BOOK REVIEWS
Essentials of orthognathic surgery, 2nd
edition
Johan P. Reyneke; Quintessence; 2010; www.quintpub.com;
280 pages; 821 illustrations (most in color); $180.00
Reviewed by Alex Jacobson
T his text begins with a concise description of the
principles and treatment objectives of orthognathic
surgery, consultation, and clinical evaluation of a patient,
analysis of diagnostic records, treatment planning, surgi-
cal procedures, and possible complications. The patient
with a dentofacial deformity receives the best results
from surgical therapy when there is clear and effective
communication between the orthodontist and the maxil-
lofacial surgeon from the outset of treatment. This type of
communication is stressed in chapter 2, “Systematic
patient evaluation.” Numerous craniofacial and cephalo-
metric analyses are cited; to reduce the confusion, the
author has provided summary analyses of anteroposterior
and vertical dentoskeletal and soft-tissue relationships,
and study cast evaluations. Chapter 3, “Diagnosis and
treatment planning,” begins by providing a detailed case
overview, which in effect is a systematic patient evaluation
method whereby the short list in turn leads to an initial
diagnosis of the patient’s deformity. Described are the
facial changes associated with skeletal repositioning,
the esthetic objectives and surgical indications, and the
specific orthodontic treatment required for facial surgery.
Included is the best sequence of treatment to obtain the
described result and the development of the final visual
treatment objective.
Chapter 4 provides guidelines for the diagnosis and
treatment of specific dentofacial deformities, beginning
with patients having mandibular anteroposterior defi-
ciency and Class II malocclusion, which is the largest group
of surgical-orthodontic patients. Two such patients are
shown and described. This is followed by the treatment
sequence of 2 patients, one with mandibular anteroposte-
rior excess and the other with maxillary anteroposterior
deficiency. Also shown and described are patients with
maxillary vertical deficiency, vertical excess, rotation of
the maxillomandibular complex, open-bite deficiencies,
and dentofacial asymmetry. The chapter ends with
a section on distraction osteogenesis and orthognathic
surgery. Treatment procedures and results are described
and shown. The fifth and final chapter is devoted to
describing various orthognathic surgical procedures. The
following stepwise procedures are described and illus-
trated: bilateral split ramus osteotomy (36 steps), intraoral
vertical mandibular ramus osteotomy (14 steps), LeFort I
maxillary osteotomy (43 steps), and genioplasty (23 steps).
The chapter ends by identifying and describing intraoper-
ative diagnosis of condylar sag after bilateral split
osteotomy or during LeFort I maxillary osteotomy. The
diagrams and illustrations are unusually good, no doubt
carefully selected and in many instances almost self-
explanatory. The text should adequately meet the needs
of orthodontic and maxillofacial surgery residents as
well as clinicians interested in orthognathic surgery.
Am J Orthod Dentofacial Orthop 2011;139:139
0889-5406/$36.00
Copyright Ó 2011 by the American Association of Orthodontists.
doi:10.1016/j.ajodo.2010.11.007
Biomechanics in orthodontics:
Principles and practice
Ram S. Nanda and Yah S. Tosun; Quintessence; 2010;
www.quintpub.com; 168 pages; 350 two-color illustrations;
$98.00
Reviewed by Alex Jacobson
T he introductory chapter describes the physical laws
of mechanics governing forces and motions in the
context of orthodontics. Described are concepts such
as moments and couples, centers of resistance, center
of rotation, and moment-to-force ratio, all of which
are essential to the understanding and control of ortho-
dontic tooth movements. The second chapter, “Applica-
tion of orthodontic force,” discusses the physical
properties and the many variables involved in the variety
of materials used in the components of an orthodontic
appliance, such as brackets and the forces generated
from archwires, coil springs, and elastic modules. Phys-
ical properties, such as stiffness, strength, working
ranges, spring back, and formability, and the testing of
these properties are described in detail. Chapter 3, “Anal-
ysis of two-tooth mechanics,” details the force systems
created by straight and bent wires placed in the brackets
of 2-tooth segments. In cases of crowding, an elastic
straight wire is engaged in the brackets of teeth at differ-
ent angles and levels. The teeth move in response to the
elasticity of the wire; however, deciphering all the forces
and moments in a complete dental arch is extremely
complex because of the different anchorage values of
the teeth, each having brackets and tubes of different
widths and at various angulations and levels to each
139
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other. A wire engaged even in only 2 brackets affects the
teeth in 3 planes of space (sagittal, transverse, and
vertical). For simplicity, the authors described the 6
named geometry classes that can occur between 2
teeth, as originally described by Burstone and Koenig.
Space closure mechanics can be achieved by using
either a “Friction or frictionless system” (chapter 4). In
the friction system, the teeth move by sliding a bracket
along an archwire. The frictionless system entails moving
teeth by means of loops. Whichever system is chosen,
some unpredictable adverse mechanical effects during
treatment are to be expected. These effects, together
with the advantages and disadvantages of both systems,
are fully explained. Anchorage, the resistance against
undesired tooth movement, is comprehensively covered
in chapter 5, “Anchorage control.” Various intraoral and
extraoral methods of anchorage are described and shown.
A brief section is devoted to the use, stability, biomechan-
ical considerations, and limitations to microimplants.
Chapters 6 and 7 are devoted to the biomechanics of
correcting vertical and transverse arch discrepencies.
January 2011  Vol 139  Issue 1 American Journal of Orthodontics and Dentofacial Orthopedics
Book reviews
Chapter 8 deals with the correction of anteroposterior
arch discrepancies. Class II molar relationships can be
corrected by distal movement of the maxillary molars,
mesial movement of the mandibular molars, or a combina-
tion of both. Shown are the biomechanics of the various
methods of achieving these end results. The ninth and
final chapter relates to space closure after the extraction
of teeth as a consequence of arch to tooth-size discrep-
ancies or skeletal problems. Factors to consider include
severity of crowding, vertical growth pattern, midline
discrepancies, incisor-lip relationship, anchorage, differ-
ential mechanics, and general strategies to close spaces.
The book represents a comprehensive, in-depth coverage
of the biomechanical principles as they relate to orthodon-
tics. The numerous illustrations are clear and almost
self-explanatory. The text is informative and should serve
as an excellent reference.
Am J Orthod Dentofacial Orthop 2011;139:139-140
0889-5406/$36.00
Copyright Ó 2011 by the American Association of Orthodontists.
doi:10.1016/j.ajodo.2010.11.006