Date: Wednesday, January 31, 2007 12:22 AM
From: "ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>
Subject: ESCO Digest - 25 Jan 2007 to 30 Jan 2007 (#2007-12)

There are 7 messages totalling 6752 lines in this issue.

Topics of the day:

  1. AAO Dispute
  2. Bisphosphonate-Charlie Ruff
  3. Invisalign and...ELASTICS!
  4. Bisphosphonates
  5. Re: Digital Camera

Date: Friday, January 26, 2007 7:56 PM
From: Roy King <rkking@BELLSOUTH.NET>
Subject: Re: AAO dispute

Dear ESCO,

It would seem like an accurate statement that the AAO does not advocate
comprehensive treatment at 7 years old but then what is comprehensive
treatment. Is it the start of crossbite correction? Personally I would leave
the AAO out of the debate and site the research that substantiates your view
Roy King

Date: Friday, January 26, 2007 7:51 PM
From: Roy King <rkking@BELLSOUTH.NET>
Subject: Bisphosphonate-Charlie Ruff

Dear ESCO and Charlie,
I have not had problems closing spaces with patients on bisphosphonates but
I have worried about it. There is a select set of adults that seem to resist
closure. I do not believe that we know the answers. I actually worry a
little over patients that take aspirin in regards to slow closure but I have
seen patients who does not follow our literature and I have no trouble
closing spaces. It makes sense that tooth movement would be slowed down but
I have not found that to be true.
Roy King

Date: Friday, January 26, 2007 5:01 PM
From: Barry Raphael <drbarry@ALIGNMINE.COM>
Subject: Invisalign and...ELASTICS!

OK, If you're sick of Invisalign and Orthoclear, lets talk some meat and potatoes.  Dave P, are you there?

How are you working Class II elastics with Invisalign?  How well does it work for you?

I've done a few cases by cutting “C” holes in each aligner and pushing out the middle of the “C” as an elastic hook..  I do it with a high speed.and a small flame diamond.  It works well but it's a pain to do four times for every set.  I'm sure glueing a 4 buttons is a pain too.  I don't totally like the idea of putting a button on the tooth because the aligner can't fight the vertical vector on the anchor tooth, I don't believe. ( I wish the lab would come up with  a manufactured hook.  If it can cut the margins of the aligner so precisely, why not an internal cut as well?)

What do you guys use?


Date: Friday, January 26, 2007 4:24 PM
From: Paul M Thomas <p.thomas@EARTHLINK.NET>
Subject: Re: Bisphosphonates

Dear Ron,

Osteonecrosis is associated with patients on IV therapy having oral surgery.  To my knowledge there are no reports of osteonecrosis in an orthodontic patient taking one of the oral preparations.  There are very few reports of patients on oral meds (eg for osteoporosis) having osteonecrosis following surgery.  As I mentioned in the post to Charlie, the oral meds will slow bone turnover and thus the rate of tooth movement.  Is that what you mean by bad news??  I don't think you should suggest that Charlie's patient is at risk for osteonecrosis.

Paul M Thomas


Date: Friday, January 26, 2007 12:01 PM
From: Andrew Kouvaris <Andrew@CUPERTINOORTHODONTIST.COM>
Subject: Bisphosphonates

I recently successfully treated a patient taking oral bisphosphonates with a removable appliance to close a diastema. The teeth moved as I would have normally expected, there seemed to be no inhibition of tooth movement that I could tell. More recently on another patient taking oral bisphosphonates, I have undertaken a more complex case with severe crowding. I am treating with aggressive IPR and Invisalign appliances.  I have not seen any problems as of yet, but my guess is that tooth movement will be inhibited slightly due to a decrease in cellular response. If needed I will ask the patient to wear each aligner over a longer time period. However, I am hopeful to complete the case without a major problem...I will keep you all posted. For these patients I was sure to include informed consent on the possibility of inhibited tooth movement (or no tooth movement) due the medications taken. I believe osteonecrosis is only a concern if extensive “invasive” dental procedures are done, therefore I would not treat any of these bisphosphonate orthodontic patients with extractions.

Andrew Kouvaris, DDS, MSD

Cupertino , CA


Date: Thursday, January 25, 2007 4:47 PM
From: Brett Kerr <brettkerr@IINET.NET.AU>
Subject: Re: Digital Camera

Hi Robert,

I wondered when someone would ask that!!!!

I've shrunk these to 640x480.  I usually use 2048x1536 or thereabouts.