Hugo De Clerck is a graduate of the Ghent University orthodontic program, he received his PhD in 1986 and he maintains a private practice in Brussels.  He has been Professor and Chairperson of the Department of Orthodontics at the Université Catholique de Louvain from 1989 to 2006.  Currently he’s an Adjunct Professor at the University of North Carolina at Chapel Hill.  He’s a former President of the Belgian Orthodontic Society and Fellow of the Royal College of Surgeons of England.  His main research interests are in skeletal anchorage, biomechanics and orthopedics.  He lectured extensively on these topics throughout the world.

Lecture Abstract

Miniplates resist better high discontinuous forces than miniscrews do.  Therefore they can be used for intermaxillary orthopedic traction.  Class III elastics can be fixed between Bollard anchors on the buttress of the maxilla and in the canine region of the mandible in young growing patients.  Which biomechanical approach should be used, which loading protocol?  What is the best timing?  Can the growth of the maxilla and/or mandible be stimulated, restricted or redirected?  Is the outcome predictable?  Is this protocol an alternative for orthognathic surgery after growth?  The results of this continuous bone anchored traction will be discussed based on Cone-beam CTs at T1 and T2 registered on the anterior cranial base, also in cleft patients.  The outcome will be compared with a control group and face mask orthopedics with or without RPE.
Successful class III orthopedics often result in the creation of a class II malocclusion.  Since the upper miniplates are fixed at a distance from the dental arch, they can also be used to distalize the complete upper arch.  This can be done by simultaneous ‘en masse’ retraction of small or large groups of teeth.  For optimal efficiency, good control of the vertical dimension is needed.

Lecture Outline

  • Bone anchored class III orthopedics: timing and indications
  • Bone anchored maxillary protraction compared with face mask and Alt-RAMEC
  • Outcome of class III orthopedics in non-cleft and cleft patients: skeletal, dento-alveolar, and soft tissue changes
  • Maxillary rotations: the key to successful class III orthopedics
  • Placement and removal of miniplates; video recordings of the surgical protocol
  • Post-surgical follow-up: patient instructions, loading protocol. How to avoid and manage complications
  • Biomechanics of non-compliance upper molar distalization
  • Distalization of the complete upper arch: vertical control and transverse changes