Journal of Orthodontics, Vol. 30, No. 2, 178,
June 2003
© 2003 British Orthodontic Society
Letter to the Editor
Ama Johal and
Robert Kirschen
Dear Sir
We would like to congratulate Jonathan Sandler for his direct, yet thought provoking guest editorial, published in the December 2002 edition of the Journal. The editorial highlighted the valuable contribution of space analysis in the planning and execution of orthodontic treatment. Whilst the majority of us would accept that orthodontics is by no means an exact science, fundamentally, it remains a question of redistribution of space. Orthodontics thus revolves around the assessment, planning and management of space.
The use of cephalometry as a useful tool to clinical diagnosis is taken for granted and is, indeed, expected of candidates sitting specialty examinations. Similarly, in an era of ever increasing public accountability for all aspects of treatment, it is not unreasonable to expect that the justification for proceeding with either extraction or non-extraction therapy should be based on a methodical and disciplined analysis of space. The same reasoning applies to other decisions, such as the need to prescribe intermaxillary elastics, functional appliances or headgear.
Whilst we are obviously committed to the analysis that has been evolving over the last 18 years at the Royal London Hospital,1,
2 we acknowledge that other space analyses have been described. More important is the recognition that a formal space analysis per se can assist the clinician to ascertain whether planned treatment goals can be attained, and whether the mechanics and anchorage proposed are appropriate to these goals. Nowhere is this more important than within our training institutions.
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References
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1 The Royal London Space Planning: An integration of space analysis and treatment planning. Part I: Assessing the space required to meet treatment objectives. Am J Orthod & Dentofac Orthop 2000; 118: 448–455.[Medline]
2 The Royal London Space Planning: An integration of space analysis and treatment planning. Part II: The effect of other treatment procedures on space. Am J Orthod & Dentofac Orthop 2000; 118: 456–461.[Medline]
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