The goal of this book is to teach—to provide students with a solid foundation in diagnosis, treatment planning, and “in‐treatment” decision‐making when managing malocclusions—with special emphasis on the vertical dimension. Problems in the vertical dimension can be especially challenging to manage, and a clinician must achieve a high level of proficiency in addressing these challenges. Careful study of our book will provide the foundation for achieving this proficiency. The practice of orthodontics and dentofacial orthopedics is a cognitive discipline. Over 90% of what an orthodontist does is observe, reason, and make decisions. Treatment planning and treatment delivery for each patient essentially consist of your ability to correctly answer a seemingly infinite series of questions related to that patient’s care. During orthodontic residency, when you examine a patient, the attending faculty asks what problems you observe, and you answer. The attending faculty asks how you would treat these problems, you answer, and the faculty provides you with positive and constructive feedback. Whether in the classroom or clinic, we have found orthodontic residents mature fastest and best using this method of question–answer teaching. The format of our book is similarly based on this question– answer style of teaching, as we view our book as an orthodontic miniresidency. We use the question–answer format in order to keep you intellectually involved, to encourage critical thinking, to offer you the opportunity to reflect on our questions and your answers, and to gauge the progress of your understanding.
Using this format, we will coach you to address a very broad range of challenging clinical problems and to formulate appropriate decisions. To grasp the principles upon which we focus, we recommend that you study each case from beginning to end at one sitting. Carefully think through answers to the questions we present (ideally, by writing down your answers), and make the best decisions you can. You should do this before you refer to the answers we have provided. Answer each question as thoughtfully as you would if the patient was sitting in front of you, and you had to make the right decision to care for him or her. Your orthodontic diagnostic, treatment planning, and in‐treatment decision abilities will strengthen in direct proportion to your efforts to work through each problem presented—before making your decision and reading our answers. You will find certain principles are emphasized and applied repeatedly throughout this text. This is our objective—to instill patterns of analysis and habits of rational decision making by repetition and by presenting many different patients with a multitude of problems. Problems in the vertical dimension are inextricably related to problems in the anteroposterior and transverse dimensions. The principles and cases presented comprehensively illustrate these interrelationships and will strengthen your ability to treat patients in all three dimensions. Also, as occurs with every patient you will treat in your practice, each patient presented in this text has diverse problems apart from the primary problems in the vertical, anteroposterior, and transverse dimensions. Many of the problems that you will likely encounter in private practice will be examined and addressed in this text.