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The Alexander Discipline, Vol. 3: Unusual and Difficult Cases


192 pages, 1,030 illustrations. $176. 2016.
Quintessence Publishing Co., Inc., 4350 Chandler Drive, Hanover Park, IL, 60133.
(800) 621-0387; www.quintpub.com.

Dr. R.G. "Wick" Alexander is well known to JCO readers as a long-time member of our editorial board and a regular contributor. He has spoken practically everywhere orthodontic lectures are given. Furthermore, as a professor at several universities, Dr. Alexander has helped form the diagnostic, treatment-planning, and clinical skills of myriad orthodontic students. His clinical philosophy has attracted a worldwide following under the moniker of the Alexander Discipline, with its concomitant technique and appliance, the Vari-Simplex Discipline.

Three previous books, along with a classic series of articles in JCO (May-October 1983), have detailed Dr. Alexander's principles and procedures. The Alexander Discipline: Contemporary Concepts and Philosophies was published in 1986. My copy is heavily worn with fingerprints and scribbled notes. It has obviously been a text I have referred to throughout my career, and it is still one of my primary "go-to" books on clinical techniques and office management.

Its successor, The 20 Principles of the Alexander Discipline, published in 2008, codified the discipline into 20 clearly stated principles. The result was a high-level, easy-to-follow textbook of orthodontic techniques that has seen wide adaptation in graduate orthodontic programs around the world. Each case presentation in these first two books included the diagnosis, treatment plan, individual archwire sequence, and elastic forces applied to finish the case.

The Alexander Discipline, Vol. 2: Long-Term Stability was released in 2011. Proposing six guidelines for building facial harmony and stability, this text addressed torque, skeletal, and transverse control; occlusion; and the soft-tissue profile. All three books featured high-quality illustrations and clear presentations of cases depicting the author¬Ęs techniques.

The Alexander Discipline, Vol. 3: Unusual and Difficult Cases steps up to an even higher level of excellence, offering cases outside the normal boundaries of day-to-day orthodontic practice. As Dr. Alexander states, "The purpose of this book is to demonstrate how certain changes should be made from the 'routine' system to adapt to the individual 'unusual' case. These changes can include unusual extraction patterns, bracket angulations, treatment timing, and substitution of selected teeth." The "unusual" situations include open and deep bites; borderline treatments; Class IIIs; early treatment; adult treatment; atypical extractions; and impacted, transposed, and missing teeth. The writing, illustrations, presentation, logic, and esthetics are all outstanding. I already use this material in my own practice and in my teaching.

At one of the first lectures by Dr. Alexander I ever attended, he spoke about the KISS principle, commonly translated as "Keep It Simple, Stupid". By keeping his clinical techniques simple, Dr. Alexander has been able to systematize orthodontic treatment into an extremely effective paradigm that can handle practically any malocclusion. As I look back on all four of these books, I realize that he applies the KISS principle to his writing as well; in so doing, he develops an extremely effective paradigm of teaching clinical orthodontics.


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Dr. Keim is Editor, Journal of Clinical Orthodontics. Email at editor@jco-online.com.

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