Topics of the day:
Ortho II Management and Imaging Software
Saw the comments of Drs Michael Barnard and Lee Erickson, especially Dr. Erickson's comment that "Orthotrac service is 'pretty good' ". I have to say that my personal feeling is that service needs to be "great", not just "pretty good". I have been using Ortho II practice management software for the past 15 years, beginning with the DOS product in 1990 and then upgrading to ViewPoint, the Windows-based system, more than 7 years ago. My background is that I was trained at University of Washington in Seattle and have been on the orthodontic faculty at University of Colorado School of Dentistry. I have also served as a beta tester for Intuit's Quicken product as well as for Interactive Communications and Training (IACT) during the development of their consultation software.
Dr. Jon Kinne
Article in May 2004 AJO,describes progressively slicing the distal of the lower 2nd deciduous molars to allow the forward drift of the lower 1st permanent molars.Extraction of the upper 2nd premolars (without controlled slicing)produced the same favorable result as the controlled slicing on the lower.It was recommended that the procedure start by about age 8 or 9 for best results.
Dear Dr. Johe et al,
With all of the various orthodontic techniques, disagreement is common among orthodontists. And that is valuable because it is provocative and educational. I think that spirit pretty much characterizes this study club and is among one of its chief values. And that is why I was happy to read Dr. Joheâ€ôs remarks.
However, my views have not changed. For those who are compelled to bond every lower incisor, I feel the use of twist wire is a poor choice chiefly because it is weaker than a comparably sized solid wire, and offers no compensating advantages. This would seem to make it more susceptible to deformation, breakage, and fraying, particularly when one or more bonds become loose. Additionally, because of its flexible nature, achieving absolute passivity is more difficulty and in rare instances may lead to untoward movement in the hands of those not as skilled as Dr. Johe.
Until we have a prospective long term study, I believe this little controversy will remain just that. And until I see some hard data to the contrary, I only see disadvantage to the use of twist wire.
There is no question that the presence of individually bonded incisors greatly increases the incidence of plaque and calculus accumulation even in this relatively self-cleaning area, and particularly in those calculus prone individuals. To believe that all of your patients will maintain the necessary oral hygiene is simply not realistic. And equally unrealistic is the assumption that a well meaning hygienist will not occasionally loosen one of your bonds.
Regarding the placement of any lingual retainer, I differ from Dr. Johe in that I feel that the wire should be placed as incisally as esthetically possible, rather than in the center of the crown, to facilitate better hygiene.
I have the dubious distinction of having placed lower 3-3â€ôs before the advent of bonding, utilizing a lingual wire soldered to canine bands. Yes, there was occasional relapse, but it was minimal. Because of the hygiene advantage, today I would still opt to bond only the canines and an occasional incisor that was severely rotated. Many have found the use of bonding pads unnecessary.
One has to wonder about the procedure of lingually bonding lower incisors before the case is stripped and has a chance to settle, as practiced by some. What a distinction from Tom Mulliganâ€ôs (â€úCommon Sense Mechanicsâ€) philosophy of removing all appliances for six weeks and then assessing the resulting stability! Until we have more evidence that clearly dictate the optimum approach, the options for an ideal retention protocol, as well as the selection of the best treatment plan and mechanotherapy for our patients, remain a personal choice. Reaching that choice is sometimes difficult, but it is always challenging and stimulating. Orthodontics is certainly the thinking personâ€ôs profession!
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