Date: Tue, 13 Feb 2007 00:20:47 -0600
From: "ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>
Subject: ESCO Digest - 9 Feb 2007 to 12 Feb 2007 (#2007-18)

There are 3 messages totalling 323 lines in this issue.

Topics of the day:
1. The tale of the headless lateral...
2. Technology
3. Suresmile, Technology et al


Date: Sat, 10 Feb 2007 08:07:49 -0500
From: "Barry Raphael" <drbarry@ALIGNMINE.COM>
Subject: The tale of the headless lateral...

Here's an interesting problem…34yo female has UR2 (#12 for my international friends) with root canal and crown. The GP has condemned the tooth due to root fracture and scheduled an implant.  The patient wants the incisors aligned before the implant is placed…No problem.  But on diagnosis, I see the incisors are ahead of APo by 11mm.  “I've always wondered about that”, she says, and expresses interest in retraction (with 4 bi's, of course). Now the GP says, fine, but the crown on UR2 can't hold up to ortho and he's going to remove the crown but LEAVE THE ROOT.  He will drill it down below the surface of the gingival and let it heal over.  In this way, he will preserve the alveolus for the implant over the course of the orthodontics.  Smart.  And I should place a pontic on the archwire or in the aligner (we're still undecided on treatment modality). Fine.  And I can maintain the space needed for the pontic no problem.

Here's the question.  If I retract the anterior teeth 6mm, as per plan, will the lone root travel along?  Will the adjacent incisors encourage remodeling on the lingual and labial of the lone root?  Or will it lag behind somehow, left protruding –even if just some – on the labial side?

Any experience in the world with this situation?

Barry Raphael

Clifton, NJ


Date: Sat, 10 Feb 2007 15:11:15 -0500
From: "jean-marc.retrouvey" <jmretrouvey@VIDEOTRON.CA>
Subject: technology

I am an avid user of technology.  I work in an hospital where we use 3D scanners to better diagnose complex malocclusions (specially in syndromic kids). I also use self ligating and Damon type brackets. We also have a research project at McGill where we use Geodigm software to treat complicated malocclusions using their software. I love it. My point was that I have a hard time  justifying  complex and time consuming  3D technology for "standard" orthodontic cases. I truly believe the technology advancements are welcome but optional for a great number of our cases

Jean Marc Retrouvey


Date: Sat, 10 Feb 2007 09:08:07 +0000
From: "Owen Crotty" <owenc@EIRCOM.NET>
Subject: Suresmile, Technology et al

With regards to John Mamutil's comments regarding Suresmile marketing the scanner alone with a view to replacing impressions, I think that would be a great idea but......

1. Technology not quite fast enough yet to directly capture the images (but improving I am sure)

2. The digital image would probably be locked into using proprietary software to read it.

3. If there was a need to later produce physical models, again the proprietary software would be required.

4. If, If, if....the company holding the patents to the proprietary software went belly up at some stage in the future, where would we be.

On the other hand, I would love to see some group define a workable open standard, as there is JPEG for static images, and MP3 for music, and have this standard defined so that 3-D scanners can capture images in that form. Then we can build machines that could reproduce physical models if required. Taking it a step further, software could be written to allow appliances to be designed digitally, information sent to labs digitally, and appliances constructed according to those standards. Eliminate the need for plaster alotgether and also eliminate the need for posting items to labs, postage costs, infection ccontrol measures etc. etc. This would not eliminate the need for us to use our clinical acumen and sound biomechanical principles when treating the patients, in the same way that having cruise control and automatic gear shifting in our cars does not eliminate the need to us to drive carefully and courteously, but it would ease and simplify the physical tasks. Before anybody asks, no I am not in a position to define/write such standards. I have neither the techological background nor the finance backing to even contemplate it. However, I feel we have a huge orthodontic community worldwide, we have some incredibly intelligent members, we have the ability to call on fantastic research facilities and minds.....and out there is the ability to start and complete such a project. Let us set the ball rolling soon before commercial interests take over.

Owen crotty Ireland