Biometrically-driven orthodontic treatment using the Biocreative Orthodontic Strategy (BOS)

When determining the appropriate time for orthodontic treatment, a traditional clinical examination, a model evaluation, 2D and 3D radiographic assessments, and determining the relationship between the TMJ and masticatory muscles, are all necessary. This is especially true with patients who present with anatomic limitations, such as root resorption, alveolar bone loss, extremely thin alveolar bone around the teeth, an unstable mandibular position with TMD symptoms, and when there exists tripod collapse. The Biocreative Orthodontic Strategy (BOS) independently targets the moving of teeth, and/or the bone, or the soft tissues, using temporary skeletal anchorage devices, while avoiding unnecessary orthodontic appliances, to treat only the dental segments that will definitively benefit from orthodontic treatment. Often, this approach can be an effective solution for the complicated orthodontic patient. In addition to employing 2D or 3D cone beam computed tomography (CBCT), Biocreative orthodontics (BOS) focuses on finding actual problem occlusal contacts by combining T-Scan 10 computerized occlusal force analysis with electromyography (EMG), joint vibration analysis (JVA), and 3-dimensional jaw tracking (EGN), as well as performing a dynamic sleep analysis. This biometrically-driven orthodontic approach leads to an integrated diagnosis, a definite treatment plan, and ultimately to the orthodontic treatment itself. This methodology has been termed, "Multifactor Malocclusion Services (MMS)." This chapter will introduce Biocreative Orthodontics by describing its' key principles, treatment concepts, treatment effects, and then illustrating how innovatively it corrects complicated orthodontic cases with solely tooth movement (without orthognathic surgery), directed by an MMS biometrically-driven diagnosis.