Mithran Goonewardene

Biography

Mithran Goonewardene completed Dental School at The University of Western Australia in 1981 and attended the Forsyth Dental Center/Harvard School of Dental Medicine in Boston, USA from 1984-1987 where he completed his Certificate in Orthodontics and Master of Medical Science degree. He took up a teaching position in orthodontics at The University of Western Australia in 1987 and has been Head of Orthodontics and Graduate Program Director at The University of Western Australia since 1989. Dr Goonewardene is a full member of The Edward Angle Society of Orthodontists and is Certified by the Australian Orthodontic Board. He visits Sri Lanka regularly as a visiting Consultant in Orthodontics in the Dental Institute, Colombo and participates in part-time private practice in Perth.

Title

Orthodontic Re-Treatment

Abstract

Significantly more adult patients are seeking orthodontic treatment primarily for aesthetic improvement. A large number of patients are also presenting with a history of earlier orthodontic treatment. It is important to appreciate the motivation for re- treatment and shortcomings of the original treatment.

Aims and objectives.

Attendees will be informed of the predominant reasons for original treatment failings: poor treatment, maturational changes, inadequate retention, shortcomings in diagnosis and treatment planning, and unfavourable growth. Other reported causes were related to lac of appreciation of a transverse deficiency, secondary malocclusion (subsequent to periodontal breakdown), poor retention compliance and TMJ degeneration. Dr Goonewardene will review the findings of a study of adult patients compared to first time patients with clinical examples demonstrating some of the aforementioned shortcomings. Clinicians must learn from their diagnostic and therapeutic mistakes so we do not repeat such shortcomings. Moreover, clinicians should be mindful of the patient profiles of retreatment seekers and vigilant about the possible causes of failings of orthodontic treatment to avoid sub-optimal outcomes.  

Learning outcomes

After this lecture attendees will

• Appreciate the possible pitfalls in managing specific types of malocclusion traits.
• Have a series of recommendations to avoid shortcomings in diagnosis and treatment.
• Observe suggested therapeutic strategies to manage some of these adverse outcomes.