Date: Tuesday, February 06, 2007 8:39 AM
From: "ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>
Subject: ESCO Digest - 2 Feb 2007 to 5 Feb 2007 (#2007-15)

There are 5 messages totalling 592 lines in this issue.

Topics of the day:

  1. Prioritising ESCO posting topics
  2. Temporary Anchorage Devices
  3. SureSmile Opinions
  4. Invisalign Elastics
  5. Re: ESCO Digest - 30 Jan 2007 to 1 Feb 2007 (#2007-13)

Date: Saturday, February 03, 2007 10:11 PM
From: Dr. M.Jayaram <jmailankody@GMAIL.COM>
Subject: Prioritising ESCO posting topics


It is said 'great men discuss ideas, ordinary men discuss events, and lesser ones discuss persons'.            

As an ardent reader/participant of this excellent forum for the last so many years, I have come to note that, of late the forum is loosing track and direction. More of appliances, mechanics and brands are discussed, sometimes leading to personalities, not in good taste. The ESCO is here, if I am not mistaken, for healthy discussions and exchange of objective information among orthodontists.                    

For the products and services(orthodontic commercial/lab) there are special journals and conference exhibitions earmarked.(e.g:AJODO-Supplement April 2006). When one is attached to a 'technic' or  'brand', emotionally or financially, his judgement becomes blurred. As we have seen in these columns earlier,(e.g:Orthoclear vs. Invisalign) the discussion goes onto personalities from brands and onto the limbic system(ego & emotions). This, probably is inherited from the 'Extraction debate' of the 1910's.            

Some years back, Adrian Becker was lamenting that Orthodontic professionals in the ESCO group, largely were uninterested in discussing congenital anomalies like cleft palate.It's time we raise to professionalism of noble health care personnel standards, leaving aside mundane matters of appliance/brand/patents. One has to remember that appliances are only means to an end and not an end in itself!            

It is not intended to totally eliminate mechanics, but to stress that orthodontic professionals should be giving more emphasis(at least thru this forum) to concepts, diagnostics, rationale, appraisals and academics, less of iconistic technics and least to patented commercial brands. We are not here to promote or demote a technic or brand, but to provide objective vision for the betterment of profession, our patients and the global public at large. Why not we paraphrase 'Great orthodontists discuss concepts and rationales, ordinary orthodontists discuss technics and appliances, lesser ones discuss brands and commerce' ?            

It is hoped that the readers and participants of ESCO will ponder over these points and respond.

Jayaram Mailankody
Calicut, INDIA.

Date: Saturday, February 03, 2007 2:09 PM
From: Ejpdrb@AOL.COM <Ejpdrb@AOL.COM>
Subject: Temporary Anchorage Devices

Dear Study Club Members:

For a powerhouse symposium on Temporary Anchorage Devices, be sure to attend the New-Conn Orthodontic Foundation's 21st Biennial Seminar this April. For more information, check out the New-Conn website at: .

Eric Ploumis


Date: Monday, February 05, 2007 9:36 AM
From: mbellard@AOL.COM <mbellard@AOL.COM>
Subject: SureSmile Opinions

Re: SureSmile Opinions

Hi Peter,

I was one of the first few orthodontists to begin using SureSmile a few years ago. I was looking for a way to get away from indirect bonding, and it looked like a great alternative. I was wowed by the concept and the technology, and I signed on with them before they were ready for prime time. I spent a huge amount of time working with SureSmile...and figuring out how to make it work. I wasn't classified a beta site, but in reality that's what I was. The software went through several upgrades and is now very polished and functional. It's by far the most sophisticated orthodontic cad/cam software I've seen. Makes Orthocad, etc look very primitive. There are several VC firms that have invested heavily in the OraMetrix, and the company is staffed with quality people and some intellectual heavyweights. With that said, it may surprise you that I recently quit SureSmile. Bottom line is it required far too much of my time outside of patient hours, and I grew tired of it. If it actually worked in most cases as advertised, I would probably be their best referral source. Maybe my approach was wrong and I didn't "get it", but I still don't see the real benefit of using it in most cases. I got some outstanding results with a few very difficult patients that I probably couldn't have gotten without SS, but in most cases I had to spend inordinate time just to get the cases to come out as good as they would have with my conventional techniques. It's was my experience that the wires rarely performed in the mouth the same way they did in the virtual world, and that's after spending a lot of time being sure everything was done very well on the setup. On several cases, I eventually had to remove the SS wires and finished with conventional wires, after watching the case get worse, not better, with SS wires. It seems that there is often a disconnect between the virtual world and the mouth. With the indirect bonding I do, my cases typically finish very well with only a few archwire adjustments necessary at chairside, and I believe that's a better and more efficient use of my time and the patient's time. The cost issue was the other side of the coin. Their stance is that you save so much time that it's worth the upcharge to the orthodontist and the patient alike, and you will eventually have increased patient capacity due to overall shorter treatment times. Again, that wasn't my experience. I tried very hard to make it work, and if I had gotten several consecutive high quality finishes without expending Herculean effort, I would have converted my practice to SS as they were hoping I would do. One point that often gets overlooked in quoting treatment times is this: how well did the case finish? I could have bailed out of a lot of cases by declaring that we were finished after using the SS wires, but they weren't finished to my standards, so I had a lot more work to do and time to spend trying to finish well. Sorry to be long-winded, but it's not a simple story. Let me know if you have any questions.

Mark Bellard

Date: Friday, February 02, 2007 8:20 PM
From: Roy King <rkking@BELLSOUTH.NET>
Subject: Re: Invisalign Elastics

Dear ESCO,

I must admit that I am clueless when talking about useing Cl 2 elastics for
aligners. I am unsure how much correction are you trying to achieve( ie 1
mm, 2 mm or a full Class 2 which is 7 mm).  Since aligners have a hard time
with occlusion and Cl 2 elastics affect occlusion, how is that handled. The
braces have so many attachments which allows us so much control when useing
Cl 2 elastics. I also wonder if the correction is minor which Invisalign
says it can correct a 2 mm discrepancy by molar distalization then I can
only conclude that we are talking 3 mm or greater Cl 2 correction. Why not
distalize the upper molars with an esthetic distalizing appliance first and
then move to aligners? To me it would appear that Cl 2 elastics maybe
opening up a can of worms in aligner treatment. I would love to see 10
consecutive cases treated with Cl 2 elastics in aligners so we all could
evaluate the cases. Is that to much to ask?

Go Gators!!
Roy King

Date: Friday, February 02, 2007 4:47 PM
From: Peter De Wilde <wezo.bvba@TELENET.BE>
Subject: Re: ESCO Digest - 30 Jan 2007 to 1 Feb 2007 (#2007-13)

Hi Dick,

The use of oral contraceptives is usually not reported by patients during routine orthodontic anamnestic procedures. Very interesting although to start paying attention to it. From my part following observation: in all (female) patients I treated during pregnancy, I observed a significant accelaration of treatment progression, which diminished progressively post partum. This must be due to changes in oestrogen and prolactine levels and their consequent promotion of osseous turn-over and loosening of the fibrous tissues.  I make you guess what I tell to my young female adult patiënts, in case they start whining about the slow progression of their treatments!