Burstone’s Biomechanical Foundation of Clinical Orthodontics

Kwangchul Choy, DDS, MS, PhD, 2022, Quintessence Publishing Co., www.quintpub.com

Whenever a classical textbook such as Biomechanical Foundation of Clinical Orthodontics reissues in a new edition, it returns to us in a new context. Dr. Burstone (1928-2015) is no longer here, and the book has taken a new title. Additionally, other changes have occurred based on reader feedback that have resulted in the re-creation of all the images for greater clarity, and video files with QR codes now accessible with smartphones or tablets. These videos illuminate and animate some of the topics to simplify readers’ understanding.

This book is the text par excellence for orthodontic biomechanics and should be the first book in every orthodontist’s library, for without the knowledge contained therein, clinicians will struggle to understand many of the iatrogenic creations that challenge and slow patient therapies.

Orthodontic technology continues to proceed — e.g., the 21st century has exploded with new procedures such as bone modification, distraction osteogenesis, temporary anchorage devices, new wire materials, and, of course, aligners. But despite what changes occur in therapies, none of them will supersede the need for a foundation in biomechanics described in this book. And that has special relevance as clinicians attempt to use aligners without such knowledge. Unfortunately, Burstone’s biomechanics are generally poorly understood and thus seldom taught in most orthodontic curricula. This new edition can remedy that intellectual deficit.

Orthodontic clinicians work in a dynamic environment that tests them daily and often severely. My own experience has reinforced the lesson that without a thorough knowledge and application of sound biomechanics that daily task becomes much harder and much less predictable, and readers of this book will discover cures for those lapses.

This new publication has eliminated two previous chapters without jeopardizing its central message, but it still approaches 9 lbs., so it isn’t a tome with which you want to snuggle in bed. Unlike a thrilling novel that readers refer to as “page turners,” this serious book is what I call a “page stopper” because you often need to carefully reread the text and then consider its application and compare the content with one’s own experience. And, finally, by solving the problems at the end of each chapter, readers will quickly learn if they completely understand the material.

Dentists by training and patient expectation are therapists, not diagnosticians, and that results in their being susceptible to new and promising therapies, which they can apply quickly without much thought. For example, one learns to use a new bracket system or incorporate a new Cl II corrector quickly without much effort or thought, whereas learning the lessons of biomechanics can challenge and even discourage the finest technical practitioner. Additionally, clinicians are inundated with hyperbolic advertisements, endorsements of shills in the employment of manufacturers, and visiting sales representatives. The best antidote for such extravagant claims is to apply scientific biomechanical principles and apply a simple test: New techniques with more marketing than research should undergo scrutiny like Catholic saints — guilty until proven otherwise.

Frederick Crews once aptly said that “Fatigue with rational standards in one generation becomes the pathetic ignorance of them in the next.” Fortunately, Dr. Choy has kept the faith with Dr. Burstone’s rational standards and his intentions with this new edition, and it will continue to be a principal guide for orthodontists as they seek to provide the type of patient care envisioned and practiced by Dr. Burstone. My hope is that orthodontics never suffers fatigue with the biomechanical principles so carefully developed by Dr. Burstone and remembered here by Dr. Choy.

Readers will appreciate the care and quality Quintessence has rendered with this book — e.g., thick pages, excellent images, and a design that encourages readership and increases understanding.

Review by Dr. Larry White.