Topics of the day:

1. ESCO - The Electronic Study Club for Orthodontics
2. Effective bur
3. Very effective bur for removing porcelain brkts
4. Sassouni (spin off from Cuspid Protection or Group Function?)
5. Craniofacial Orthodontic Fellowship
6. Tip-Edge/Space Closure
7. Facemask
8. Mitutoyo digital caliper

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

From: Mark Cordato [markc@IX.NET.AU]
Sent: Tue 1/28/2003 2:40 AM
Subject: Re: effective bur

Dear Rick,

Coarse dimond burs.

Where the bulk is large and obvious, I use a high speed with coolant.
When you are close to the enamel I use a slow speed with triplex air blown on the tooth surface. You should be able to distinguish the three materials, the porcelain by feel a appearance (opaque white look for the border between the composite and porcelain) look, the composite by appearance (opaque white, scratces easily) and the enamel by its glossy appearance.

I remove the residual composite with a tungsten carbide in a slow speed (progressively thin the opaque composite and the last bit of the composite flicks off leaving enamel and avoids me marking the enamel).

NB. of course we all know ... Diamond is a harder material than saphire. A diamond can scratch a saphire but a saphire cannot scratch a diamond. Saphire is probably harder than most of our metal burs hence it grinds down our burs rather than the burs grinding our porcelain.

On 20 Jan 2003 at 15:24, Rick Curtis wrote:

> Does anyone know of a bur that is effective for removing broken
> ceramic brackets?
> Richard L. Curtis
> Salt Lake City, UT

Cheers (Aussie) Mark Cordato


From: GJ/RR Oppenhuizen [doctoro@MACATAWA.COM]
Sent: Fri 1/31/2003 2:45 PM
Subject: very effective bur for removing porcelain brkts

For removing residual ceramic from broken ceramic brackets I use the following bur: In the Brassler # 6 catalog, page 29 you will find the #909 rounded wheel. You want the FG 31, for high speed with the .065 diameter head, coarse grit, with 3.0 mm head length. The total length is 19 mm.

This bur is also available for a straight handpiece, but that is not what you want for the purpose of removing residual ceramic. I'm sure this is in other Brassler catalogs too. Their phone is 800 841 4522. This bur works like a charm. You won't do better. 

If you don't have a high speed turbine, then you need to get that too. You can clearly see when you have reached the level of the composite and the ceramic is all gone. Then you can remove that as you normally would.

I have never had to use the 909 with high speed for Clarity brackets. But, I have trouble occasionally with removing Inspire brackets following the specific instructions given by Ormco and using their special pliers. Most of the time they come off fine. Occasionally it is uncomfortable for the patient with that technique and a bit of a chore. Rarely, the 909 is your salvation since it really works very easily.

You may wish to evaluate the debond problems with one bracket type versus another. I don't personally believe that they are all created equal.

Greg Oppenhuizen
Holland MI

From: PAUL JOHNSON [p8johnson@YAHOO.COM]
Sent: Sun 2/2/2003 1:35 PM
Subject: Sassouni (spin off from Cuspid Protection or Group Function?)

Dear Paul,

I would be very interested in your posting the Sassouni Analysis you use.  Vertical problems are very difficult and I think Sassouni is good at that type of identification.

thank you,

Durham, NC

Comment regarding “Vertical problems are very difficult.” Have you tried the Sagittal removable appliance? An open bite skeletal with blocked out maxillary cuspids responds nicely with the plastic occlusal coverage. You end up with more overbite than with traditional full bonds, which destroys overbite. And, you no longer have a lack of space for the canines. One problem is that the intermolar width can increase up to one third, or more, of an inch, so if this is not indicated you place the screws parallel to each other and not diverging.

Dear Paul,

Great to read that there are still more Sassouni adepts on this planet. Every day again I'm being impressed by the simplicity and accuracy of Sassouni's analysis. Was it purely a lucky shot that brought this man to such a genius tool.

This analysis was carried back right from the department of Vigen Sassouni to Belgium by Prof. DERMAUT from the University of Ghent in the late seventies and still is taught to all under and postgraduate students at the Universities of Ghent and Brussels.

Wonder how many more Sassouni admirers are kept alive now a days?

Assistant professor

Department of orthodontics

Free University of Brussels

From: Barry Grayson [barry.grayson@MED.NYU.EDU]
Sent: Mon 1/27/2003 7:55 AM
Subject: Craniofacial Orthodontic Fellowship

Craniofacial Orthodontic Fellowship
Institute of Reconstructive Plastic Surgery New York University Medical Center

Applications are being accepted for the 2003-2004 Fellowship in Craniofacial Orthodontics (June 15th 2003 - July 1, 2004).
Program Description: This fellowship program provides advanced training in the treatment of patients with cleft lip and palate and other craniofacial anomalies. The Fellow will have a broad clinical experience in the pre and post surgical orthodontic management of patients undergoing craniofacial and orthognathic surgery. . This Fellowship will provide the recent orthodontic graduate with an alternative to the conventional practice of Orthodontics.
The training will include the following subspecialty practice experiences:
1. Presurgical orthopedics for infants born with cleft lip and palate.

2. Orthodontic management of patients with cleft or craniofacial anomalies from the deciduous through adult dentition.

3. Surgical/orthodontic treatment planning, pre and post surgical orthodontic management, surgical splint design and construction, and insertion of surgical fixation splints in the operating room.

4. 3D Computer based surgical planning

The Fellow will have the opportunity to express their interest in the design and execution of clinical research within the time constraints of a 12-month program. Institute faculty will provide mentorship and guidance in this clinical research endeavor.

The Fellow will participate in weekly meetings of the Cleft and Craniofacial Teams in preparation to serve as an orthodontic clinical consultant to other University or Hospital based Teams. This Fellowship training will provide the clinical skills needed for the diagnostic planning and orthodontic treatment of our most complex and challenging patients.

Requirements for application: The applicant must be a graduate of a dental school accredited by the American Dental Association and be qualified to take the National Dental Boards, parts I and II. The applicant must have graduated an orthodontic training program, accredited by the American Association of Orthodontics

Application Process: Please contact Dr. Barry H. Grayson, Director of Craniofacial Fellowship Training Program Tel. 212 263 5206 or Fax 212 263 5400
Barry H. Grayson DDS
Associate Professor of Clinical Surgery (Orthodontics) New York University Medical Center Institute of Reconstructive Plastic Surgery 560 First Ave.
New York, New York
10016 USA
Phone: 212 263 5206
Fax: 212 263 6002

From: Mort Speck [morton_speck@HSDM.HARVARD.EDU]
Sent: Thu 1/30/2003 6:54 PM
Subject: Tip-Edge/Space Closure

Tip-Edge/Space Closure

For Jerome, Charlie, and all interested-

I just returned from an aborted vacation (severed my Achilles tendon!) to find the issue regarding molar protraction raised by Jerome Wanono, whom I recently had the pleasure of meeting at TP. He wondered why I hadn’t considered a Tip- Edge solution. My answer, Jerome, is that I was replying directly to Mark Lively’s posting regarding congenitally missing lower 2nd bicuspids and the possibility for extracting the E’s and attempting space closure. My solution was aimed at avoiding any anterior retraction. These cases with an incisor position that you want to maintain, in combination with congenitally missing teeth, present the greatest challenge to space closure because, after removing lower E’s, you are faced with the problem of protracting your molars almost 10 mm. To my knowledge, there is no bracket/wire combination, even with uprighting springs on laterals, cuspids and 1st bicuspids, that will create stationary anterior anchorage against which molars can be fully protracted over this distance. That is why I did not consider the use of springs in this instance.

As you know from your lectures, there are many factors that contribute to the stability of your anchorage unit; and one of the more important, in addition to the amount of applied force, is the length of time that the force is applied. In the usual bicuspid extraction case, where you may have a couple of mm. of posterior protraction to accomplish, applying the brakes with cuspid springs is quite effective (regardless of your bracket), because the duration of force application is rather short. But to repeat, in my opinion, the same anterior setup would fail, even with the addition of 1st bicuspid uprighting springs, in an effort to protract a molar 9-10 mm. with no lingual movement of the anterior teeth. It was an oversight on my part not to have explained this first, before launching into a possible scenario to beef-up anterior anchorage for the closure of such a large space. And that suggestion, in addition to traditional bracket/wire mechanics, was to bond a wire to the lingual of lower
4-4 (no lingual arch, Jerome!) to create a solid anterior unit. Even then, the possibility for anterior retraction still exists for the reasons previously stated. I hope I’ve made this clearer to you on the second try. Let me close by saying that you will be well served by continuing to question statements, facts and concepts when you find yourself at variance with them.

This is for Charlie Ruff: Thanks a lot for you kind words in my absence. I love your statement about recruiting you to the dark side, but I have to say it was possible only because you are such an open-minded pragmatist. (You've probably been called worse!) Regarding the paucity of Tip Edge practitioners, I have my own ideas, but that’s for another time.

Mort Speck

From: rajesh patil [rajeshp_us@YAHOO.COM]
Sent: Sat 2/1/2003 1:08 PM
Subject: facemask


i am Dr Rajesh an Orthodontic resident from delhi ,india. I wanted to clarify some doubts about ideal treatment timing for giving a Facemask in maxillary retrusion cases.We have a case of of Pseudo Class III Malocclusion with decreased lower anterior facial height. the patient has already proclined upper incisors which are in crossbite.the only problem is patient is 12 years chronologically showing stage of acceleration stage in cvmi. so would a protraction headgear will be indicated for such a case.

Dr Rajesh Patil

From: João Cerejeira [jcerejeira@MAIL.TELEPAC.PT]
Sent: Wed 1/29/2003 6:20 PM
Subject: Mitutoyo digital caliper

Dear group.

I´m performing a master thesis in which I must measure tooth diameters in plaster casts. All the values obtained will be transfered to a software developed by me and some technicians in order to obtain very accurate tooth inter-relations. The question is: I know that the Mitutoyo digital calipers are widely used, specially across the USA, but which caliper? (there are lots of calipers in Mitutoyo´s web site, for instance 0-4", 0-6", 0-8", etc.). What does this means? I would appreciate any answer to my question. Thanks in advance

Paulo Gonçalves
Orthodontist Porto, Portugal