Topics of the day:
1. Re: Tip Edge / Begg
I would beg(sic) to differ. The Begg and TipEdge systems allowing the free tipping of teeth bears little resemblence to an edgewise system.
However, when comparing systems .... perhaps refering to only one edgewise low friction bracket system is selective and omits old favourites such as Speed, and then there is Inovation, 3M's self- ligating bracket etc which all could claim as being low friction.
Call me cautious, careful, skeptical but I'm waiting for a few decent clinical studies to verify claims of less anchorage needs from any of the above systems. Call me cynical but I'm guessing I'll be retired before I see a decent clinical study that supports the often stated premise of differing anchorage needs and the same goals achieved.
Since I saw so many questions about Micro Screw Implant Anchorage (MIA), I thought it's time to share our experiences with the group.
We have been placing Micro Screw implants in our patients for better part of two years. Our count till to date is 21 cases- (91 implants), mostly for anchorage conservation whilst retraction and combined with intrusion of anterior teeth when needed. Occasionally we have used them for exclusive intrusion of anterior or posterior teeth, as well as correction buccal cross bites without disturbing the occlusal cant (compared to cross-bite elastics).
These Micro Screw anchors seem to have done wonders in terms of sheer amount retraction, in those severe bi-alveolar/ bi-dental cases (geographically we are blessed with ever so many of these cases!!!) leading to exceptional facial corrections. More so we do consistently see a favorable anti-clockwise rotation of mandible –even in non-growing adults- enhancing facial improvements. The only bio-mechanical explanation that could be put forth for such a consistent change is the fact since the retraction forces are from the implants, the buccal molar segments neither move mesially nor elevate (which is ever so common with conventional mechanics!). On the contrary due to in-built moderate reverse curve in the continuous arch wires, compounded by the retraction pull at the incisor end, the molars do supposedly get depressed, leading to favorable rotation of mandible. (Well it is hypothetical and indeed needs further scrutiny)
Though we did stat off with Italian screws, switched quickly to Korean ( Dentos Inc, Absoanchor , Daegu , Korea ) as they were thinnest available then. In most of our buccal/labial applications we do prefer to use Tapered screws – 1.3mm at the head and 1.2 at the tip- of varying length depending upon the quality of cortical bone at the site -6 to 8mm. They do fit in perfectly between the roots, ideally about a millimeter away from the adjacent roots. Usually achieved by slanting the insertion path of the screws( as the roots taper apically) 30 to 40 degrees in maxilla and 20 to 30 degrees in the mandible to the long axis of the teeth. Such a slant increases the purchase available, particularly at the buccal maxillary root area where the cortical bone is rather thin. But when you do insert them more apically (in cases where you need intrusion in addition to retraction) in maxillary buccal segments you need to have a small vertical stab incision –as you encounter free gingiva- and insertion path has to be more horizontal to avoid the maxillary sinus.
The Dentos screws are self-drilling; we just drill a purchase point (1mm deep) with a round bur and screw -in the implant, rather gently with the driver held in a pen-grip, with copious cold saline irrigation. We do try and use topical anesthesia (15% Lidocaine ) in spray or sponge soaked form, but many a times bit of local infiltration may be indicated.
We chose to place our implants by ourselves. Many occasions the implants may have to be relocated due to failure or by the dictates of biomechanical need on a short notice - it could be at any given appointment. Looking for a MF surgeon then doesn't make great sense (It is not cost effective either), so we placed all our implants- think we do know more of them, especially from the standpoint of their use and applications. Having said that I must admit failure of implants is very much a part of this modality- the most common causes are two: root proximity or poor quality of cortical bone at the site, leading to loosening in a few days, Our first 45 screws showed a failure rate of 25% and the next 45 a rate of 17% …. …. there is definite learning curve!
Mani K. Prakash
Dr. Mani K. Prakash B.D.S., M.D.S
103, Charisma Centre,
I have a 14 year old female patient with root resorption of teeth #'s 6,7,8,9, 10 and 11, 3mm average per tooth, typical pipette shaped roots. She has a reopening diastema so I suspect a tongue thrust. The question I have is will the bonding of a lingual wire to the centrals to prevent diastema opening have any effect on further root resorption. Any studies anyone know of? I have come up empty in my search.
Thanks for your help!
Robert W. Bruno (orthodontist)
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Heritability of craniofacial characteristics between parents and offspring estimated from lateral cephalograms
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Evaluation of posttreatment changes in Class II Division 1 patients after nonextraction orthodontic treatment: Cephalometric and model analysis Semra Ciger, Muge Aksu, Derya Germeç
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Directory: AAO Officers and Organizations Directory: AAO officers and organizations Contents Editors choice
I would like to bring to the attention of your subscribers the convenient cephX way of sharing photos and radiographs via the internet. It dovetails very neatly with those orthodontists who have a treatment plan query or would like to download digital images to this group. cephX is a data management system for orthodontists with remote cephalometric tracing, computerized analyses, surgical CAD features, photo management , daily worksheets and treatment plan modules - all via the internet. You can also design your own web-site address and manage full a patient communication system to improve patient PR The web address is www.cephx.com . Check out the interactive or Flash demo
Dr Zeev Abraham
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