Topics of the day:
I'm treating a 15 years old boy showing a Class II malocclusion generated chiefly (in my humble opinion) from two central upper incisor geminated ( or for that matters, fused with supernumerary elements. No tooth is missing) and severely rotated (the angle between the central incisor and the supernumerary is not flat but almost 120°). Roots fused.
Now I've corrected the canine and molar classes, aligned the arches but he still show of course a large OVJ. In order to finalize esthetically, I considered to split the centrals to normal size ( a tricky and harmfull procedure which can easy lead to root resorption and teeth loss). Or central incisors extraction and move laterals mesially, build up with veneer or crowns and implants for the laterals. Anyone of you have any idea for the final correction?
Thank you very much for any suggestion about a very unusual case. I can send pictures and model scanning to anyone would desire them.
Dear Dr. Heiber,
Firstly, you might want to inform the patient and her mother of some of the potential generic problems associated with transfer cases. These might include additional costs of orthodontic treatment, possible dramatic midcourse changes in orthodontic appliance design and strategies, and lastly, treatment time estimates. "Beating the growth spurt clock", notwithstanding, the disadvantages of beginning treatment (for the patient and parent) under these circumstances, might outweigh any well intended effort to begin treatment at this time.
Another alternative might be to locate such an orthodontist now (check the AAO and World Directories), and fully discuss this case prior to beginning orthodontic treatment. Will the new orthodontist feel comfortable with the nonextraction treatment plan that you propose and the use of the Herbst appliance? As you have astutely noted, "as no treatment has started on this patient, a myriad of options are available, etc." By consulting with an orthodontist who might be accepting this case prior to beginning orthodontic treatment, you would have the opportunity to minimize many of the potential problems that sometimes accompany transfer cases.
To avoid waste, time, improper proportion, and clogging plaster trap, has anyone figured out weight or number of scoops of powder and water for an average set of study models? Filling up little baggies might be a project for lab. assistant when lull in schedule.
Howard Tichler DDS
I have been running Orthotrac Unix for years and am now thinking of upgrading to the Windows version. Crazy? Please let me know.
Also, I looked at Dolphin practice management and found that they could only convert 60 days worth of financial date from Orthotrac so I would lose anything older than 60 days. Does that sound right?
Any other systems I should look at? thanks
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