Ideal Occlusion is Not Always the Ideal Treatment Plan William Dayan. AAO June 2021. Episode 93

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Farooq Ahmed

Ideal Occlusion is Not Always the Ideal Treatment Plan William Dayan


Class 2 retrognathic mandible

·      Patient declines orthognathic surgery

·      Accepting occlusal compromise, however achieving alignment


Class 3 lower incisor extraction case

·      Canine guidance not achieved, midlines not correct, molar relationship not ideal

·      However alternatives are extraction of lower premolars or surgery,

·      Camouflage of the class 3, efficient and effective with lower incisor extraction



Midline shift mandible LHS

·      Can use asymmetric elastics, however can result in cant in maxilla

·      William’s approach

o   Asymmetric curve of Wilson

o   Differential toque in power posterior teeth, greater on affected side

o   Tip crowns lingually on effected side – not require cross elastics

·      Accept lower centreline discrepancy

o   Balancing risk of centreline correction Vs negative effects of cross elastics


Severe AOB case, with posterior crossbite

·      Level, align, fall together

o   Posterior intrusion

o   Accept crossbite as alveolar processes distant

·      No use of elastics

·      Canine crossbite correction – for functional occlusion, accept posterior crossbite


Black triangles



Reasonable under the circumstances

·      Can be biological and appropriate






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