Issue #01 - Harvard Society for the Advancement of Orthodontics

Transcription

>
NEWSLETTER
VERITAS
PRESIDENT’S
MESSAGE
from Dr. Gregory Baker
PROFILE:
DR.
MASOUD
our new Orthodo ntic Program Director
1
TECH
TALK
Customized Orthodo ntic
Applia nces
CLINICIAN’S
CORNER:
I nvisalign technology
FEBRUARY 2014
ISSUE 1
WWW.HSAO-ONLINE.ORG
ISSUE 01 - FEBRUARY 2014
>
>
>
> Features
Our goal is to have recurring featured sections, such as Founder’s
Corner, Resident’s Corner, Alumni Spotlights, Business “Pearls” and
Clinician’s Corner with our sections strategically highlighted.
12
FOUNDER’S CORNDER with Dr. Jack
Dale
08
10
Q & A With Dr. M. Masoud
25
FUTURE PLANS Advances Journal
26
RESIDENTS CORNER Meet them!
28
AAO 2014 See you in New Orleans!
36
FROM THE ARCHIVES Photos
Harvard Society for the
Advancement of Orthodontics
c/o 290 Baker Ave.
Suite S204
Concord, MA 01742
DR. MOHAMED MASOUD Meet the new
clinical director
[email protected]
2
Editor-in-chief: Shawn Miller
Associate Editor: Virginia Bocage
HSAO Officers
President: Gregory L. Baker
06
PRESIDENT’S MESSAGE by Dr. Greg
Baker
22
Vice-President: Manish Lamichane
PRACTICE 101 Staff Bonus Systems - are
they right for your office?
Treasurer: H. Ivan Orup, Jr.
Secretary: Virginia Bocage
Director: Donald B. Nelson
Director: Michael J. Cognata
International VP: Ahmet Keles
University VP: Mohamed I. Masoud
Student Rep: Rishi Popat
Student Rep: Michelle Mian
30
CLINICIAN’S CORNER Invisalign Case
Reports by Dr. Bella Shen-Garnett
> WWW.HSAO-ONLINE.ORG
18
TECH TALK Customized Orthodontic
Treatment by Dr. Abdullah M. Aldrees l
Social Media Lead: Hessam Rahimi
A NOTE FROM OUR
>
Welcome to Veritas, the innovative
newsletter of the Harvard Society for the
Advancement of Orthodontics (HSAO)!
The HSAO was started over 20 years ago by a group
of dedicated and accomplished HSDM Orthodontic
Program Graduates and faculty members. Over the
years, the society has held scientific conferences
around the globe, published issues of the Advances
Journal and encouraged the free and lively exchange
of information on the science and practice of
orthodontics.
While the HSAO enjoyed great success for a number
of years, unfortunately there were periods when
membership waned and participation declined.
Despite the best efforts of a number of dedicated
members, such as editor Joe Ghafari, the Advances
Journal ceased regular publication, and many ideas for
the society never came to fruition.
However, as the venerable William Shakespeare wrote,
“What’s past is prologue.” Under new leadership, both
HSAO and the HSDM Post-Doctoral Orthodontic
program are ready to usher in an era with renewed
efforts in pursuit of our founders’ goals. We are
fortunate to have Dr. Greg Baker has our new HSAO
President, and Dr. Mohamed Masoud as the new
orthodontic program director.
When I was approached to help create a modern
publication for HSAO, I was excited for the opportunity
that the challenge presented. Together, the directors
decided it was best to start a Newsletter as a separate
publication from the Advances Journal (for many
issues, Advances doubled as both a social newsletter
and clinical orthodontic journal). The new ‘version’ of
the Advances Journal is in its infancy, but the goal is
to create a well-respected peer-reviewed orthodontic
journal.
3
ignite interest in HSAO and once more build our
membership to enable HSAO to once again thrive.
Veritas is designed to be modern, dynamic and
interactive. It should be informative, but fun. And it
should be filled with HSDM pride, including involvement
from current residents (the future!). Of course, keeping
with its modern design, it won’t be printed!
With modern technology, we can embrace the luxury
of being multi-platform to encourage participation
from members. We have a Facebook group page, a new
website in the works, this online Newsletter Veritas,
a Blog on the way and the ability to send emails to all
graduates through Constant Contact.
In this issue look for places to “click”, such as videos,
email address to instantly send an email, and links to
other relevant websites and pages.
Enjoy the first issue of Veritas!
Shawn Miller, DMD, MMSc
[email protected]
So why the Newsletter – Veritas? The goal is to reWWW.HSAO-ONLINE.ORG
>
>
>
Durable Proven Protection
Against Decalcification
Just words?
Over 10 independent University studies document these claims.
FRESH
Start
Under the leadership of Dr. Gregory
Baker at the HSAO and Dr. Mohamed
Masoud at HSDM, we have an
extraordinary opportunity to shape
the future of Orthodontics at a
challenging time.
HSAO CONTINUES TRADITION
Dr. Virginia Bocage
HSAO Secretary
Founded in 1867, the Harvard
Dental School was the first dental
school in the United States to be
connected with a university and
coordinated to its medical school,
thus making the full scholarly and
scientific resources of a university
available to dental education.
4
5
Pro Seal fluoride releasing and recharging
enamel sealant. Protection for all your patients.
The Harvard Society for the Advancement of Orthodontics was founded in 1991 by 31 orthodontists who wanted to “influence progress in orthodontics and share ideas with colleagues linked by experiences in the orthodontic programs at Harvard,
Forsyth, and the Children’s Hospital.”
©2009 Reliance Orthodontic Products, Inc. All rights reserved.
For more information, contact…
(800) 323-4348 • (630) 773-4009 • Fax (630) 250-7704
www.relianceorthodontics.com
The society owes its existence to Coenraad F.A. Moorrees, a professor of orthodontics at Harvard from 1964–1987 and the
author of seminal publications that shaped the fields of craniofacial biology and orthodontic practice. Moorrees suggested to
some of his trainees that they form a professional group that would be a legacy to the future for people coming through the
program.
WWW.HSAO-ONLINE.ORG
>
>
>
HSAO President
Dr. Gregory Baker
HSDM Orthodontic Faculty
Email: [email protected]
President’s
message
Dear Friends and Colleagues:
As we celebrate our 22nd anniversary, the Harvard
Society for the Advancement of Orthodontics (HSAO)
certainly has many reasons to be energized. The
Harvard Graduate Orthodontic program is moving
towards a promising future under a new director and
we have a fresh panel of HSAO board members with the
energy and enthusiasm to continue the tradition and
mission of the HSAO.
6
>
The appointment of Dr. Mohamed Masoud as
the new Program Director represents an important
step towards furthering the excellent reputation of the
Harvard Orthodontic Program and augmenting the
legacy begun by Dr. Coenraad Moorrees. Dr. Masoud
is a past graduate of the Harvard Orthodontic Program
and the former Clinic Director of the Orthodontic
Department at Boston University. With Dean Donoff’s
full support, Dr. Masoud has welcomed many previous
part-time faculty as well as new part-time faculty to
deliver a clinical and didactic education worthy of a
leading institution.
interaction via continuing education events in
and outside of Boston and by developing social
media outlets.
Your participation is a key element to the
HSAO’s achievement of these goals. A society
is only as strong as the bonds between its
members. Our members and alumni span
the globe and we are unified by our collective
pursuit of clinical and academic excellence.
7
As the HSAO progresses, we cherish the past
and embrace the future. We look forward
to addressing the challenges and seizing the
opportunities that lay ahead. We sincerely
hope we can count on your full support.
Sincerely,
Gregory L. Baker, DDS
President HSAO
The Society’s core mission is to further the study and
advancement of orthodontics through education,
research, and fellowship. In support of this goal, we
will promote a strong sense of community through
networking, collaboration, and participation among our
members. We will create opportunities for personal
WWW.HSAO-ONLINE.ORG
>
>
>
MEET
DR. Mohamed
MASOUD
Under new leadership, the Post-Doctoral
Orthodontic Residency program looks to continue
the rich Harvard tradition, while creating a new
technology-driven legacy
8
Dr. Mohamed I. Masoud was born in
ready...
set...
mo!
Fairfax, VA. He completed his orthodontic specialty
training at the Harvard School of Dental Medicine in
2006, and earned his Doctorate degree (DMSc) from
the HSDM the following year. Dr. Masoud then went
on to become a Diplomate of the American Board of
Orthodontics and an affiliate academic member of
the Angle Society.
During his years as a resident, he was awarded
the Joseph Henry award for clinical and research
excellence, and has been involved in several research
projects that have earned him the prestigious Harry
Sicher award awarded by the American Association
of Orthodontists for best clinical research. He
taught part time at Harvard between 2007 and 2010,
and worked in private practice in Jeddah, Saudi
Arabia, between 2007 and 2011. He then went on
to become the clinic director at the orthodontic
department at the Boston University Henry M.
Goldman School of Dental Medicine. On the first of
9
July 2013 he became the director of the orthodontic
program at the Harvard School of Dental Medicine.
His current research focuses on growth prediction
and new approaches to orthodontic diagnosis. His
work has been published and presented at several
local and international meetings.
Dr. Masoud is very excited about his return to
Harvard and spending time with all of his old
friends. He also wants to work towards making
the orthodontic program at Harvard one of the top
clinical orthodontic research centers in the country.
Dr. Masoud lives in the Back Bay with his wife Nour
and their twins Mariam and Ibrahim. He has many
interests outside of orthodontics including playing
on the Harvard club squash team, painting, sailing,
underwater photography, and snowboarding.
[email protected]
WWW.HSAO-ONLINE.ORG
>
>
>
I’m excited to be back at Harvard. It
is a special place, with outstanding
faculty and students...
Q+A
10
Mohamed
11
Masoud
Q
What are the biggest challenges
you’ve had to face so far as
program director?
Interview by Shawn Miller
A
While travelling to
saudi arabia with
a short layover
in Germany, Dr.
Masoud took the
time to answer a few
questions. Mohamed
still travels to
Saudi Arabia to
treat patients in
his father’s private
practice.
Q
What are your current research
interests, and areas that you’d like
the HSDM Ortho program to work on?
A
For the past two years, I’ve been
working on developing 3D norms
for the face and the smile using 3D
facial photographs and 3D intra-oral
scans. We have a second project that
is validating this norm on orthodontic
patients and comparing diagnosis and
treatment planning outcomes for our
proposed records together with a pano
compared to traditional ABO records
to determine what types of patients
require the addition of a ceph or a cone
beam for adequate diagnosis. The nice
thing about these records is that you
can also simulate treatment, model soft
tissue response to treatment, and use
them to generate a virtual articulator.
We are planning on publishing some
of this data in the beginning of 2014
and presenting it at next year’s Angle
meeting. I think the future will involve
3D combined intra-oral/extra-oral
photos together with a limited field,
low resolution CBCT when deemed
necessary.
Right now we are focused on
rebuilding the curriculum for
the residents. Over the years, the
structure of the curriculum had been
altered substantially and it needed to be
addressed. It is something that recent
and current students have requested.
We are also trying to increase the
number of clinical cases for each
resident by increasing the patient base
and expanded our scope of services.
Q
A
Are there any large projects you
are working on right now?
We are looking to hire a second
full time faculty member. There
aren’t enough hours in the day for me
right now to adequately complete all the
work that is required. Of course it is
also that time of the year to sort through
applications for the new incoming class
of residents and select those who we will
be interviewing. Lastly, I want to start
getting the residents at HSDM involved
with clinical orthodontic research. I
have several projects I will be offering
them but I also want to set up a clinical
research committee to discuss resident
projects and meet quarterly to monitor
progress.
Q
What are some techniques,
technology or appliances you like
to use?
A
I’ve really became a big fan of
distalizing using palatal TADs
(Temporary Anchorage Devices).
Q
You’ve been all over the world for
underwater photography -- what’s
your favorite?
A
The wildlife in Kona was great. It’s
actually hard to say -- Cozumel and
the Dominican had fantastic coral.
Q
What was your best memory or
experience from your time at
HSDM as a resident?
A
The day we moved out of the tiny
residents’ room (a large closet)
located in the basement to the residents’
room in the new building. It was a
complete contrast with panoramic views,
and such a large room for all of us to
work, interact and store our stuff. And
Manny’s [Dr. Lamichane ‘07] futon was
icing on the cake - it’s still there by the
way!
WWW.HSAO-ONLINE.ORG
>
>
>
Founder's
Corner
Written By
Dr. Jack dale
“Tic, Tic, Tic, You can do it!”
How many times did I hear that dreaded statement? I must be honest, I was not happy when I
heard it. Now I am eternally grateful. Dr. Moorrees was driving us to learn as much as we possibly
could while we had the golden opportunity to do so. How blessed we were to be taught by this worldrenowned scientist and clinician at the highly regarded Harvard University for three intensive and
incredible years. I repeat, I am so proud to have been a student of Dr. Moorrees!
As an Honorary Life Member of the Board of Directors I say, with mixed emotions,
“Congratulations and Thank You!”
to the new members of the Executive Board of the Harvard Society for the Advancement of
Orthodontics, HSAO.
They are: Dr. Gregory Baker, (President), Dr. Manish Lamichane, (Vice President), Dr.
Virginia Bocage, (Secretary), Dr. Ivan Orup, (Treasurer), Dr. Donald Nelson, (Director) and
Dr. Michael Cognata, (Director).
With sadness, because I speak on behalf of three very special people in my life: Honorary
Patron, Professor Coenraad F. A. Moorrees, Dr. Laure Lebret and Dr Anna-Marie Grøn; all, unfortunately, have passed away in the recent past.
12
One of my favorite photographs!
The final photograph, in my possession, of the three individuals who had a major influence on
my life ... our lives. It was taken at a special luncheon to honour Dr. Anna-Marie Grøn, Dr. Coenraad F. A. Moorrees and Dr. Laure Lebret just before Dr. Grøn and Dr. Moorrees left Boston. With
appreciation to Dr. Sheldon Peck for his photograph.
I could write forever about my three magical years in Boston, and beyond, but I will conclude
with our final meeting. During my programme at Harvard in 2003 Professor Will and her staff
organized a historic luncheon as a tribute to professors Moorrees, Anna-Marie Grøn and Laure Lebret. We learned, just before the programme, that both Anna-Marie and Dr. Moorrees were leaving
Boston. With a very short notice, we had an estimated 100 local alumni and students in attendance.
The memory of that event will remain with all of us for the rest of our lives.
13
With happiness, because I know that all three of them would be very, very happy that your group
has come together to give our beloved society another try. You have made, not only the four of us
very, very happy, but also the entire alumni membership, worldwide. God Bless each and everyone
of you.
As for myself, Founding President, 1991, I am 83 years of age and, although I stopped gallivanting all over this planet in 2006 when I had a quadruple bypass ... on my birthday, I am still very
active. I practise two days a week with my daughter, Dr. Hali Dale; the other five days I am enjoying
a quiet existence writing with my wife, my Guardian Angel, Dr. Anne Dale.
Anne has been writing a very important book entitled:
The History of the Profession of Dentistry in Canada and its Relation to
The Dental Museum,
Faculty of Dentistry, University of Toronto
Our faculty has one of the most important dental collections in the world. The collection began
138 years ago when the Royal College of Dental Surgeons was founded in 1875 in Canada. It now
contains 10,000 artifacts in superb condition. Anne has been the curator for the past 40 years. When
completed, it will be the only book of its kind in Canada.
As a past president of the HSAO who has been quite concerned about our orthodontic program
and our society, I support you one hundred percent, and ... urge you on. When you become success-
WWW.HSAO-ONLINE.ORG
>
>
>
ful, our whole specialty will benefit, in fact, our precious specialty needs you badly! I will enlarge
on that in a future issue.
Reverend Robert Schuller says it best:
“Every human being has problems
... Every organization has problems.
Nobody is free of problems
... No organization is free of problems.
A problem free existence is an allusion; it does not exist; it is a mirage in
the desert; it is a dangerously deceptive perception which can mislead,
blind and distract; to pursue a problem-free existence is to run after an allusive fantasy ... it does not happen.
All problems cannot be solved, but they can be managed. Our reaction
to a problem is the bottom line.
Turn an obstacle into an opportunity, a stumbling block into a stepping
stone, a problem into a possibility.
... in some dark subterranean corner of the mind. In this defense manoeuvre, the brain shelters
itself against the painful sting of insulting disappointments, rude rejections and dashed hopes.
But, let someone utter the magic words:
The word POSSIBILITY creates a mental climate of creativity.
14
Simply suggesting that something might be possible releases creative forces from their invisible prison of subconscious defense mechanisms.
To understand the power of this word ... POSSIBILITY, consider its antonym that negative
13-letter word:
IMPOSSIBILITY
Uttered aloud this word is devastating in its effect,
• Thinking stops
• Doors slam shut
• Research comes to a screeching halt
• Projects are abandoned
• Progress is terminated
• Dreams are discarded
• The brightest and the best of the creative cerebral cells ...
nosedive,
clam up,
hide out,
cool down, and
turn off
“It’s Possible”
Those stirring words, with a siren appeal of a marshalling trumpet, penetrate into the subconscious tributaries of the mind, challenging the cerebral cells to turn on and turn out new ideas,
•
•
•
•
•
•
•
•
•
•
•
•
15
Buried dreams come alive
Sparkles of fresh enthusiasm flicker and burn into flames
Tabled motions are brought back to the floor
Dusty files are reopened
Lights go on again in darkened laboratories
Telephones start ringing
Computers light up and work their wonders
Budgets are revised and adopted
Help wanted signs are hung out
New services are provided and new products appear
New markets are opened
The recession has ended; the winter has passed; spring has returned.
The sun has outlived the storm and a great new era of
adventure,
experimentation,
expansion,
productivity, and
prosperity is born ... so
It is possible to succeed ... following failure.”
WWW.HSAO-ONLINE.ORG
>
>
>
It is possible to be successful with a new Harvard Society for the Advancement of Orthodontics.
The key to success is simple.
“Think positively, just get started and ... never quit.”
Sir Winston Churchill, not only inspired the full thrust of patriotism in his country, but he
had a direct influence on the outcome of World War II. He changed the course of history, and he
affected the future of mankind on this planet. He did it with “his best thing ... ‘the word’.”
Churchill was unconditionally committed:
16
“We shall not flag or fail.
We shall go on to the end.
We shall fight in France,
we shall fight on the seas and oceans,
we shall fight with growing confidence
and growing strength in the air,
we shall defend our island,
whatever the cost may be.
We shall fight on the beaches,
we shall fight on the landing grounds,
we shall fight in the fields and in the streets,
we shall fight in the hills;
But ... we shall never surrender!”
The enemy hesitated; Churchill’s leadership prevailed, and ... the allies were victorious.
With your uncompromising commitment, allowing no room for failure ... you will be victorious and we will have a new ...
Harvard Society for the Advancement of Orthodontics
and
as Dr. Moorrees would say:
“Tic, Tic, Tic, You can do it!”
17
A Game Changer in Orthodontic Bonding
A New Generation of Beauty
• No flash clean-up
• Saves bonding time for doctor, staff and patient
• Improved patient bonding experience
• Proven APC™ Adhesive family performance
• Available on Clarity™ ADVANCED Ceramic Brackets
• Brilliant Aesthetics
• Trusted Strength and Small Bracket Design
• Predictable, Consistent Debonding
• Enhanced Patient Comfort
• Available in MBT™ Bracket System and
Roth* Prescriptions
For more information or a demonstration visit 3MUnitek.com
or contact your 3M Unitek Representative today.
*3M Unitek version of this prescription. No endorsement by the Doctor is implied.
© 2014, 3M. All rights reserved. 1401
WWW.HSAO-ONLINE.ORG
>
>
>
Tech TALK
Customized Orthodontics
AUTHOR
Dr. Abdullah m. Aldrees
18
BIO
dental degree (BDS) from
the College of Dentistry,
King Saud University with
first-class honours in 1999.
orthodontic education
at HSDM - DMSc ‘05 With a
Certificate in Orthodontics.
Dr. Aldrees joined the
orthodontic faculty of
the Department of Pediatric
Dentistry and Orthodontics
at the College of Dentistry,
King Saud University where
he currently serves as an
Associate Professor at the
Division of Orthodontics,
and the Director of the
Postgraduate Program in
Orthodontics. Dr. Aldrees
is involved in teaching
both predoctoral and
postgraduate students,
research, and providing
orthodontic care to cleft lip
and palate patients. In addition
he is maintaining a part-time
private practice.
KSU, College of Dentistry
Do Customized Orthodontic Appliances/Wires Provide
More Efficient Treatment?
>
Orthodontists’ attempts to create an efficient system that allows for the
production of quality treatment in the shortest possible time has led to the
development of the Straight-Wire Appliance that incorporated the order bends
into the bracket prescription.1 Finishing with the straight-wire appliance often needs
frequent bracket rebonding and/or detailing bends in the archwires due to variations
in the tooth morphology,2-8 incorrect bracket positioning,2, 9 and inherent mechanical
inaccuracies in the appliances.2, 5, 10
Recent technological advances have brought the possibilities of incorporating 3D
imaging and precise manufacturing processes into the development of custom
orthodontic appliances that are commercially introduced for improved treatment efficiency. Two examples of patient-specific products that utilize computer technology
to create an interactive treatment plan and then manufacture a custom-designed
appliance are: Insignia®, and Suresmile®.
The Insignia® system allows the clinicians to virtually design the final occlusion
through the use of the 3D Interactive Approver™ software, and then the company
reverse-engineer brackets and archwires used to obtain the intended
result. A complete custom solution is then delivered: patient-specific brackets, precision (computer-assisted)
bracket placement, and custom wires.1, 11 The customized brackets are transferred to the patient
by means of indirect-bonding transfer jigs.1
The manufacturing company, Ormco Corporation, claims that the Insignia® system addresses the three challenges
of treatment efficiency by allowing
the staff to deliver the appliances
and thus saves the doctor’s time,
by matching the appliances to
the patient’s needs and dental
anatomy, and by decreasing the
reliance on hand-eye coordination.11 Dr. David M. Sarver
recommended the Insignia®
system because of its “ability to
design treatment as individually as possible, rather than a ‘1
Dr. Abdullah Aldress
[email protected]
size fits all’ approach. It allows us to truly plan treatment
with the end in mind.”12
A clinical report explaining the main features and the
clinical advantages of the Insignia® system was recently
published by Gracco et al.13 The authors from the University of Padova, Italy briefly outlined the manufacturing
steps of the custom-brackets/wires of the system and
demonstrated the treatment efficiency in the case of a
16-year-old male patient who presented with a Class II
subdivision right and unilateral crossbite and was treated
in 17 months without the need to rebond the brackets or
bend the archwires.13
The only available report on the efficiency of Insignia®
system was published as a pilot study by Weber et al.1
The authors evaluated pre- and post-treatment records
of cases (n=35) treated with the Insignia® system in two
practices and compared them with 10 cases treated conventionally by one of the two clinicians. The pre-treatment
diagnostic casts were analyzed using the Peer Assessment Rating (PAR) system to insure that the two samples
were matched in the severity of malocclusion and the
post-treatment casts and panoramic radiographs were
evaluated by both the PAR index and the ABO grading
system to measure the quality of the finished results. The
initial and final PAR scores were not significantly different
between the two groups, however, the ABO Cast and Radiographic Evaluation scores were lower for the Insignia®
group (P = 0.03), indicating a finished result closer to the
ideal ABO criteria. In addition, the treatment time was significantly shorter for the Insignia patients (14.23 months
vs. 22.91, P < 0.0001), with about seven fewer appointments on average. Numbers of unscheduled emergency
appointments, debonded brackets, repositioned brackets,
and wire bends were similar between the two treatment
groups. The authors realized that the sample size of the
conventionally-treated group was small and that the initial
PAR scores were low in both groups, and thus they stated
that the findings of this study may not apply to patients
with more severe malocclusions. The authors also concluded with the recommendation to conduct randomized
clinical trials with larger sample sizes to analyze the effectiveness and efficiency of the Insignia custom bracket
system.1
Suresmile® is a digital orthodontic care solution that
uses 3-dimensional diagnostics to develop customized
prescription archwires. SureSmile® relies on three key
technological components: digital imaging with intraoral
scanners (like: OraScanner®, OraMetrix, Inc, or iTero®,
Align Technology, Inc) or CBCT, SureSmile® Diagnostics
and Treatment Planning software, and robotic technology used for custom fabrication of prescription archwires.
Suresmile® by OraMetrix, Inc. was founded in 1998, and
the first articles that present the development and the
clinical procedure of the Suresmile® system were published in 2001 by the Chief Clinical Officer at OraMetrix,
Inc, Dr. Rohit C.L. Sachdeva in the JCO and the AJO-
DO.14, 15 Initially, Suresmile® system allows the clinicians
to scan the dentition and virtually treatment plan the
cases and then indirect bonding trays created to contain
the bracket selected by the orthodontist and archwires
are manufactured and shipped to the orthodontist. Then,
the clinical protocol of the Suresmile® system evolved in
response to the clinical studies findings and the process
was streamlined. In the current protocol, the treatment
starts with straight-archwire mechanics, then, after three
to five months of initial leveling and alignment, an in vivo
update scan is taken to produce a Suresmile® prescription archwire. The updated protocol was published by
Sachdeva et al. in 2005.16 In that article, the authors
showed the records of 7 cases treated with Suresmile®,
and they reported a comparison of treatment time between 96 Suresmile® patients and 135 conventionally
treated patients selected by the participating doctors.
The reported average treatment time for the Suresmile®
patients was 12.1 months, compared to 23.1 months for
the conventionally treated cases.16 The sample selection criteria and the data collection technique were not
declared in the methodology, and thus these results do
not drive valid conclusions in regards to the efficiency of
Suresmile®.
Clinicians’ experience with Suresmile® was reported in
two articles by Dr. Randall Moles in the JCO, 2009 and
Dr. Nicole M. Jane, who is also an advisor for SureSmile®, in the AJODO, 2009.17, 18 Dr. Moles reported treating more than 500 cases with SureSmile®, with an average treatment time of 13.1 months. He also illustrated the
treatment of an adolescent extraction case and an adult
non-extraction case using SureSmile®, and his decision
to treat all fully bonded cases with SureSmile®. The
incorporation of SureSmile® in his practice added about
7% to the expenses which was covered by increasing
the treatment fees.17 Dr. Jane reported that since 2007
she decided to treat all the comprehensive patients using
SureSmile®. Dr. Jane also reported that in her practice,
the average treatment time with SureSmile® was 14 to 16
months compared to 20 to 22 months to finish a patient
traditionally.18
19
In Sachdeva et al. articles (2001-2010), SureSmile® system was described as the tool designed to
substantially reduce the errors in treatment resulting from
appliance management, therefore shortening treatment
time without sacrificing the quality of results.14-16, 19 So
far, three retrospective studies that looked at the quality of the finished results and the efficiency of treatment
using the SureSmile® system were published. The first
paper was published in the World Journal of Orthodontics in 2010 by Saxe et al.20 The authors collected preand post-treatment study models of the 38 most recent
consecutively completed SureSmile® patients and 24
conventionally treated patients from three orthodontic
practices. Pre-treatment casts were used to calculate the
Discrepancy Index (DI) as a measure of the malocclusion
severity, and the post-treatment casts were evaluated
WWW.HSAO-ONLINE.ORG
>
>
>
Table 1. A summary of the studies reviewed on the efficiency of Insignia® and SureSmile®.
Article
Treatment
Insignia®
Weber et al.
Sample
Size
(n)
35
Pre-Treatment
Analysis Score
10.60
Total Treatment
Time (months)
14.23
PAR
1
Traditional
10
10.64
P = 0.98
22.91
P<
0.0001
8
months
Post-Treatment
Analysis Score
21.66
ABO
CRE
27.09
difference
SureSmile®
Saxe et al.20
38
9.2
14.7
DI
Traditional
24
11.0
?
20.0
P<
0.001
5
months
26.3
30.7
69
13.2
15.8
DI
Alford et al.
22
Traditional
SureSmile®
20
Sachdeva et
al.23
Traditional
63
9390
2945
15.8
P=
0.0423
-
-
23.0
7
months
24
P<
0.001
8
months
difference
by the American Board of Orthodontics (ABO) Objective
Grading System (OGS) to determine the treatment quality. The results showed that the SureSmile® patients had
a statistically significantly lower ABO OGS scores (mean
26.3) and shorter treatment time (14.7 months) compared
to conventionally treated patients (mean ABO OGS is
30.7, mean treatment time is 20.0 months).20 Critical
appraisal of this study reveals that the sample was small
and convenient and not randomized, and the criteria to
ensure that the conventionally treated patients had a
similar degree of malocclusion severity was not clear.21
The authors calculated and reported the pre-treatment DI
(9.2 for SureSmile®, and 11.0 for Conventional) without
examining the radiographs, and they did not report a
statistical comparison between the two mean scores. In
addition, the authors doubled the sample by combining
the recorded scores of the two examiners, so instead of
dealing with a sample of 38 patients treated with SureSmile®, they reported 76 cases.21 It seems clear that
based on the results of this study on small samples of
relatively simple and unmatched initial malocclusions that
valid conclusions on the treatment time of SureSmile®
can’t be drawn.
The second study was published in the Angle Orthodon> WWW.HSAO-ONLINE.ORG
Non-randomized
Simple malocclusion
P<
0.005
Non-randomized
No radiographs
Doubled the sample
ABO
CRE
20.8
variables. Also, the selection criteria of the conventional
cases were not defined and the possibility that the majority
of these cases might be extraction cases could have affected the comparison of the overall treatment time with the
SureSmile® cases.21
It seems that the available evidence is not strong enough
to support a valid conclusion regarding the efficiency of the
Insignia® system (Table 1). On the other hand, retrospective studies suggest that a reduction in the total treatment
time can be expected with the use of SureSmile® for
mainly simple malocclusion cases.21 The utilization of either
system remains a practice management decision based on
balancing the added expenses of incorporating the custommade orthodontic appliances and the possible savings in
reducing the treatment time and the number of patient’s
visits.
References
18.5
difference
16
?
P=
0.0001
Small sample size
Small sample size
ABO
difference
SureSmile®
P = 0.03
Limitations
The third study was published in the Orthodontics: the Art
and Practice of Dentofacial Enhancement journal in 2012
by a group of 7 authors, 3 of them are employed or has
financial interest in OraMetrix.23 The authors “Sachdeva et
al.” showed the analysis of the completed treatment records
reported to OraMetrix by volunteer SureSmile® practices.
Data about treatment time, Angle classification, patient’s
age, and the total number of treatment visits of 9390 patients treated with SureSmile® and 2945 patients treated
conventionally were reported by 142 SureSmile® practices
in the United States and they were statistically analyzed
with non-parametric tests. Results showed that the median
treatment time for the SureSmile® patient pool (15 months)
was 8 months shorter than that of the conventional patient
pool (23 months) and that was significant at P < 0.001.23
Although the sample size is large, the authors admit that
there was no standardization and no calibration in the data
collection and that might affect the accuracy of the provided
P=
0.0541
Non-randomized
Low DI in SureSmile®
1. Weber DJ, 2nd, Koroluk LD, Phillips C, Nguyen T, Proffit WR. Clinical effectiveness and efficiency of customized vs. conventional preadjusted bracket systems. J Clin
Orthod 2013;47(4):261-6; quiz 68.
2. Creekmore TD, Kunik RL. Straight wire: the next generation. Am J Orthod Dentofacial Orthop 1993;104(1):8-20.
3. Miethke RR, Melsen B. Effect of variation in tooth morphology and bracket position on first and third order correction with preadjusted appliances. Am J Orthod Dentofacial Orthop 1999;116(3):329-35.
No standardization
-
?
No calibration
No selection criteria
tist in 2011 by Alford et al.22 The authors assessed a convenient sample of 146 consecutively finished, cooperative patients, treated conventionally and with SureSmile®
without extractions by one orthodontist. A specific inclusion criteria were defined which includes the presence of
second molars in occlusion, and the absence of dental
agenesis. A total of 63 cases that were treated conventionally and 69 cases finished with SureSmile® formed
the two studied groups. The groups were compared for
pretreatment differences using age, sex, and beginning
discrepancy index (DI) as covariates, and post-treatment
ABO cast/radiographic evaluation (CRE) scores and
treatment time were calculated and compared. SureSmile® group had significantly lower DI scores (mean 13.2
vs. 15.8, P = 0.0423), and significantly shorter treatment time (in braces-only patients: mean 15.8 months
vs. 23.0, P = 0.0001). SureSmile® group tends to have
a lower total ABO CRE score (P = 0.0541), but the root
angulation variable score tended to be higher in the
SureSmile® group (P = 0.0692). The authors considered
this study an initial attempt to answer the question of
efficiency and effectiveness and they recommended a
randomized clinical trial using 3D imaging for assessment
to reach a definitive comparison.
4. Dellinger EL. A scientific assessment of the straight-wire appliance. Am J Orthod 1978;73(3):290-9.
5. Schwaninger B. Evaluation of the straight arch wire concept. Am J Orthod 1978;74(2):188-96.
21
6. Miethke RR. Third order tooth movements with straight wire appliances. Influence of vestibular tooth crown morphology in the vertical plane. J Orofac Orthop
1997;58(4):186-97.
7. Germane N, Bentley BE, Jr., Isaacson RJ. Three biologic variables modifying faciolingual tooth angulation by straight-wire appliances. Am J Orthod Dentofacial
Orthop 1989;96(4):312-9.
8. Bryant RM, Sadowsky PL, Hazelrig JB. Variability in three morphologic features of the permanent maxillary central incisor. Am J Orthod 1984;86(1):25-32.
9. Balut N, Klapper L, Sandrik J, Bowman D. Variations in bracket placement in the preadjusted orthodontic appliance. Am J Orthod Dentofacial Orthop 1992;102(1):627.
10. Archambault A, Lacoursiere R, Badawi H, et al. Torque expression in stainless steel orthodontic brackets. A systematic review. Angle Orthod 2010;80(1):201-10.
11. Ormco-Corporation Increasing clinical performance with 3D interactive treatment planning and patient-specific appliances. Orange, California, USA: 2006.
12. Scholz RP, Sarver DM. Interview with an Insignia doctor: David M. Sarver. Am J Orthod Dentofacial Orthop 2009;136(6):853-6.
13. Gracco A, Stellini E, Parenti SI, Bonetti GA. Individualized orthodontic treatment: the Insignia system. Orthodontics (Chic.) 2013;14(1):e88-94.
14. Mah J, Sachdeva R. Computer-assisted orthodontic treatment: the SureSmile process. Am J Orthod Dentofacial Orthop 2001;120(1):85-7.
15. Sachdeva RC. SureSmile technology in a patient--centered orthodontic practice. J Clin Orthod 2001;35(4):245-53.
16. Sachdeva R, Fruge JF, Fruge AM, et al. SureSmile: a report of clinical findings. J Clin Orthod 2005;39(5):297-314; quiz 15.
17. Moles R. The SureSmile system in orthodontic practice. J Clin Orthod 2009;43(3):161-74; quiz 84.
18. Jane NM. Interview with a SureSmile doctor: Nicole M. Jane. Interview by Robert P. Scholz. Am J Orthod Dentofacial Orthop 2009;135(4 Suppl):S140-3.
19. Scholz RP, Sachdeva RC. Interview with an innovator: SureSmile Chief Clinical Officer Rohit C. L. Sachdeva. Am J Orthod Dentofacial Orthop 2010;138(2):231-8.
20. Saxe AK, Louie LJ, Mah J. Efficiency and effectiveness of SureSmile. World J Orthod 2010;11(1):16-22.
21. Alford TJ. SureSmile, an unbiased review (Lecture). 113th Annual Session of the American Association of Orthodontists. Philadelphia, Pennsylvania, USA; 2013.
22. Alford TJ, Roberts WE, Hartsfield JK, Jr., Eckert GJ, Snyder RJ. Clinical outcomes for patients finished with the SureSmile method compared with conventional fixed
orthodontic therapy. Angle Orthod 2011;81(3):383-8.
23. Sachdeva RC, Aranha SL, Egan ME, et al. Treatment time: SureSmile vs conventional. Orthodontics (Chic.) 2012;13(1):72-85.
WWW.HSAO-ONLINE.ORG
>
>
PR
AC
TIC
E
>
101
Exploring staff
bonus systems
in orthodonitc
private practices
>
Should you use a bonus system at you
office?
Only if you want to increase production,
collections and also protect your
overhead. Got your attention? OK, let’s
elaborate.
has 6 employees and is to pay bonus for the month of March.
The numbers in parentheses are the amounts that we are
using for the exercise.
A. Average of the last 3 months collections, January to March.
($100,000)
B. Salaries paid in March ($19,500)
I’m sure you have been familiar for quite
a while with general practitioners giving
bonuses to their staff depending on how
many whitening cases they sell, how
many veneer cases they can produce out
of their hygiene recall program, etc., etc.
It reminds you more of a car dealership
instead of a professional health care
provider. Anyway, I never really paid
much attention to them and actually
thought of them as a tasteless way to
reward the staff for selling products to
patients that they frequently don’t even
need to begin with.
C. Percentage that salaries are of total collections. This
number is picked by you based on where you want to be.
Average is 18-22 %. (20%)
D. Number of employees eligible for bonus (6)
The equation to find what the bonus will be is:
1. Find out the salary percentage of the last three months
average:
$100,000 x 20%=$20,000
A
Fortunately, for me and my staff, about
4 years ago I was introduced to a bonus
system by my practice management
consultant. I obviously changed my mind
on the topic and so I want to share with
you what we are now doing at the office.
22
x C =AC
Why give a bonus?
1. It motivates the staff by making them feel part of
the practice.
2. It protects the doctor’s overhead by setting
a predetermined percentage of what staff
salaries should be of total collections. It’s
important to note that when the bonus
system is introduced the staff has to be
informed that the system of yearly raises
is no longer in effect. From that point
on the staff’s income is also going to
be tied to the office’s growth.
3. Staff will be intimately tied to
the office’s collections. There
will be a clear benefit for
an assistant to never miss
reporting a charge, for
staff to invite patients
to refer friends and
family, etc.
2. Find the difference between the salaries paid and the
calculated salary:
23
$20,000 - $19,500 = $500
AC -B= bonus to be paid
IN OM
E
RL S.C
E
G TIC
O
RD DON
A
DU THO
E
R. OR
D
IN
:
E
Y
L
B
N GER
E
T @
RIT EIN
W RL
GE
R
D
S
A
E
D
I
T
N
E
M
E
G
A
N
A
M
The bonus system that we use works
by pre-determining a percentage, from
total collections, of what the sum of all
salaries of staff (excluding doctor) will
be. This is usually 18-22%. We then
calculate the actual amount that was
paid on salaries at a specific time. The
difference is what makes the bonus.
3. Divide the bonus amount among the staff members that are
eligible:
$500 / 6= $83. Each staff member will be
paid a bonus of $83.
Let’s do the exercise for an
office that collects
$100,000,
WWW.HSAO-ONLINE.ORG
>
>
>
in the works 2014
THE FUTURE OF HSAO
REGISTRATION NOW OPEN
HandS-on lingual
ortHodonticS training
Learn how to integrate HarMonY – the only
digitally customized, self-ligating lingual
system, into your practice. Dr. Brandon
Comella’s Harmony Expert Program will
give you the core knowledge
and techniques you
need to offer your
patients this truly
invisible solution.
24
dr. Brandon coMella
WHat You’ll learn
•Patientselection
•Impressiontechnique
•Bondingprocedures
•Advancedmechanics
•Much,muchmore!
Space is limited, so register today!
Visit www.harmonyexpert.com
©2014 AmericAn OrthOdOntics cOrpOrAtiOn
+1 920 457 5051 | AmericAnOrthO.cOm
HOT OFF THE PRESS
Advances journal
I wish to thank Dr. Joseph Ghafari for his leadership and hard
work in being the editor of Advances in Orthodontics since its
inaugural publication in 1994. I am also grateful to have his
continued involvement in the journal as Founding Editor. In
the second edition Dr. Ghafari called for HSAO members to submit
clinical reports, scientific papers, surveys, opinions, counterpoints,
comments and news. Part of the foundation was a strong connection
with the Advanced Education in Orthodontics at the HSDM, which
after a difficult time hopefully is being rebuilt. With that, and a revitalization of the HSAO, is the development of the HSAO newsletter
VERITAS, and planned reemergence of Advances in Orthodontics.
>
VERITAS will now carry some of the information that appeared in
Advances in Orthodontics, so one question now is, what will be contained in Advances? News is obvious to be in VERITAS. Perhaps also
some of the other types of pieces listed previously may be included
in it as well. Clinical reports could be in Advances, as well as scientific surveys, opinions and counterpoints. I would like to know what
the members of HSAO would like to see in the journal now. There
are a plethora of new “open,” i.e., non-subscription online journals.
Do we add Advances to the mix? Do you alter the name to Advances
in Orthodontics and Craniofacial Biology, or some other name, to
reflect the depth and breadth of what the members are doing? Do
we send in our own scientific papers for peer review and publication,
even if there is no “impact factor” associated with having the paper
published in the journal? Do we work towards building a type of
scientific journal that would have its papers cited, building an impact
factor? Do we encourage our residents in the programs in which
many of our members are the leaders and or on the faculty to send
in research abstracts or papers?
Dr. James Hartsfield
25
I would appreciate any and all comments about the questions I have
put forth, as well as any others, that I might discuss with Dr. Ghafari. I am excited about the future of Advances in Orthodontics, but
also believe that without the support of the HSAO membership, the
journal will not be what it can be again; a venue for the discussion of
data and opinion in a civil manner with integrity. My alumni email
address is [email protected], and I look forward to your
comments.
WWW.HSAO-ONLINE.ORG
>
Resident
Sightings
SMILE!
>
Resident's
Corner
>
Resident BBQ. Boston. June 2013. Left to Right: Mike Sunwoo, Shankar
Venugopalan, Henry Ohiomoba, Michelle Mian, Michelle Chou, Gayatri
Horowitz
Yankee Dental. Boston. Jan 2013. Left to Right: Michelle Chou, Mike
Sunwoo, Dr. Todd Rowe, Rishi Popat, Mahshid Bahadoran, Henry
Ohiomoba, Michelle Mian, Nithya Chickmagalur
GORP. Chapel Hill, NC. Aug 2013. Left to Right: Eddie Kim, Peter
Chen, Mike Sunwoo, Henry Ohiomoba, Michelle Mian, Nilou Sherf,
Hamid Barkhordar, Michelle Chou
26
27
Dr. Bob Williams Lecture with Dr. Greg Baker. HSDM. Dec 2012.
Goodbye Party for Dr. Allareddy. Sept 2013. Top Left to Right: Christopher
Hickey, Peter Chen, Michelle Mian, Henry Ohiomoba, Negin Katebi, Nilou
Sherf, Hamid Barkhordar, Mike Sunwoo, Yajun Cui, Irene Lee, Shankar
Venugopalan, Naoshi Hosomura.
Bottom Left to Right: Wanida Ono, Eddie Kim, Dr. Veerasathpurush
Allareddy, Mahshid Bahadoran, Rebecca Chen, Hye Won Choi, Nithya
Chickmagalur, Michelle Chou
HSAO Student Reps:
Rishi Popat: [email protected]
Michelle Mian: [email protected]
Lecture with Dr. Domingo Martin and Dr. Renato Cocconi. Boston. July
2012 Left to Right: Dr. Domingo Martin, Nithya Chickmagalur, Shankar
Venugopalan, Gayatri Horowitz, Mahshid Bahadoran, Michelle Mian,
Wanida Ono, Dr. Renato Cocconi.
WWW.HSAO-ONLINE.ORG
>
>
>
The
big
Easy
>
AAo 2014
New Orleans
>
The AAO meeting will be a great excuse to
get together with old friends and faculty. Our
Facebook page would be a great way to connect
with fellow HSAO members and plan any events.
We are pleased to confirm the
participation of the Harvard / Forsyth
Alumni in the American Association of
Orthodontists’ 2014 Annual Session
Alumni . The Alumni Receptions will be
held on Saturday April 26, 2014 from
6:30pm-8pm in the Warwick room
at the Hilton New Orleans Riverside
(New Orleans, Louisiana)
28
“ I’m not going to lay down in words the lure of this place. Every
great writer in the land, from Faulkner to Twain to Rice to Ford,
has tried to do it and fallen short. It is impossible to capture the
essence, tolerance, and spirit of south Louisiana in words and to try
is to roll down a road of clichés, bouncing over beignets and beads
and brass bands and it just is what it is. It is home. “ Chris Rose -
>
29
WWW.HSAO-ONLINE.ORG
>
>
>
MEET
DR. BELLA SHEN
GARNETT
30
A GRADUATE
OF STANFORD
UNIVERSITY AND
THE HARVARD
SCHOOL OF
DENTAL MEDICINE,
DR. BELLA SHEN
GARNETT IS
AMONG THE FEW
BOARD CERTIFIED
ORTHODONTISTS
IN SAN FRANCISCO
AND IS PURSUING
MEMBERSHIP
IN THE ANGLE
SOCIETY. SHE
IS AN EXPERT
IN INVISALIGN
AND IS THE TOP
INVISALIGN®
PROVIDER IN SAN
FRANCISCO. SHE
IS ALSO A SUPER
ELITE INVISALIGN®
PROVIDER AND IS
AMONG THE TOP
1% INVISALIGN®
PROVIDERS.
CLINICIAN’S CORNER
Can I use Invisalign more in my practice?
S
hortly after teaching, I
opened my practice in
San Francisco in 2006. I
continued to use Invisalign and
became an Elite provider in 2010
and a Super Elite Provider in 2011.
I just treated my 1000th case.
Through the years, I have learned
to treat almost every case with
Invisalign ranging from deep bite
cases, to open bite cases, to Class II
and Class III cases.
I
nvisalign is an appliance that I have
used to treat over half my patients.
Without Invisalign, I do not think
I could have grown my practice to
where it is today. I have learned over
the years not only to straighten teeth
with Invisalign; but also to use it to
correct difficult malocclusions that I
once thought Invisalign was incapable of
fixing.
I
started using Invisalign after
graduating from Harvard in 2004,
and I actually started by treating
myself. During that time, I worked in New
York City spending 5-6 days a week on
the upper east side and one day a week
at an Invisalign only satellite office. That
first year out of residency, I treatment
planned and performed over 200
Invisalign cases. In 2005, I moved back
to San Francisco and started teaching
Invisalign at the University of Pacific
Dental School.
I
n order to maximize the
movements of teeth with
Invisalign, I utilize auxiliaries
such as elastics, TADS, and bite
turbos with my treatment plans, just as I
would do with my fixed appliance cases.
In fact, I am in the process of joining the
Angle Society and my high-angle case is
an Invisalign case with TADs.
A
s orthodontists, we should
treat all of our open bite and
high-angle cases exclusively
with Invisalign because it is so good at
controlling the vertical.
P
resented below are some difficult
adult cases that I have treated with
Invisalign. The key in each case is
to use the same auxiliaries that you would
use for fixed appliance cases. For example,
if we were to treat a low angle deep bite
case with braces, we would place bite turbos
on the lingual of the upper anteriors to
help increase the vertical and extrude the
posterior teeth and intrude then anterior
teeth. The unwanted side effect of molar
intrusion makes treating these patients with
Invisalign difficult.
Case #1 and # 2
I placed bite turbos on the upper
anteriors with the mini-molds by Ortho
organizers, and then scanned the teeth. I
then removed the bite turbos and placed
them back on at the first visit with the
attachment template, just as we would
place the rest of the attachments. In the
Clin Check Software, I program posterior
extrusion to sock in the teeth. Both
Case #1 and #2 photos are taken prior to
refinement.
Case #1
31
39-year-old Asian female with the
chief complaint, “I want to decrease my
protrusion.” She is hypodivergent with a
SN-MP of 24 degrees. This case is not yet
complete. This is the result just before
refinement to coordinate midlines more.
Case #2
46-year-old male with the chief
complaint, “I want to correct my
overbite.” He is hypodivergent with a
SN-MP 28 degrees. With such a low
mandibular plane angle, it is a difficult
case to treat with fixed appliances as
well. This is also the result of the bite
opening with the use of bonded bite
turbos just before refinement. In the
refinement, we will rotate LL5 more and
sock-in occlusion
WWW.HSAO-ONLINE.ORG
>
>
>
Cases #3,# 4, #5
Case #5
Invisalign is also great for distalizing and correcting Class II malocclusions. By intruding the posterior teeth you
can control the vertical and get some autorotation of the mandible. You can also distalize molars without them
extruding with the support of Class II elastics and get very little proclination of the lower incisors by adding
lingual root torque into the aligners. In general, I distalize all cases using the aligners if it is ¾ cusp Class II or
less. If the bite is high angle, I usually correct it with the autorotation and just have the patient wear Class II
elastics. If it is a full cusp Class II, I tend to use TADS first and then retract the U5-5 en masse with the aligners.
22 year old Asian female who presents with the chief complaint, “I want to decrease
my protrusion.” She presents half cusp on the right and ¾ Cusp Class II on the left. I
decided to distsalize first using sectional braces using TADS for anchorage and then
retracting the U5-5 en mass to close the space supported by Class II elastics.
Case #3
27-year-old female presents with the
chief complaint, “I want to straighten my
teeth.” She presents ½ cusp Class II with
an anterior open bite and a mandibular
plane angle SN-MP of 51 degrees. In a
fixed appliance case, you would never use
class II elastics. In this case treated with
Invisalign, we used Class II elastics and
intruded the posterior molars.
32
I placed TADS between the U6 and U5 and bonded the U5’s to the TAD with a 19X25
SS. I then placed sectional braces on the U5,6,7. I used a push coil placed between
the U5s and U6s to distalize the U6,7.
we should treat
all of our open
bite and highangle cases
exclusively
with Invisalign
because it is
so good at
controlling the
vertical
33
Case #4
29 year old male with the chief complaint:
“I want to fix my bite and I don’t want
braces.” I treated this case with Class II
elastics and sequential distalization.
WWW.HSAO-ONLINE.ORG
>
>
>
After 6 months later after distalizing, I achieved a Class I molar relationship. I then used the same TAD and
placed a new 19X25ss wire is bonded to the U6s and the TAD. I made a temporary Essix for the patient to wear
and now scanned the teeth with my ITero to begin Invisalign.
One bottle. Simple.
Assure® Universal Bonding Resin will bond to:
• Any enamel or dentin
surface, wet or dry,
withoutadditionalprimers
• All metal surfaces
In only, 10 months using Invisalign with class II elastics, I was able to close the remaining space and retract the
U5-5 en masse. I scanned the teeth again to now begin refinement.
34
• Composite restorations
• Porcelain Crowns when
used with Porc Etch and
Porcelain Conditioner
35
Assure.®
Keep your
chairside bonding
reliable, effective, simple.
Bella Shen Garnett
HSDM DMD 01, MMSc ‘04
San Francisco, CA
www.bellasmile.com
[email protected]
For more information, contact…
(800) 323-4348 • (630) 773-4009 • Fax (630) 250-7704
www.relianceorthodontics.com
WWW.HSAO-ONLINE.ORG
>
>
>
>
Virginia Bocage, Bella Shen,
Charles Ruff, Ivy Chen, Vivian
Fan
Were we that young
once?
Mauricio Berco, Rachel
Lorenz, Shawn Miler,
Michal Kleinlerer, Matt
Miner, Manish Lamichane
(Note the braces on our
central incisors -- See one,
do one, teach one!)
37
>
Party Time
36
M
FRO
AR
E
TH
>
Y
R
E
S
L
O
L
T
A
O
H
G
P
..
.
.
E
CHIV
GORP 2003
Kerwin Ho, Ivy Chen,
Laski Kung, Bella Shen,
Gabriel Bendahan,
Virginia Bocage
>
Looking for trouble
SEE MORE
PICTURES ON
FACEBOOK
Laski Kung, Travis
Sorensen, Don Nelson,
Gabriel Bendahan
WWW.HSAO-ONLINE.ORG
>

Issue #01 - Harvard Society for the Advancement of Orthodontics

Transcription

Similar documents

Debonding as a Marketing Tool Clear Aligner Usage Survey Focus

10-DGAC-042_Dr. Roncone Brochure R12.indd

to the Orthodontist - Guajardo Orthodontics

Skate Party Consent Form_2016

The University of Iowa Department of Orthodontics “Advancing

Mini Lingual Spur Educator

Pediatric And Orthodontic Dentistry Internship

HERE

Redefining Adult Cosmetic Orthodontics

Dep Pandis 2016 engx web.indd