Non Surgical Orthodontic Treatment of Skeletal Asymmetries in Adult Patients.

The development of  a cranio-facial asymmetry in the juvenile and adolescent  age can be frequently prevented by guiding the mandible growth, with proper functional or occlusal therapies.

On the contrary, established skeletal asymmetries in adult patients are conventionally considered beyond the therapeutic possibilities of orthodontics, unless coupled with orthognatic surgery.

In the last eight  years our group has attempted to correct skeletal asymmetries in adult patients, with no TMD symptoms, by condylar repositioning and subsequent orthodontic occlusal stabilization.

During this presentation we will discuss the clinical and instrumental methods that are used to set a new condylar position, the orthodontic treatment planning and mechanics used to stabilize the new occlusion after the initial condylar repositioning, and the stability of these treatment after some years from the repositioning.

Giorgio Fiorelli, MD DDS Spec. in Orthodontics; Paola Merlo, DDS Spec. in Orthodontics; Arezzo, Italien

Giorgio Fiorelli, MD DDS Spec. in Orthodontics


Medical degree, dental degree and orthodontic postgraduate program at the University of  Siena, private practice limited to orthodontics since 1983.

Part time assistant Professor at the orthodontic department of the University of Siena from  1993 to 2014, where he has been  responsible for adult orthodontic treatments.

Affiliated to the orthodontic department of University of Aarhus, Denmark, where he has been involved in the short term and post graduate teaching, since 1992.

Affiliated to the orthodontic department of the University of Buffalo USA, where he has been teaching from 2011 to 2014.

Secretary General of the Italian Orthodontic society in the years 98-99. Vice- president of Italian Society of of Orthodontic Biomechanics in the years 1999-2002.

His main professional interests are: orthodontic biomechanics, use of computer within the orthodontic practice (especially related to mechanics design and treatment planning), segmented arch technique and adult orthodontic treatment.

He has published  about 30  papers about the above mentioned fields.

Has co-published with Prof. Birte Melsen the “Biomechanics in Orthodontics” multimedia software , presently at release 4.

Co-writer in two chapters of the book “Adult Orthodontics” edited by Birte Melsen, and in the book orthodontic Pearls, edited by Larry White.

Author of the chapter “Statically Determined Appliances and Creative Mechanics” in the textbook “The Biomechanical Foundation of Clinical Orthodontics” edited by Prof. Burstone and Choy.

Invited speaker at meetings of American, European, Italian,  Japanese,  Australian, Finnish, Greek and Greater Dallas orthodontic societies.

Has lectured about biomechanics at the  universities of Aarhus – Denmark, Edmonton – Canada, Baylor – Dallas, New York (NYU and Columbia), Buffalo, Philadelphia and Chicago. USA, Berlin Humboldt – Germany and several Italian schools.

He was responsible for “Adult orthodontics” postgraduate program at the University of Siena, Italy 2002 to 2013.

He currently holds private courses of biomechanics in Italy, Poland and Portugal, and is head of the International Orthodontic Biomechanics School, which organizes an intensive five weeks program attended by orthodontists worldwide.


Paola Merlo, DDS,
Specialist in Orthodontics – 2004, Università dell’Insubria, Italy

Dr. Paola Merlo  attended the orthodontic department in Siena from 2008 to 2012, where she completed the postgraduate master course in “Adult Orthodontics” directed by Prof. Roberto Giorgetti and  Dr. Giorgio Fiorelli. She discussed the final thesis about Mandibular Repositioning in Adult Patients in July 2012.

She works in her private practice, limited to orthodontics,  in Lugano (CH) and Luino (Italy)

Member of  SIBOS (Italian society of biomechanics and segmented arch technique)  and  SIDO ( Italian Society of Orthodontics)

She has participated as instructor and teacher in biomechanics courses together with  Dr. Giorgio Fiorelli in Italy and abroad (USA; Portugal. Poland)

Invited speaker at the Panhellenic Orthodontic Congress in 2016

She is author of  4  papers published in Italian journals and she has contributed to the book “Orthodontic Pearls” edited by Larry White, and coauthored one chapter in the book “Biomechanical Foundation of Clinical Orthodontics” edited by Burstone and Choy.