Date: Thursday, August 23, 2007 11:09 PM
From: "ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>
Subject: ESCO Digest - 22 Aug 2007 to 23 Aug 2007 (#2007-66)

There are 4 messages totalling 795 lines in this issue.

Topics of the day:

  1. Re: Headgear assisted by RPE expansion/contraction
  2. ABO certification
  3. Patient with family history of late mand growth
  4. Re: Cl.III  RPE

Date: Wednesday, August 22, 2007 9:20 PM
From: "Roy King" < >
Subject: Re: Headgear assisted by RPE expansion/contraction

> Scott,
> I am an expert because I have done one case but I have slept in a Holiday
> Inn Express. The protocol is two turns a day for 1 week then two turns on
> contraction per day for one week. One should do this for 6 weeks then
> expand as normal for the 7th week. I forget when to start the facemask but
> I start it at the beginning. The maxilla becomes unbelievable mobile. On
> your next case grasp the maxilla and firmly wiggle it and then change your
> underwear. I did this on a no charge ortho case that couldnot afford
> surgery and she was 15 year old. I got motivated to try this technique
> because an buddy of mine spoke so highly of it. His name is Dr John
> Marchetto in Westin, Fl. It is fine to call him and tell him that I said
> so. .
> Roy King

Date: Wednesday, August 22, 2007 9:27 PM
From: Typodont@AOL.COM <Typodont@AOL.COM>
Subject: ABO certification

The radical ABO departure from its previous policies has certainly “ruffled a few feathers”. But, concerning the inappropriate use of ABO status? The ABO has never condoned Diplomates  using their ABO certification status as a means to imply some degree of superiority over any other colleague. And that is just plain wrong for any of us to do that. It is wrong ethically to do so for a variety of reasons. Firstly, the ABO had always stressed that the voluntary process of an individual seeking ABO certification would yield benefits that were somewhat more enlightened than holding one's self out as a superior practitioner. It was meant as a profound learning experience that simply has to make the successful candidate a better orthodontist than he/she was before they experienced the ABO certification process. And to a great extent, that was true. To present your treatment outcomes with copious documentation of the diagnosis, treatment plan, treatment implementation, and finishing were indeed a grueling and time consuming process. Those who had experienced going through this process before the new ABO certification process changes can attest to that experience.

The new ABO certification process was an attempt to “jump start” the inclusion of more of our colleagues into the certification process. Some, view this new process, as a dilution of the Board's original intent, particularly, the Gateway program which no longer exists. Additionally, the “medical model” of certification has been adopted to a great extent. This places great demands on the individual residency programs and their faculties to get their residents “up to ABO speeds” almost immediately upon entering an their residency program. It should be interesting to see if our residency programs can rise to the occasion. Certainly, 2 year programs are now placed at a distinct disadvantage, as residents will have a definite handicap in producing quality treatment outcomes as well as let's say our extended programs from 30 month or 36 month orthodontic residencies. This is a matter that will be discussed from different authors (including me) in the next issue of the AJO.

Dr. Ploumis does bring up some interesting points. The ABO, itself, will be challenged to develop meaningful “recertification” exams for those who may have received their ABO certification by simply mailing in the required amount of money (and having passed the written exam some time in their career). Will it be a meaningful exam or just some exercise to keep all those new Diplomates on the ABO roster? None of us know at this point. But I can assure you that the ABO is working diligently, as it explores exam possibilities in light of the new digital technology,etc.

One of the issues that I have raised in the past is that until board certification becomes an important element in the orthodontist's professional status, ability to join faculties, or serve on hospital staffs, and perhaps to avoid differential reimbursements from insurance companies as a result of not being ABO certified, there are few incentives to pursue ABO certification (with the exception of avoiding being bad rapped by a small minded colleague who might have his or her certification). The issue is more complex than our own perceptions and gripes.

I would suggest that all of us stay abreast of the progress that the Directors of the ABO and attempt to offer our constructive input to our Directors of the ABO.

Remember, the ABO had embarked upon a more objective and fair ABO process long before the new certification protocol changes were introduced. Still, the results were disappointing with respect to dramatically increasing the number of Diplomates among our ranks. So, perhaps, the ABO gambit that initially included more of our colleagues in the process would help this situation, at least on the short run (it has actually has done just this).

Keep in mind that the “medical model” means more than what is perceived at the surface. It also has to do with establishing a minimal competence level (similar to medicine) rather than creating an Elite group of individuals who have demonstrated somewhat superior orthodontic treatment skills. It is this philosophical difference (unnoticed by many) that really is at the heart of this paradigm shift and the core of this controversy.

I can assure you that the ABO Directors are not unaware of these challenges (and colleague criticism and cynicism) and I wish them the very best success in rectifying any colleague disappointments and reservations about the new ABO certification process. Specialty unity, ABO support, and increased dialogue with the Directors of the ABO in the next few years will most assuredly result in a more accurate assessment of the new ABO certification criteria and greatly facilitate any necessary changes. Forums such as ours (and others), allow such “airing” of AAO member feelings and beliefs, and hopefully, will be seriously and enthusiastically received by both the AAO and the ABO Directors. Let us hope so.

Elliott Moskowitz, DDS,MSD,

New York City

Date: Wednesday, August 22, 2007 5:31 PM
From: David Paquette <dave@PAQUETTEORTHO.COM>
Subject: Re: patient with family history of late mand growth

I have a female patient who is 30 yrs 9 months old who had treatment as a teenager with apparently excellent results.  She came in complaining that her front teeth now hit hard and she is wearing and chipping her upper incisors (this has developed recently, i.e. the last couple of years).  On reviewing her history it turns out that her mother is currently in orthodontic treatment in another state for a class III malocclusion that has developed over the past 10 years.  She also reports that her father developed an “underbite” in his 50s. 

This woman takes impeccable care of her teeth and asked me what was going on and if it was genetic.

It obviously is late onset mandibular growth, but I find it hard to conceive of a gene suddenly turning on at this age, although the family history would suggest that.  Is it possible there is a familial late onset endocrine issue? Has anyone else run across something similar?  Would you refer to an endocrinologist?


Dave Paquette


Date: Wed, 15 Aug 2007 12:41:21 -0700
Subject: Re: Cl.III  RPE

Dear Scott: Re: Cl.III  RPE assisted reverse head gear At the Seattle meeting, the head of Univ. of West Virginia presented an excellent lecture on this topic. I am sure the AAO has this lecture on disc. He gave his protocol along with some clinical cases.                                                                        

Irwin Schiff