Itamar Michael Friedländer

A case I treated seven years ago illustrates the evolution of our interdisciplinary approach. We can also treat skeletal asymmetries to some extent.

This 30-year-old patient came to us seeking improvement of her function and discomfort, she didn’t consider orthognathic surgery. On the right side we chose to correct her crossbite using upper symmetric expansion with MARPE and, on the lower left side, applied the technique — allowing controlled movement of teeth beyond their original bony housing while simultaneously enhancing the periodontal phenotype.

Seven years later, she returned for a follow-up CBCT, giving us the opportunity to evaluate the stability of the graft over time. The long-term results speak for themselves.

Today, we have treated more than 120 cases with The Surgical Orthodontic Concept, with success observed 7–8 years post-treatment.

Join us in Barcelona this June 2026 for our course, where we will present many clinical cases, share detailed treatment protocols, and provide all the tools you need to implement this approach in your daily practice.

A 30-year-old patient presented with chief complaint of discomfort during biting. The patient had already consulted several orthodontists, all of whom recommended a combination of orthodontic treatment and orthognathic surgery.

Patient-Centered Decision-Making
I routinely ask patients with skeletal discrepancies: "Do you wish to improve your facial profile and bite, or address only the bite?" In this case, the patient sought only to improve bite, function and achieve a healthy, stable occlusion—precisely where the Surgical Orthodontic Concept (SOC) proves most valuable.

Orthognathic Surgery
Only a small percentage of patients opt for orthognathic surgery. While we prepare and refer numerous patients annually, most prioritize enhanced health and occlusal stability over a major surgical intervention.

Benefits of the SOC
The SOC has revolutionized my practice by enabling compensation of severe open-bite cases without typical drawbacks:
1. Unesthetic changes in the profile.
2. Periodontal compromise (our protocol actually yields thicker periodontal phenotypes despite unfavorable movements).

Much like skeletal anchorage transformed my practice 15 years ago, and corticotomies with bone grafting did 8 years ago, the SOC now offers an incredible viable alternative.

This different protocol, which avoids orthognathic surgery for suitable cases, is what and I teach in our course.
We hope to see you in Barcelona. June 18th-20th. (Almost all seats are taken)

15-year-old patient presenting with a biretrusive profile, thin lips, Class II malocclusion and a reduced periodontal phenotype.
This case exemplifies the challenges we face in daily clinical practice and highlights the key role of The Surgical Orthodontic Concept in our office for managing such situations.
In patients with this type of profile, distalization or retraction of the maxillary teeth is not possible, not even by 1 mm, while advancing them 5–6 mm would severely compromise the periodontium.
What is the solution? In our hands, the application of has become an essential tool for resolving complex cases such as this one, and it is truly a must in the modern orthodontic toolbox.
Orthodontics is evolving: skeletal anchorage and alveolar bone surgery have radically transformed the way we diagnose and treat our patients.
Join our international course - June 18th-20th in Barcelona.
Colleagues from all over Europe and beyond are already registered; it is an excellent opportunity to learn a new and more predictable approach to treating your patients. We have limited seats.
Beautiful visualizations by .plaksin

Different orthodontics:
A 32‑year‑old male patient presented with a full‑cusp Class II relationship, transverse maxillary deficiency, tooth wear, and partially edentulous spaces. Teeth 35–45 had been extracted in a previous treatment, resulting in significant loss of anterior support. The patient also exhibited a thin periodontal biotype with multiple gingival recessions in the lower arch. Treatment was planned according to the Surgical Orthodontic Concept protocol: maxillary expansion was performed with MARPE, the lower molars were uprighted, and spaces were opened for future implant placement in the mandibular arch using wide‐based corticotomies and bone augmentation from the lower first molar to the contralateral lower first molar (mandibular 6–6).
You will see this full case and many others in our course in Barcelona. June 2026
For more info: [email protected]

Skeletal anchorage represents a fundamental tool in the contemporary management of complex interdisciplinary cases.

Slide 1: This clinical case presents a 50-year-old female patient with generalized tooth wear and failing restorations, resulting in compromised function and aesthetics.

Slide 2: A digital treatment plan was developed, incorporating diagnostic wax-ups based on facial analysis. The decision was made to initiate restorative procedures prior to orthodontic intervention.

Slide 3: Transitional restorations were placed, followed by orthodontic treatment utilizing digital indirect bonding.

Slide 4: When restoring patients in seated condylar position (SCP) with modifications of the vertical dimension of occlusion, mandibular asymmetry frequently manifests as a unilateral Class II malocclusion.

Slide 5: To address the unilateral Class II relationship, skeletal anchorage was selected over Class II elastics to avoid undesirable side effects, particularly upper midline deviation. A 20mm FATscrew was strategically placed in the parasymphyseal region, providing excellent biomechanical control for Class II correction.

Slide 6: The treatment mechanics incorporated a power chain for molar mesialization on the affected side, while an active beta-titanium jig simultaneously repositioned the lower midline.

Slide 7: Upon completion of orthodontic treatment, bilateral Class I molar relationships were achieved with centered dental midlines, allowing the patient to proceed to definitive full-mouth rehabilitation.

Slide 8: Comparative analysis demonstrates significant smile transformation following provisional restoration and orthodontic treatment.

is from Air Orthodontics
clinicafriedlander clinicadentalbarcelona FATscrew
soc thesurgicalorthodonticconcept thesoconcept ортодонтия

Today, I’d like to share some details of an interesting case, now 8 months into treatment. The patient is a 45‑year‑old female presenting with a biretrusion, full‑cusp Class II malocclusion, and transverse deficiency.

Our treatment approach involved MARPE combined with corticotomies and anterior mandibular bone grafting to address the underlying skeletal and periodontal limitations.

After 8 months, we have completed the first stage of treatment: achieving a Class I canine relationship and a significant improvement in lower lip support.

If you’d like to explore alternative therapeutic approaches for your patients, join us at our upcoming course in Barcelona, June 2026.

clinicadentalbarcelona FATscrew
soc thesurgicalorthodonticconcept thesoconcept ортодонтия

Today I want to share this great example of what we can achieve with retrmolar . A Treatment of a mild occlusal plane change (CW rotation) for improving the upper incisor exposure. The patient is a dentist and want to improve her occlusion and the upper incisor exposure.

1. She wanted to be treated with Aligners, but because one of our treatment goal was to rotate the upper occlusal plane, and not just achieve incisor extrusion, we decided to use lingual orthodontics on the upper arch.
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2. After the rotation of the occlusion plane was achieved (about 9 months) we finished the case with aligners.
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3. Asked my friend .plaksin from .lab to create these beautiful images of the superimpositions. 3D superimpositions are becoming a standard in analyzing the results after an orthodontic treatment. This has improved a lot my way of understanding my treatments.
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You can see minor mandibular changes, very mild distalization and the rotation of the occlusal plane.
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The rotation of the occlusion plane may or may not be a desirable effect of the treatment proposed. It's the orthodontist responsibility to diagnose and decide if he or she needs the rotation to improve occlusion and aesthetics.
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In our course in June 2026 we will discuss, show and demonstrate how to treat many cases of this type.


#ортодонтия

A 15-month treatment in a young patient presenting with a complex vertical Class II malocclusion and open bite. The combined use of aligners and 4 made it possible to manage the dentoalveolar components in a controlled manner. The true key to success in this type of cases lay in the correct diagnosis & the precise sequencing of each stage.

We invite you to join us at our upcoming “Patient-Centered Orthodontics” course, which will take place in June 2026 in Barcelona — a unique opportunity to explore in depth the principles and strategies that make complex cases like this one possible.


#ортодонтия

The course in Chile was a blast! Amazing energy and special feeling.
Loved lecturing with my partner in crimen
Many thanks to & for their collaboration.
And a big thank you for all the attendees.
Next course (in English) will be in Barcelona in 2 months. We are very excited to host doctors from around Europe.


#ортодонтия

Last week we had Dr. Lea Terrasse in our office.
Exchanging experiences about orthodontics.
Thank you for your visit.