Journal of Orthodontics, Vol. 28, No. 4, 319,
December 2001
© 2001 British Orthodontic Society
Early Orthodontic Treatment
J. D. Subtelney Quintessence, Illinois, 2000 312 pp. $98 Hardback ISBN 0–86715–372–5
R. G. Oliver
This is a new book from a respected author. Two chapters are by other contributors, one on time of treatment and the other on TMJ problems in children. The remaining chapters are all by Subtelney. They are divided into 5 parts: Maxillary Jaw Malocclusions, Mandibular Jaw Malocclusions, Vertical Jaw Malocclusions, Skeletal Dysmorphology Jaw Malocclusions, and How Early and Why Early (which includes the two contributed chapters).
Subtelney argues that early intervention offers the greatest possible control over form, function, and changes with time, to the extent of minimizing or eliminating the consequences of undesirable craniofacial growth. To his credit, the author opens with an example of an inappropriate management approach to a Class III maxillary retrusion case. In his defence, the then current approach (1966) was mandibular surgery. An alternative approach is given for the younger brother of the first case (who presented with a similar malocclusion) starting at age 7 years with intermittent appliance therapy, including face masks, and without extraction of permanent teeth over the next 11 years. The message of this first chapter is that early treatment with protraction headgear and rapid palatal expansion may assist the development of the maxilla. Subsequent chapters follow a pattern of defining the problem illustrating the treatment and results and generalising from these cases. Some of the cases illustrated are ‘straight forward’ problems of excess or insufficiency in one or other jaw. However, the author also includes some of the more challenging conditions that orthodontists meet, such as asymmetries and vertical facial excess.
This book is not a vade mecum for any particular technique. The techniques vary according to the condition and therein lies its strength. Nor is it a book that should be diligently read from cover to cover. However, it is a valuable resource for the practitioner to visit, find the appropriate type of problem, and sit back and contemplate the book's message. That message is clearly based on reflection by the author of his own experiences. In a sense it is more like a chat at the end of the clinical day than a formal lecture or seminar, hence postgraduate students seeking ‘the answer’ may be disappointed whereas the hospital consultant will find much of value.
