There are 6 messages totalling 741 lines in this issue.

Topics of the day:
1. Re: An Alternative to Max. Bicuspid Extraction
2. Re: growth hormone
3. Dr. Lively
4. turned around premolars
5. growth hormone effect on arch length
6. Re: open bite retention

Hi Mort,

Firstly let me say that I agree with you - I can't understand why so few orthodontists use TipEdge.  I reckon it's the same mentality as driving Fords or GMH cars - in the majority, but not what I want to drive!

Secondly, can I ask why people keep worshipping a Class I molar relationship?

I am unaware of any science to base this on, and believe it dates back to the era of wisdom teeth causing crowding, or functional appliances growing mandibles.

If anyone can point me to scientific articles justifying the quest for the Class I molar at all costs I will be pleased.  Until then, I will treat my patients to the best occlusion I can pragmatically achieve!

Cheers,
Brett

That was a great posting Mark. Thanks I've taken the liberty of posting the two seminars in orthodontics issues you referred to at http://homepage.mac.com/orthodmd for those of you who might want to look over what Mark referred to Best to all.

charlie ruff

Dr. Lively,

I am interested in your experience with Damon that you discussed briefly in your last email. Could you please elaborate?

Thank you,
Sincerely,
Alexander Waldman DMD

I was thinking appliance design some more and had two questions for the crowd: When you have a premolar (usually in the maxilla) that is turned 180 degrees, do you always rotate it back?  I usually do..although for one adult who wanted to get through treatment quicker we left it turned.  Does everyone else turn them too? 2nd, does anyone have anything slicker than the button and chains to turn?  For these teeth you place buttons, pull pull pull, then have to re-position the buttons, pull pull pull, then place the brace...and suddenly you are staring 2 years of treatment in the face... I have always fought being lazy about this, but is there any research out there studying how the changed interproximal contact causes issues?  Does anyone enameloplasty to create the open lingual embrasure?

thanks for thoughts
scott smoron

I have a female patient who was diagnosed with a pituitary cyst at 11 years of age. (I had noted an enlarged sella turcica on her initial ceph and sent it over to the pediatrician, who referred the patient to endocrinology. ) I started arch expansion treatment on her with a maxillary expander and mandibular lip bumper, but treatment had to be discontinued four months later so the MRIs could be done. The patient had the cyst surgically removed, was put on growth hormone, and has grown 8 inches in two years.

I have records taken at 11 years of age, and 3y9mo later, about a year after the growth hormone  treatment was started. There is less than 1 mm. increase in maxillary or mandibular arch width or length during that time span. FMA decreased 1 degree during that time. The patient is in active orthodontic treatment, still on growth hormone, and I have not noted any clinically signficant changes in arch length or width.

Mary Barkley
Chelsea Michigan

Hi Jayaram,

if it can help , I use a transpalatal bar with a resin "button" that will help hold or increase intrusion of the upper molars. Adaptive tongue thrust in open bites should end as bite is closed. I feel that the problem could be in identifying primary tongue thrust habits ; EMG of the peri-oral muscles during swallow can give some prognostic indication.

Best regards,
Fabio Savastano
Italy