Date: Fri, 13 Jul 2007 00:14:42 -0500
From: "ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>
Subject: ESCO Digest - 9 Jul 2007 to 12 Jul 2007 (#2007-58)
To: ESCO@LISTSERV.UIC.EDU

There are 4 messages totalling 1603 lines in this issue.

Topics of the day:

1. Re: Damon system a reaction to Dr Lively
2. Re: Damon
3. Re: Damon
4. Re: Damon system and SL brackets

 

Date: Tue, 10 Jul 2007 20:28:04 -0400
From: "Lively Orthodontics, P.A." <mdlively@BELLSOUTH.NET>
Subject: Re: Damon system a reaction to Dr Lively

As always, thanks for your insightful reply. You are right, there is a pearl to be found in every technique.

With warmest personal regards,
Mark David Lively, DMD
Lively Orthodontics, P.A.
mdlively@bellsouth.net

 

Date: Tue, 10 Jul 2007 20:24:54 -0400
From: "Lively Orthodontics, P.A." <mdlively@BELLSOUTH.NET>
Subject: Re: Damon

Hi Anthony:

Thanks for the reply.  As for finishing the cases, we are working around the problems and getting things done.  I am trying not to expose my staff to yet another technique.  They are very happy with the Inovation system and our wire sequencing.  Actually, I was doing fine before I changed over to self-ligation but felt the need to change things-up.  I try to stay ahead of the curve and use the newest technology.   We have been paperless since 1999 and self-ligation fit into our practice philosophy.  A friend told me that I should probably stick with what works and live happily ever after.  I wish he had given me the advice before I started using the Damon system 3 1/2 years ago.

With warmest personal regards,
Mark

Mark David Lively, DMD Lively Orthodontics, P.A. mdlively@bellsouth.net

 

Date: Tue, 10 Jul 2007 20:15:08 -0400
From: "Lively Orthodontics, P.A." <mdlively@BELLSOUTH.NET>
Subject: Re: Damon

Hi Dave:

Thanks for the response.  You are right, everyone does walk away with a different experience.  I do believe, that had the D3 not come into my life, things would have been different with the Damon system and I would have worked around other issues, just as one would with any other system.  I also believe that many of the positive issues I experienced came from switching over from an .018 to an .022 system, such as bite opening and posterior expansion.  As to your question about the elastomeric ties, placing these on the braces creates the same response you would have on any traditional bracket; introducing torque into the process at an earlier stage by binding the wire.  If you take the doors off the Damon system and use elastomeric ties, you have a traditional bracket system.  The same can be done with the doors closed.    I would like to believe that I am a skilled orthodontist, and should be able to work with anything put in front of me to align teeth.  Based on the number of responses that I have received, I am not alone.  Other than the D3 issues, we managed to overcome all other obstacles the Damon system threw at us.  Others have manipulated the system, using traditional on the anterior segments and Damon in the posterior (to get some additional expansion).  Issues with torque in the anterior and posterior segments has been the universal response I have received since my posting.  Many, wisely stayed away from the D3 and all problems associated with that bracket.  It truly bothers me that the bracket went to market with so many issues.  I was surprised at your staff's response to being exposed to only one case involving the Inovation system and having the entire staff reject the bracket.  What was it that they were so unhappy about, other than having to open the door differently?   My staff had been exposed to the Speed system for years, so making the transition to the Inovation System was easy for them.  The doors actually open easier than the Speed since they do not get jammed.   Only a few doors have broken since using them last July.  Plus, the door opens in the direction away from the gingival tissue and makes it much easier to close.  Then again, the Mx compared to the D2 made closing doors much easier. As for seeing patients less often, we have been seeing our patients every 8-10 weeks for over 8 years.  It did not take Damon to increase time between visits, the CNT wires did this for our practice.  I believe that the biggest impact that Damon tried to have on our profession (selling point) was moving towards more non-extraction cases.  This can be attested to if you have ever watched his video.  The extraction photos in the video reminded me of the Witzig propaganda from years ago.  I think he actually used the same photos Witzig used in his lectures and reference materials.  I bought 250 DVDs but never handed them out in fear that someone might come back to me or another orthodontist blaming us for hurting their profile or their child's profile, based on Dr. Damon's video.   The video failed to mention that anything that could possibly looked like his videos were home grown or severe class II bimaxillary retrusive cases with teeth extracted.  But, the last lecture I attended, more extraction cases were being displayed on the big screen. In closing, the Damon system is just another tool for us to use.  I wanted to respond to the many emails I received about my experiences with the system so I posted to the group.   I have survived, my staff has survived and my practice has survived.  My patients are very happy with the end result, I have changed my retention protocol and the sun still rises in the east and sets in the west.  As with any system, you have to take the bad with the good, unless there is more bad than good, enough said.  I wish you all a wonderful summer and promise not to bring up my issues with the Damon system, ever again, I promise ... I think ... well maybe ... no really ... enough said.   Go Red Sox!

With warmest personal regards,

Mark

Mark David Lively, DMD

Lively Orthodontics, P.A.

mdlively@bellsouth.net

 

Date: Tue, 10 Jul 2007 17:38:44 +1000
From: "Dr P. Miles" <pmiles@BEAUTIFULSMILES.COM.AU>
Subject: FW: Damon system and SL brackets

Dear Greg and group;

I just wanted to suggest some possible explanations for some of the observed responses mentioned in your email below. For example, you state "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." Perhaps the difference in the "narrow-arch" cases is that you use 16x22 wires in your 18 slot Innovation cases but I assume use 18x25 or 19x25 ss wires in your 22 slot Damon cases. The degree of stiffness in the first order/arch expansion as well as the wider Damon archform would significantly influence the amount of arch expansion and available space which I feel would explain your preference for them in these constricted cases more than any particular property of the bracket itself. I personally use 18 slot conventional brackets and similar wire sequences as to your Innovation cases but if I need more ooomph in the first order I up it to a 17x25ss to gain the expansion or desired archform change. In your extraction cases you state "In extraction cases, it works best due to easier sliding mechanics for whatever reason." We recently completed a prospective clinical trial comparing sliding mechanics on conventional brackets ligated with ss ligatures vs. a passive self-ligating bracket and found no difference in the rate of space closure (to be published in the AJO). I do think as you state, "Frankly the approach to treating cases in the Damon system is very intelligent and I would recommend taking these classes to every orthodontist." There are definitely ideas there with merit - e.g. as Samuels and Rudge demonstrated some time back, coil springs in sliding mechanics are certainly more efficient than other methods of en-masse space closure. Prolonged time intervals to allow our initial archwires with 'shape memory' to express this to the max also from an efficiency perspective make sense but this can be used with any bracket system. Two other clinical trials we conducted comparing passive self-ligating brackets during initial alignment again found no difference in the ability to align the lower front teeth when left over the same time frame when using identical wire sequences. (Miles PG, Weyant RJ, Rustveld L "A clinical trial of Damon 2 vs. conventional twin brackets during initial alignment." Angle Orthod. 2006;76:480-485. Miles PG "SmartClip versus conventional twin brackets for initial alignment: is there a difference?" Australian Orthod J. 2005;21:123-127.) SL brackets certainly save time in ligation which in itself can be a valid reason for changing over but until sufficient prospective clinical trials exist, particularly using identical wire sequences (as this is a major confounder in some research), the water remains muddy with regard to their true clinical abilities. I anticipate that over the next two to three years some of this research will begin appearing in our literature and we all can make a more balanced appraisal.

Your sincerely

Peter Miles
Caloundra AUSTRALIA