Orthodontic Treatment of Impacted Teeth

ADRIAN BECKER, BDS, LDS, DDO

3rd edition. 446 pages. $166.99. 2012.
Wiley-Blackwell, John Wiley & Sons, 10475 Crosspoint Blvd., Indianapolis, IN 46256.
(877) 762-2974; www.wiley.com.

The third edition of Adrian Becker's landmark publication on impacted teeth has now arrived, 14 years after the first. With a new publisher, a lower retail cost, and an additional 94 pages, Dr. Becker's latest version is a testament to his constant dedication to resolving one of the most difficult challenges of orthodontic treatment. So many texts attempt to cover the entire spectrum of orthodontics that it is a rare pleasure to see an entire publication-- especially one so thorough and definitive--devoted to one aspect of the specialty.

The key to almost any health-related issue is the capacity to diagnose. The first of Dr. Becker's 15 chapters covers virtually every diagnostic modality, including cone-beam computed tomography (CBCT). Considering the growing popularity of CBCT and the recent investigations into genetic relationships between other dental abnormalities (especially congenitally missing teeth) and impaction, I imagine a future fourth edition will be even more expansive.

Next to diagnosis, prevention of a particular health problem is of primary importance. Dr. Becker offers recommendations for early intervention, including non-orthodontic options. Pros and cons of various alternatives for surgical exposure and attachment are completely explored, covering more than just impacted canines; for example, special attention is paid to maxillary central incisors.

The hallmark of this book, however, has always been its attention to detail regarding the biomechanics involved in treating impacted teeth. As always, these are well illustrated, documented, and described in excellent case reports.

Most interesting are the discussions of problems associated with impactions, including root resorption, dentigerous cysts, cleidocranial dysplasia, extreme situations, iatrogenic issues, difficult treatment decisions, and failed results. Such topics make this much more than a handbook for treating impacted teeth.

All in all, Dr. Becker's latest contribution provides a comprehensive exploration of one of the most vexing issues faced by orthodontists. After the recent loss of three other revered experts on impactions (Vincent Kokich, Tiziano Baccetti, and Juri Kurol), I hope this indispensable textbook will stimulate new contributors to fill the void in our specialty.

S. JAY BOWMAN, DMD, MSD