Professor Birte Melsen


Professor Birte Melsen was born in Aabenraa, Denmark 9th of June 1939. She did not want to become a dentist, but her stephfather encouraged her to choose dentistry instead of mathematics, which had been her preference.

During her dental studies she met E.Harvold who inspired her to go for orthodontics. She became professor and Head of Department of Orthodontics at the university of Aarhus Denmark i 1975. She retired from this position 2012 and is now affiliated with the University of West Australia Perth, NYU NewYork and the university of Hannover Germany with the title of visiting Professor. 1986 -2020, she has been working part time in a private practice in Lübeck, Germany (limited to adult orthodontics). Professor Melsen has authored more than 400 publications in the fields of growth and development based on research of human autopsy material, bone biology and clinical implant studies.

The inspiration she ows to many colleagues, among others A.Bjørk, M.Moss, H. Frost, C.Burstone. In recent years her professional interests have focused primarily on the fields of Skeletal Anchorage, Virtual Imaging and Adult Orthodontic Treatment and the Future of Orth0doontics. In 2000 she received the Knighthood of Dannebrog 1st degree.

Lecture 1: TADs, a Blessing or a Curse?

The TADs were introduced in the nineties when ”zygoma ligatures” were replaced by surgical screws. Soon orthodontic companies all over world presented special TADs and almost 1000 publications on TADs have appeared.

 The blessing is that TADs widened the spectrum of Orthodontics making treatment previously considered impossible possible; the curse is that by making anchorage easier TADs also made careful planning superfluous. 

The blessing has been that the TADs have served as handles for displacements of bone e.g. in relation to arch widening. The curse is that long-term observations have demonstrated that the changes not always compatible with normal function and can generate major periodontal damage.

 A blessing may be that TADs can be used as a temporary tooth replacement of missing teeth and bone maintainers.  The curse is, however, that when removed and not replaced immediately by implants the alveolar bone will disappear.   

The blessing is that distal occlusion can be corrected by driving the molar distally with a TAD as anchorage The curse is that when the distal occlusion is of skeletal origin intramaxillary displacement of the molar beyond the “Key ridge” will relapse.

 It is often in a state of despair that new inventions are done. The TADs are no exception; 

Learning objective 1: Define the indication for the use of TADS.

Learning objective 2: Describe how TADs can be used as bone Maintainers.

Learning objective 3: Realize when the indication for TADs is wrong  

Lecture 2: Arch width. What are the limitations? 

Over the last decennia our perception of aesthetics have changed and the focus has been on ”black corridors” indicating the perceived  need for expansion. This has been done both with prefabricated arch wires, with TAD supported expansion devices or surgical assisted skeletal expansion by opening of the mid-palatal suture. Performing such treatments without a thorough knowledge of factors of importance for the transverse development has led to both relapse and iatrogenic damage. Both genetics and function have an impact that should not be overlooked.

 Why do some treatments relapse?  

An understanding of the postnatal development of the maxillary arch must be the basis for a treatment plan involving changes in the arch width.  Changes in form must be followed by change in function.

An understanding of the how the timing can influence the closure of the mid-palatal suture can help defining the possibilities and limitation in the treatment induced changes in the arch width.

 The lecture will discuss the recent trends within treatment including changes in arch width in the light of basic science research done over the last forty year and demonstrate how the companies are dominating the trend in clinical routine, marked driven orthodontics.

Learning objectives:

1.To mention factors of importance for the transverse dimension of the dental arch .

2. To describe the drawback of the widening of the arches.

3. Understand why sutures close.