fascinating field of Orthodontics has come a long way since the era of finger pressure and crude wires to the more sophisticated, state-of-art techniques and appliances of today. The oldest specialty of dentistry has witnessed immense progress in the last few decades, both in terms of technology as well as patient management. Braces are no more only for children and adolescents. More and more adult patients are seeking orthodontic treatment in the recent years. Thanks to technical advances in the appliance design, there has been increased understanding of cellular responses to orthodontic force and awareness among general public.
The ever-growing field of Orthodontics and Dentofacial Orthopedics as it is called today is fascinating and at the same time complex. Teaching orthodontics to undergraduates had never been more challenging, especially, in the view of vast literature and comparatively minimal exposure to clinical orthodontics, the undergraduate students generally have during their course. This book is a humble step towards meeting this enormous challenge of providing an all comprehensive, yet simple-to-understand text for the students of dentistry. The objective is to narrate the essentials of orthodontics in a simple and logical way, at the same time arouse interest in the minds of undergraduate dental students about this wonderful field. Furthermore, it is also hoped that the book will be of value to postgraduate students as well.
The 49 chapters, encompassing 15 sections have been compiled by an impressive bunch of academicians around the world. The chapter, History of Orthodontics gives a quick glance at the turning events in the evolution of the first speacialty of dentistry. Often asked and considerably difficult concepts such as Cephalometrics and Model Analysis are explained systematically with provision for quick review. Management of different types of malocclusion is narrated in simple manner with complete case records to support the text.
A separate chapter on Preclinical Orthodontics has been included for the first time which deals with rationale, armamentarium and step-by-step wire bending procedures, much required for undergraduate students. A working classification of basic orthodontic instruments is given with their modes of usage in chapter 27Orthodontic Instruments. There is another section that covers the Recent Advances in Orthodontics including implants, invisalign and application of lasers in orthodontics.
Over 2,000 high quality clinical photographs and professionally done graphic illustrations with informative legends in the book make the text easy to grasp. Incorporation of tables, flow charts and boxes throughout the textbook wherever necessary will give the reader a convenient summary of key features and also make reviewing easier.
An accompanying booklet MCQs in Orthodontics features over 2,300 multiple choice questions given chapter-wise with answer keys. Furthermore, in each chapter, the questions follow the same order of points given in that particular chapter, thus can act as a very good means of revision of that topic/chapter and at the same time prepares the student for viva voce as well as PG entrance test and other competitive tests.
I regret any deficiencies and shortcomings that might have crept in despite our best efforts. I would also welcome comments and suggestions from both students and teachers for further improvement of the book.
Basavaraj Subhashchandra Phulari
fm11Acknowledgments
There are several people who have contributed to this project without whose cheerful cooperation the task would have been arduous if not impossible.
With profound sense of gratitude and respect, I express my heartfelt thanks to Dr Rajendrasinh Rathod MDS, Chairman of Manubhai Patel Dental College and Hospital, Vadodara, Gujarat, India; Chairman and Dean of Mauras College of Dentistry, Hospital and Oral Research Institute, Republic of Mauritius, for his timely suggestions, critical observations and above all for his inspirational support not only in this endeavor but throughout my academic career. He has been a constant source of encouragement and guidance throughout this project while providing me with all the facilities required for completion of this work. My special thanks to Dr YK Desai, Professor, Prosthodontics for support and comments he provided to this work. I would also like to thank Dr Yashraj Rathod, Trustee, Manubhai Patel Dental College and Hospital, Vadodara, Gujarat, India for his unstinting support and encouragement during this endeavor.
I have much pleasure in acknowledging the help I have received from my students of Mauras College of Dentistry, Hospital and Oral Research Institute, Republic of Mauritius in grueling sessions of spell check, and for familiarizing me with ‘student's point of view’
I am indebted to Dr Anil Shah and Dr Aakash Shah for all the help and encouragement I have received from them during the formative stages of this project. I am proud to have them as contributors.
I extend my special thanks to Mr Chitranjan Luchoo for his expert comments and suggestions regarding photography, and Mr Prakash Gopoul for providing crisp, neat line drawings for the book. I will be failing in my duty if I do not mention the affection and support I have received from Dr Goyal and family, Jayantee Raghunandan and family, Ramesh Purgus and family and Gopoul family who have always provided that moral boost much needed during compilation of the book.
I take this opportunity to thank my beloved parents Mr Subhashchandra Phulari and Mrs Shivalingamma Phulari, and brothers Sangamesh, Jagadish, and Manjunath Phulari for their constant support and cooperation during the entire course of this publication. I thank my beloved wife Dr Rashmi GS Phulari MDS (Oral Pathology and Microbiology) for being a constant source of inspiration and support throughout this project, helping me at every step right from checking the flow of text, arrangement of photographs to final proofs. I fondly acknowledge my dearest sons Yashas and Vrishank for their patience and love.
I profusely thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President) and production team of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India for their enthusiasm, excellent cooperation and constant support in publishing the book.
Most of all, I thank God for all the kindness and mercy showered upon me.fm12fm13fm14fm15fm16