1. ESCO - The Electronic Study Club for Orthodontics
2. American Journal of Orthodontics and Dentofacial Orthopedics January
2003, Vol. 123, No. 1
3. Tip-Edge: how do you feel, as part of a minority?
4. Cuspid protection or group function continued.
7. Porcelain polishing
8. effective bur
9. ESCO Digest - 11 Jan 2003 to 17 Jan 2003 (#2003-3)
10. ESCO Digest - 2 Jan 2003 to 11 Jan 2003 (#2003-2)
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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Joseph H. Zernik, D.M.D. Ph.D.
Professor of Orthodontics
From: Elsevier Science eTOC Service [periodicals.web@MOSBY.COM]
Sent: Fri 1/17/2003 1:33 PM
Subject: American Journal of Orthodontics and Dentofacial Orthopedics January 2003, Vol. 123, No. 1
American Journal of Orthodontics and Dentofacial Orthopedics Table of Contents for January 2003, Vol. 123, No. 1 http://www.mosby.com/scripts/om.dll/serve?db=c&id=od
On the cover
Manpower and the changing economy
David L. Turpin, DDS, MSD, Editor-in-Chief Seattle, Wash
Comparison of in vivo and in vitro shear bond strength Stephen D. Murray, BDS, BSc, FDSRCS (Eng), MSc, MOrth RCS Edin, Ross S. Hobson, BDS, MDS, PhD, FDSRCPS, MDORCPS Sunderland and Newcastle, United Kingdom
In vivo inhibition of demineralization around orthodontic brackets Jasmine Gorton, DMD, MS, John D. B. Featherstone, MSc, PhD San Francisco, Calif
In vitro comparison of orthodontic band cements Declan T. Millett, BDSc, DDS, FDS, MOrth, Sheena Duff, BDS, Lynsey Morrison, BDS, Alistair Cumming, W. Harper Gilmour, BSc, MSc, CSat Glasgow, United Kingdom
Effect of thermocycling on the shear bond strength of a cyanoacrylate orthodontic adhesive Samir E. Bishara, BDS, D Ortho, DDS, MS, Raed Ajlouni, BDS, MS, John F. Laffoon, BS Iowa City, Iowa
Arch width after extraction and nonextraction treatment Anthony A. Gianelly, DMD, PhD, MD Boston, Mass
Tongue pressure on loop of transpalatal arch during deglutition Yuki Chiba, DDS, Mitsuru Motoyoshi, DDS, PhD, Shinkichi Namura, DDS, PhD Tokyo, Japan
Familial correlations and heritability of maxillary midline diastema Jedidiah R. Gass, DDS, MSD, Manish Valiathan, BDS, MDS, MSD, Hemant K. Tiwari, PhD, Mark G. Hans, DDS, MSD, Robert C. Elston, PhD Cleveland, Ohio
Functional appliance therapy accelerates and enhances condylar growth A. B. M. Rabie, MS, CertOrtho, PhD, T. T. She, BDS (Hons), Urban Hgg, DDS, Odont Dr Hong Kong SAR, China
Replicating mesenchymal cells in the condyle and the glenoid fossa during mandibular forward positioning A. B. M. Rabie, BDS, CertOrtho, MS, PhD, Louise Wong, BDS, Marjorie Tsai, BDS Hong Kong SAR, China
Effects of upper lip closing force on craniofacial structures Min-Ho Jung, DDS, MSD, Won-Sik Yang, DDS, MSD, PhD, Dong-Seok Nahm, DDS, MSD, PhD Seoul, Korea
Three-dimensional relationship between the critical contact angle and the torque angle Bo-Sun Kang, DDS, MSD, PhD, Seung-Hak Baek, DDS, MSD, PhD, James Mah, DDS, MSD, PhD, Won-Sik Yang, DDS, MSD, PhD Seoul, Korea, and Los Angeles, Calif
Orthodontic treatment considerations in patients with diabetes mellitus Luc Bensch, DDS, Marc Braem, DDS, PhD, Kristien Van Acker, MD, PhD, Guy Willems, DDS, PhD Edegem and Leuven, Belgium
Laser debonding of ceramic brackets: A comprehensive review Ezz Azzeh, Paul J. Feldon, BSc Toronto, Ontario, Canada
Segmental odontomaxillary dysplasia: An unusual orthodontic challenge David L. Drake, DDS, MS Tiffin, Ohio
Unerupted maxillary central and lateral incisors and canine with crossbite and asymmetry Koshi Sato, DDS, PhD, Hideo Mitani, DDS, MS, PhD Sendai, Japan
AAO Continuing Education
Questions and registration forms
Zane Muhl, DDS, PhD, Editor
Litigation, Legislation, and Ethics
Subjective expert opinion evidence
Laurance Jerrold, DDS, JD
Massapequa Park, NY
Reviews and Abstracts
In vitro evaluation of three-dimensional orthodontic mechanical force systems Rick Daniel Alter
Comparison of bond strength between a conventional resin adhesive and a resin-modified glass ionomer adhesive: an in vitro and in vivo study Andrew Summers, DDS, Peter Ngan, DMD, Elizabeth Kao, DMD, MS, Jeffery Gilmore, DDS, MS, Erdogan Gunel, PhD
Reliability of orthodontic bond strength testing Mark David Crane, DDS
Investigation of frictional resistance on orthodontic brackets when subjected to variable moments Edward Mah, Michael Bagby, Peter Ngan, Mark Durkee
Predicting the eruption pattern of maxillary canines using a panoramic tomograph and cephalometric radiograph Frank P. Iuorno, DDS
Shear bond strength of a self-etching primer in the bonding of orthodontic brackets Tanya N. Paskowsky
Treatment effects of the edgewise Herbst appliance: A cephalometric and tomographic investigation Ryan Van Laecken, Peter Ngan, Terry Dischinger, Mark Durkee, Chris Martin, Thomas Razmus http://www.mosby.com/scripts/om.dll/serve?article=amod0340
News, comments, and service announcements http://www.mosby.com/scripts/om.dll/serve?article=jmod0312301an
Directory: AAO Officers and Organizations
The American Association of Orthodontists, its constituent societies, the American Board of Orthodontics, the American Association of Orthodontists Foundation Board of Directors, and the College of Diplomates of the American Board of Orthodontics http://www.mosby.com/scripts/om.dll/serve?article=jmod0312301ao
In search of anatomic truth: 3-dimensional digital modeling and the future of orthodontics http://www.mosby.com/scripts/om.dll/serve?article=jmod0312301co
David L. Turpin, DDS, MSD, Editor-in-Chief
Buying staff not the solution
Different logic might provide new answers Marinho Del Santo, Jr
The cervical vertebral maturation method: Some need for clarification Tiziano Baccetti, Lorenzo Franchi, James A. McNamara, Jr
Information for authors
Information for readers
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Bound volumes available to subscribers
Editors of the American Journal of Orthodontics and Dentofacial Orthopedics
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From: Jérôme Wanono [jeromewanono@YAHOO.FR]
Sent: Sat 1/18/2003 8:44 AM
Subject: Tip-Edge: how do you feel, as part of a minority?
Hello Dr. Ruff,
I never said or think I'm a " Tip-Edge Master " : I only said I never treated a single case, that's why before I choose this technique, I'd like to know from edgewise practionners, what are its limitations but with good arguments coming from "informed" people.
About Dr. Speck, I never presumed he was not a " Tip-Edge Master " ! ! that's the opposite ! that's why I was wondering why, in his reply about molar protraction, he was not mentionning the possibility to use uprighting springs, even in edgewise brackets with vertical or horizontal auxiliary slots. (We do it with SPEED brackets!!)
It seems to me that people are pretty sensitive out there : I'll watch carefully to the words I choose…
Concerning the fact that Tip-Edge is used only by 2% of practionners, I would suggest you to ask that question to Dr. Adrian Becker, he has an excellent answer about that: his students who learn Tip-Edge choose for most of them regular SWA because they don't want to think too much!
This is mine : as a jew, I'm part of an extremely small community comparing to the world population, who always faced a terrible opposition (this term is very conservative, I'm starting to take care of sensitive people). It does not make me think that my beliefs, religious or not ( sionism for example) are false.
Second answer : hundreds of millions of people appreciate Stallone and Schwarzenneger and I don't, and they hate Woody Allen, Fellini, Almodovar and so on, and I don't…Millions of people listen to Celine Dion ( I don't) and don't know anything about Guershwin : it does not make me feel stupid, that's rather the opposite !
Thank you for your invitation to Harvard and thanks for the compliment about anchorage managment.
From: PAUL JOHNSON [p8johnson@YAHOO.COM]
Sent: Mon 1/20/2003 1:40 PM
Subject: Cuspid protection or group function continued
Additional comments regarding archives item #15 in the December Digest. Group Function or Cuspid Protection, 11/27/2002. Here is a cc.
1: Dtsch Zahnarztl Z 1989 Jan;44(1):30-3
[Cuspid protection and muscular reaction][Article in
German]Ott RW, Lechner KH.In an epidemiological study
we found bilateral cuspid guidance in only 4, and
unilateral cuspid guidance in 3 out of 247 patients
examined. This suggests that cuspid guidance is a rare
form of articulation. In the experimental part of this
study the electric activity of the masseter and
anterior temporal muscles was measured during empty
mastication before and after the canines were treated
with build-ups in a patient group with muscular and
TMJ problems and matched against the results obtained
in a control group of 10 healthy … With cuspid
build-ups allowing correct cuspid guidance the
patients with muscular and TMJ problems were
symptom-free after just three days. After approx. one
year the patients …were recalled for a follow-up
check. These and other results are discussed.PMID:
2598855 [PubMed - indexed for MEDLINE]
The first part of the above abstract indicates that about 3% of this epidemiological group of 247 patients had either unilateral or bilateral canine lift, a rare form of articulation.
These numbers indicate that 97% of our exams require orthodontic correction if we believe cuspid protection is the optimum arrangement for the dentition. It appears that many ESCO members believe this to be true. A huge assumption is involved here: that we are able to produce mutual protection in every patient. Skeletal class III open-bite patterns often make it impossible to achieve three mm of overbite in the finish models. My guess is that we can end up with this ideal situation in at least 50% of our patients today, with “proper mechanics” that is. By the end of the 21 st century perhaps we will be able to raise it to 75%.
Jaw surgery is not always the best answer for your own child; last Thursday evening a study club member reported that one of his surgical patients told him, “I thought I was going to die (just after the lengthy operation).” It was questionable whether the beginning records warranted all that involvement: the results were not spectacular compared to the start. I.e. not all surgeries end up perfect.
During the diagnostic phase of treatment it is possible to determine those dentitions where three mm of overbite is possible; in those situations when the excessive overbite is reduced to the ideal you stop the type of treatment that would destroy more overbite. It would be wrong to deliberately harm the patient by continuing the “leveling” until there is only two mm overbite, or worse.
Functional appliances often provide the best diagnostic answer for some of our difficult patterns, especially if your goal is to have the finish better than the start.
The inexperienced optimist might say, “The bite will settle in.” Some do and some don't: deep bites tend to settle; open bites do not.
An important diagnostic tool for me was the Sassouni Cephalometric Analysis. It told me graphically, without any numbers, whether the pattern was class II or III, open or closed bite; viewing the tracing from a ten-foot distance tells you what the skeletal behavior will be. A good idea is to know these critical factors before treatment is started. I'd be happy to scan the basics of the Analysis into a posting if anyone is interested.
Back to the second half of item #15: “With cuspid build-ups allowing CORRECT (my emphasis) cuspid guidance, the patients with high muscular and TMJ problems were symptom-free after just three days.” This has to be a compelling point favoring what the goal of orthodontic treatment should be.
From: Mark Cordato [markc@IX.NET.AU]
Sent: Tue 1/21/2003 2:56 AM
Subject: Re: Edgewise/Tip-Edge
Season's greetings. I've had a delightful time off clambouring over Ankor Wat and some great spots in Thailand so my reply is slow, sorry. For brevity, and the sanity of everyone who reads this I will mostly address your premise and leave the other points for the moment.
Once upon a time many orthodontists believed braces moved teeth only and had no influence on skeletal growth. Then along came people who saw quick movements with big lumps of plastic and some orthodontists said "we are growing mandibles with functionals and then we can move teeth with the braces".
The philosopher, Karl Popper, in his book "Objective Knowledge"
speaks of the flaws in inductive reasoning and the above example is perfect. Next time you hear of a student wanting to "test an hypothesis"
in their thesis you could point them to Popper as a source for cementing that approach to our objective knowledge.
Just because the first explanation that jumps to mind (or you read in the technique manual) looks plasible, without testing, does not mean it is correct. We now know the second paragraph of this message does not stand contemporary scritiny, the hypothesis failed the test.
My strong objection is to the claim of a technique, which has in essence been around for 40 years, can induce a significantly
(dramatically?!) different response in humans (just like functionals and fixed appliances were once thought to and now don't) yet you cannot produce evidence to support your claim just criticise three relevant articles which contradict your claim. Thus far your claims are purely subjective opinions backed up by a commercial manual against three refereed articles, no matter how poor (and I think if you stacked the science in these against the science in the workbook you would could be embarrassed).
If one pictures a Class II div 1 with a central incisor which need retraction of say 8mm of the incisal edge and 5mm of the apex the root needs to be moved through the same volume of alveolus whether it is bodly translated or tipped and uprighted. Your hypothesis is a Tip edge approach will retract the tooth with less response from the teeth it is pulling against. Given Tip edge has been available for at least 15 odd years and Begg has been used widely for 40 years there should be a stack of articles for you to cite. (I have also seen lots of orthodontics completed on patients without banding 7s from practices that don't use headgear nor TPAs from Australia and USA so surely there are matched comparison groups available)
I found this intersting quote from Charles Burstone from the first edition of Proffit's "Contemporary Orthodontics" P 268 paragraph 2 " Although the progress records with this approach (referring to the Begg appliance)looked vastly different, it is not surprising that the overall anchorage control was similar to Tweed's since both used two steps to overcome some frictional problems."
My conclusion is that you make a claim for extraordinary anchorage of a Tip-edge appliance yet you cannot support this with an objective study. As King Lear said to Polonious "more substance and less art" I make a plea for more science when claims of extraordinary movements are made. From what I can fathom, in terms of science as we try to logically and critically follow it you have an hypothesis available to test, no more.
References quoted before by me:
A Cephalometric Comparison between the Begg and the Segmental Edgewise Orthodontic Techniques; Chris Edelen Am J Orth Vol 86 No
6 December 1985 P 525
Angle Orthod Vol 43 No1 January 1973 p119-126, John J Barton A cephalometric comparison of cases treated with Edgewise and Begg techniques
Am J Orth Vol 86 Tony Gianelly et al, No 4 Oct 1984 P269-276
And now Karl L Popper "Objective Knowledge" (full reference is at my
On 23 Dec 2002 at 12:03, mort speck wrote:
> 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
> email@example.com (Mort Speck)
Newly named "Australian Mark" to be distinguished from the distinguished "American Mark"
From: Mark Lively [mdlively@BELLSOUTH.NET]
Sent: Sun 1/19/2003 12:09 AM
Subject: Re: SCANNERS
Thanks so much for the reply. I have ordered the 1680 Pro for the Epson Website and I am awaiting its arrival. Thanks again.
From: GJ/RR Oppenhuizen [doctoro@MACATAWA.COM]
Sent: Fri 1/24/2003 10:55 AM
Subject: Porcelain polishing
I am writing in response Ted Schippers question about polishing porcelain after roughening the surface. I have found that the "Porcelain Polishing Kit" available from Shofu works quite well to restore the surface. It consists of a series of polishing wheels in two different shapes. I think it does a very good job, but the luster may not be quite as good as it was before it was roughened. It gets you pretty close.
From: Rick Curtis [drcortho@ATT.NET]
Sent: Mon 1/20/2003 9:24 AM
Subject: effective bur
Does anyone know of a bur that is effective for removing broken ceramic brackets?
Richard L. Curtis
Salt Lake City, UT
From: Ormond Grimes [heyorm@RAINBOW-ORTHO.ORG]
Sent: Sun 1/19/2003 12:30 PM
Subject: Re: ESCO Digest - 11 Jan 2003 to 17 Jan 2003 (#2003-3)
Someone in London, England contacted me and is looking for a good orthodontic/surgical consult. He has an open bite and Bruxes. He has a retruding mandible and chin. If you know of someone you could recommend contact me or email him at <firstname.lastname@example.org>. Thanks, Orm
Orm's Web Site is <http://www.Rainbow-Ortho.org> Mailto:HeyOrm@Rainbow-Ortho.org
From: Nanda,Ravindra [Nanda@NSO.UCHC.EDU]
Sent: Mon 1/20/2003 9:08 AM
Subject: Re: ESCO Digest - 2 Jan 2003 to 11 Jan 2003 (#2003-2)
I wanted to set the record straight regarding comments by our friend Jerome from Montreal. He has been in correspondence with me after his post on this forum.
Being in orthodontic education 35 years, one thing I have learned that no one technique has answers to our problems. I always teach that brackets are not the prime movers of good orthodontics. They only facilitate reaching our treatment goals. A proper diagnosis, optimal treatment plan, and an understanding of forces, moments, loops and efficient execution of mechanics are far more important than a bracket. Look at Tweed technique with standard brackets, has some of the most wonderful clinicians in the world. And than we look around and we have half a dozen very popular prescriptions with very respectable orthodontists to back them.
TE or any other bracket system is as good as basic concepts and practioners behind it. I personally know orthodontists who do a great job with TE system including Parkhouse, Kesling's, and Mort Speck. The sad part is sometimes people only get part of the message and hence our quest to find magic bullet continues.
Incidentally, Jerome is indeed a wonderful enthusiastic young man. This year his department head Dr. Remise is bringing all his residents to UConn for a few days. And ofcourse Jerome has a standing invitation.
You mentioned that you were bilingual and your English was not as strong as it could be. While I am not bilingual I am bifocal :-), so I hope that I really understood your point in the above section. You seem to imply that Dr. Speck may not fully understand the TE principles (again, I may be wrong on this one. It could be a language problem). You seem to be lecturing an acknowledged TE master on how to use his appliance to blow lower anchorage.
It sort of reminds me of Kwai Chang Caine, "grasshopper", in the old David Carridine Kung Fu TV show.
More on point, however, I would like to call your attention to the TE Guide, specifically the Q&A section, page 6. If you will read the fine print under the third question, you will see that Dr. Speck is cited as a master clinician in Kesling's own book.
I also know that Dr. Speck has taught Begg and now TE at Harvard for at least 30 years. He his held in high esteem by the faculty and the residents as both a fine clinician and a true mensch (see
http://www.bartleby.com/61/97/M0219700.html for definition of mensch).
I'm a brand new Tip Edge instructor at Harvard recruited to the "Dark Side"
by Dr. Speck. I've yet to finish a case but have started approximately 25 in my private practice and I am really enjoying the process and how this technique solves some of the problems inherent in edgewise. But I've been around the block enough times to understand that each appliance has it own goods and bads and eventually I will understand better the limitations of the TE appliance. Hopefully, I will be able to pick and choose the best appliance for any particular patient.
I really enjoyed your comment at the end:
· "Well, this letter is already too long and I'm sorry cause I would have many other things to say, to add arguments favoring the TE. The only thing I wish to say is that the anchorage needs are not different. What is different is anchorage management ! ! For G. 's sake, please dear Edgewise fanatics, take the time to read the Tip-Edge Guide, because one day , people who know some things about the Tip-Edge will be tired to take the time to compensate for your ignorance."
The comment contrasting anchorage needs versus anchorage management is priceless. I will use that often when instructing students. You clearly have a good understanding of orthodontics even though you are still a resident.
My last comment is one in general and that is my firm belief that when "you build a better mousetrap, the world will beat a path to your door." Why has that not happened in this case? TE is used by only 2% of the orthodontics in the US (see most recent JCO Survey)
If you have the chance to come to Boston, I would love to host you for the day at Harvard.