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School of Dentistry




Clinicians make decisions for their patients everyday. Ryan Hamilton, in his course guidebook, How You Decide: The Science of Human Decision Making, summarized the current research on the 4 R's of decision-making that matter: reference points, reasons, resources, and replacement. The authors will apply this principle in the decision- making necessary for the growing Class III patients. First, the decision on whether to treat or not to treat Class III patients in the mixed dentition rely on a thorough diagnosis and objectives for early treatment. For example, elimination of a functional shift of the mandible may be a good reason to institute early treatment. Second, the decision on when to start Phase II treatment relies on the follow-up observation after Phase I treatment. The authors suggested the use of a “checklist” to decide whether patient will be benefited from surgical intervention or nonsurgical orthodontic treatment. If the checklist review has several negative checkpoints, it will help the clinicians to decide on an aggressive stage of 4–8 months therapeutic re-diagnosis to confirm the surgical or nonsurgical decision.

Source Citation

Ngan P, Musich D. Early class III treatment decision making. APOS Trends Orthod 2019;9(2):68-72.


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