Topics of the day:

1. ESCO - The Electronic Study Club for Orthodontics
2. ESCO Digest - 10 Dec 2002 to 20 Dec 2002 (#2002-42)
3. Sticking alginate
4. bonding to porcelain
5. RPE & Nasal air flow
6. Mark Lively and congenitally Missing teeth.
7. Edgewise/Tip-Edge
8. Imaging Program
9. [ortho] Surgical repositioning of 47 10. REVISTA ORTOUSTA EN LA WEB

Dear Colleague:

The Electronic Study Club for Orthodontics (ESCO) is a free forum for exchange of information and opinions among orthodontists, and for distribution of professional information, sponsored by the Department of Orthodontics, University of Illinois at Chicago.  Information distributed on this list-server is NOT edited or refereed, and it represents only the opinions of the writers of the individual messages. Such writers bear the sole responsibility for the content of messages they author.  Authors are required to verify information regarding other parties included in their messages.  

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For answers to these questions and more, please check our web site: htm

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Enjoy your reading!


Joseph H. Zernik, D.M.D. Ph.D.
Professor of Orthodontics


From: ATogrye@AOL.COM
Sent: Sat 12/21/2002 10:09 AM
Subject: Re: ESCO Digest - 10 Dec 2002 to 20 Dec 2002 (#2002-42)


I also follow a similar TX protocol and attempt to preserve primary second molars if possible. On occasions where I have recommend extractions, root development of the first molar seems to have a roll in the amount of drifting you can expect. If you are to extract the earlier the better. The other aspect I pay attention to is the degree of crowding that is present. In this case I would consider extraction if :
1- First molars are unerupted and significant root development remains.
2- Anterior and posterior crowding is ( or will be ) present.
3- Mom understands that your crystal ball is cracked and does not work.

Anthony Togrye, DDS
Murfreesboro TN

From: The Armstrong's [armstrong@TURBONET.COM]
Sent: Sat 12/21/2002 4:35 PM
Subject: Sticking alginate

When we use Kromopan impression material to take indirect impressions ,we often have the material stick to the patient's teeth.This of course produces a poor model for positioning brackets.It's probably due to brushing just before the impression is taken, but is there a very accurate brand that won't stick?

From: Utley3@AOL.COM
Sent: Sun 12/22/2002 7:24 PM
Subject: Bonding to porcelain

In a message dated 12/21/02 12:07:47 AM Central Standard Time, LISTSERV@LISTSERV.UIC.EDU writes:

Hello all,

I am very much interested in finding a reliable way to bond brackets to porcelain.  Who has a tried and true method for me?


John Benkovich
(Annapolis, MD)


I have used the materials (porce-etch, porcelain conditioner) from Reliance Orthodontics for years with excellent results.  I follow the technique that is provided with the kit.  First I roughen the porcelain with a medium diamond bur. Dry the surface. Apply porce-etch for 60 seconds.  Wipe most away with cotton roll or gauze and rinse rest into high speed suction for 10 seconds.  Dry surface. Apply porcelain conditioner and wait 60 seconds.  Apply second coat of porcelain conditioner and wait 120 seconds.  Then I apply light cure sealant, cure for 10 seconds, then place bracket.  It is a bit of a pain, but I very rarely have a failure.  Now, if I could have the same luck bonding to metal surfaces??

Kevin C. Utley

From: Tichlersax@AOL.COM
Sent: Mon 12/23/2002 5:12 PM
Subject: RPE & Nasal air flow

Is there any literature confirming or refuting the theory that max. expansion promotes greater nasal air flow?   Our local pediatricians have been referring mouth breathers to us for expansion.  If we do not encounter a narrow arch and/or posterior cross bite, we do not propose expansion. Increasing case starts  by expanding almost "every kid" is  not a proper way to build a practice .  Please voice your opinion and literature  to substantiate. 

Howard Tichler

From: mort &/or gayle speck [morton_speck@HSDM.HARVARD.EDU]
Sent: Sat 12/21/2002 12:34 PM
Subject: Re: Mark Lively and congenitally Missing teeth.

Onplant/implant auxiliaries might be the most reliable method to achieve posterior space closure. Sorry I don't have references handy, though others may.

If the parents object to the minor surgical procedure, other considerations might be:

1. Protraction face mask.

2. Securely bond 4-4 (on the lingual), place a mild tip back distal to the 4's and protraction of the molars on a non-full slotted wire to reduce friction. I recall doing this with a rectangular wire utilizing an .036 tube to encourage some degree of tipping, and subsequent uprighting once the molar was in contact with the first bicuspid. I felt that trying to move the molar bodily could overtax the anterior anchorage. Ditto for any bruxing habit. I would start with lighter forces (4-6) ounces and gradually build up as necessary.
Excessive forces could retract the entire anterior segment.

I know you are well aware that other factors certainly weigh into the
decision: The presence and position of 2nd molars, the presence of 3rd molars, the patient's skeletal pattern, the presence of crowding/spacing, the financial ability to pay for implant treatment, etc.

Happy Holidays all!

Mort Speck (Mort &/or Gayle Speck)

From: mort speck [morton_speck@HSDM.HARVARD.EDU]
Sent: Mon 12/23/2002 11:04 AM
Subject: Edgewise/Tip-Edge

Dear Mark (as in Australian, Mark),

I finally got to the library to access your references which you said “…fully support the case that tipping and uprighting and “light” elastics in a Begg and, most likely, a Tip-Edge Appliance, provide no anchorage advantage over edgewise appliances.” But I found that you referenced no articles which compare comparably banded/bonded edgewise appliances. The abstract comparing Burstone's appliance and Begg fails the comparison test because Burstone utilizes a transpalatal auxiliary and frequently bands 2nd molars. Yes, your second citation does show some comparable results between traditional edgewise and Begg, but the edgewise cases utilized headgear and banded 2nd molars. And even with lower second molars banded, the edgewise cases showed less than one mm. advantage in the retraction of the lower incisors! Mark, don’t you think you’ve proved my point?

It is not clear why you included the Gianelly study that compared non-extraction results treated with three treatment modalities when it has no bearing on our discussion of anchorage. And you somewhat misstated Gianelly views when you wrote that he “…perhaps disagrees with the premise of headgear
increasing anchorage…” The fact that he routinely utilizes headgear for
anchorage control in his non-extraction treatment procedures contradicts your view.

A word about the insufficient torque reported in the articles you cited: this observation was noted in cases treated with the original Begg bracket. The newer Tip-Edge bracket, with its full expression of the prescribed tip and torque, makes final positioning more precise.

Let me be crystal clear, Mark: my premise (once again!) is that with Tip-Edge, unlike edgewise, you do not have to routinely band 2nd molars, or utilize headgear, transpalatal arches or other auxiliaries for anchorage purposes.
Nowhere is it written that you cannot use anchorage auxiliaries with Tip-Edge, but rare is the extraction case that requires this.

Your statements regarding improper alignment of second molars completely beg (no pun intended) the question. Of course these second molars have to be evaluated for possible banding, but that is not the point. The point is that with Tip-Edge they do not have to be banded for anchorage purposes, as is necessary in many edgewise cases.

You write: “Somehow I have never come across a Tip-Edge lecture where they confess any familiarity with torquing pliers…” and “…I have never heard of Tip-Edge lecturers commenting on repositioning brackets either.” Those statements are not even worthy of a response.

Shortcomings that you perceive in tooth position in the Parkhouse video, or in any presentation, Straight-Edge or straight wire, are under the operators’
control. Bracket positioning is critical, as both Roth and McLaughlin and his colleagues point out. When additional torque is needed for specific teeth, it can be affected with individual root torquing springs without subjecting the patient to the rigors of a further adjustment of the base arch wire. And it is not necessary to overtorque if you have chosen the correct prescription.
Unlike rotation, there is no evidence that torque relapses.

You state “Some of the above-mentioned Begg, Tip-edge practitioners have noted that the control of the palatal cusps to anywhere near American board standards is very difficult.” Which Tip-Edge practitioners who utilize .0215 x .027 wires in the final stage have made this statement? Any deflection of these wires in response to the uprighting/torquing spring is clinically insignificant. It was Isaacson, not Nicolai, who responded to Kesling’s description of torque (AJO/DO Dec. 1993). Furthermore it was Parkhouse who published a mathematical validation of the Tip-Edge torquing mechanism in the June 2001 Journal. Let me conclude this issue by quoting your countryman Maurice Costello, “…clinically, one sees with this appliance system the inbuilt torque of the bracket expressing itself while not observing any clinical reciprocal action” (AJO/DO, May 1994).

OK, Mark, let’s sum up. You seem to have gone off in a lot of different directions in response to my statement that Tip-Edge was more conserving of anchorage than edgewise.

1. In your previous posting, you stated, “Funny thing is though, all studies I have seen comparing Begg and edgewise where no extra-oral traction was employed cannot distinguish between the changes in the finished results.”
When I challenged you, you were not able to reference a single study where this comparison was made. The best you could do was to make a plea to readers for information regarding a purported Lysle Johnston study.

2. Webster defines “Red Herring” as something that distracts attention from the real issue, and that is just what your comments on hanging cusps do.

3. You insist on imposing the deficiencies of the original Begg appliance onto the Tip-Edge appliance, when their torque delivery and torque control are as different as night and day. Tip-Edge has proven to be clinically much more effective and accurate.

4. Your comments regarding the anchorage-enhancing ability of headgear as hearsay baffle me. Are you to have us believe that headgear, which is capable of correcting a Cl. II molar relationship in a variety of proven ways, is incapable of enhancing posterior anchorage solely because there may not be a study that shows this?

5. Your remarks reporting lecture statements regarding familiarity with torquing pliers or repositioning brackets are just plain impertinent and have no place in this discussion.

I previously wrote that we must guard against the tendency to resort to exaggeration and unsubstantiated criticism when faced with ideas that differ from our own and threaten concepts we hold dear. I think this bears repeating.

Happy Holidays to all,

Mort Speck (Mort Speck)

From: Quick Ceph Systems [info@QUICKCEPH.COM]
Sent: Tue 12/24/2002 12:14 PM
Subject: Re: Imaging Program

In regard to the claims posted in David Young's message, it is very easy to copy and store images at the original high resolution from a digital camera onto the computer.  If you wanted to retain the original images from the digital camera, you can easily copy them to your hard disk, or burn them to a CD.  You would not even need an imaging software to do so.  However, it is another matter to actually use the images at the high resolution.  Can the orthodontic imaging software process, digitize, perform treatment simulations, and morph images at a higher resolution than 640 x 480 pixels?

In regard to the use of Bezier curves, while they are used by other imaging products such as Adobe Illustrator, the method by which Bezier curves are applied in both Quick Ceph Image Pro and Quick Ceph 2000 is patented in the U.S., and international patents have been filed.  This is what allows our software to accurately predict soft tissue movements during orthodontic and surgical treatment simulations.

I hope I have dispelled some of the confusion created by David Young's message.  Please feel free to contact us if you have any further questions.


Ton Luu
Chief Technician
Quick Ceph Systems
tel. 858-720-0903
fax 858-720-0871

From: Tom Wang [avortho@HOTMAIL.COM]
Sent: Mon 12/23/2002 12:40 AM
Subject: Re: [ortho] Surgical repositioning of 47

Dear all,         Anyone is interested in Lingual Orthodontics. You are very welcome to join our discussion group.

Kind regards, Moderator, Lingual Orthodontics

From: Marco Alonso Galvis C. [magaco@HOTPOP.COM]
Sent: Mon 12/30/2002 6:39 AM

I invite you to read aour Journal ORTOUSTA from


Tengo el gusto de comunicarles  a los particiantes Red dental, que pueden consultar los artículos de la revista ORTOUSTA en nuestra página web  en el enlace que hace  referencia a la revista.

Los artículos están disponibles en formato .pdf , luego es necesario tener instalado el plugin de acrobat reader de adobe. En el mismo enlace de la revista podrá encontrar un hipervínculo para poder descargarlo y disfrutar de la revista.

En el segundo número se ha incluido en la mayoría de las referencias bibliográficas, hipervínculos a los abstracts de las publicaciones que están indexadas en la base de datos Entrez Pubmed.

Además, contiene interesantes artículos, muchos de ellos son meta-análisis que se desarrollaron para el segundo simposio de ortodoncia en donde el conferencista invitado fué el Dr Osca Medina, también hay dos artículos sobre dos de las líneas de investigación que se están trabajando, y un artículo que recopila una breve muestra de lo que es una junta decisiones virtuales, el cual recopila las diferentes participaciones hechas en este caso clínico. El Dr. Juan Carlos Velarde de lima - Peru, tiene impresa su participación en este artículo.

Como verán es un motivo de orgullo para todos nosotros en especial para la Dra Liliana Otero , coordinadora de nuestro postgrado, quien es la gestora e implusadora de este proyecto que es una suma de esfuerzos continuos y dedicados en cada publicación en donde cada semestre será mejor como todos deseamos.


Marco Alonso Galvis C. Residente Postgrado Ortodoncia U. Santo Tomás Bucaramanga - Colombia