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The Art of Detailing: The Philosophy Behind Excellence


360 pages, 158 illustrations. $240. 2013.

Quintessence Publishing Co., Inc., 4350 Chandler Drive, Hanover Park, IL 60133.

(800) 621-0387; www.quintpub.com.

Interdisciplinary treatment of an adult patient with a complex malocclusion is one of our greatest challenges, requiring the orthodontist to work within the confines of a compromised periodontium, the patient's demands, and the referring dentist's often unrealistic expectations for establishing an ideal occlusion. In this book, Dr. Rafi Romano describes the steps required to successfully treat such patients and, more important, shows the dramatic smile transformations that can occur if clinicians are willing to commit themselves to comprehensive interdisciplinary treatment planning.

The Art of Detailing: The Philosophy Behind Excellence is not a book about orthodontic finishing, as the title might suggest, but rather the final volume in Dr. Romano's trilogy on complex interdisciplinary adult treatment, following The Art of the Smile and The Art of Treatment Planning. Filled with beautiful step-by-step illustrations, the new book comprises 22 outstanding case reports organized into four sections--"Careful Patient Evaluation and Diagnosis", "Interdisciplinary Treatment Planning", "Minimally Invasive Approach", and "Patient- Centered Treatment"--with each example selected to teach an important principle of interdisciplinary treatment.

The seven cases involving orthodontics are full of clinical pearls such as flipping (but not switching) lateral incisor brackets for labial root torque, predictable resin bonding of incisal embrasures, and application of Emdogain for restoration of a bony defect. Three chapters are of particular interest: Dr. Birte Melsen demonstrates nonsurgical orthodontic treatment of an adult male with an impinging overbite and collapsed mandibular third molar, using a bonded anterior bite plate and intrusion utility wires (a technique often employed in my own office); Drs. Giovanni Zucchelli and Giulio Bonetti recommend a bonded rectangular lingual retainer to resist lingual root torque in a patient with a nail-biting habit, showing remarkable results from an autogenous connective tissue graft; and Dr. Romano presents an elegant treatment of an adult patient with bilaterally impacted maxillary canines, using a combination of custom lingual and traditional labial brackets. My only wish was that every case's interdisciplinary treatment plan would have involved some form of orthodontic therapy.

At the beginning of each chapter, the authors provide a philosophical basis for the treatment and highlight the challenges faced by the team, allowing the reader to follow their thought processes before reviewing the steps involved in successful completion of the case. Even more intriguing is a retrospective evaluation of how the clinicians might treat the patient differently today. Haven't we all wished we could go back and retreat certain cases after knowing what we know now?

Although this book covers interdisciplinary treatment planning from the orthodontist's point of view, it will be useful to anyone who practices interdisciplinary dentistry. Together with Dr. Romano's other two volumes, The Art of Detailing offers an expertly guided tour through the art and science of complex dentistry.


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