THE HISTORY OF AN ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS WAY OF THINKING
- THE BIOPROGRESSIVE THERAPY-
To talk about the history of Bioprogressive Therapy Philosophy we must travel back to the past and start to analyze the beginnings of the so-called “Ortodontia”, in order to understand the context of that moment of changes. Since the first steps of Dr Angle and his contemporary colleagues such as Dr Calvin Case and followed by their followers such as Dr Charles Tweed and many others, the main goal on Orthodontic treatment was to align the teeth and as soon as the teeth were in alignment a comfort zone could be reached, this way the alignment of the teeth alone was the first priority, no matter if was needed teeth extractions or enlargement of the arches. In the beginning everything was developed by attempt and mistakes, all appliances were hand made till the discovery of X-Rays and the Roentgenography. Before the advent of chrome alloy (stainless steel), orthodontists had to be skilled craftsman as well as doctors. In fact, much of their time was spent devising, constructing, and maintaining their own oral appliances. Because those appliances were typically fabricated from gold alloy, which tended to loosen in a short period of time, a large part of an orthodontist’s work was dedicated to repairing and adjusting the appliances after they had been put into use. The orthodontist’s job demanded mechanical skill, diligence, and even artistry.
All of that changed with the development of versatile stainless steel alloys coupled with the ingenuity and foresight of RMO®’s founder, Dr. Archie Brusse, and those inventive changes were first presented in 1933, in Oklahoma. At that moment the company was named Rocky Mountain Metal Products.
When Dr Robert Murray Ricketts decided to enter the Dental School in Indiana, in January 1943, this was the Orthodontics environment at that moment. The world was affected by two world wars, many of young doctors at that moment had to serve the Army and somehow this status influenced them. This also happened to Dr Ricketts, the money disappeared and was very difficult to have enough money to afford a graduation course. Apart of hard days, his fist contact to Orthodontics happened when he was a graduating student in Indiana. He received his first lecture on Orthodontics from Dr Thomas Spiedel and it was utilized Dr Jacob Salzmann’s textbook. By that moment he got fascinated for the specialty and start his mission to become a post-graduate student of Orthodontics. He came to Indiana University Dean William Crawford and asked for advice about it, and instantly he recommended the program at University of Illinois at Chicago, under Allan G. Brodie responsibility. After some attempts Dr Ricketts was accepted to the program in September of 1947. As Dr Brodie had being a Dr Angle’s pupil, the program was focused on the Edgewise experience. According Dr Ricketts words: “Dr Brodie had the most exceptional proclivity to instill in his students a sense of the importance of Orthodontics to their lives and to our whole culture in general. He expressed a love and respect for the profession that I had never experienced before.”
Being a student and researcher in Chicago, Rick made many good friendships and connections, he had the opportunity to work with Dr Pruzansky, his classmate, Dr. William Downs, his mentor, met Dr Cecil Steiner and Dr Silas Klöen. Dr Steiner was the one who encourage him to move to Pacific Palisades in California, open an office and start his own practice, receiving his first patient on July 1st, 1952.
During his days as a student and researcher in Chicago Rick produced his first papers on TMJ subject, utilizing Laminagraphy.
Also following Dr Downs suggestions he developed a technique of forecasting the facial growth for 2 years period from lateral radiographies. During his practice in California, little by little continued to work on new mechanical techniques and appliances.
After his first 10 years in practice, collecting many patients’ records, Rick started to convince many colleagues about his thoughts and expressive results.
In 1959 he accept a young man under a preceptorship, Dr Ruel Bench. Dr Bench would become one of his most important helper and partner on the development of Bioprogressive Therapy Philosophy.
His long partnership with Rocky Mountain Orthodontics – RMO – helped him to develop many useful products and devices, such as preformed bands and pre adjusted brackets, presented on AAO meeting in Los Angeles, May of 1962.
In 1963 Dr Ricketts started his advanced classes for groups of 15 to 25 people and in 1968 all students were invited to met together and it was founded the FOR (Foundation for Orthodontic Research), in san Francisco – CA.
In 1966 the facial growth on side view started and in 1968 was located a radial point from which the face growth as “sun rays”, it was called “polar growth phenomenon”.
After many travels around the world for lecturing, Rick made lots of great connections and followers in all Continents, in many countries.
In 1970 Dr Ricketts was already associated to Dr Bench in his practice and lectures, and they decided to hire a new doctor to join the team, Dr James Hilgers. This way Dr Ricketts could have more free time to dedicate himself to research and teaching.
The arcial growth of the mandible was described in 1971 and first published in 1972.
During the years 70s Ricketts was under his most motivated moment to lecture, expand his thoughts and ideas. Ironically, on the other hand, he experienced difficulties of acceptance of those news ideas. In the history of the world it was quite common, particularly when new investigators pointed and show new directions in science… And it wasn’t different with Dr Robert M. Ricketts. In 1975 alone Rick published six articles and had received the Ketchum Award.
At this moment, with the help of Dr Carl Gugino, Ricketts ideas were spread all around the world. But in 1977 Rick and Bench ended their practice partnership, but kept as good friends.
After some turbulent years, in 1979 Dr Ricketts had a new start on his science production by producing six new papers and a book: “Bioprogressive Therapy”; it was done together to Dr Ruel Bench, Carl Gugino, Dr James Hilgers and Robert Schulhof. This book became the textbook for Bioprogressive Philosophy; it included many Ricketts and cooperators papers and added lots of detailed information on mechanics and description of the techniques involved in the Philosophy. This book was translated into many languages all around the world.
During the ending of 70s and beginning of 80s new Doctors helped and assisted Dr Ricketts: Dr Ken Fischer, who became manager of FOR (Foundation for Orthodontic Research) and Dr Rick Jacobson to who Dr Ricketts sold his practice.
After the discovering of arcial growth of the mandible, geometrics and mathematics fascinate Dr Ricketts. In order to have better understanding on this field he visited Dr Melvin Moss, in New York. Dr Moss instigates him to research and study about Divine Proportion and the Fibonacci numbers, it was in 1979. In 1980s Ricketts started to lecture about those principle to orthodontists and plastic surgeons.
In 1985 and 1986 Ricketts dedicated his efforts to publish a book collection together to RMO, trying to put all his ideas and efforts on past years together, with the objective of tell a story. It was published, in fact, two books, so called as Book One with Part I and II, in 1989. It never happened the Book Two…
I COULDN’T FIND EXACTLY WHEN RICK STOPPED HIS PRACTICE…
On years 1990s he dedicated his career to keep improving and proving his growth prediction system and travelled all around the world for lecturing. He also published some manuals describing and updating his thoughts and the Bioprogressive science on many details.
From 1997 till 2002 Ricketts launched 13 manuals on many Bioprogressive Therapy subjects, under Bioprogressive Institute for Bioprogressive Education, Scottsdale – Arizona label.
He didn’t stop to publish and lecture till he passed away in June 2003.
After Rick death, it was organized a FOR meeting, held in Orlando – FL, in 2004, with the presence of Bioprogressive and Dr Ricketts followers from all around the world. Many subjects were debated, including the idea of change the name of Bioprogressive Therapy, what was rejected by the majority of the doctors. A big party happened, this was what Rick requested to all of his friends and family. Unfortunately this was the last FOR meeting and the group dissolved.
It is easy to understand the reason why the Bioprogressive Therapy did not become as popular as some other Straight Wire techniques… The Bioprogressive Therapy was developed by Ricketts and all of his followers little by little, aggregating more and more information, as soon as new biological findings were being discovered, some new Biomechanical artifacts were being aggregated, and this way on, making the Orthodontic and Dentofacial treatment of the human being customized to each individual that entered an Ortho office. Those findings and customizations increased the learning curve; Orthodontics is not simply teeth alignment anymore. Now biology enter to the consciousness and diagnosis and treatment planning became much more complex. People usually scare with difficulties and try to search for something that can make their lives easier and simpler, without cutting earnings.
Treatment protocols can be easier to be taught to post graduation students, but what will happen when the students have to face their first problems in their offices? If the treatment protocol can’t give them answers, what should they do?
If we observe that is happening to the specialty nowadays what can we see? The major changes are focused on brackets prescriptions and design. Many authors believe by changing torque, angulation and tipping in some amounts of degrees here or there, now we can have a perfect “system”. The is no doubt that the addition of new technologies, developing new materials and alloys can reduce somehow treatment steps, but it will never change the biological principles. Those principles described in 1979’s text book was supposed to be the guidelines for any orthodontic treatment, one by one here they are:
1. The use of systems to approach to diagnosis and treatment by the application of the visual treatment objective in planning treatment, evaluating anchorage and monitoring results.
2. Torque control throughout treatment.
3. Muscular and cortical bone anchorage.
4. Movement of all teeth in any direction with proper application of pressure.
5. Orthopedic alteration.
6. Treat the overbite before the overjet correction.
7. Sectional arch therapy.
8. Concept of overtreatment.
9. Unlocking the malocclusion in a progressive sequence of treatment in order to establish or restore more normal function.
10. Efficiency in treatment with quality results, utilizing a concept of prefabrication of appliances.
We lose our mentor, the man that drove the professionals who followed this approach of treat patients and after the last FOR meeting in Orlando – FL – 2004, we also lose a meeting group. But, several doctors kept practicing the Bioprogressive Therapy all around the world; the principles didn’t stop to be practiced!
Now, with the Modern Bioprogressive Organization, we want to have the meeting point back. Make this portal as an area for debates, suggestions and more than anything, a place where we can create new papers for publishing, and scientific works can be done. Why call as Modern Bioprogressive? Because, apart of the need of keep the principles alive, we now have new products and material that can be integrated and make our lives easier, developing mechanical procedures faster but driven the treatment to the excellence. Can the Modern Bioprogressive be fashion in the world of Orthodontics techniques? Maybe yes, maybe not, but this is not the main intention, what we want is to have a portal of continuous progression. This way we can certainly affirm that respecting the BIO and PROGRESSIVE we will be fashion, with our patients.