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GU n. 63 del 10/03/2020
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The Authors



72 pages • 504 color illustrations

ISBN 978-88-7572-153-4

Prezzo di copertina 60,00 €


57,00 €


The Authors

Medical doctor and surgeon
Specialist in Odontostomatology
Specialist in Orthodontics
Associate Professor of Odontostomatology
General Coordinator of the Smile House at the San Paolo Hospital in Milan

Graduate in Dentistry and Dental Prosthetics
Specialist in Orthodontics
Adjunct professor at the School of Specialisation in Orthodontics, University of Milan

Graduate in Dentistry and Dental Prosthetics
Private practitioner in Milan


Orthodontics is a field that was first pioneered in Italy in the 1950s by masters such as Professors E. Muzi, G. May and O. Hoffer. It subsequently grew and evolved, thanks to the creation of the first Italian Orthodontics Study Group (G.I.S.O. - 1967), the Italian Society of Orthodontics (S.I.D.O. - 1968), and Italy’s Postgraduate Schools of Orthodontics, beginning with Cagliari in 1973, but also as a result of the setting up of advanced courses and Masters’ degree courses. In this way, over several decades, having been launched by a handful of early pioneers, it evolved into a field involving several thousand professionals.

Hence there emerged the need for the present series, made up entirely of monographs. In line with our approach, it was decided that, in this volume, ample space should be devoted to images, in order to facilitate its use as a reference book/ atlas, and thus encourage its practical application. The text, always concise, has been prepared with rigorous attention to its scientific and bibliographic content, and it is set out in an effective and logical way. It is easy to consult, thus enabling the reader to use it to its greatest advantage. To our deep satisfaction, a few years ago the series reached its “silver jubilee” 25th volume, from thereon advancing rapidly towards new milestones that were certainly more than could have been envisaged when, in 1996, the project tentatively got under way with the first volume. The merit for this achievement must certainly go to all of Italy’s various university schools of orthodontics and to the independent professionals of proven experience, who, over the years, have readily and enthusiastically supported the initiative, being prepared to pour the best results obtained in their specific fields of research into the highly significant monographs that have made it such a valuable collection. In more recent years, the series has been further enriched thanks to the important decision, stemming from the vision and courage of Dr Alfredo Martina and his children, Vincenzo and Nadia, to publish these volumes in two languages contemporaneously: English as well as Italian.

The tasks of an editor are numerous, ranging from guaranteeing the scientific quality of the work published to reminding authors to respect delivery/correction deadlines, providing them with advice and help as they prepare their volumes, and assisting the publisher in the decision-making process. However, I feel that the editor’s main task is, out of absolute respect for the reader, that of selecting and coordinating the titles and ensuring that the order in which they are published is exactly the right one.

Because the reader must be stimulated and not allowed to become bored. Accordingly, the five most recent volumes in the present series deliberately cover a range of areas: classical clinical topics (No. 32 on functional therapy), advanced research (No. 33 on genetics), specific situations (No. 34 devoted to traumatic injuries), specific sectors (No. 35 on alignment of the back teeth), and appliances (No. 36 on the lip bumper). Thus, two and a half years on, it was felt to be high time to return to a classic topic in our field: orthodontics in adults. This is an area, encountered daily in our clinical practice, in which we are becoming increasingly involved on a technical level.

I make no secret of the pleasure and satisfaction I feel each time we bring out a new volume in our series devoted to orthodontics, and I am now delighted to present the 37th volume, written by one of the leading professionals produced by the Milan school of orthodontics.

It is often said that the pupil should surpass the master; this is true, very true, but it is also very rare. However, and I assure you that here I am speaking from direct experience of various relationships (father/son, teacher/follower, director/ intern), it is actually far better when masters and pupils work together, each pouring all that he or she has to offer into the final product, which thus becomes the result of a coming together of experience, a balanced diagnostic approach, new technologies, enthusiasm, intellectual fervour and, most important of all, an EXCHANGING OF IDEAS. Certainly, on reading the draft of this volume written by Prof. Giovanna Garattini, together with her “pupils” Dr Elena Bazzini and Dr Luca Boschian-Pest, I immediately found myself imagining a group of people gathered around a table, or, if you like, a dentist’s chair. This volume is divided into eight chapters in which the reader will find evidence and solutions relevant to the problems he or she may come up against. The set of images, clear and precise, accompanies a series of clinical cases and is supported by pertinent and practically useful information. It is therefore a monograph suitable not only for novices, but also for more experienced orthodontists, who will find it to be a rich source of small or sometimes more important tips that can help them to improve in their work.

I wish, once again, to acknowledge and thank our publisher, Dr Alfredo Martina, for the tireless energy and enthusiasm that he continues to display. Finally, I wish to congratulate the authors most sincerely on the work they have done.

Prof. Alberto Caprioglio

Associate Professor of Orthodontics
Director of the School of Specialisation in Orthodontics
University of Insubria

PS: The idea of publishing the present volume, “ORTHODONTICS IN ADULTS”, was very strongly supported by my father Damaso, who has great respect and affection for Prof. Garattini, with whom he shares many memories. In recent years he “has really urged Giovanna to write”. On more than one occasion, I have noted with admiration the patience with which Prof. Garattini accepted my father’s input, each time wondering about the source of the generous dose of the cardinal virtues she possesses. But given the outcome of this endeavour, I have to admit that, as has often been the case, he was right!


It is very unusual for the Director of a series of scientific volumes to write the foreword to a monograph included in the series.
I made an exception in the case of the monographs written by two of my former pupils from the Parma school, with whom I share a warm relationship based on decades of collaboration, respect and gratitude.

I am now delighted to be making a second exception; indeed, I felt honoured when Prof. Giovanna Garattini and her excellent collaborators asked me to write the foreword to this volume.

Prof. Garattini and I are bound by three decades of deep friendship and mutual esteem, during which we have frequently exchanged ideas in the course of our professional activity (both clinical and research work) and shared the joys and times of sadness that life’s ups and downs have brought us – the emotions, fears, anxieties and concerns, but also the moments of great satisfaction.

I first met her when she was the young pupil of a dear friend of mine, whom I considered to be one of the finest teachers of the early 1970s: Professor Giorgio Vogel.
Indeed, I held him in such high regard that when I left the University of Pavia at the end of the 1960s, I decided, in response to a warm and pressing invitation from him, to join him, in my capacity as a freelance lecturer of clinical dentistry, at the institute at the University of Milan which he directed.
I was fascinated by his school which was always holistic and involved all the various dental disciplines.

I was impressed by his teaching method, which, anticipating the concept of evidence-based medicine, was precise, meticulous, always supported by the best international literature, and based on scientific research always conducted as a team endeavour according to a serious and rigorous approach that involved lengthy and repeated verification and immediate and direct comparison with the work done in the best foreign schools; I was also struck by his clinical approach, which was thorough, precise, passionate and extremely human, never conditioned by factors such as social class and income, and in which the priority was always the patient and his diagnosis and treatment.

In this remarkable school he trained some excellent pupils, today themselves distinguished teachers across all fields.
Giovanna Garattini was one such pupil – pragmatic, precise, rigorous, passionate and also faithful to his teachings – who, gradually, managed to grow and excel in her chosen discipline: orthodontics.

We formed a friendship, strengthened by our mutual regard for each other. Through our attendance of courses and congresses we got to know each other better and even though we differed in age, this was never a barrier; on the contrary it made our friendship all the more precious.

As time went by, I came to appreciate all the qualities that her teacher had instilled in her, which she managed not only to assimilate and make her own, but also to enhance, improve and, in turn, pass on to her own pupils.

Thus she formed her own school and her own team, based at the San Paolo hospital in Milan. It is a close-knit and enthusiastic team with a rigorous and precise approach, which has created a stimulating and gratifying working environment.

I first asked her to write this monograph years ago, aware of her great professionalism and that of her pupils, especially in the field of orthodontics in adults.
It was a tough job convincing her.

The fact that she did not feel sufficiently qualified for the task underlines her remarkable humility and modesty, qualities that make her even more valuable and reliable. “Vera Scientia Est Celare Scientiam”!

I think that her guiding motto has always been to: “study, research, teach and treat, always with care, consideration, diligence, great humanity and a sense of responsibility towards students, staff and patients”!

Quietly and painstakingly she began to collect and gradually verify, through rigorous follow ups, all the documentation she had produced in the course of her decades of clinical and research work.

Only after she had completed this careful verification did she agree to prepare this monograph.

She has been flanked in the task by two excellent collaborators, Dr Elena Bazzini and Dr Luca Boschian-Pest, both of whom have, like her, gradually acquired the rigour and methodology of their teacher.

The result is a monograph of enormous scientific and practical value, as already stated in the presentation.

Every orthodontist, from the most expert professional to the postgraduate student in training, will find it to be a source of clinical and research knowledge that can be readily applied in the multifaceted, varied, difficult and insidious field of orthodontic treatment of adults, where, once again, an interdisciplinary and multidisciplinary approach can be seen to be vital and irreplaceable.

This is an aspect that clearly emerges from the list of chapters, which show that diagnosis and orthodontic problems are always addressed in relation to other disciplines and areas: periodontics, restorative dentistry, prosthetics, maxillofacial surgery and complex situations.

There is no doubt that this is one of the most complex and challenging fields in the increasingly fascinating discipline of orthodontics!

What emerges, on looking through the different chapters, is the validity, practical importance and considerable experience of Prof. Garattini’s school. Finally, it should be pointed out that, together with all the different treatments proposed, it is also necessary to add another special ingredient. As the authors themselves point out in the conclusions: We should always try to apply “clinical common sense” !!

This monograph, number 37 in the series, means a great deal to Prof. Giovanna Garattini and I am sure that it will bring her much gratification and recognition!

For my part, I am delighted that the fruits of her labours and her prestigious school have now become a part of this series and that this experience has further deepened and enriched our friendship.

Prof. Damaso Caprioglio

Professor and Former Chairman
Department of Orthodontics
University of Parma
Dean of Postgraduate Italians in Orthodontics


Undertaking to write a monograph is a very important and dangerous decision, loaded with responsibility: “it takes courage” and also a measure of presumptuousness!
This book is intended to serve as a starting point for the reader wanting to gain a more in-depth insight into the topics covered. It is largely iconographic, with the many images serving to illustrate the various types of treatment that are possible in adults.

After working in the field of orthodontics for more than 30 years, I came to the decision to write a “summary” of this experience. The enormous encouragement of Maso Caprioglio, to whom I certainly owe this undertaking and who, for this and other reasons, I will never stop thanking, was decisive!

I wish to express my profound gratitude to my beloved mentor, Giorgio Vogel, whom I remember with real affection and whose fundamental teachings and professional example I guard jealously. I count myself extremely fortunate to have had a teacher of such high intellectual and cultural calibre! I remain deeply saddened by his death.

A fond and grateful mention also goes to Misa Ferro, my first teacher of orthodontics.

I wish to say a special thank you to Roberto Brusati, a great master of maxillofacial surgery, extraordinary clinician and person of great determination and tenacity, with whom I have shared years of intense work and great professional satisfaction.

I warmly thank my co-authors – Elena Bazzini who, as I often recall when introducing her, was once an assiduous student of mine and is now not only my right arm but also my left, and Luca Boschian-Pest, who represents the complementary part or missing link of my profession – for being by my side on a daily basis for so many years, both in the clinical departments at the San Paolo Hospital in Milan and in private practice.

A warm mention also goes to my longstanding pupil and collaborator, Giacomo Grasso who, to his regret, was unable to take part in the writing of this book.

Then, of course, I must mention all my former pupils, most of whom are now fine and well-established professionals. I may have been their teacher, but for me they have been a source of innovative ideas, vital energy and enthusiasm: to name just a few of them would mean leaving out many others, therefore I extend my thanks to them all collectively.

In addition, how could I fail to thank all the colleagues from other disciplines who have actively contributed to the solution of many adult cases requiring an interdisciplinary approach: Claudio Gatti, Paolo Crozzoli, Eugenio Romeo, Franco Brenna, Matteo Chiapasco, Alessandro Rossi, Mauro Belluz, Mario Pignanelli and many others besides.

Indeed, we have addressed numerous clinical cases together, and have done so united by a common desire and determination to do our very utmost for our patients.

Last but not least, as the saying goes, I wish to extend my deep and loving thanks to the men in my life: Carlo, Maurizio and Giò Rossi, who have been deprived of so much of my time and my attention on account of my day-to-day work.

And of course to my beloved parents.

Prof.ssa Giovanna Garattini

Associate Professor of Odontostomatology
General Coordinator of the Smile House
at the San Paolo Hospital in Milan