Orthodontics
The Orthodontics is the branch of dentistry that deals with the prevention, detection and treatment of deformities of the jaw and the teeth ( malocclusion is concerned). The content of the department is better represented by the term Dento-Maxillary Orthopedics (jaw regulation). The term orthodontics (dental regulation) is mainly used in non-German speaking countries.
history
The first orthodontic special work was written in 1836 by Friedrich Christian Kneisel, Carl von Prussia's personal dentist, with The Misalignment of Teeth [...]. The first systematic textbooks on orthodontics were published by Norman Kingsley in 1880 and by Edward H. Angle , the "father of orthodontics", from 1887 onwards. Until the middle of the 19th century, the first instructions for tooth regulation published by Joseph Fox (1755–1816) were in use in England. The introduction of orthodontics (dental regulation) as an examination subject in Germany in 1927 was the merit of the dentist Alfred Kantorowicz, who was important for the development of modern orthodontics and school dental care .
Orthodontic diagnostics
A detailed diagnosis must be carried out prior to any orthodontic treatment. This consists of a detailed general and dental anamnesis, as well as the etiological assessment of the patient's situation. This is followed by a clinical examination, a functional analysis, model analysis and a cephalometric examination. With the help of this examination, the jaw relation, the positional relationship between the upper jaw and lower jaw, is shown. At the same time, the dentoalveolar findings are recorded and the dentition stage is determined.
classification
Various classifications exist to classify and delimit the anomalies. The most common classification in everyday medical communication is the division into angle classes.
The Angle classification divides misaligned teeth into three classes, depending on the position of the six-year-old molars to one another.
These classes are numbered Roman I to III, whereby
- Class I describes a eugnath (i.e. regular / neutral) relation.
- Class II describes a distal (i.e. a dorsal (towards the back)) position of the first lower molar relative to the first upper molar.
- Class III describes a mesial interlocking of the molars. It is also called prognosis . It can come with a progeny.
The disadvantage of this division is the viewing along only one spatial axis in the sagittal plane in the final bite . Deviations in other spatial axes, asymmetrical deviations, functional disorders, etc. are not recorded.
In Germany, the classification into orthodontic indication groups (KIG) is relevant for those insured by statutory health insurances , as the subsidy from the health insurances is based on the severity of the deformity. In Austria, the payment of orthodontic treatments for children and adolescents by the social insurance funds has been based on the Index of Orthodontic Treatment Need (IOTN) since 2015 , whereby the documented treatment quality, measured according to the PAR index, also plays a role.
Times for starting treatment
The timely diagnosis enables an adequate start of therapy, which may shorten the duration of the treatment or reduce the scope of the treatment. Some dysgnathy treatments are only possible within a specific time window.
Postnatal
In patients with cleft lip and palate and syndromes affecting the orofacial area, an orthodontic examination should be part of a multidisciplinary overall concept in the first few days of life.
Milk tooth eruption
During the deciduous tooth eruption, attention should be paid to the control of gaps so that the indication for an orthodontic gap holder can be made in good time.
Complete deciduous dentition
The deciduous dentition is complete around the third birthday. At this point in time, an orthodontic examination is recommended to clarify the indication and timing of orthodontic therapeutic measures, since the advantage of early treatment can be scientifically proven for certain dysgnathies, or early treatment can be advantageous.
Mixed dentition
In the first phase of the mixed dentition (around 6 to 8 years of age) and in the second phase of the mixed dentition (around 9 to 12 years of age), early treatment may be indicated for various indications. If necessary, if extraction therapy is planned, extractions should already be carried out during this phase of life.
Permanent dentition
The most common orthodontic treatments are performed between the ages of 12 and 18, after all permanent teeth (except for the wisdom teeth ) have erupted. Here it is also decided whether wisdom teeth are to be removed surgically or alternatively other teeth. Dysgnathia operations also often fall within this period.
Adult orthodontics
Orthodontic treatment can be carried out for patients in whom the diagnosis or treatment of craniomandibular dysfunctions was missed, during preprosthetic orthodontic measures or in the case of pathological tooth migration in the context of advanced periodontal disease . However, with a few exceptions, this is not covered by the statutory health insurance companies.
Therapy methods
Orthodontic therapy can be carried out with removable or fixed devices. Regardless of this, a distinction must be made between influencing the skull and moving teeth.
Functional orthodontics
Functional orthodontics, or FKO for short, is the favorable influencing of skeletal structures by specifically influencing functional processes. As an example, a patient with a lower jaw can be used who is being treated with a functional orthodontic device, for example an activator . The activator trains the patient to push his lower jaw forward. If this stimulus is sustained long enough, it should come to a skeletal manifestation, i.e. to a lower jaw growth that exceeds the genetically determined extent. Classic functional orthodontic devices are removable. The classification of fixed devices with a similar effect (e.g. autumn hinge ) in the group of functional orthodontics is controversial.
Dentofacial orthopedics
By exerting greater forces, usually over 500 cN, on the upper or lower jaw, a growth-influencing effect can be developed. Examples are the inhibition of lower jaw growth using a head and chin cap and the upper jaw protrusion using a Delaire or Grummons mask.
Orthodontics
Orthodontics, as opposed to functional orthodontic influencing of skeletal structures, means the movement of teeth . Orthodontic tooth movements can be carried out with removable as well as with fixed appliances, with fixed appliances generally being advantageous with regard to the movements that can be carried out and the duration of treatment as well as independence from the patient's cooperation. Orthodontic measures can also be carried out long after growth is complete, i.e. in adults.
Surgical orthodontics
If there is a malalignment of the jaw ( dysgnathia ) after the growth has finished , which cannot be compensated by orthodontic measures , it is possible to bring about an improvement through an operation. The orthodontist has to work with an oral and maxillofacial surgeon . Such therapy is often divided into three phases:
1. Orthodontic pretreatment with decompensation
- If the jaw is misaligned, a tooth position has often developed that partially compensates for this skeletal defect. This compensation must first be canceled. This is usually done with a fixed appliance.
2. surgical intervention
- After completing the pretreatment, the surgical jaw relocation takes place. It is possible for the upper and / or lower jaw, depending on the need.
3. Orthodontic fine-tuning
- After establishing a proper jaw position, it is the task of orthodontic therapy to create a secure occlusion .
Orthodontic treatment in Germany
Orthodontic treatments were included in contract dental care based on a ruling by the Federal Social Court in 1972.
Contribution in kind
The orthodontic treatment of insured persons who have reached the age of 18 at the beginning of the treatment cannot be charged to the statutory health insurance. This does not apply to insured persons with severe jaw anomalies that are of such magnitude that combined oral surgery and orthodontic treatment measures are required. Since January 1, 2002, such treatments can be billed to the GKV if they have at least the treatment requirement grade 3 according to the orthodontic indication groups.
Orthodontic treatments before the start of the 2nd phase of the tooth change (so-called early treatments) are only indicated in exceptional cases as part of contract dental care.
The scope and prerequisites of orthodontic treatment in statutory health insurance are primarily derived from the guidelines for orthodontic treatment of the Federal Joint Committee and Annex 4 of the Federal Dental Contract .
Statutory own share
Even with a claim against the statutory health insurance, the insured, usually the parents, pay a share of the treatment costs. If a child is receiving orthodontic treatment, this own part is 20%, and for each additional child 10% of the amounts billed as benefits in kind.
When the treatment has been completed to the medically necessary extent determined by the treatment plan, the health fund will repay the portion paid by the insured.
Additional and additional services
For a long time it was controversial whether the agreement of services that are not included in the catalog of services of the statutory health insurance was permissible while maintaining the entitlement to benefits in kind, i.e. whether patients only had to pay the additional costs for certain services. With the Appointment Service and Supply Act passed on March 14, 2019, the legislator clarifies this. This would strengthen personal responsibility and expand the options of the insured when choosing orthodontic treatment alternatives. The following paragraph 5 was added to § 29 SGB V:
"(5) In the case of orthodontic treatments, if insured persons choose services that are comparable to the orthodontic services shown in the uniform assessment standard for dental services and differ only in the type of implementation or the treatment agents used (additional services), the insured persons have the additional costs incurred through In this case, the treating dentist must invoice the responsible dental association for the comparable orthodontic service shown in the uniform assessment standard for dental services as a service in kind. Paragraphs 2 and 3 apply accordingly. "
In order to better structure the service process and make it more comprehensible for all involved and to increase patient sovereignty, information and agreement obligations (paragraph 7) and inspection rights of the KZVs (paragraph 8) have been included - as before . The evaluation committee has been commissioned to work out a catalog of services that can be billed as additional services by December 31, 2022. As early as 2016, the KZBV and the Professional Association of German Orthodontists, with the scientific support of the DGKFO and the DGZMK, agreed on regulations to ensure an orderly and transparent agreement, provision and billing of additional and additional dental services in connection with orthodontic treatments.
Additional services
Additional services are services that are comparable to the orthodontic services shown in the uniform evaluation standard for dental services and differ only in the type of implementation or the treatment means used.
If additional services are agreed, the benefit in kind will be billed to the health insurance company. The patient receives a private invoice based on the fee schedule for dentists (GOZ), from which the value of the benefit in kind is deducted.
Typical additional services are tooth-colored or miniaturized brackets or highly elastic arches.
Additional services
Additional services are orthodontic services that are not included in the evaluation standard and are not to be regarded as additional services.
These are typically services that are related to the orthodontic treatment, but cannot be billed to the statutory health insurance in a similar form.
Typical additional services are the legally excluded functional diagnostics, the integration of a permanent retainer and much more.
Standard orthodontic treatment is usually possible even without additional or additional services.
Training as a specialist dentist for orthodontics
Training in Germany
After completing a degree in dentistry , according to the German license to practice medicine, every dentist has access to the entire range of dentistry treatments. After obtaining a dental license, dentists can undergo specialist training in the field of orthodontics. In addition to oral surgery and further training to become a dentist for public health , orthodontics is the only other option for specialist dentist training in Germany. The exception is periodontology , here there is the possibility of completing a specialist dental training periodontics at the Münster Chamber of Dentists (and currently only there, as of 6/2014).
The further training to become a “specialist dentist for orthodontics” has to take place all day and full-time and takes three years to complete. The subject-specific further education must be at least one year, but can take up to three years at a university dental clinic . There is also the option of completing two of the three years in an orthodontic practice with special training qualifications. Two years of the three-year subject-specific training period must be completed without interruption at one of the two above-mentioned training centers. Depending on the dental association , evidence of a fourth year in which you worked as a general dentist must be provided.
At the end of the further training period, a specialist dentist examination must be taken before an examination board of the responsible dental association . After successful completion, the dentist is entitled to use the title “Orthodontist”, “Dentist for Orthodontics” or, in some chamber areas, also “Specialist dentist for orthodontics”.
Training in Switzerland
The prerequisite for training as a “specialist dentist for orthodontics (Switzerland)” is a degree in dentistry and at least one year of work as a general dentist. This is followed by four years of full-time training at one of the four dental university clinics in Switzerland. The professional title "Specialist for Orthodontics (Switzerland)" is awarded after a specialist examination with a theoretical and practical part.
Training in Austria
In Austria there is no state-recognized specialist dentist training for orthodontics. There is, however, the Association of Austrian Orthodontists (VÖK), which was founded in 1998 and promotes three-year university training. A prerequisite for full membership in the VÖK is an examination by a specialist commission. To be admitted to this exam, the candidate must have worked in orthodontics for at least five years, predominantly or exclusively.
Training in the USA
A dental degree, DDS, DMD or BDS, is a prerequisite for continuing orthodontic training in the USA recognized by the Commission on Dental Accreditation (CODA). The American Board of Orthodontics (ABO) requires full-time training of 24–48 months at an American Dental Association (ADA) accredited training facility. Certification as an orthodontist takes place during (after 18 months) or after completion of such a training program through a written examination at the ABO. After successfully completing the advanced training program and the written examination, the clinical examination takes place with a presentation of patient cases that were carried out in-house. The certification is limited in time and must be renewed after ten years with the presentation of further patient cases.
Recognition of specialist dentist titles
Due to European regulations, numerous European qualifications are automatically recognized as equivalent in Germany. Dentists who are entitled to use a recognized professional title according to the regulations of their country of origin can also use the title "Orthodontic Specialist" on application. A list of recognizable designations can be found in Annex V, no. 5.3.3.
For further training courses outside the European Union, evidence of the equivalence of the further training must be provided in order to allow (sometimes only partial) recognition of the further training.
Additional qualifications and their meaning
The increased emergence of advanced training programs for practicing dentists, especially postgraduate master’s courses, has blurred the boundaries to specialist dental training.
Focus on orthodontics
After completing the dental degree , every dentist is entitled - within the limits set by the respective state dental association - to define one or more main areas of activity.
It is up to the dentist himself to determine his focus of activity. It serves the patient as an orientation for special experience of the dentist in the specified area. The main focus of activity is to be distinguished from further training to become a specialist dentist. Full-time training or an examination is not required.
According to Section 21, Paragraph 2 of the Model Professional Regulations for Dentists (MBO-Z), it is permissible to identify areas of activity in addition to the designations acquired under the further training regulations. In sentence 2 of this paragraph it is stipulated that references according to sentence 1 are inadmissible insofar as they create a risk of confusion with subject names or are otherwise misleading.
The main focus of activities is generally permitted if the person concerned actually has special experience in the field (BVerfG NJW 2001, p. 2788). On the one hand, the dentist must regularly take part in relevant advanced training events and, on the other hand, be actively involved in the area designated as the focus of activity. Following a decision by the Federal Administrative Court, conducting the main area of activity “Orthodontics” is permitted in these cases.
Master of Science in Orthodontics
The Austrian private university Danube Private University (DPU) in Krems offers the opportunity to obtain the academic degree “Master of Science” (M.Sc.) in various dental fields. The part-time course “Master of Science Orthodontics” costs 23,750 euros.
The training comprises 45 days with 10 lessons of 40 minutes each spread over five semesters. The target group of this training are practicing dentists. Holders of a Master of Science Orthodontics degree acquired in another EU country are permitted, according to a BGH ruling, to use this degree in the form awarded in Germany, but the graduate may not call himself an orthodontist or (specialist) dentist for orthodontics .
Discussion and criticism
In the last few years there has been a lot of debate within the specialist societies about additional qualifications in addition to being a specialist in orthodontics. The many different training courses could lead to 1st, 2nd and 3rd grade orthodontists in the future.
According to the German Society for Orthodontics (DGKFO), there is a high risk of confusion between the “Master of Science Orthodontics” from Krems and the planned Master’s courses in Germany. According to the DGKFO, the master’s degree is an additional university qualification that does not replace the specialist dentist, but is an offer for colleagues who are interested in content or also title-oriented.
Due to the lack of transparency of the qualifications actually acquired, the German Dental Association is calling for a new law on further training in dentistry. This should integrate the different qualifications and at the same time differentiate them from one another for the consumer. She sees it as important to protect the specialist dentist as the “professional tip” in dentistry, oral and maxillofacial medicine. In a statement by the German Dental Association (BZÄK) it says:
"... that the 'master's training' in Krems does not meet the requirements and requirements of the German state dental associations in order to then register for the specialist dentist examination."
BGH judgment on the management of the "Master of Science Orthodontics"
initial situation
After completing her dental studies in Germany, a dentist obtained a “Master of Science Orthodontics” from Danube Private University. She used this title in her practice. Orthodontists resident in a neighboring town feared deception of the patients and took them to court for unfair competition against the colleague. (I ZR 172/08)
Judgment
The Federal Court of Justice has ruled that the Master’s degree is one of the academic degrees in Austria that can be used in Germany - according to an agreement between Germany and Austria. Stating a legally acquired title on the practice sign or on the Internet does not violate professional law, nor would patients be deceived. Accordingly, it cannot be changed if the patients misunderstand this title and equate it with that of a German specialist dentist for orthodontics. It is their job to find out more about this.
state of scientific knowledge
The German Institute for Medical Documentation and Information (DIMDI) has stated in its Health Technology Assessment (HTA) - report on oral health after orthodontic treatment with fixed appliances, among other things, that "orthodontics is to be regarded as scientifically insufficiently secured" and "... supports Finding scientific evidence of the effectiveness of orthodontic measures on numerous open questions. Above all, he complains about the poor state of studies on effects on dental or oral health. The authors see a gap between the practical application of orthodontics and research into its effectiveness. They therefore urgently demand research efforts in order to be able to use orthodontic treatments in a scientifically better way in the future. "
The highest German professional society, the German Society for Orthodontics (DGKFO), contradicted this view:
“The present HTA study shows numerous serious methodological deficiencies, inadequacies and incorrect assessments. The bibliography has not been carefully checked; it contains a large number of errors and inconsistencies. Obviously, the authors have insufficient expertise with regard to the meaning, the status and the content of the selected topics. The assumption arises that a methodical 'mask' has been adopted that does not fit the questions. The statements of the study are therefore not relevant and conclusive. "
At the beginning of 2018, the Federal Court of Auditors pointed to what it considered to be an insufficient scientific basis and what it believed to be a massive increase in costs. The DGKFO and the professional association of German orthodontists (BDK) disagreed with the criticism. The Federal Ministry of Health then commissioned an expert opinion to determine the state of science and further research needs. The IGES Institute came to the conclusion that "the experience of orthodontists from years of use [...] stands in striking contrast to a lack of evidence from scientific studies". A final assessment of the long-term benefit patients have from orthodontic treatment is currently not possible. However, studies have shown that orthodontic measures are on the one hand suitable for eliminating tooth and jaw misalignments and on the other hand have a positive influence on quality of life after orthodontic treatment studies. The IGES Institute also found it difficult to achieve a high level of evidence.
Even before the BMG published the report, the BILD newspaper headlined "Secret report: Government confirms suspected rip-offs with braces". The BMG, however, made it clear on the same day that it did not "doubt the necessity of orthodontic services". Only the existence of a "meta-study by the IGES Institute on the subject" was confirmed. As stated in the clarification, the study authors come to the conclusion that the data basis is currently insufficient to conclusively assess this question. The fact that braces reduce morbidity (caries, periodontitis, tooth loss, etc.) cannot be proven, but according to the institute it cannot be ruled out. On the other hand, the study authors state that misaligned teeth and the quality of life of the patients improve as a result of this treatment. In principle, it is not the legislature that evaluates the benefits of a therapy, but the Federal Joint Committee, emphasizes the ministry. And finally: "The BMG will discuss further research needs and recommendations for action with the organizations involved."
The DGKFO subsequently criticized the fact that the IGES report had often been misinterpreted:
"The fact that the long-term effects of the treatment on oral health cannot be proven by the studies is not due to a poor study situation in the field of orthodontics, but to the general problems of certain clinical studies in which desirable endpoints could only be recorded after many years , realistically cannot be achieved and therefore substitute parameters have to be evaluated. Therefore, such investigations cannot reach the maximum level of evidence. On the basis of the available literature and clinical experience to date, it has been proven that orthodontics at various levels, including breathing and monitoring and correction of disorders of the development of the teeth, the restoration of chewing efficiency, the correction of surplus or missing teeth as well as interdisciplinary therapy pathways represent an indispensable component of dentofacial diagnostics and therapy. "
The BDK also criticized the IGES Institute's report. Not only the effectiveness of orthodontic treatments and an improvement in quality of life have been proven, but - directly due to the effectiveness, also a direct patient-relevant benefit in the form of the restoration of body functions and the removal of distortions. The preventive effects of orthodontic treatments are also the subject of numerous publications.
The BDK further pointed out that the increase in costs presented by the IGES Institute and the Federal Audit Office was incomprehensible. The development of the total expenditure of the statutory health insurance for orthodontic treatments is primarily due to the adjustment of the point values and thus the increase in fees for the entire area of contract dental care. The alleged cost increases were justified with a decrease in the number of cases, which, however, was neither noticeable in practice nor correlated with other data (e.g. the number of billed treatment plans).
There was general agreement that further health services research should be carried out in the field of orthodontics. Orthodontic content will therefore be integrated into DMS VI from 2021. German orthodontists finance a considerable part of the costs.
See also
literature
- Peter Proff: Orthodontics. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 734-737.
Web links
- Further information on the German dental information portal (advertising-free information portal) - Awarded the HONcode by the Health On the Net Foundation .
- Communication from the German Dental Association on the specification of key areas of activity
Individual evidence
- ↑ Peter Proff: Orthodontics. 2005, p. 734.
- ↑ Ullrich Rainer Otte: Jakob Calmann Linderer (1771-1840). A pioneer in scientific dentistry. Medical dissertation, Würzburg 2002, p. 21.
- ↑ Ali Vicdani Doyum: Alfred Kantorowicz with special reference to his work in İstanbul (A contribution to the history of modern dentistry). Medical dissertation, Würzburg 1985, pp. 35-38.
- ↑ FG Sander, N. Schwenzer, M. Ehrenfeld: Orthodontics. 2nd, newly created and expanded edition. Georg Thieme Verlag, Ulm 2010.
- ↑ G. Watzer, A. Watzer: IOTN and PAR index in Austria - manual for correct and correct use. Published by the Association of Austrian Orthodontists, 2020, ISBN 978-3-9519790-0-7 .
- ↑ Recommended times for orthodontic examinations ( Memento of July 8, 2014 in the Internet Archive ) (PDF; 32 kB), statement by the German Orthodontic Society (DGKFO), 2007.
- ↑ Statement of the DGKFO "Optimal time for the implementation of orthodontic measures" (2000/07)
- ↑ Functional orthodontics in the practice of dentistry, Orthodontics II, Volume 2. Google Book Search
- ↑ Hideo Mitani, Toshihiko Sakamoto: Chin Cap Force to a Growing Mandible - Long-term clinical reports. In: The Angle Orthodontist ( page no longer available , search in web archives )
- ↑ Article list in the Angle Orthodontist for the keyword "Maxillary Protraction" ( page no longer available , search in web archives )
- ↑ Bärbel Kahl-Nieke: Introduction to Orthodontics - Diagnostics, Treatment Planning, Therapy, Section 19.1. Google book search
- ↑ Treatment phases in surgical orthodontics, dysgnathic surgery , Göttingen University Medical Center. Retrieved March 12, 2019
- ↑ BSG, October 20, 1972 - 3 RK 93/71
- ↑ § 28 SGB V
- ↑ a b c Orthodontic Guidelines - Federal Joint Committee. Retrieved August 19, 2020 .
- ↑ § 29 SGB V
- ↑ Breg: government draft TSVG. Retrieved August 19, 2020 .
- ↑ a b c d KZBV and BDK: Guarantee of an orderly and transparent agreement, provision and billing of additional and additional dental services in connection with orthodontic treatments. Retrieved August 19, 2020 .
- ↑ gesetze-im-internet.de
- ↑ dgkfo-vorstand.de
- ^ Ordinance on further training and examinations to become a dentist in the public health system (WOZÖGW) of the state of North Rhine-Westphalia
- ^ Professional association of specialist dentists and specialists in periodontology (BFSP) e. V.
- ↑ a b Sample further training regulations of the German Dental Association
- ↑ swissortho.ch ( Memento of May 8, 2013 in the Internet Archive )
- ↑ voek.or.at
- ↑ About Board Certification Examination Process Overview , ABO. Retrieved March 12, 2019.
- ↑ L_2005255DE.01002201.xml. Retrieved August 19, 2020 .
- ↑ cf. § 6 MWBO of the BZÄK as well as the corresponding regulations in the further training regulations of the state dental associations
- ↑ Communication from the German Dental Association on the indication of main areas of activity: " Relaxation of the ban on advertising offers new opportunities / areas of activity may in future be shown on practice signs ", August 2, 2001.
- ↑ German Dental Association, sample professional regulations (PDF; 46 kB)
- ↑ BVerwG, judgment of September 4, 2003, Az .: 3 BN 1/03
- ^ Danube Private University
- ^ Danube University in Krems, Orthodontics
- ↑ zwp-online.info
- ↑ donau-uni.ac.at
- ↑ BGH NJW-RR 2010, p. 1628 ff.
- ↑ dgkfo-vorstand.de ( Memento from July 8, 2014 in the Internet Archive )
- ↑ juristischerpressedienst.de ( page no longer available , search in web archives )
- ↑ markenmagazin.de
- ↑ juristischerpressedienst.de ( page no longer available , search in web archives )
- ^ Wilhelm Frank, Karin Pfaller, Brigitte Konta: Oral health after orthodontic treatment with fixed appliances. DIMDI HTA study 2008, report no. DAHTA066. (PDF; 381 kB)
- ↑ DIMDI: New HTA report sees orthodontics as scientifically inadequate to date ( memento of May 26, 2008 in the Internet Archive ), April 22, 2008
- ↑ DGKFO, Statement on HTA ( Memento from July 8, 2014 in the Internet Archive ) (PDF; 100 kB)
- ↑ 2017 Comments - Supplementary Volume No. 09 "The benefits of orthodontic treatment must finally be researched" (pdf) - Home page. Retrieved August 19, 2020 .
- ↑ Orthodontics. Retrieved August 19, 2020 .
- ↑ Government confirms suspicion: Are braces used to rip off? Retrieved August 19, 2020 .
- ↑ Back and forth on IGES opinion on the benefits of orthodontics. Retrieved August 19, 2020 .
- ↑ DGKFO: Press release January 11, 2019 IGES expert opinion on the benefits of orthodontic treatment is often misinterpreted. Retrieved August 19, 2020 .
- ^ Professional Association of German Orthodontists eV: Statement on the report of the IGES Institute "Orthodontic Treatments". Retrieved August 19, 2020 .
- ↑ News - German Society for Orthodontics. Accessed on August 19, 2020 .