The ‘Kesling set-up’ is a visual aid to communication between the clinician and the patient at the treatment planning stage. It helps the clinician to plan the stages and type of orthodontic treatment required, and gives the patient an idea of what is achievable and what is involved. It can also highlight the limitation of tooth movement alone, indicating the need for surgical intervention. Kesling described the concept of planning individual orthodontic tooth movement in 1945. He used a ‘set-up’ of casts to plan the sequential stages of treatment, then designed appliances to achieve each of the individual movements. The ‘set-up’ involved separating the teeth on a model of the patient’s dentition and repositioning them with wax according to the desired movement. The photographic ‘Kesling set-up’ can provide a way of addressing the patient’s main concern, i.e. the aesthetic appearance of their face and teeth, and provide a relatively realistic representation of the potential outcome in a way they can visualize and understand.
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