R.G. "WICK" ALEXANDER, DDS, MSD
232 pages, 1,000 illustrations. $138. 2008.
Quintessence Publishing Co., Inc.
4350 Chandler Drive
Hanover Park, IL 60133
(800) 621-0387; www.quintpub.com.
Although Dr. R.G. "Wick" Alexander's numerous academic, professional, and clinical contributions to the specialty of orthodontics have been well documented and recognized by his colleagues, this book might represent his greatest and most enduring gift to all of us. The 20 Principles of the Alexander Discipline represents a lifetime of critical thinking and assessment.
These 20 principles--all aimed at producing treatment plans and treatment outcomes that optimize esthetics, function, and stability--are presented simply and understandably, accompanied by high-quality patient records, illustrations, and other photographs. Most of the chapters, each focusing on one principle, are short. Still, they are supported by credible evidence-based research and impressive clinical experience, with long-term stability documented, in some cases, 30 years or more out of retention.
For example, Principle 9 illustrates the importance, requirements, and subtleties of establishing ideal archform during orthodontic treatment. Many of the myths surrounding the extraction/nonextraction decision, as well as the potential outcomes of such treatment, are successfully debunked. Dr. Alexander demonstrates how beautiful (and full) smiles can be attained in either extraction or nonextraction cases, without "negative space" in the buccal corridors, when proper attention is paid to archform and individual tooth positions.
Principle 14, "Level the Arches and Open the Bite with Reverse-Curve Archwires", is another study in how to attain optimum clinical results in a critical area of orthodontic treatment. The author demonstrates consistent leveling of the curve of Spee without excessive flaring of the mandibular incisors.
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If I were to summarize Dr. Alexander's use of the word discipline in this text and in his other teachings, I would simply intepret it as "doing the right thing at the right moment for each and every individual patient". The 20 Principles of the Alexander Discipline is no cookbook for achieving orthodontic success. It is, however, a logical and sensible thinking process that will enhance treatment outcomes by helping us avoid the mistakes that contribute to compromised results. The text is steeped in concepts relating to the ethical responsibilities of orthodontists to every patient. Most refreshing, however, is the absence of dogmatic and unsubstantiated claims intended merely to entice clinicians. While the author demonstrates the ease with which many of these cases have been treated with the Alexander orthodontic appliance--including individual tooth alignment, leveling, space closure, control of incisor positions, and establishment of appropriate torque--it is clear that his concepts remain universal to any edgewise mechanism if used judiciously. All orthodontists and students who aspire to rendering optimal treatment to their patients, regardless of their preferred appliance systems, will be engaged, intrigued, and inspired by Dr. Alexander's extraordinary book.
ELLIOTT M. MOSKOWITZ, DDS, MSD