Dr. Fred Schudy: Orthodontics Has Reached an Impasse!!

Orthodontics Has Reached an Impasse!!

It is with deep emotion, a heavy heart, and profound regrets that I feel that I should say what I am going to say. It gives me great pain to say what I feel I must say. I pray that the Almighty will bless me in these efforts of love and good will toward all colleagues.

I feel that the orthodontic profession is at the point of stagnation. There have been no basic concepts reported in several years. There have been a number of innovative procedures to enhance treatment for which I am grateful, but there have been no new fundamentally basic anatomical and functional concepts reported in a number of years.

Through the last forty years we have pointed out several innovative concepts such as the following:

We recognized the importance of the vertical growth of the craniofacial complex. This revolutionized the treatment of malocclusion. Today millions of children and adults are receiving better treatment around the world as a result of this new concept.

1. We discovered the basic growth increments and their relationship to one another, as well as how the jaws function.

2. We discovered what causes the mandible to rotate forward and backward. We recognized the reciprocal nature and function of the jaws.

3. We observed that lower incisors, when intruded, have a strong tendency to erupt post treatment and close the bite. This usually results in crowding of the lower incisors.

4. We discovered that when the distance from Ans to menton, in treatment, is increased as much as or more than the depth of the overbite and growth has ceased, then the overbite correction is permanent for life, provided that torque, interincisal angle and overbite has been adequately corrected.

5. When a reviewer expressed favorable comments about the Basion Horizontal Analysis, I became frightened for fear that its acceptance would spread. So I got in touch with Western Reserve University and requested records to study this analysis. Dr. Broadbent, the custodian of the marvelous records, was very kind and accommodating and provided me with some long term growth records. After a thorough study it was found that the analysis is invalid. Please see Article 11 of the Schudy Chronicles.

6. We thoroughly studied vertical and horizontal growth increments in relation to the treatment of malocclusion and in relation to post treatment growth.

7. We published several articles in the Angle Orthodontist, the AAODO AND Journal of Clinical Orthodontics, where we thoroughly, objectively and comprehensively recorded many treatment results. Please see Article 16 of the Schudy Chronicles.

8. We published 44 articles in the Schudy Chronicles. In these discussions we recommended a new growth analysis based on stable vertical and horizontal landmarks from which horizontal and vertical growth can be accurately measured. In these Internet discussions we pointed out several published articles which were either incorrect or inadequate or both. Please see Article 24 in the Schudy Chronicles.

9. In his post doctoral thesis my son, Dr. George Schudy, first discovered that the bending of the gonion angle limits condylion/gnathion distance and thereby unfavorably affects the treatment of malocclusion. This thesis was published in 1972. In the book, Orthodontics for the Next Millennium, Creekmore and Radney pointed out some very important concepts.

10. In Article 1 of the Schudy Chronicles, in Fig. 5 and Fig. 6, we reported a shocking variation in the reduction in the gonion angle resulting from growth. This remarkable difference in the reduction of this angle has a marked effect on the condylion/gnathion distance and on the treatment of Class II malocclusion.

11. We discussed the need for a new paradigm pertaining to the growth of the jaws. It was suggested that we base our analysis on the actual growth increments, not on the effects of these increments.

12. While all of the above events were occurring over a 40 year period of time, so far as I know and believe, there were few new basic concepts being reported. The work of Björk was new, quite extensive, and very much appreciated. During this period there was a considerable amount of discussion pertaining to various facial analyses, most of which have been shown to be invalid.
To be fair with my colleagues, it must be said that there has been much improvement in treatment technique-bonding of brackets, pretorqued brackets, superelastic wires and orthognathic surgery to name a few.

The above accurate history is why I say that Orthodontics has reached an impasse-a plateau from which we should be moving on.

It would seem that the first thing we need to do is face the above facts. If there is a lack of understanding of these concepts by the academic community, we should get rid of our false price and set about on some real learning.

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1.	We discovered the basic growth increments and their relationship to one another, as well as how the jaws function.
2.	We discovered what causes the mandible to rotate forward and backward. We recognized the reciprocal nature and function of the jaws.
3.	We observed that lower incisors, when intruded, have a strong tendency to erupt post treatment and close the bite. This usually results in crowding of the lower incisors.
4.	We discovered that when the distance from Ans to menton, in treatment, is increased as much as or more than the depth of the overbite and growth has ceased, then the overbite correction is permanent for life, provided that torque, interincisal angle and overbite has been adequately corrected.
5.	When a reviewer expressed favorable comments about the Basion Horizontal Analysis, I became frightened for fear that its acceptance would spread. So I got in touch with Western Reserve University and requested records to study this analysis. Dr. Broadbent, the custodian of the marvelous records, was very kind and accommodating and provided me with some long term growth records. After a thorough study it was found that the analysis is invalid. Please see Article 11 of the Schudy Chronicles.
6.	We thoroughly studied vertical and horizontal growth increments in relation to the treatment of malocclusion and in relation to post treatment growth.
7.	We published several articles in the Angle Orthodontist, the AAODO AND Journal of Clinical Orthodontics, where we thoroughly, objectively and comprehensively recorded many treatment results. Please see Article 16 of the Schudy Chronicles.
8.	We published 44 articles in the Schudy Chronicles. In these discussions we recommended a new growth analysis based on stable vertical and horizontal landmarks from which horizontal and vertical growth can be accurately measured. In these Internet discussions we pointed out several published articles which were either incorrect or inadequate or both. Please see Article 24 in the Schudy Chronicles.
9.	In his post doctoral thesis my son, Dr. George Schudy, first discovered that the bending of the gonion angle limits condylion/gnathion distance and thereby unfavorably affects the treatment of malocclusion. This thesis was published in 1972. In the book, Orthodontics for the Next Millennium, Creekmore and Radney pointed out some very important concepts.
10.	In Article 1 of the Schudy Chronicles, in Fig. 5 and Fig. 6, we reported a shocking variation in the reduction in the gonion angle resulting from growth. This remarkable difference in the reduction of this angle has a marked effect on the condylion/gnathion distance and on the treatment of Class II malocclusion.
11.	We discussed the need for a new paradigm pertaining to the growth of the jaws. It was suggested that we base our analysis on the actual growth increments, not on the effects of these increments.
12.	While all of the above events were occurring over a 40 year period of time, so far as I know and believe, there were few new basic concepts being reported. The work of Björk was new, quite extensive, and very much appreciated. During this period there was a considerable amount of discussion pertaining to various facial analyses, most of which have been shown to be invalid.