In orthognathic surgery，what is important in the collaboration between orthodontists and surgeons is the sharing of major treatment policies and patient backgrounds．1，Avoid maxillary setback．2，Preoperative correction of skeletal open bite does not require closing the open bite．3，In Class III case，there is no need to create the amount of movement．4，Genioplasty perform in two stages．5，Bi-gnathic surgery is recommended for facial asymmetry and mandibular retrognathia．6，Final occlusion should be determined by the orthodontist．7，In patients with depression and dysmorphophobia，orthognathic surgery does not improve symptoms．Avoiding intervention in patients with avoidable problems can lead to increased patient satisfaction．

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Both dental caries and periodontal disease are caused by hyperpathogenicity of biofilms. Biofilm hyperpathogenicity is referred to as dysbiosis, a phenomenon in which environmental changes such as nutrition, temperature, pH, and anaerobic conditions surrounding the biofilm activate the bad bacteria （cariogenic or periodontopathic bacteria） to multiply and increase the pathogenicity of the biofilm. Dysbiosis causes the biofilm to shift from a stable state （symbiosis） to a highly pathogenic state. As a result, The equilibrium between the aggressive forces of the biofilm and the defensive forces of the teeth and periodontal tissues is upset, and dental caries and periodontal disease develop. Caries dysbiosis is initiated by the feeding of fermentable sugars （sugar, glucose, fructose, lactose, and cooked starch） to multiple acid-producing bacteria. Periodontal dysbiosis begins as a nutritional symbiosis between bacteria that starts in an old biofilm, and then becomes full-blown when the biofilm is fed proteins and iron by bleeding from periodontal pockets. The prevention and treatment of dental caries and periodontal disease is the elimination of dysbiosis.

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To perform an individual technique accurately is important for successful dental treatment. However, accurate diagnosis and precise treatment planning are even more important. In the dental field of Japan, dentists often say, I diagnosed. However, this is an experienced diagnosis based on the treatment covered by health insurance, and true diagnoses have not been made, I think.When I retired from the university, there were not dental implants or CAD/CAM technology. However, such generation is not current. Patients are not satisfied unless their dental arch is alignment, they can bite well with dental implants, and they can have esthetic restorations. Despite such generation, the partial dentures and poorly colored prosthetics are also placed on the malocclusion currently. I am a prosthodontist. As long as the dental arch is aligned, prosthetic treatment is easy. However, many patients have malocclusion and do not desire orthodontic treatment. If the dental arch is not aligned, it is obvious that the occlusion will collapse, even with good prosthetic treatment. It is important that occlusion, perio, endo, implant, orthodontics, and prosthetics are evaluated and diagnosed interdisciplinarily rather than independently. I also ask dentists to understand that the goal of treatment is not to finish the treatment, but to maintain a sustainable condition for a long-term after treatment.In this clinical case report, we would like to discuss together what should be considered before and during treatment, and the way forward for dentistry in Japan in the future.

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包括的歯科治療の対象となる患者は何らかの歯科的問題を抱えている．その問題がいかに起こったかを診断し改善することで，今後同じような不具合が発生することを防止できる．その問題の多くは不正咬合に由来することが多く，その改善には矯正治療が必要となる．包括的歯科治療における矯正治療の目的は治療のシンプル化と治療結果の長期安定である．長期安定のためにはミューチュアリープロテクテッドオクルージョンを達成させ，側方運動時，前方運動時に臼歯の離開を与えることが重要である．では，具体的に包括的歯科治療において矯正治療は何が出来るのか．大きく4つに分類される．異常に動いてしまった歯を元に戻す（回復），歯を動かす事で歯周組織を作る（再生），悪影響がある歯列を整える（再構築），歯を動かす事で抜歯を回避する（保存）である．また，舌側矯正はセットアップ模型の必要性，下顎前歯の固定の強さ，舌側咬頭のコントロールのしやすさなどから包括的歯科治療と相性が良く，有効性が高いと言える．的確な診断のもと，適切なメカニクスを確実に使用する事で包括的歯科治療において矯正治療は有益だといえる．

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In lingual orthodontics, the set-up model has a great influence on treatment results. Therefore, we devised a half-digital set-up model that combines the advantages of both digital and analog set-ups. This time, we would like to show you how to improve the half-digital set-up to make it more convenient and accurate.

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Opinions are divided on whether or not to incorporate overcollection into the setup, and the percentage of orders we receive is about the same for both. The role of the Ideal Setup is to clarify the treatment goal, simplify the wire, and create an appropriate custom base. On the other hand, by incorporating overcollection according to the case, it is not possible to reduce the wire bend at the chairside as much as possible, although it is not no-bend. If you are an experienced doctor in lingual orthodontics, you can ask for instructions on over-collection that suits your treatment based on the accumulated results, but there are many situations where the opinion of a technician is asked during setup design consultation. In this presentation, I will introduce an example of how to give instructions so that the setup design consultation between the orthodontist and the technician will be smooth. In addition, the criteria for including overcollection will be shown, so that it will help to organize the overcollection, which tends to be ambiguous, and simplify treatment.

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It is very important for lingual orthodontic treatment to determine the setup prescription based on the diagnosis and treatment plan. If the prescription is appropriate, simpler, smoother and more efficient, tooth movement is possible. Therefore, I would like to introduce a method and prescription for fabricating a setup that incorporates an overcorrection for sliding mechanics using the straight wire method. In order to fabricate an accurate setup, it is desirable to determine the one jaw first (i.e., the side where treatment is to be started). The torque value of the central incisor in the setup is calculated as follows. In this paper, we report the numerical values, calculation methods, and set-up fabrication procedures for the setup models through actual cases.

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Corticotomy is considered effective for shortening the duration of orthodontic treatment and modifying phenotypes. However, the conventional corticotomy techniques introduced generally involve significant invasiveness, which is a drawback for patients. Moreover, it is believed that the effect of corticotomy diminishes after four months as bone remodeling progresses, leading to a weakening of the acceleration effect on tooth movement. In cases where third molars or premolars are extracted, tooth movement may be accelerated during the leveling phase due to the surgical invasion caused by tooth extraction, potentially obviating the need for corticotomy. Therefore, it is believed that minimally invasive local corticotomy performed during the closure of extraction spaces is more effective than during the leveling phase. Clinically, it is recommended to make a deep groove from the cortical bone to the cancellous bone without extensive gingival detachment, and to insert a bone chisel into the bone groove to confirm the movement of the tooth to be relocated. This method is currently considered the most balanced approach in terms of the degree of surgical invasion and the effect of promoting tooth movement.

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Recently, orthodontic temporary anchorage devices （TADs） have been used as skeletal anchorage. TADs provide absolute anchorage for various tooth movements without the need for active patient compliance. This report describes an excellent result in the treatment of malocclusion case using lingual bracket orthodontic technique and TADs. TADs were also used for distal movement of the maxillary dentition and mesial movement of the mandibular dentition and midline improvement．

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