Date: Fri, 18 Aug 2006 00:10:38 -0500
From: "ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>
Subject: ESCO Digest - 14 Aug 2006 to 17 Aug 2006 (#2006-22)

There are 6 messages totalling 3645 lines in this issue.

Topics of the day:
1. Re: Tip-Edge
2. Ceramic Tip-Edge
3. Re: Tip Edge
4. Re: Tip-Edge
5. Re: Best Digital Camera
6. Edgewise and Tip-Edge Comments


Date: Tue, 15 Aug 2006 09:32:26 -0400
From: "Ernest McCallum" <emccallum@EMERALDIS.COM>
Subject: Re: Tip-Edge

Like you I do not enjoy ceramic Tip edge and try my hardest to talk patients out of them. I do not have any evidence, but I feel that I am slower using them. I have had a few SS Tip Edge plus brackets come loose from from their bases...seems like it is always a central....perhaps a bad batch. TP has always sent me a replacement and seemed interested in looking at the failed bracket.



Date: Tue, 15 Aug 2006 13:51:51 +0200
From: "Adrian Becker" <adrianb@CC.HUJI.AC.IL>
Subject: Ceramic Tip-Edge

I stand with Kim Mizrahi regarding not changing to any other bracket than Tip-Edge and I have been using and teaching Begg (initially) and Tip-Edge for just as long. I too had many problems with the ceramic brackets delaminating from the bases - but TP have assured me that the new brackets will not do this. I traded in my entire remaining stock of the older type for the latest model, just recently. Most of us place ceramic brackets on adults, rather than kids. The adults are largely the ones who build up the calculus and it simply fills the bracket slots. However, I get the impression that the ceramic brackets seem to attract calculus deposit much more quickly than the metal brackets. I guess it must be the smoothness or texture of the material itself and perhaps this needs to be looked into. When I remember, I try to pass a thin wire through the deep slots and vertical slots on the routine adjustment visits even when I am not placing auxiliaries, simply to make sure that I do not have this problem when I need them.

Best wishes,
Adrian Becker


Date: Tue, 15 Aug 2006 16:26:56 -0400
From: "Charles Ruff" <orthodmd@MAC.COM>
Subject: Re: Tip Edge

Hi Charlie,

I have been using Tip-Edge ever since I stepped foot out of the doors of Columbia U., amazing results over the years, Thanks Dr. Meistrell! I remember asking Malcolm Meistrell during my residency (1989) as he was showing me a Class II case with a 1/2 mile of overjet resolved with Tip-Edge/elastics, "why don't more orthodontists use this technique and why do they even bother with head gear, palatal arches, nance appl. etc for anchorage, it makes no sense to me?" He hesitated, shrugged his shoulders and said, " I don't know." I still don't know why orthodontists even bother with all of the techniques you mentioned. I suppose compliance with rubber band wear could be a factor but most kids with moderate to severe overjet want to look better so the motivational factor kicks in. Even if I do not get good elastic compliance, I use Mulligan mechanics with anchor bends mesial to the molars and e--link modules from molar hooks to anterior circles on wire. Resolves overjet and corrects class II with no compliance from patient needed. You mentioned that you use a distal jet in mild OJ cases. Why don't you use Tip-Edge also? I also use a .016 niti underlay and 21x25SS or TMA, works well! Kudos to the Keslings! Regards!

Rob Bruno,
Manhasset, NY


Date: Tue, 15 Aug 2006 18:31:37 +0300
From: "Moanad Aker / Maed College" <daker@MED.ALQUDS.EDU>
Subject: Re: Tip-Edge

Dear Charlie, so how do you "torque" the incisors with 0.016 NiTi?

cheers, Moanad Aker

Date: Tue, 15 Aug 2006 11:40:16 +0200
From: "Peter De Wilde" <wezo.bvba@TELENET.BE>
Subject: Re: Best Digital camera

Anyhow the need for an SLR-camera with macrolens and ringflash is out of discussion. Best orthodontic camera combination without compromise for quality, at an affordable price is: NIKON D50 (or D70s) TAMRON macro 90mm 1:2,8 SP Di  (=135mm conventional: nearste aproach to the focal lenght of the good old Nikor medical and superb image quality)) SIGMA ring flash EM-140 DG NA-iTTL (the only flash that reallly works fully automaticaly) set on focus (lens):  on manual, to choose your prefered magnification factor exposure program A: aperture driven  set on f:22 for intra-oral   f:6,7 for extra-oral (on camera) All you need to do further is feed the batteries (only every 2000 frames!) , aim and shoot. Peter De Wilde Wetteren - Belgium
Mijn Postvak In wordt beschermd door SPAMfighter


Date: Mon, 14 Aug 2006 12:26:04 -0400
From: "Speck, Morton" <morton_speck@HSDM.HARVARD.EDU>
Subject: Edgewise and Tip-Edge Comments

Dear ESCO Members:

For my edgewise colleagues.

Please look at the enclosed attachments which show the spontaneous distal drifting the Tip-Edge bracket allows with NO FORCE applied. The first attachment is a sequential photo series of a cuspid replacement bimax case with a 2 nd bi removed on the opposite side. (Tongue spurs subsequently added) The 1 st bi has moved into contact with the first molar which has remained stationary (held with a tip back bend; no force applied). The 2 nd attachment is a lower 2nd bi extraction case showing Cl. I retraction of the lower anteriors. The freedom of movement inherent in the Tip-Edge bracket has allowed the right 1 st bi to spontaneously â€outrun” the retractive force with zero force applied to it.

Why waste your anchorage retracting 1st biâ€s when these teeth want to move naturally? In single arch extraction cases, why remove the robust and esthetically pleasing 1 st bi and leave the patient with the unesthetic and often undersized 2 nd bi? The answer seems to be that the friction inherent in the edgewise appliance forces you to do this. What a millstone friction has been for you in so many cases, causing you to resort to a wide variety of anchorage-enhancing strategies in instances where a much reduced force or no force is actually necessary.

Proffit states that 100grams is needed to retract the cuspid and 100 grams is needed to overcome friction. Doesnâ€t it just blow your mind to know that Tip-Edge can retract 6, 8 and even 10 teeth (in max. 1 st molar extraction cases) with less force than edgewise needs just to overcome friction? Yes, self-ligating brackets can reduce this problem, but as long as your bracket has four corners, this handicap will continue to exist for you, not only for retraction, but for intrusion as well.

Parkhouse has said that Tip-Edge is orthodontics†best kept secret, and I believe this to be true. I challenge you to look at his book, Tip-Edge Orthodontics , and observe the great simplification of treatment that is available to you and your patients.

For Charlie, Paul, Ernie and other Tip-Edgers: it certainly is tempting to consider finishing with 21x25 TMA, particularly since it facilitates wire transition from .020. I know youâ€re wary of this wireâ€s ability to balance the bite-deepening effect of Stage 3. Of equal and perhaps even greater consideration is your ability to achieve ideal torque with 21x25. Though only incrementally smaller than the .022x.028, it will create a slight reduction in torque. In some of my school cases, I sometimes feel we barely achieve sufficient torque with 22x28, hence my concern with 21x25. Yes, I know itâ€s only a nit, but one that can make a difference.

A few words about Cl. II correction: in a growing individual with a good lower arch, traditional Tip-Edge works well. The mechanics hold the upper molars back, and growth does most of the work. Mulligan and others maintain that some distal tipping can be part of the equation, and I believe this to be true, while some have stated there may also be an increment of mandibular repositioning.

In non-growers with a good lower arch, the removal of upper 2 nd biâ€s is much to be preferred. An alternative is Raleigh Williamâ€s suggestion to remove upper 1 st molars when the 3rds are well developed and positioned. (AJO: Oct. 1979).

Regarding either Cl. I or Cl. II extraction cases, I believe the ideal pattern is the removal of upper 2 nd biâ€s and lower 1 st biâ€s; upper 2 nd biâ€s for the reasons stated above, lower 1 st biâ€s because the 2 nd bi - 1 st molar contact is much to be preferred to the alternative. Oftentimes the anatomy of the lower 1 st bi resembles the cuspid and is a less than ideal neighbor for the molar. I have removed 4 second biâ€s in minimum anchorage cases, but I think many of these cases would be better served by the removal of lower 1 st biâ€s, with the early application of lower braking mechanics.

I welcome your further comments, suggestions and questions, particularly from my edgewise colleagues.

Mort Speck