©2008 JCO, Inc.
May not be distributed without permission.
www.jco-online.com
EDITOR
Robert G. Keim, DDS, EdD, PhD

SENIOR EDITOR
Eugene L. Gottlieb, DDS

ASSOCIATE EDITORS
Birte Melsen, DDS, DO
Ravindra Nanda, BDS, MDS, PhD
John J. Sheridan, DDS, MSD
Peter M. Sinclair, DDS, MSD
Bjorn U. Zachrisson, DDS, MSD, PhD

TECHNOLOGY EDITORW. Ronald Redmond, DDS, MS

CONTRIBUTING EDITORS
R.G. Alexander, DDS, MSD
S. Jay Bowman, DMD, MSD
Robert L. Boyd, DDS, MEd
John W. Graham, DDS, MD
Robert S. Haeger, DDS, MSWarren Hamula, DDS, MSD
James J. Hilgers, DDS, MS
James Mah, DDS, MS, DMS
Melvin Mayerson, DDS, MSD
Richard P. McLaughlin, DDSJames A. McNamara, DDS, PhD
Elliott M. Moskowitz, DDS, MS
Michael L. Swartz, DDS
Jeff Berger, BDS, DO (Canada)
Vittorio Cacciafesta, DDS, MSC, PhD (Italy)
José Carrière, DDS, MD, PhD (Spain)
Jorge Fastlicht, DDS, MS (Mexico)
Masatada Koga, DDS, PhD (Japan)
Jonathan Sandler, BDS, MSC, FDS RCPS,MOrth RCS (England)
Georges L.S. Skinazi, DDS, DSO, DCD(France)

MANAGING EDITORDavid S. Vogels III

ASSISTANT EDITOR
Wendy L. Osterman

BUSINESS MANAGER
Lynn M. Bollinger

CIRCULATION MANAGER
Carol S. Varsos

GRAPHIC DESIGNER
Jennifer Johnson
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VOLUME XLII NUMBER 8

THE EDITOR’S CORNER
Keep It Simple
I recently received a copy of Dr. R.G. “Wick” Alexander’s new book, The 20 Principles of the Alexander
Discipline. Dr. Alexander has been a familiar face on theorthodontic lecture circuit for many years; he has also
been one of JCO’s Contributing Editors since the earlydays of the journal. Everyone in the specialty knows Dr.
Alexander as a down-to-earth practitioner with the ability
to produce outstanding results using the most basic methods. His entire battery of treatment modalities consists oflittle more than braces, elastics, Kloehn-type headgear,and removable bite plates. The new book, which isreviewed elsewhere in this issue, presents an abundance ofcases ranging from the relatively straightforward to thenotably complex, yet he is able to produce enviable results
time and time again. His KISS motto—“Keep It Simple,Stupid”—governs his treatment decisions, while his credoof “Effort = Results” serves as a guiding light. The end
result of his application of these principles is a legacy ofexcellence.
As I read through the book and looked over case aftercase of remarkable results, it struck me that all these highquality treatments were achieved without relying on manyof the newer developments in our field. In this day and ageof high technology, it is refreshing to remind ourselves ofwhat can be accomplished with a basic approach and aminimal armamentarium. For example, I did not see
three-dimensional cone-beam technology being used for
diagnosis; instead, I saw conventional lateral cephalometric tracings with only seven variables measured. All therecords were meticulous, and each treatment plan was assimple as possible. It’s obvious that considerable thought
went into both the diagnosis of each case and the overall
delivery of care.
Since I have always had a difficult time getting mypatients to wear any sort of headgear, I envy Dr. Alexander’sability to convince his young patients to comply with suchprograms. No esoteric orthopedic appliances, no fancy
mandibular propulsors, no fixed correctors, no miniscrews
with nickel titanium coil springs—just good, old-fashioned© 2008 JCO, Inc.

433

EDITOR’S CORNER

headgear, producing consistent Class II orthopedic corrections and full, beautiful smiles. Bite
opening is achieved not with intrusion using
miniscrew anchorage, but with simple, removableacrylic bite plates that are applied after establishment of the maxillary archform. For closure of
extraction spaces, Dr. Alexander falls back on thetime-tested closing-loop archwire that Tweed
promoted so effectively. Mild-to-moderate growing Class IIIs are effectively treated with reversepull headgear, without the need for skeletal
anchorage. Interarch relationships and midlines
are corrected, and occlusions are settled, by thejudicious use of ordinary elastics. Skeletal crossbites are dealt with using the time-tested technique of rapid palatal expansion.
When I look back at the accomplishmentsof orthodontists like Dr. Alexander, who weretrained prior to all the modern technological developments that we see throughout the literatureand in clinical presentations, I can’t help but434

notice that the results they achieved were not only
equal to what we produce nowadays, but perhaps
even better and more stable. I do not mean toimply that the myriad technological developments of the last 20 or so years are useless—theyhave made treatment a little easier and more efficient for all of us—but an overreliance on advanced radiographic techniques, superelastic
archwires, and on-demand skeletal anchorage
can result in a diminution of the skills and acumen of the individual clinician, who, in the finalanalysis, is responsible for the outcome of eachtreated case.
It behooves us all not only to stay abreast ofscientific and technological developments in ourfield, but to continually rededicate ourselves tohoning our basic skills. Technology is no substitute for high personal standards and mastery ofproven techniques. Dr. Alexander’s work stands
as an extraordinary testament to this principle.
RGK

JCO/AUGUST 2008