Peck Sheldon
Department of Orthodontics, University of North Carolina, Chapel Hill, NC, USA.
Historian, The Edward H. Angle Society of Orthodontists.
Eur J Orthod. 2017 Apr 1;39(2):109-115. doi: 10.1093/ejo/cjx004.
From the beginnings of modern orthodontics, questions have been raised about the extraction of healthy permanent teeth in order to correct malocclusions. A hundred years ago, orthodontic tooth extraction was debated with almost religious intensity by experts on either side of the issue. Sheldon Friel and his mentor Edward H. Angle both had much to say about this controversy. Today, after significant progress in orthodontic practice, similar arguments are being voiced between nonextraction expansionists and those who see the need for tooth extractions in some orthodontic patients. Furthermore, varying concepts of mechanical retention of treatment results have evolved over the years which have been misinterpreted as enhancing natural orthodontic stability.
In this essay, representing the Ernest Sheldon Friel Memorial Lecture presented in 2016 at the 92nd Congress of the European Orthodontic Society, a full spectrum of evidence from biology, anthropology and history is critically discussed in the search for truth among highly contested orthodontic variables: extraction versus nonextraction, fixed retention versus limited retention, and rationalized stability versus biological homeostasis.
Conscientious clinicians should try to develop individualized treatment plans for their patients, and not be influenced by treatment 'philosophies' with untested claims in clinical orthodontics.
自现代正畸学诞生之初，就有人对为矫正错颌畸形而拔除健康恒牙提出质疑。一百年前，正畸拔牙问题在争论双方的专家之间引发了近乎宗教般的激烈辩论。谢尔顿·弗里尔和他的导师爱德华·H·安格尔对此争议都有诸多见解。如今，在正畸实践取得显著进展之后，不拔牙扩弓派与那些认为部分正畸患者需要拔牙的人之间也出现了类似的争论。此外，多年来出现了各种关于治疗结果机械性保持的概念，这些概念被误解为增强了自然正畸稳定性。
本文是2016年在欧洲正畸学会第92届大会上发表的欧内斯特·谢尔顿·弗里尔纪念讲座内容，全面探讨了来自生物学、人类学和历史的证据，以在正畸领域备受争议的变量中探寻真相：拔牙与不拔牙、固定保持与有限保持、合理化稳定性与生物稳态。
尽责的临床医生应为患者制定个性化治疗方案，而不应受正畸临床中未经检验的主张的“理念”影响。
