Simplified bio-progressive approach to solving difficult situations

1. Enza Robotti
UNIVERSITA’ DEGLI STUDI DI CAGLIARI
Scuola di Specializzazione in Ortognatodonzia
Direttore Prof. Vincenzo Piras

2. PROBLEM SOLVING
The process of finding solutions to
difficult issues
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3. PROBLEM SOLVING
Systematic Approach
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4. What is the
best
solution?
HOW TO SOLVE THIS PROBLEM?
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5. Pretreatment lateral and posteroanterior cephalometric and
panoramic radiographs
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Am J Orthod, St. Louis, v. 70, no. 4, p. 358-397, 1976. 5. Ricketts RM. et al. Orthodontic
diagnosis and planning – their roles in preventive and rehabilitative dentistry.

6. DECISION MAKING
Act
of narrowing down
the possibilities,
choosing a course of
action
and determining the
action’s potential
consequences.
PROBLEM SOLVING PROCESS
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7. PROBLEM SOLVING PROCESS
Accepting the Problem
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8. PROBLEM SOLVING PROCESS
STEP 1 : What is the problem?
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9. PROBLEM SOLVING PROCESS
STEP 2 : What are the alternatives?
0
2
4
6
Estraction No Estraction Surgery Compensation
aesthetics
occlusion
mechanics
Create a vast number of possible solutions without judging these solutions
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10. STEP 3 : What are the ADVANTAGES and/or the
DISADVANTAGES of each alternative?
PROBLEM SOLVING PROCESS
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1. Improve aesthetics
2. More difficulty in biomechanics
3. Surgical risks
4.Tooth loss

11. STEP 4 : What is the solution?
PROBLEM SOLVING PROCESS
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The patient said she was unhappy about his smile..
She was SOCIALLY EMBARASSING!
We decided to estract premolars and have a
preorthodontic treatment and a surgical treatment.

12. IS IT POSSIBLE TO TEACH PROBLEM
SOLVING SKILLS?
KNOW THE DIFFERENT STAGES OF TREATMENT MECHANICS FOR
DIFFERENT MALOCCLUSIONS ACCORDING TO THE DIFFERENT
PHILOSOPHY
to help improve understanding
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13. BYOPROGRESSIVE STEPS
EXTRACTION TREATMENT – GENERAL SEQUENCES
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MAXILLARY ARCH
• Extraction of both maxillary first
premolars
• Arch allineament and closure of
the spaces
• Movement of the canines into the
arch
Ricketts RM, Bench RW, Gugino CF, Hilgers JJ, Schulhof RJ:
Bioprogressive therapy, Book I, Denver, 1979,

14. Enza Robotti
BYOPROGRESSIVE STEPS
EXTRACTION TREATMENT – GENERAL SEQUENCES
MANDIBULAR ARCH
• Decompensation of the incisors
• Leveling of the curve of Spee
• Estabillishment of interarch compatibility

15. STEP 5 :How well is the solution working?
Multidisciplinary approach to treatment
PROBLEM SOLVING PROCESS
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16. Enza Robotti
Post-treatment results

17. Post-treatment lateral and posteroanterior cephalometric and
panoramic radiographs
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18. STAY MOTIVATED WHEN HANDLING LONG-
TERM ISSUES
BEFORE
TREATMENT
AFTER
DECOMPENSATION
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FINALLY

19. Post-treatment results
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20. Enza Robotti
Thank you for the attention!