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Features Section |
The book starts with an introduction to clinical examination and practice management, and scheduling that sets, in part, the tone for the following chapters. This book is very much the outcome of McNamara's experience in academic orthodontics and orthodontic practice, and this combination results in a book that presents a matter of fact approach to treatment mechanics with the supporting rationale and scientific literature.
The Section on General Treatment Strategies starts with chapters on Dentitional Development and Tooth-size/Arch-size Discrepancies, which give the scientific background to the philosophy of mixed dentition treatment and non-extraction treatment in over 80 per cent of cases. An outline of the treatment of Class II and Class III malocclusion introduce the concepts of rapid maxillary expansion and functional jaw orthopaedics, topics that are to become recurring themes. This section concludes with an excellent chapter on the Vertical Dimension, one of the most difficult subjects in orthodontics and, interestingly, the most difficult chapter to write by the author's own admission. However, McNamara's efforts have been rewarded with one of the best thought out treatises on vertical problems I have read recently. The effort involved in preparing this chapter is perhaps shown in the 305 references cited, the most of any chapter in the book.
The second half of the book, Clinical Management, then takes the reader through the orthodontic armamentarium as used by McNamara and colleagues in their practice—if they don't use it, it isn't included here. Comprehensive Fixed Appliance Therapy and Utility Arches are chapters that present the bioprogressive technique employed by the authors using an 0.018-inch slot pre-adjusted system. This seems somewhat dated in an era when the straight wire appliance with 0.022 slot seems to be becoming the norm. In contrast an interesting chapter on the use and abuse of transpalatal arches follows and then a chapter on Rapid Maxillary Expansion. The bonded RME appliance appears to the reader to be the standard appliance employed by the authors, with the addition of facemask for Class III cases or Herbst for Class II cases.
Four excellent chapters on functional appliances take the reader through the background, current literature, and clinical procedures for the Twin Block, the FR-2 of Frankel, the Herbst, and the Bionator. All these chapters are commended to the reader.
The final chapters cover the much of the remainder of orthodontics. These include the myriad of distalizing appliances, extra-oral traction with considerable detail on J-hook headgear, and its use in the Tweed–Merrifield technique, facial mask and its combination with RME and the FR-3 of Frankel. Interestingly, after a brief chapter on finishing and retention protocols McNamara closes the clinical techniques section with an appraisal of the contemporary technique Invisalign®.
Throughout the book McNamara's easy to read literary style shines through. Despite its 550 pages, this book is approachable and soon you find yourself engrossed. This is aided by the copious quality drawings attributed to the co-author, William Brundon. In contrast, some of the clinical slides, reproduced in black and white look a little jaded, and do not always do justice to the quality of the text and drawings.
In summary, I would liken reading this book to attending an orthodontic congress: each reader will find something new and something familiar, something to agree with and something to disagree with, but if the acid test is whether or not the experience will change your clinical practice, then this text passes with flying colours. Whilst not the first book I recommend to a new postgraduate student, I would highly recommend it to all practising orthodontists.
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