Date: Tue, 15 May 2007 00:13:02 -0500
From: "ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>
Subject: ESCO Digest - 11 May 2007 to 14 May 2007 (#2007-48)

There are 2 messages totalling 151 lines in this issue.

Topics of the day:
1. Biocryl retainers
2. SureSmile


Date: Mon, 14 May 2007 10:14:37 -0500
From: "Dr. Tim Dumore" <drtimbo@DRDUMORE.COM>
Subject: Biocryl retainers

Hello folks,

Does anyone have any experience using a Biostar to make retainers? I have always made standard acrylic retainers, but have recently sent an assistant to a Great Lakes lab course where one of the things that she learned was how to use Biocryl as the major connector. For those who are not familiar with the concept, you bend your wires as you normally would, then just prior to thermoforming 2mm or 3mm Biocryl over the cast, you mix a little acrylic and flow it over the wires. I vaguely recall doing this once in my residency. The concept is appealing because the thickness of the plastic tends to be more or less uniform, and apparently this type of retainer is much less prone to breakage. However, before heading down this path, I thought that I would canvas the group for its collective experience. I would hate to make a whole bunch of these only to discover that it is a better concept than reality.

Tim Dumore

By the way: if you haven't marked your calendar yet, the 2008 Canadian Association of Orthodontists meeting will be held in Winnipeg, September 11-13. Consider yourself invited!


Date: Mon, 14 May 2007 00:03:10 EDT
From: "Randall Moles" <Molesr@CS.COM>
Subject: SureSmile


    I have been using SureSmile for 3 years and would never practice without it!
The quality of the finishes, especially the buccal segments is superb. It is unfortunate that doctors often look at the cost, which gets in the way of their truly looking at the whole system. There is also a fair amount of misinformation out there regarding SureSmile.
   I have seen no evidence of increased resorbtion after having completed almost 300 cases. In fact, there shouldn't be, since there is no round tripping of the teeth. And we all know that round tripping causes osteoid formation when the force is reversed, and that is more resistant than cementum to resorbtion. SureSmile simply moves all the teeth at once to the desired positions. That is one of many reasons it is faster. In addition the wire is 35 deg. CuNiTi so the forces are below what we traditionally use for finishing wires.
    Of course teeth don't always move as we would like and the beauty of SureSmile, compared to other systems, is that it is always adjustable (with precision). I have no problem with bending wire after having been trained in Multiloops. However, with SureSmile I can check the patient at 7 or 8 weeks, see the small changes in a marginal ridge height or rotation and get a new wire with those corrections (to the degree or .1mm) in two weeks.
   As far as cost, I have found that patients willingly pay for the additional speed with quality results. The average SureSmile treatment time in my practice was 11.8 months last year with non-extraction cases treating in 6 to 8 months and extraction treating in 14 to 18 months. Of course it takes time to learn the system well enough to get those results but I am not the only doctor doing it. Moreover, my practice (which is mature 30+ years) increased significantly last year. We have all been told how fast or good a system is, but most of the information is subjective and often anecdotal. OraMetrix has comparison records on every doctor that initiates SureSmile and can document 40% reductions in treatment time. Quality, does not suffer and that is also trackable.
    SureSmile is not for those that don't take the time to learn it!  I would liken it to giving a surgical microscope to a neurosurgeon who never used one before. Practicing in the totally virtual world is a major shift, and it takes work to "get it." However, when you do, you would never want to go back. In my opinion (and that's exactly what it is -- my opinion), this technology "leapfrogs" all of the rest. You can spend the time and effort to learn other systems in order to save money. That may, in the long run, be false economy.
My best to all,

Randy Moles

Moles Orthodontics
5801 Washington Ave.
Racine, Wisconsin   53406