|Date:||Monday, July 09, 2007 11:16 PM|
|From:||"ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>|
|Subject:||ESCO Digest - 27 Jun 2007 to 9 Jul 2007 (#2007-57)|
There are 24 messages totalling 6580 lines in this issue.
Topics of the day:
2. Damon system a reaction to Dr Lively
3. Re: Damon
4. Re: Nickel allergy
6. CL III treatment
7. Adult Clearance Form
8. Wow, Mark!
9. canker sores
10. ink jet
13.Nickel allergy: suggestions?
14. Canker sores
15. Another random question: periapical films
16. Self ligation bracket (2)
17. Age as determinant of success with palatal cuspids
|Date:||Monday, July 09, 2007 2:49 PM|
|From:||Nasreddine Tsouria Belaid <tsouria@HOTMAIL.COM>|
if your patient have an hypersensitivity to Nickel you could use
brackets,wires ,molar tube free Nickel;these material is available in
Cobalt-Chromium(see Orthoorganizers) or in Titanium(at Ormco or
Best regards for all and happy holiday
|Date:||Friday, June 29, 2007 8:30 AM|
|Subject:||Re: Damon system a reaction to Dr Lively|
Dear Mark and my colleagues:
When problems at the office screw up your personal life you must change.
I am glad you found helpful friends.
I have read your letter with understanding of the issues you have
expressed. Some of your issues may be unique, but certainly not all.
Frankly, I thought that I would be the person to write Dr Lively's
letter to the ESCO. I have seriously considered writing an article for
JCO about my experience (I doubt that they would publish it). I
discussed this with some users at the Damon forum last January and they
were highly positive about writing a paper to that effect. I last wrote
about my experience to ESCO with the D3 system nearly two years ago
which prompted a personal reply to me from Dwight Damon.
When I think of the D3 bracket, I am reminded of the start of the old TV
show, _Mission Impossible_. At the start of each episode just after Jim
would get the mission the voice on the tape recorder would say, “This
tape will self destruct in 5 seconds. Good luck, Jim!”
I say, “D3 brackets will self destruct in 15 months – Good luck Greg!”
Thanks I need it. The race is on – you better hustle.
There is not a D3 user anywhere that does not know (by hard knocks) that
the D3 bracket lacks the integrity to function anywhere except the
maxillary anterior – even that is debatable. In my office the D3 bracket
has added 30% to the time to treat a case as well as the number of
visits. The reason: fundamentally they just self destruct. I was doing
very well with time and visits before D3. Worse than that, the bracket
has cost me personally thousands of dollars in time and materials to fix
the problems associated with D3. I had one patient, early in the
process, with short clinical crowns (bad news) that simply left the
practice due to bond failure problems. That's a problem that will shake
you to the bones.
Addressing Mark's letter, I have not seen posterior bite opening as an
issue that is different from my experience with Innovation or any other
system I have used. I have not seen the posterior teeth tip buccally.
That, perhaps, may have to do with some nuance I employ to shape wires,
which is not standard Damon protocol.
I find a very slight increase in rotational issues in the lower anterior
which I have solved completely with selective use of c-chain to resolve
the rotations – mostly without wire bending.
I have seen no increase in torque problems in the lower anterior. The
perennial problem of upper anterior torque in any 22 system is due to
the wire size/slot size discrepancy. The problem is incisors that are
too upright. This can be accommodated by adding about 5° torque
(minimal) to the wire to eliminate the slop as well as anticipating the
issues and using increased torque NiTi wires earlier in alignment.
The biggest problem with the system is finishing wire stiffness and the
multiple wires to finish. If a bracket comes off (think second premolar)
in finishing, the system lacks forgiveness. I attribute this problem
mostly to intrinsic issues with the 22 slot that are magnified by the
door. You just can't cram a stainless steel or even a TMA wire into a
bracket that is too shifted. 1-3 month detours are possible. Of course,
occasionally it makes sense to use a ligature and some c-chain to save
the day in these specifics. But the wire stiffness/door issue is mostly
intrinsic and must be assessed in treatment planning. The system also
requires more wires than are necessary for many cases.
I have not had bond failure problems with the Dmx bracket that exceed
the norms. I bond with a modified L-Pop technique. I etch very briefly,
and then apply the L- pop as indicated in the directions. This works
very well since the strengths of both techniques appear to supplement
each other and counteract human errors applying either etch mechanism.
I applaud Ormco for finally doing the right thing and changing the mesh
on the Dmx bracket as well as offsetting the lower premolars. Why in the
world didn't you do that in the first place? Can't figure that one -
Fortunately for me I was using Innovation before I entered the fray with
D3. As I stated two years ago, I have not had problems with the
Innovation bracket. With thousands of brackets bonded, I have had less
than a dozen clip failures of any type. My worst situation ever, by far,
was a patient this week where tartar immobilized 3 Innovation brackets
(really threw off the statistics).
My experience with both systems permits me to make comparisons that may
I use the Damon system to this day and I grow more fond of it as my D3
cases fade away. I use Dmx 5 to 5 in the lower with selective torques. I
am getting more creative this way every day. In the upper I use Dmx
exclusively on the 4's and 5's. I use D3 on 3 to 3 and am starting some
Dmx here as well.
You should ask yourself, why in the world would he use the Damon system
at all? The reason is simply this: for crowding cases with narrow arches
it works best. My definition of a narrow arch may be different from many
of my peers. It is clearly superior to my Innovation system (18x25 slot)
in this type of case. Cases unravel better and there is better incisor
control for torque. The disadvantage of finishing wire/door issues are
offset by advantages elsewhere. In extraction cases, it works best due
to easier sliding mechanics for whatever reason.
So today I triage my cases. Cases which are not so crowded are
Innovation R and Innovation C. I use fewer wires and I can be in
finishing in less than 6 months routinely in all but Herbst cases. I can
use Class II or Class III elastics with better arch shape and torque
control earlier in treatment. I use Innovation on most Herbst cases.
Herbst cases can be in finishing in about a year. The reason is fewer
wires, earlier torque control, and a more linear start to finish
sequence using my approach to treating with the Herbst.
I find most cases can be treated easier and consequently faster with my
approach to using the Innovation system. I treat my 18x25 slot
Innovation cases in a manner like my D3/Dmx cases. I must applaud and
thank Dr Damon for improving my wire sequencing with self ligation based
on what he teaches with the Damon system. I start with 013 or 014
Thermal NiTi wires. I think the data is getting better that there are
other wires with favorable attributes which are much less expensive than
Copper NiTi or TMA and generate equal or better force loading and
unloading. My next wire is 16x22 thermal NiTi. This wire finishes
alignment and can be used to reposition as needed (I have much more to
say about this for some other time). I finish in a posted 16x22 ss wire
in the upper and a 16x22 TMA (Resolve) in the lower. If a bracket breaks
in finishing rarely do you have to back off to 16x22 NiTi since all the
wires are smaller and can be comfortably inserted into a slot/clip
configuration. If I do have a greater displacement of a tooth in
finishing I can continue elastics with virtual impunity in the
Innovation system before going back to the finishing wire in a month or
less – no detour.
Frankly the approach to treating cases in the Damon system is very
intelligent and I would recommend taking these classes to every
orthodontist. You will become an even better clinician if you can
expunge some of the dogma some hold so dear. These classes can help a
lot. The system is outstanding but has intrinsic flaws, just like
As a clinician I am comfortable with using two systems in my office. I
use exclusively self ligation. I would recommend the lecture by Dr
Harradine from the 2007 AAO meeting as to why you really should be using
self ligation exclusively. I use both systems in a very similar manner
so my staff does not need to shift their mindset to use one or the
other. Frankly, where I am at now I believe the two systems are better
than either one alone.
My opinion is never cast in stone so I will continue to evaluate and
re-evaluate until I ride off into the sunset (hopefully a long time from
now). I do believe that there is a lot of nonsense that people believe
about the Damon system, mostly because they don't know or care to learn.
You should learn this information and also listen to others who have
gone down the road before you.
It is uncommon to see anything by Damon users that are negative. I think
this is because there are so many positive things to be said about the
system. What's going on in self ligation treatment is a major step
forward for our profession and for patient care. If a person does what
they have always done using a self ligating bracket then they will not
maximize the advantages that are available.
No other group has done more to demonstrate a better way than the Damon
users and the Damon system lecture series. If you cast aside learning
about the Damon system you are really cutting off your hand to spite
your arm. I encourage every orthodontist to learn what Dr Damon et. al.
I started my letter here quite negative, because the D3 bracket is such
a flawed bracket and everybody needs to know this. But the system, at
the very least, has a lot for everyone one to learn and grow from.
I invite additional responses on the self ligation, Damon system topic.
It's a lot like talking about the President.
|Date:||Thursday, June 28, 2007 9:18 PM|
Have you given any thoughts to using SURESMILE to help finish your remaining cases?
|Date:||Saturday, June 09, 2007 6:36 AM|
|From:||Ganesh Somayaji <ganeshsomayaji@YAHOO.COM>|
|Subject:||Re: Nickel allergy|
Does this happen often with this child? If so a visit to a rheumatologist would be a good idea. Could be a mild form of Autoimmune disorders.
Call me if you need more info.
|Date:||Thursday, June 28, 2007 7:34 PM|
|From:||Roy King <rkking@BELLSOUTH.NET>|
|Subject:||Fw: Nickel allergy: suggestions?|
I have used titanium bractkets or clear brackets. The wires did not make a
difference but there are coated archwires out there.
|Date:||Thursday, June 28, 2007 2:34 PM|
|From:||David Paquette <dave@PAQUETTEORTHO.COM>|
I find your experience interesting. It is funny to me how we all go through similar experiences yet arrive at different places.
I have used self-ligation for 10 years, beginning with the Twin Lock. I then switched to the Damon brackets and have used all variants of them. I don't believe there is anyone who would disagree with you that the D3 hybrid bracket was a delaminating nightmare, and like you we limited the use to upper 3-3. Nuff said.
As for the wire force, I was quite surprised by their findings and I am looking into the research because their values are different than those I have seen elsewhere. I will let you know what I find out. It is important to note that for orthodontic movement it is the unloading force that is important, not the loading force.
I don't understand the problem with colors, we simply place under the wires if the kids want them, although if they want them changed it takes an extra minute to open the doors.
Unlike you, I would never trade the response and finish I get with the Damon System for anything else I have ever used and my staff feels even more strongly about it. The GAC Innovation experience I had was exactly the opposite of yours…my staff universally refused to even treat the one patient we had after working with them one time (she transferred in shortly after having her appliances placed) and even my head assistant became so frustrated with them even she broke down and insisted that I “deal with it” or replace them with D3 mx. More than one said that if I ever thought of switching to the GAC brackets they would quit. I am surprised by your experience being so different.
Bonding with the D3MX requires attention to detail because of the high profile and small pad. The 100 mesh pad that was used for a short time was an issue but that is no longer the case because they are now using the 80 mesh again. I did have a period where we had some bonding issues, but learned in the process that insidious shortcuts were creeping into the process.
I do not have the finishing issues you describe, although bracket placement and proper torque selection are critical due to the intentional play at the bracket-wire interface. Using elastomeric ties to achieve torque seems counterintuitive to me because torque is expressed by the edges of the wire against the walls, not the wire against the base of the brackets (see Proffit). If anything I would have thought that the elastomerics would have made finishing more difficult. As far as the posterior open bite is concerned, I have seen that but now begin posterior vee elastics at the first sign.
All in all, I work 3 days a week, get better results than I ever dreamed possible and have to explain to parents why we don't need to see their kids for 12 weeks when their friends see other orthodontists every 4-6. That is all thanks to the Damon System. Our biggest issue now is creative financing so payment plans don't go too much over our shorter treatment times.
I guess we live in parallel universes
All the best,
|Date:||Thursday, June 28, 2007 12:33 PM|
|From:||Adrian Becker <adrianb@CC.HUJI.AC.IL>|
B.J. Runquist, DDS, MS of Davis, CA described an adult (40 years of age)
case with bilateral impacted maxillary canines and asked 4 questions. I
venture to make the following very personal offerings of relevant published
material, in answer to those questions - the subject just happens to be a
hobby of mine:-
Questions and answers as follows:-
Question 1. prognosis for being able to successfully bring #6 and #11 into
place (age related?).
Becker A, Chaushu S. Success rate and duration of orthodontic treatment for
adult patients with palatally impacted maxillary canines. American Journal
of Orthodontics and Dentofacial Orthopedics. 2003; 124:509-514.
This is also reviewed in the second edition of my book (see flyer attached)
in chapter 9 pages 210-214 and chapter 12 pages 262-263.
Question 2. possible 'long-term' side effects that should be mentioned
(relapse/intrusion; unesthetic gingival contours, etc.).
This is fully reviewed in the second edition of my book chapter 3 pages
32-43. The views of Kokich and of Vanarsdall differ from those that I
recommend, but these are all discussed at length in the review in that
Question 3. ability to distalize buccal segments to create room... to avoid
excess overjet by bringing her upper incisors forward (no wisdom teeth
present). The ability to achieve
distal movement of the posterior teeth in an adult (discarding extra-oral
forces as an option) is to use temporary bone implants, such as zygomatic
plates - see second edition of my book - chapter 9 page 227.
Question 4. value of cone-beam CT scan in making decisions.
Chaushu S, Chaushu G, Becker A The role of digital volume tomography in the
imaging of impacted teeth World Journal of Orthodontics, 2004; 5:120-132.
This is also fully reviewed in the second edition of my book, chapter 2
While I have your attention guys, let me also ask a question. Aside from the
Graduate orthodontic program at the Hebrew University-Hadassah School of
Dental Medicine, in Jerusalem, there is no graduate/postgraduate orthodontic
program, worldwide (to my knowledge), that specifically teaches the various
aspects related to impacted teeth as an integral part of its 3-4 years
specialist training course, with a weekly dedicated clinic session. Given
that the problem is so common and these cases are essential constituents of
the cross-section patient load in any orthodontic practice, why should it be
necessary to send out a cri-de-coeur into cyberspace to obtain this kind of
|Date:||Sunday, July 08, 2007 8:46 AM|
|From:||Marcel Marc Koos <kosmarc@EDPNET.BE>|
|Subject:||CL III treatment|
Who have good result with CL III treatment: two orthodontics implants in the maxillary next the molars ,two implants in the mandibule next the canines and CL III élastics at 11 ans girls.?? titels of articles in the JCO ? THANKS for rapid response.
|Date:||Thursday, June 28, 2007 6:35 AM|
|Subject:||Adult Clearance Form|
Does anyone have a standardized form or letter that they use requesting restorative and or perio clearance from the patients G.P. prior to starting ortho?
|Date:||Wednesday, July 04, 2007 9:38 AM|
|From:||Speck, Morton <morton_speck@HSDM.HARVARD.EDU>|
Wow, Mark, what grief you've had!
If you and your fellow readers have seen my previous postings, you know where I'm coming from. I wish I had known you were in Boston (Go Sox!); I would have loved to have had an orthodontic discussion. You've really suffered enough. As soon as I return from vacation I'm going to send you a copy of Parkhouse's book.
Gentle readers: don't you find it curious that current advertisements and articles touting the advantage of the new brackets now emphasize the reduction in friction and the degree of tipping they allow? Suddenly, tipping is now in vogue because of its friction reducing properties. Begg talked about these advantages way back in the ‘50s when he resurrected Angle's old ribbon arch bracket; and with all its faults, it opened the door to an entirely new friction and anchorage reducing era. Yet many edgewise practitioners simply ignored him, instead maintaining their allegiance to Angle's original bracket, a bracket that was never intended to move teeth along the arch wire. As a result, you have had had to work long and hard in so many cases to overcome its friction producing and bite deepening properties. That is sad simply because it is unnecessary.
Recent articles in JCO have described procedures for cupid retraction, a subject that has consistently appeared in the literature after extraction orthodontics was accepted. One article dealt with sectional arch treatment. This was described by Harry Bull in the ‘40s. Another advocated Tweed 's original technique for separate cuspid retraction. Both methods are over 50 years old! Does that seem like progress to you?
The choice is yours. You can continue to practice 20 th century orthodontics and struggle with anchorage, bite opening and brackets that don't perform, or you can give some serious consideration to Tip-Edge. At the very least, you should try Tip-Edge brackets for your cuspids, as advocated by Rodrigues in his text Simplified Straight-Wire Technique (Dental Press).
|Date:||Thursday, June 28, 2007 6:13 AM|
|From:||David Paquette <dave@PAQUETTEORTHO.COM>|
I have used miracle mouthwash for years with pretty good success for chronic recurrent apthous ulcers. I have attached a copy of the prescription. Laser treatment also gives instant relief. I hope this helps.
|Date:||Thursday, June 28, 2007 6:13 AM|
|From:||charles ruff <orthodmd@MAC.COM>|
when the AAO convention was in Chicago, an exhibitor named Red River Paper had a booth. I've dealt with them ever since. They will recommend printers (I'm not sure they sell printers, however) but they specialize in inks and papers for the ink jet process. Really great people to deal with.
the other great place to ask these kinds of questions is Dolphin.
|Date:||Thursday, June 28, 2007 3:46 AM|
|From:||David E. Paquette <dave@PAQUETTEORTHO.COM>|
I have one patient, adult male that I brought a canine in by putting a screw in the lower canine-first premolar area and used it to pull against in order not to create a cant. It worked quite nicely, however I did get the OS to mobilize the tooth when they were in there and started traction immediately.
|Date:||Thursday, June 28, 2007 3:42 AM|
|From:||David E. Paquette <dave@PAQUETTEORTHO.COM>|
I have worn scrubs for 18 years and would never change primarily because I hate ties…they remind me of bankers and lawyers. I have never seen the appropriateness of them in an orthodontic office, I guess because the only time I will wear (my only) one is when required at weddings and funerals.
|Date:||Thursday, June 28, 2007 7:30 AM|
Response to Dr. Mark Lively,
I was pleased to see that Dr. Lively observed one of the biggest problems with the Damon appliances - that is the ability to finish the treatment with good results - the inabiltiy to get proper torque control. I have never used the Damon appliance, but you must realize the history of the appliance. The appliance is nothing more than a modification of the Activa appliance developed by A Company. I used the Activa appliance for about two years and finally gave up - strippped all the cases and replaced the brackets with the A Company Roth brackets (which I used from the day they were available).
The main problem for finishing with the Activa (& the Damon) is the inabiltiy to get torque control. This is because to get torque control the arch wire must be seated completely into the bracket. A passive clip does not seat the arch wire completely into the bracket. Dr Lively that is why you are happy with the GAC In-Ovation R applianace. THe spring clip seats the arch wire when you get to sizes greater than .019.
You are correct in that you were waking up the tongue when you created the hanging lingual cusps. After many years of using of using myofunctional therapy (even to the point of having a full time speech therapist in the office) I realized that most tongue thrusts is "Mother Nature's" splint. This revelation came after using splint therapy to stabilize condylar position and then treating my patients to a seated condylar position. Once the condyle was stabilized with the splint - there was no thrust. When you created the hanging lingual cusps you caused centric interferences which the neuromuscular system did not accept - so the tongue was placed between the teeth to prevent the excess forces & protect against the fulcrum created on the prematurities.
Another interesting observation that you made was that you realized an appliance is not biologic - it does not grow bone. You must do a complete diagnosis of each patient - thus, you realized that you needed to returrn to extractions on more of your patients. I have had special opportunities in my orthodontic "life". I have taught with Dr. Roth ( & contiune to teach) for over 25 years & have worked on patients, diagnosed patients with doctors, looked at problem cases in about 20 different countries. My conclusion is that the biggest cause of failure is improper &/or incomplete diagnosis. If you do not know the total problem then you do not know how to treat the case.
Another point that might be of help in the future. I do not know what appliance system you used before the Damon & now the In Ovation R, but you are now using a totally programmed appliance. If the brackets are in the correct positions as you finish the case -that is detail teach individual tooth - you will be able to place an 022 x 028 arch wire (with no bends) to do the final detailing. This is very important for long range health & stability - you will get the proper torque on the posterior (no hanging lingual cusps & you can get centric stops) & anterior teeth (proper toqrue for disclusion).
Dr. Lively, I thank you for bringing it to the attention of many orthodontists the problems you were having, your keen observations & the solution to the problem. Dr.
Robert E. Williams, LOs Altos, CA
|Date:||Thursday, June 28, 2007 7:30 AM|
|From:||Dr. M.Jayaram <jmailankody@GMAIL.COM>|
|Subject:||Re: Nickel allergy: suggestions?|
I have come across a Frostadent PEA kit which claims to be Nickel Free. If
this could serve as brackets, you may choose reasonable wire(?TMA)or so to
take care of the rest with power chains or so.
N.B: I have no financial interest in the company or product.
|Date:||Thursday, June 28, 2007 1:48 AM|
In hold 'em poker lingo, you are almost drawing dead here (in my opinion). There are way more ways to fail than to succeed. There was just a recent article somewhere that did a good study of adult impacted cuspids regarding tx time. The times get very long after age 30 or something like that. I am thinking that you are looking at 36 to 48 months here, if things go well. If not then you end up.....where? With absolute anchorage, why not extract the cuspids, move the buccal segments anterior, torque and retract Upper 2-2 and be done in 18 months? Set the bracket on the first bi to get the proper gingival height and rotate the tooth to the mesial (aka Zacherison's article in the JCO some years ago) and you both will be happy. I did a mild crowded, reasonably up right just to the palatal impacted cuspid on a 32 year old male about 5 years ago. It went well, but it took forever. I would do it again, just charge a lot more than I did. Anything harder than that in the palate I would look for any other option. On a personal note, Good seeing you on the board, I hope your knees are holding up and you are still running.
John McDonald Salem, OR
|Date:||Wednesday, June 27, 2007 11:50 PM|
|From:||SCOTT SMORON <scottsmoron@COMCAST.NET>|
my first question would be about any medications the patient has been on
that might trigger the canker sores rather than what he could be put on
(usually something in the last couple of weeks which might have seemed
inoculous)...anything from steroids to antibiotics to ????...does he ever
consume cinnamon gum/sweet rolls...dry mouth problems...SLS
allergy...etc....there are so many things that patients encounter that they
do not understand can cause reactions to the oral soft tissues...
with alot of sores, if it's not an initial herpes outbreak, could be a soft
tissue management disaster as treatment progresses...
if you have a soft tissue laser, you may want to try treating a lesion or
two and seeing if that helps resolve, and then consider adding an overall
fee to the treatment plan to cover intermittent laser treatment...
otherwise, without knowing what is triggering the sores, I wouldn't try
anything other than topicals and rinses since you may trigger a greater
response...and you could consider things like viscous lidocaine rinses if
the sores get bad...also, the Zilactin stuff from Walgreens/CVS can be
useful for managing the sores...
|Date:||Wednesday, June 27, 2007 8:21 PM|
|From:||Lively Orthodontics, P.A. <mdlively@BELLSOUTH.NET>|
|Subject:||Re: Nickel allergy: suggestions?|
Ormco has brackets that are pure titanium along with wires.
|Date:||Wednesday, June 27, 2007 11:50 PM|
|From:||SCOTT SMORON <scottsmoron@COMCAST.NET>|
|Subject:||Another random question: periapical films|
Does anyone out there have full mouth series taken prior to orthodontics? When I was a resident I took these myself prior to every patient. I don't think every patient warrants a full series, but on patients with impacted teeth, short roots, or full Class II malocclusions, I would like periapical films. Here's my problem: I call dentists and ask for whatever films they have, and most often a 16 year old will have no films. No bitewings, no periapicals, nothing. Then a few have bitewings. Rarely do they have periapical films. The really quality dentists have more films (sometimes a full series taken at age 12/13 right before their referral to me), then there's the rest. And when I request a series (or whatever they have) via letter, their staff will call and ask my staff, "He didn't really want those x-rays, did he?" Sometimes they will send me a panoramic film despite the fact that my request has one on it and I ask them not to send me a pano. In addition, some dentists charge for a full mouth series of periapicals when they take the pano and charge the patient for it. So, it's like pulling teeth to get the proper films. There's something in the back of my mind that wonders why a dentist would resist doing an appropriate procedure when the business has already been referred to them? Are these the same dentists who complain they aren't busy enough so let's do the braces ourselves? What is everyone else's experience? Do you request FMX? Do you take them yourself? Do you get them easily or not? Am I completely alone here?
|Date:||Thursday, June 28, 2007 11:30 AM|
|From:||Abraham B. Lifshitz D.D.S., M.S. <braces@PRODIGY.NET.MX>|
|Subject:||Self ligation bracket|
---------- original -----------
De : "Abraham B. Lifshitz D.D.S., M.S." email@example.com
Para : "esco" firstname.lastname@example.org
Fecha : Thu, 28 Jun 2007 12:27:43 -0500
Asunto : Self ligation bracket
Two week ago I attended a passive self ligation bracket seminar (Damon System) in Mexico City; the speakers were Dwight Damon and Alan Bagden, with the support of 8 good orthodontists from Latin America and Europe.
Damon's lecture was interesting, he mentioned why he developed the system and talked mainly of continuous light forces and orthodontic movement with no friction, showing his bracket and cases where expansion was developed on both arches, all of them non extraction, in which totally blocked out cuspids and other incisors, were aligned with, posterior expansion, and (he claimed) no flaring of incisors.
He said that this expansion and new arch form was long term stable due to an adaptation of the tongue in a higher position, even do, all the cases shown had a fixed 3-3 lower retainer, and (of course) also recommended some kind of a splint posterior retainer.
Bagden's lecture was mainly on mechanics, and in my opinion his knowledge on biomechanics is quite limited and lack of sound principles.
Their main strategy is "fuller more beautiful smiles" are worth long time retention, and extraction cases have proven relapse to be inevitable anyway.
There were about 500 people attending the lectures, and it amazed me the strong influence that they had on the audience, not only graduate students and young orthodontist, but some mature 20 year practitioners, with this easy to do, failure proof system.
My questions are the following:
. How much influence this system has had in the U.S.?
. Are there many orthodontist doing this system?
. Are graduate students pressing their school instructors to teach and try this system?
. Are patients asking for treatment with this bracket
. Could this system mean the end of classic orthodontics the way we know it?
. Could the law of "the least effort" triumph over scientifically based conscious orthodontics
Thank you for your input.
Abraham B. Lifshitz D.D.S., M.S.
Graduate Orthodontic Program
College of Dentistry
Mexico City, Mexico
Editor in Chief
The Orthodontic CYBERjournal
|Date:||Thursday, June 28, 2007 5:55 AM|
|From:||Paul Thomas <PaulT@DOLPHINIMAGING.COM>|
|Subject:||Re: Age as determinant of success with palatal cuspids|
In Vegas they call this making 7 the hard way. From my experience (and I suspect that of others) the odds of successful retrieval go down significantly in a patient that age. Even if you can get them moving, you're in for a long haul and as you've correctly identified, trying to fit them in a tight spot or distalise the upper arch without proclining the incisors. Although this can be done with bone anchors or TADs it's a challenge. I can remember at least 3-4 similar patients where we went through the expose and bond only to follow with surgical removal 4-5 months later. If you get the canines removed and place implants, you'll have perfect anchorage to distalize the buccal segments for a bit more space. Contrary to what some restorative people say, canine implants are no problem with guidance. Have a high quality heat processed provisional placed and use it for anchorage to distalise the buccal segments without concern for the incisors flaring. Your treatment time will be signficantly reduced as opposed to trying to schlep the impacted canines into a tight spot. The need for cone beam is questionable. Somehow I got through 35 years of practice without it, but that's a call for the surgeon.