Cover / Editorial / Content / A review of the original Combination Technique and philosophy / How to avoid extractions when treating malocclusions / Events / Dr. Cristina Teixeira named chair of the department of orthodontics at NYUCD / Study: 20-30 percent of bib clips harbor bacteria even after disinfection / ClearCorrect reaches new milestone with charitable clean water project / Industry / Submissions / Imprint
Cover
01 - 01 viewEditorial
03 - 03 viewContent
04 - 04 viewA review of the original Combination Technique and philosophy
06 - 11 viewHow to avoid extractions when treating malocclusions
12 - 19 viewEvents
20 - 24 viewDr. Cristina Teixeira named chair of the department of orthodontics at NYUCD
25 - 25 viewStudy: 20-30 percent of bib clips harbor bacteria even after disinfection
26 - 28 viewClearCorrect reaches new milestone with charitable clean water project
30 - 30 viewIndustry
32 - 36 viewSubmissions
37 - 37 viewImprint
38 - 38 viewArray
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[1] =>
ortho
issn 2161–7228
the international C.E. magazine of
2
2012
_c.e. article
A review of the original
Combination Technique
and philosophy
_events
MASO can help you
‘Chart a Course’ at
its annual meeting
_industry
The age of digital
orthodontics is here
North America Edition • Vol. 1 • Issue 2/2012
orthodontics
[2] =>
Technology designed the way you work
Closing the digital loop
The first open CAD/CAM system for orthodontics
3Shape TRIOS® is the new ultra-fast and easy to use chairside scanner to create accurate digital impressions in open
format.
3Shape Ortho System
3rd party
Production
•
R700
Intraoral scans, impression/model scanning, open
format STL
3Shape
Ortho System
2012
Appliance Designer™
TRIOS
®
•
Customizable analysis workflows
•
Full treatment simulation, including virtual setups
•
Virtual articulators for easy validation
•
CAD design of any orthodontic appliance
•
Free choice of manufacturing equipment and materials
Ortho Analyzer ™
See the full digital loop at an exhibition near you
Note: TRIOS® will be available in the US and Canada in 2012
Scan the QR code
& sign up for our newsletter
[3] =>
editorial _ ortho
ortho offers tips,
hints and C.E.
opportunities
I
Publisher Torsten Oemus
_The goal of this quarterly magazine, ortho, is twofold. First, it seeks to share practical orthodontic
knowledge that can be put to use in your day-to-day practice. Second, it is a vehicle to help you chip away
at your continuing education (C.E.) requirements.
The amount of new information available in the orthodontic field about new products, techniques and
research data is astounding. Running a practice and seeing patients leaves little time for catching up on
the latest clinical news and product information. Thus, we hope ortho will not only be a welcome respite
for those rare chunks of time you can devote to leisurely reading but one that provides a practical return
on your investment by providing information that you can actually put to immediate use.
In addition, we know that taking time away from the practice to pursue C.E. credits can be costly in
terms of lost revenue and time. As a quarterly magazine, ortho is here to help you chisel at least four C.E.
credits per year out of your already busy life.
To that end, every edition of ortho will include at least one hour of ADA CERP-certified C.E. credit in
which readers can answer questions about the materials at www.dtstudyclub.com to earn this credit.
Annual subscribers to the magazine ($50) need only register at the Dental Tribune Study Club website to
access these C.E. quizzes free of charge. Even non-subscribers may take the C.E. quiz after registering on
the DT Study Club website and paying a nominal fee.
If you are a practitioner with a penchant for words, it might also interest you to know that authors of
the C.E.-accredited articles receive 15 percent of the fees collected from the non-subscribers who take the
C.E. quiz online. The C.E. quiz for the articles in this edition will be available online on Sept. 17.
Dental Tribune America is part of the largest dental publishing network in the world, Dental Tribune
International (DTI), which consists of 23 license partners around the globe. The DTI network publishes a
variety of dental publications that are distributed in more than 90 countries. Please visit us online at www.
dental-tribune.com to see the variety of publications we offer and at www.dtstudyclub.com to see the
complete list of online and offline C.E. opportunities available. In the meantime, we hope you enjoy this
edition of ortho, and we welcome your feedback.
Sincerely,
Torsten Oemus
Publisher
ortho
I 03
2
_ 2012
[4] =>
I content _ ortho
page 12
page 6
page 20
I c.e. articles
I industry
06 A review of the original Combination Technique
and philosophy
32 Edge management, imaging, communication
system from Ortho2: It’s all you really need
_Dennis J. Tartakow, DMD, MEd, EdD, PhD,
editor in chief, Ortho Tribune
12 How to avoid extractions when treating
malocclusions
34 Planmeca introduces a new analysis tool for
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36 The age of digital orthodontics is here
_German O. Ramirez-Yañez, DDS, PhD,
and Chris Farrell, BDS
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_c.e. article
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A review of the original
Combination Technique
and philosophy
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[5] =>
[6] =>
I C.E. article_ Combination Technique
A review of the original
Combination Technique
and philosophy
Author_Dennis J. Tartakow, DMD, MEd, EdD, PhD, editor in chief, Ortho Tribune
_c.e. credit part I
This article qualifies for C.E.
credit. To take the C.E. quiz,
log on to www.dtstudyclub.
com. The quiz will be available
on Sept. 17.
Introduction
_During the 1960s, when the Begg lightwire
and the Tweed edgewise were the mainstream techniques of orthodontic therapy, Dr. Maxwell Fogel
and Dr. Jack Magill introduced their “Combination
Technique” (Fogel & Magill, 1969).
The Combination Technique’s philosophy was
based on combining the positive and significant
attributes of Begg lightwire and Tweed edgewise
techniques to produce a system that corrected
malocclusions quickly and easily for the orthodontist, with much less pain and a shorter period of time
for the patient, while producing American Board of
Orthodontics quality, standards and results.
_Outline of the Combination Technique
Stage I: Light-wire phase (Tipping)
1. Reduce protrusion
2. Un-crowd incisors
3. Open the bite (restore vertical dimension)
4. Class I molars and cuspids
5. Begin closing extraction spaces
6. Upright mandibular incisors
7. Cephalometric X-ray to check uprighting of the
mandibular incisors
Stage II: Bracket alignment phase (Leveling)
1. Level and align maxillary and mandibular arches
2. Closure of extraction spaces
3. Preliminary uprighting of cuspids and bicuspids
4. Preliminary correction of rotations
5. Preliminary correction of axial positions
06 I ortho
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Stage III: Edgewise phase (Uprighting)
1. Detailed axial positioning of all teeth
2. Lingual root torque for labial axial inclination of
the maxillary incisors
3. Root paralleling in extraction areas
4. Desired uprighting of molars
5. Artistic positioning of incisor segments
6. Complete correction of rotations
7. Residual space closure
Retention
Two years — indefinite
_Overview of the Combination Technique
philosophy
The Combination Technique incorporated three
stages of appliance therapy:
Stage I
The initial stage was called the light-wire or
tipping phase, employing 0.014, 0.016 and 0.018
round wires, which required approximately four to
eight months to achieve desired results. This first
phase employed Dr. Raymond Begg’s concept of
light, continuous forces to uncrowd anterior teeth,
open the bite (restore vertical dimension), reduce
the protrusion, begin closing extraction spaces and
uprighting mandibular incisors, all without straining
the posterior anchorage unit. The Begg philosophy
and mechano-therapy produced light, physiologic
forces through the use of one-point contact, freesliding, non-binding and continuously moving teeth
that were connected to the archwire (Begg, 1961).
Drs. Fogel and Magill created this appliance by
[7] =>
C.E. article_ Combination Technique
Fig. 1b
I
Fig. 1c
Fig. 1a
Fig. 3a
uniting the light-wire vertical insert pin (Fig. 1a) with
the widely spaced twin edgewise bracket (Fig. 2b) into
a single appliance unit (Fig. 1c). The joining together
of these two attachments enabled the development
of a system for controlled light-wire therapy in the
first stage of the Combination Technique. (All figures
are from Fogel and Magill’s “The Combination Technique in Orthodontic Practice.”)
During Stage I (light-wire and tipping), a single
light archwire with multiple loops and hooks was
snapped into the vertical insert pins to produce
simple tipping of the incisors, placing them in harmony with and upright over the apical base (Fig. 2a,
2b). This included correction of overjet, overbite and
jaw relationships by means of controlled anchorage
through the use of differential inter- and intra-arch
elastic forces.
Stage II
The second stage was the called the leveling
phase, employing a multi-stranded light wire, which
Fig. 2c
Fig. 2b
Fig. 2a
Fig. 3c
Fig. 3b
was later replaced by 0.014, 0.016 and 0.018 round
flexible wires, ligated into the edgewise brackets,
requiring approximately three to four months to
achieve the desired results. This second phase
included leveling and aligning maxillary and mandibular arches, closing extraction spaces, uprighting
cuspids and bicuspids and correcting rotations of
all teeth.
During Stage II (bracket alignment and leveling),
a multi-stranded light-wire (Fig. 3a, 3b) was used
to create controlled general alignment of all teeth,
including leveling, correction of rotations, preliminary correction of axial positions, continued overbite
correction and establishment of general arch form.
Stage II prepared the brackets for the edgewise phase.
Stage III
The third stage was the called the edgewise phase,
employing 0.016 x 0.016 square wires, followed by
0.017 x 0.025 rectangular wires, also ligated into the
edgewise brackets and taking approximately six to 12
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[8] =>
I C.E. article_ Combination Technique
Fig. 4a
Fig. 4b
Fig. 4c
Fig. 5
Fig. 6
months to achieve results. This third phase included
detailed positioning, proper uprighting and ideal
axial inclinations of all teeth. The Combination Technique was excellent for treating extraction cases and
difficult malocclusions, as well as being very capable
of obtaining outstanding results in non-extraction
cases.
During Stage III (edgewise), the rectangular archwire (Fig. 4a–4c) was used to achieve ideal arch form
and detailed axial positioning of both the crowns and
roots of all teeth. This included: (a) root paralleling of
teeth adjacent to the extraction areas, (b) uprighting
of molar teeth, (c) artistic positioning of the incisor
segments, (d) continued overbite correction if necessary, (e) final closing of residual extraction spaces,
and (f) lingual root torque for labial axial inclination
of the maxillary incisors.
Torquing auxiliary
During the correction of many severe malocclusions, the maxillary incisors required root torque as a
result of lingual crown tipping. In order to accomplish
incisor root torquing, an auxiliary wire was employed
similar to that used by Dr. Begg during Stage III.
The torquing auxiliary (Fig. 5) was an 0.014 wire
Fig. 7a
08 I ortho
2_ 2012
Fig. 7b
Fig. 7c
constructed with two loops in the same plane as the
archwire, which when snapped into the insert pins
placed the loops onto the maxillary central incisors
slightly sub-gingival. After snapping the torquing
auxiliary into the insert pins anteriorly (Fig. 6), it was
cinched behind the molar tubes posteriorly.
This torquing auxiliary was used in addition to the
main edgewise wire, which had been ligated into the
horizontal slot of the widely spaced twin edgewise
bracket to carry out the desired objectives of Stage
III as well as providing anchorage and stability during the torquing procedure. The torquing auxiliary
forces produced approximately one degree of lingual
root movement per month. This was substantiated by
cephalometric and visual examination.
_Example of the Combination Technique
in a severe malocclusion
Treatment of a Class II, Division I severe maxillary
protrusion and deep overbite is shown, using maxillary first and mandibular second bicuspid extractions
(Fig. 7a–7j).
Incisor coverage biteplate (Fig. 8a–8c) was required as a preliminary step as a result of the severe
Fig. 7d
[9] =>
C.E. article_ Combination Technique
Fig. 7e
Fig. 7f
Fig. 7g
Fig. 7h
Fig. 7i
Fig. 7j
deep anterior overbite. This created initial bite opening and avoided shearing of brackets, tearing of
bands and occlusal interferences.
_Combination Technique mechanics
Stage I — Single strand light-wire stage
(Figs. 9a–9c).
The objectives of Stage I were to achieve: (a)
reduction of the protrusion (edge-to-edge incisor
relation), (b) bite opening (molar uprighting and incisor intrusion), (c) incisor uncrowding and (d) Class I
cuspid and molar relationships.
Stage II — Leveling with a multi-strand light-wire
stage (Figs. 10a–10c).
The objectives of Stage II were to achieve: (a)
Fig. 8a
I
leveling and aligning of all brackets for edgewise
archwire placement, (b) preliminary uprighting of
cuspids and bicuspids, (c) correction of rotations and
labiolingual malpositions, (d) continued bite opening, and (e) arch symmetry.
The advantages of the multiple leveling appliance
when compared to the single strand wire included a
longer range of action, better resistance for distortion, increased flexibility, gentler forces and less
fatigue.
Stage III — Edgewise stage (Figs. 11a-11c).
The objectives of Stage III were to achieve: (a) a
stable anchorage for Class II elastics, (b) correct axial
inclinations, (c) root paralleling in extraction areas,
(d) uprighting of the molars and bicuspids, (e) ideal
arch form, (f) continued overbite correction and (f)
Fig. 8b
Fig. 8c
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[10] =>
I C.E. article_ Combination Technique
Fig. 9a
Fig. 9c
Fig. 9b
Fig. 10a
Fig. 10b
Fig. 10c
Fig. 11a
Fig. 11b
Fig. 11c
final closure of residual spaces.
_Summary
Historically, Dr. Maxwell Fogel and Dr. Jack Magill
believed that the unification of the Begg light-wire
and the Tweed edgewise philosophies produced an
ideal milieu for (a) universal action and controlled
tooth movement in all directions; (b) automatic, selfacting appliances, with a long span of action, a few
adjustment periods; and (c) simple, uniform design,
painless and compatible with the tissues surrounding
the teeth.
According to Drs. Fogel and Magill (1972), anchorage was the focal point in successful treatment;
gentle, free tipping movements of the canines in a
distal direction into the extraction spaces imposed
less stress on the anchor units than did bodily distal of
the solidly embedded teeth. For many years, tipping
movements for anchorage preservation was looked
upon with great skepticism.
The widely spaced twin edgewise bracket, as
suggested by Dr. Brainerd Swain in 1949, was used
to solve the problem of paralleling roots when closing extraction spaces. As Dr. Cecil Steiner succinctly
stated: “A single arch wire of uniform standard design
and size cannot serve with equal efficiency for the
various purposes necessary,” (Fogel & Magill, 1972). It
10 I ortho
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follows that different types of appliance units require
appropriate construction and design so that a variety
of wire sizes may be used for proficient and controlled
performances effecting an assortment of significant
assignments.
Drs. Fogel and Magill combined the twin edgewise
bracket with a vertically placed insert pin to produce
a natural union as a receptacle for both pliable lightwires and rectangular wires simultaneously. The
Combination Technique’s single appliance receptacle
offered the ability to achieve the desired treatment
procedures and objectives. Their goal was to produce
a technique that would correct average as well as
severe malocclusions with better results in less time
and with greater ease.
This original Combination Technique incorporated a system for moving teeth whereby the teeth
remained in place as a result of the equilibrium
that existed among the oral musculature including
the lips, tongue and the muscles of mastication.
Axial correction of root angulations was no longer
a problem. Positioning the mandibular incisors over
the basal bone enhanced anchorage potentialities
and helped to achieve a more functional and stable
occlusion. Any force that disrupted this equilibrium
created an environment for the teeth to move. When
a very light resilient wire is ligated into a crowded
dentition, the wire attempts returning to the original
[11] =>
C.E. article_ Combination Technique
shape. If the wire is tied tightly to the teeth, forces
are transmitted reciprocally between the individual
teeth in the arch.
Any extraneous forces are controlled as a result of
the anchorage unit.
During
the
late
1970s,
Fogel and Magill introduced a secondgeneration combination bracket, which featured a
double self-ligating attachment bracket to facilitate
wire insertion.
It was called the “Modular Self-Locking Appliance System: Variation of the Combination Technique.” The success of this bracket was hindered by
the deficiencies in the metallurgy technology.
The locking mechanism fatigued after several
adjustments. The availability of light memory wires
had not yet appeared, necessitating more frequent
wire changes.
Still, the concept was sound. The Combination
Technique was used well into the 1990s and was
modified by many of its proponents. During the
1990s, most orthodontists employed some form of
light-wire edgewise technique with pre-angulated
and pre–torqued brackets.
Ligatureless Edgewise brackets first appeared in
the 1930s with the Russell Lock appliance (Sathler et
al., 2011), which was an attempt to improve the clinical effectiveness for moving teeth while reducing
the time required to ligate a wire into the brackets.
Numerous articles regarding self-ligating orthodontic brackets can be found in the literature
(Self-ligating brackets, 2012), with more than 20
original patents for new self-ligating brackets; some
have gone by the wayside and some have lasted the
test of time. Sathler et al. (2011) provided an excellent review of the literature regarding self-ligating
brackets used in orthodontics.
It is interesting to note that many articles describe self-ligating brackets as either the new buzzword or as a faster and more efficient method of
tooth movement in orthodontic treatment.
However, in reality the self-ligating bracket has
prevailed since the 1930s. It has been more than 50
years since Dr. Raymond Begg introduced his “Light
Arch Wire Technique” in the late 1950s (Begg, 1961),
and Fogel and Magill introduced their Combination
Technique in the late 1960s (Fogel & Magill, 1969),
yet seldom are they cited in articles, reference lists or
bibliographic lists for self-ligating brackets.
As John F. Kennedy (1963) so adroitly stated, “A
man may die, nations may rise and fall, but an idea
lives on … we must find time to stop and thank the
people who make a difference in our lives.”_
_References
I
_about the author
1)
Begg, R. (1961). Light arch wire technique. American Journal
of Orthodontics; 47(1): pp. 30–48.
2) Fogel M. & Magill J. (June 1969). A fundamental reappraisal of popular techniques with a collective approach
toward appliance therapy. American Journal of Orthodontics;
55(6):705–713.
3) Fogel M. & Magill J. (July 1970). Retrospective on progressive
dentofacial changes after treatment and retention. Journal of
Clinical Orthododontics; 4(7):407–417.
4) Fogel M. & Magill J. (1972). The Combination Technique in
orthodontic practice. J.B. Lippincott Co: Philadelphia, PA.
5) Fogel M. & Magill J. (Sept 1976). The modular selflocking appliance system — A variation in the Combination
Technique (Part 1): Journal of Clinical Orthododontics;
10(9):653–660.
6) Fogel M. & Magill J. (Oct 1976). The modular self-locking
appliance system — A variation in the Combination Technique
(Part 2): Journal of Clinical Orthododontics; 10(10):728–741.
7) Fogel M. & Magill J. (Nov 1976). The modular self-locking
appliance system — A variation in the Combination
Technique (Part 3): Journal of Clinical Orthododontics;
10(11):826–835.
8) Fogel M. & Magill J. (Dec 1976). The modular self-locking
appliance system — A variation in the Combination
Technique (Part 4): Journal of Clinical Orthododontics;
10(12):906–917.
9) Fogel M. & Magill J. (Jan 1977). The modular self-locking
appliance system — A variation in the Combination
Technique (Part 5): Journal of Clinical Orthododontics;
11(1):51–59.
10) Fogel M. & Magill J. (1982). Begg and straight wire: a
combination approach to treatment” American Journal of
Orthodontics; 81(3):253.
11) John F. Kennedy. (1963). Quotations by John F. Kennedy.
http://www.goodreads.com/author/quotes/3047.John_F_
Kennedy
12) Messinger, S. & Tartakow, G. (2008). Combination
Technique 1976 vs. 2008 utilizing Leone’s revolutionary
slide™ ‘no-friction’ ligature — Part I, Ortho Tribune, New
York City: (3) 2/3, p 8–9.
13) Messinger, S. & Tartakow, G. (2008). Combination Technique
1976 vs. 2008 utilizing Leone’s revolutionary slide™ ‘no
friction’ ligature — Part II, Ortho Tribune, New York City: (3)
4, p 22.
14) Sathler, R., Silva, R., Janson, G., Cabral, N., Branco, C.,
& Zanda, M. (2011). Demystifying self-ligating brackets.
Dental Press Journal of Orthodontics; 16(2): 50.e1–8.
15) Self-ligating brackets. (2012). http://scholar.google.com/
scholar?q=Self-ligating+orthodontic+brackets&hl=en
&as_sdt=0&as_vis=1&oi=scholart&sa=X&ei=AB1TT8ioI
MeViALW8YQ-&ved=0CEIQgQMwAA
Dennis J. Tartakow, editor
in chief of the Ortho Tribune,
practiced orthodontics, temporomandibular joint (TMJ) disorders and orofacial pain therapy
in Palm Beach, Fla., and now
resides in Marina del Rey, Calif.
Tartakow is a consultant in
orthodontics, TMJ disorders,
orofacial pain, practice management and health-care administration. He counsels preand post-graduate students,
orthodontists and health-care
practitioners and has provided
expert testimony in numerous
orthodontic, TMJ and medicolegal litigation cases.
His professional accomplishments include being a diplomate of the American Board of
Orthodontics; a diplomate of the
American Board of Special Care
Dentistry; and a certified dental
editor. He is clinical associate
professor and former director of
the TMD section, postgraduate
orthodontic department, Nova
Southeastern University, College of Dental Medicine, Fort
Lauderdale, Fla.; senior attending, postgraduate orthodontic
section, Albert Einstein Medical
Center, The Maxwell S. Fogel
Department of Dental Medicine,
Philadelphia; and clinical associate professor, orthodontic department, craniofacial sciences
and therapeutics, University of
Southern California, School of
Dentistry, Los Angeles; former
primary adjunct professor, the
Union Institute and University,
Graduate College, North Miami Beach, Fla.; and Research
Council member of the J. Paul
Getty Research Institute and
Library, Los Angeles.
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[12] =>
I C.E. article_ Bent Wire System
How to avoid
extractions when
treating malocclusions
Using MRC’s Bent Wire System and Trainer
System for arch development
Authors_German O. Ramirez-Yañez, DDS, PhD, and Chris Farrell, BDS
_c.e. credit part II
_Abstract
This article qualifies for C.E.
credit. To take the C.E. quiz,
log on to www.dtstudyclub.
com. The quiz will be available
on Sept. 17.
_Maxillary and mandibular expansion has
been proposed to increase the arch perimeter and
to avoid extractions during orthodontic treatment.
Although controversy has persisted over the stability
of expansion techniques, there is an increasing trend
toward “non-extraction.” This paper describes a novel
method to produce expansion of the dental arches,
and, at the same time, to treat muscular dysfunctions
that may be the etiological factor of the malocclusion. The system has been developed by Myofunctional Research Co. (MRC), Queensland, Australia,
as a simpler method of phase one expansion, which
may produce improved stability because of simultaneous habit correction in selected cases. Two cases
treated with the Farrell Bent Wire System™ (BWS™)
are described, and the advantage of this method of
treatment is discussed.
_Introduction
Expansion of the jaws has been increasingly
performed in orthodontics to achieve better occlusal and maxillary relationship and, in doing so,
improving oral functions. Maxillary and mandibular
expansion has been proposed since Edward Angle to
12 I ortho
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avoid extractions (Dewel, 1964). This paper presents a
novel method to produce dental arch development in
the maxilla and the mandible, while at the same time
correcting or maintaining the inter-maxillary relationship either if a sagittal and/or vertical problem
exists or a Class I malocclusion with normal overjet
and overbite is present at the beginning of treatment.
There is a controversy regarding the ideal time
for performing the expansion. Sari and co-workers
reported that rapid maxillary expansion by means
of a fixed screw (eg. Hyrax) produces better results
when it is performed in the early permanent dentition
(Sari, 2003).
Although this statement appears to be supported
by other studies (Chung; Housley, 2003; Spillane,
1995), maxillary expansion may also be successfully
done in older adolescents and adults (Stuart, 2003;
Iseri, 2004; Lima, 2000). In the maxilla, rapid and
semi-rapid expansion produce an increase of the
lower nasal and maxillary base widths, with the maxilla moving forward and downward (Chung, 2004;
Sari, 2003; Iseri, 2004).
These changes in the maxilla produced by the
expansion are accompanied by a spontaneous mandibular response, which increases the dental arch
perimeter (Lima, 2004; McNamara, 2003) and rotates
the mandible posteriorly (Sari, 2003; Chung, 2004).
[13] =>
C.E. article_ Bent Wire System
I
Fig. 2
Fig. 1
Fig. 3
Mandibular displacement is associated with an
increase in facial height (Sari, 2003, Chung, 2004).
Net gain in the arch perimeter may be calculated
accordingly with the expansion performed. Motoyoshi and co-workers reported that 1 mm increase in
arch width results in an increase in arch perimeter of
0.37 mm (Motoyoshi, 2002). Akkaya and collaborators determined that arch perimeter gain through
expansion could be predicted as 0.65 times the
amount of the posterior expansion when treatment
is performed with rapid maxillary expansion and 0.60
times the amount of posterior expansion when treatment is performed with semi-rapid maxillary expansion (Akkaya, 1998). This is also supported by Adkins
and co-workers, who determined that arch perimeter
may increase 0.7 times the expansion produced at
the premolars.
Some authors (Hime, 1990; Housley, 2003) have
reported an expected relapse in the amount of expansion, which appears to be the result of that pressure
delivered by the cheeks on the maxillary arch and the
resistance to deformation of maxillary sutures and
surrounding tissues to maxillary expansion.
Nevertheless, maxillary and mandibular expansion rises up as one of the important phases of
orthodontic treatment, producing arch perimeter
increase and avoiding extraction of teeth. Increasing
numbers of multi-banded techniques using passive
self-ligating brackets have become popular, but few
address the challenges of adapting the soft tissues to
this new dental position. Long-term retention is the
recommended solution to stability.
The aim of the current paper is to present a new
method to produce maxillary and mandibular expansion and, at the same time, to treat the soft-tissue
dysfunction that may be responsible for treatment
relapse (Ramirez-Yañez, 2005).
Two example cases treated with the BWS Orthodontic System developed by Myofunctional Research
Co. (MRC) in Australia are presented to explain the
proposed treatment.
Photos/Provided by Drs. German O.
Ramirez-Yañez and Chris Farrell.
_The BWS Orthodontic System
The BWS Orthodontic System discussed in this
article is composed of two different appliances:
the Trainer™ and the BWS. These two appliances
combined may simultaneously produce arch development and treat poor myofunctional habits. The
Trainer, a pre-fabricated functional appliance, has
amply demonstrated an ability to relocate the mandible (Usumez, 2004) to correct improper forces pro-
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[14] =>
I C.E. article_ Bent Wire System
Fig. 4b
Fig. 4a
Fig. 5
duced by the muscles of the cheek and lips (Quatrelli,
Ramirez-Yañez, 2005a) and to change the dimensions of the dental arches (Ramirez-Yañez, 2005b).
Further research (Yagci 2011) shows that treatment
using the Trainer produced a positive influence on the
masticatory and peri-oral musculature.
However, in those cases where more maxillary
and mandibular expansion is required to avoid
teeth extractions, the Trainer combined with the
BWS produces higher amounts of expansion and,
therefore, a higher increase in arch perimeter. It
is also proposed that by utilizing the Trainer in
conjunction with the arch expansion, the force of
the tongue activates further alveolar changes that
other techniques may not achieve because of the
bulk of the appliance being located in the palate
14 I ortho
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where the tongue should naturally position.
The BWS is typically composed of a lingual arch,
which follows the lingual surfaces of the teeth
crowns at the gingival third and ends in a loop at the
inter-proximal space between the second premolar
and the first molar at both sides. The distal end engages a tube (0.7 Farrell tube by MRC) welded to a cemented band on the first molars (Fig. 1). Additionally,
the BWS is maintained in place, facing the gingival
third of teeth’s crown, by two begg premolar brackets cemented on the first premolars with the slot
directed toward gingival or by alternately composite
stops bonded to the premolar or anterior dentition
(Fig. 2). The wire component is 0.7 mm spring wire
and is fabricated to the arch form of the starting
models either by the laboratory or the orthodontist.
[15] =>
C.E. article_ Bent Wire System
The simple nature of the BWS makes it possible to assemble in-house, avoiding the fees that accompany
laboratory-constructed appliances.
An advantage of this system is that it does not
involve using acrylic in the palatal vault. A functional
appliance designed with acrylic on the palate and
that is not properly built may lower the tongue,
encouraging tongue thrusting and, thus, either
worsening the malocclusion or producing a relapse
(Fig. 3). The Trainer is a prefabricated functional appliance, which means no laboratory involvement,
and the BWS can be entirely constructed “in office”.
The BWS is not made of acrylic, nor does it occupy the
palate. It allows the tongue to position correctly and
the patient to speak normally.
The BWS is also suitable for use in the lower arch.
Typical treatment tends to use only upper expansion
for three to four months, after which time the wire
component of the BWS is removed (the bands are
kept for later use of the BWS). The i-2 Trainer (with
the inner-cage that produces arch expansion) is then
used to maintain the initial arch expansion gained
using the BWS. Lower alignment is re-evaluated
throughout this stage of i-2 Trainer use. Often, as can
be demonstrated in the cases selected, lower align-
I
Fig. 6a
Fig. 6b
Fig. 6c
Fig. 6d
ment and arch form improves because of the maxillary expansion and peri-oral musculature functional
improvement (Figs. 4a, 4b).
The BWS is held in place using standard ligatures
placed around the BWS tube as pictured (Fig. 5).
The following two cases show the effect of the
BWS Orthodontic System on arch development.
_Case No. 1
This 10-year-old female patient consulted because of a crowded dentition involving unusually
misaligned upper central incisors with a midline shift
of 10 mm and with lost “c” space on the lower left
side. The parents requested that the treatment be
non-extraction, although they had previously been
advised that future orthodontic treatment might
require this option (Figs. 6a–6d). The occlusion was
classified as Class I with normal slight overjet and
with normal overbite. No skeletal alteration was
found on cephalometric measurements, and analysis
of cast models reported a lack of arch development.
This case was diagnosed as a Class I malocclusion
with underdevelopment of both dental arches. Midline shift was primarily as a result of the lost lower “c”
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[16] =>
I C.E. article_ Bent Wire System
Fig. 7a
Fig. 7b
Fig. 7c
Fig. 7d
space. Soft-tissue analysis showed a mouth-open
posture and hyperactive peri-oral musculature. It
was considered the myofunctional habits were a
contributing factor to the malocclusion and, thus, a
suitable case for the BWS and Trainer combination
prior to fixed appliances once the permanent dentition was fully erupted.
The plan of treatment involved a first phase with
a BWS for the upper arch combined with an I-2n
Trainer — “n” for no core or cage for increased flexibility and use with the BWS. The i-2n Trainer was
used one hour daily plus overnight while sleeping.
Monthly adjustment to the activating loops of the
BWS were made in increments of 1-2 mm per month.
This treatment was continued for four months,
after which time the upper BWS was removed and i-2
Trainer was used to maintain the expansion achieved
by the BWS.
The i-2 Trainer also encouraged the tongue to assist in maintaining the maxillary expansion without
retainers. At this stage, the lower arch form and
dental alignment was assessed and showed considerable improvement. It was noted the space for
the lower left permanent canine had increased — an
effect thought to be produced by the combination of
maxillary arch expansion and correction of myofunctional habits. The midlines were also self-correcting.
16 I ortho
2_ 2012
Space for the lower canines was ultimately achieved
without a lower BWS. The case is further improved by
continued use of the i-2 Trainer and the Myobrace
Regular™ to exploit the eruption stage prior to treatment finalization with fixed appliances as required.
The observation of the effects and benefits of
the BWS Orthodontic System are evident from this
case, and the concepts are not new to orthodontics.
Maxillary expansion tends to also improve the lower
arch length and assists the orthodontist in achieving
non-extraction outcomes with more stable results
because of simultaneous correction of tongue position and retraining of the peri-oral musculature. The
second phase of treatment did not require the BWS
on the lower arch because arch development during
the treatment period sufficiently opened the space
for the lower permanent canine. The lower anterior
dentition did not require the use of fixed appliances
(Fig. 7a–7d). Thus, this case was treated during a
2-year period, required minimal chair side time, and
a difficult extraction case was converted to a simple,
non-extraction case.
_Case No. 2
This 12-year-old female patient consulted because of very underdeveloped maxillary arch form
[17] =>
C.E. article_ Bent Wire System
and ectopic erupting canines (Fig. 8a–8d). This is far
from an ideal stage to be considering non-extraction
treatment; however, the parent insisted that the
case was attempted non-extraction. The lower anterior teeth were also considerably crowded, and it
would regularly be justified in extracting the first
four premolar teeth and going into upper and lower
straight wire fixed appliances.
It could be argued that treating non-extraction
will prolong the treatment and certainly incur greater
expense on the parent. However, there is a growing
demand from parents who have had extraction orthodontics in the past to avoid this approach for their
children. Therefore, the BWS Orthodontic System can
be a beneficial technique that the orthodontist can
use in these exceptional cases.
Treatment was similar to case 1. An upper BWS
was fitted and combined with the use of the i-2n
Trainer initially for four months, after which time
the BWS wire was removed, leaving the molar bands
in place. The i-2 Trainer was introduced at this stage
for a further three months to maintain the expansion prior to a second phase of treatment using the
BWS and i2n Trainer for three months (as mentioned
earlier in this article).
This allows the dentition to “catch up” and prevents excessive tooth mobility. It is thought that
I
Fig. 8a
Fig. 8b
Fig. 8c
Fig. 8d
much of the expansion achieved by this system is
dento-alveolar rather than sutural, as with a rapid
maxillary expander and other acrylic expanders. Also,
there is more development in the anterior arch form,
which is an effect previously found in the research on
the Trainer (Ramirez-Yañez, 2005b).
The difficulty in cases like this, requiring large
amounts of expansion to achieve a non-extraction
result, is a tendency to create an open bite. Although
this occurs to some extent, the BWS Orthodontic
System does not open the bite as much as more conventional techniques because the tongue position is
favorably altered by use of the Trainer. This conjecture
may require further investigation to ratify.
Once again, spontaneous alignment of the lower
anterior dentition has occurred without the requirement for an additional BWS for the lower arch. This
effect is not just restricted to these two cases but is a
routine observation of the BWS Orthodontic System.
This case also illustrates the stability achieved in the
lower dentition as no retainers were used apart from
night use of the Trainer. Although this patient is not
at the ideal age, the pictures show that it was possible
to obtain space for all permanent canines, without
extractions and with good stability.
The bite opening is minimal and tends to decrease
with further dental development. Although this case
ortho
I 17
3
_ 2012
[18] =>
I C.E. article_ Bent Wire System
Fig. 9a
Fig. 9b
Fig. 9c
Fig. 9d
was finalized with the Myobrace Regular™ from
MRC, fixed appliances on the upper arch would possibly have delivered quicker results following the BWS
Orthodontic System. The assistance of correcting the
forces delivered by the muscles of the cheek (buccinator) and lips (orbicularis oris) at swallowing cannot
be ignored and is a key part of the modus operandi of
this expansion system.
After two years of treatment and observation,
along with night-time retention using the i-2 Trainer
for 12 months after treatment, the BWS produced
enough upper arch development to not only accommodate the erupting canines but also achieve lower
anterior alignment with minimal intervention and
minimal retention (Fig. 9a–9d). This case was a more
extreme example that orthodontists will face in the
future as more parents demand the non-extraction
option with minimal use of multi-bracket systems.
_Conclusions
Maxillary and mandibular expansion has been
shown to be an excellent alternative to increase
the arch perimeter and, thus, to avoid the need for
extractions to properly align teeth. This paper has
18 I ortho
2_ 2012
‘Maxillary and mandibular
expansion has been shown to
be an excellent alternative to
increase the arch perimeter.’
presented two cases treated using the BWS Orthodontic System, which involves the combination of
two appliance systems: the Trainer, a pre-fabricated
functional appliance, and the BWS.
Both appliances, Trainer and BWS, have to be used
in order to get the results reported in this paper. The
BWS Orthodontic System, as shown in these two
cases and in many cases treated by the authors, is
an excellent means to produce arch development in
both upper and lower dental arches in a short time.
The effect of the BWS Orthodontic System on arch
development does not change the inter-maxillary
relationship when a Class I occlusion exists at the
beginning of treatment.
However, when a Class II malocclusion associated
to a crowded dentition is present, the BWS Ortho-
[19] =>
C.E. article_ Bent Wire System
dontic System produces arch development, and at
the same time, the mandibular relocation effect is
produced by the Trainer (Usumez, 2004; RamirezYañez, 2005a; Quadrelli, 2002), which treats the
distal position of the mandible. Additionally, the BWS
Orthodontic System is shown to not only improve
the overjet and overbite but to maintain them when
they are correct at the beginning of treatment. This
system treats muscular dysfunctions, which may be
the cause of crowding and malocclusion and may
cause relapse after treatment is finished.
Thus, the BWS Orthodontic System may be proposed as an excellent alternative form of treatment
in those cases where arch development is required
to align teeth, patients want to minimize or even
avoid brackets and extractions, the mandible needs
to be relocated, soft-tissue dysfunction is present
and treatment needs to be performed in a reasonable period of time._
_References
1)
Adkins MD, Nanda RS, Currier GF. Arch Perimeter changes
on rapid palatal expansion. Am J Orthod Dentofacial Orthop
1990; 97:194–199.
2) Akkaya S, Lorenzon S, Ucem TT. Comparison of dental arch
perimeter changes between bonded rapid and slow maxillary
expansion procedures. Eur J Orthod 1998; 20:255–261.
3) Chung CH, Font B. Skeletal and dental changes in the
sagittal, vertical and transverse dimensions after rapid
palatal expansion. Am J Orthod Dentofacial Orthop 2004;
126:569–575.
4) Dewel BF. Serial extraction: its limitations and contraindications
in orthodontic treatment. Am J Orthod 1967; 53:904–921.
5) Hime DL, Owen AH 3rd. The stability of the arch expansion
effects on Frankel appliance therapy. Am J Orthod Dentofacial
Orthop 1990; 98:437–445.
6) Housley JA, Nanda RS, Curier GF, McCune DE. Stability of
transverse expansion in the mandibular arch. Am J Orthod
Dentofacial Orthop 2003; 124:288–293.
7) Iseri H, Ozzoy S. Semirapid maxillary expansion – a study of
long term transverse effects in older adolescents and adults.
Angle Orthod 2004; 74:71–78.
8) Lima RM, Lima AL. Case report: Long-term outcome of Class
II, division 1 malocclusion treated with rapid palatal expansion
and cervical traction. Angle Orthod 2000; 70:89–94.
9) Lima AC, Lima AL, Filho RM, Oyen OJ. Spontaneous
mandibular arch response after rapad palatal expansion:
a long term study on Class I malocclusión. Am J Orthod
Dentofacial Orthop 2004; 126:576–582.
10) McNamara JA Jr, Baccetti T, Franchi L, Herberger TA. Rapid
maxillary expansion followed by fixed appliances: a long-term
evaluation of changes in arch dimensions. Angle Orthod 2003;
73:344–353.
11) Motoyoshi M, Hirabayashi M, Shimazaki T, Nawra S. An
experimental study on mandibular expansion: increases in
arch width and perimeter. Eur J Orthod 2002; 24:125–130.
I
12) Quadrelli C, Gheorgiu M, Marcheti C, Ghiglione V. Early
Myofunctional approach to skeletal Class II. Mondo Orthod
2002; 2:109–122.
13) Ramírez-Yáñez GO, Farrell C. Soft tissue dysfunction: A
missing clue when treating malocclusions. Int J Jaw Func
Orthop 2005; 5.
14) Ramírez-Yáñez GO, Junior E, Sidlauskas A, Flutter J, Farrell
C. The effect of a pre-fabricated functional appliance on arch
development. 2005 (in preparation).
15) Sari Z, Uysal T, Usumez S, Basciftci FA. Rapid maxillary
expansion. Is it better in the mixed or in the permanent
dentition? Angle Orthod 2003; 73:654–661.
16) Spillane LM, McNamara JA Jr. Maxillary adaptation to
expansion in the mixed dentition. Semin Orthod 1995;
1:176–187.
17) Stuart DA, Wilkshire WA. Rapid palatal expansion in the young
adult: Time for a paradigm shift? J Can Dent Assoc 2003;
69:374–377.
18) Usumez S, Uysal T, Sari Z, Basciftci FA, Karaman AI, Guray E.
The effects of early preorthodontic Trainer treatment on Class
II, division 1 patients. Angle Orthod 2004; 74:605–609.
19. Yagci A, Uysal T, Kara S and Okkesim S. The effects of
myofunctional appliance treatment on the perioral and
masticatory muscles in class I, division 1 patients. World
Journal of Orthodontics 2010; 11:117–122.
ortho
_about the authors
Chris Farrell, BDS, graduated
from Sydney University in 1971 with
a comprehensive knowledge of traditional orthodontics using the BEGG
technique. Through clinical experience, he took an interest in TMJ/TMD
disorder and, after further research,
Farrell discovered that the etiology of
malocclusion and TMJ disorder was
myofunctional, contradicting the current views of his profession. Farrell
founded Myofunctional Research Co.
(MRC) in 1989 and has become the
leading designer of intra-oral appliances for orthodontics, TMJ and sports
mouthguards.
German O. Ramirez-Yañez,
DDS, PhD, is a dentist from Colombia
(South America) with more than 20
years of experience in guiding craniofacial growth and development. He is a
specialist in pediatric dentistry (Mexico)
and functional maxillofacial orthopedics (Mexico and Brazil) and is trained
in orthodontics (Mexico). Ramirez has
a master’s in oral biology and a PhD
in dental sciences (Australia). He has
published more than 20 articles about
early orthodontic treatment and about
craniofacial biology in peer- reviewed
international journals.
ortho
I 19
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_ 2012
[20] =>
I events_ MASO
MASO can help you
‘Chart a Course’
at its annual meeting
Author_Sierra Rendon, Managing Editor
The HIlton Baltimore on Baltimore’s
inner harbor will be the site of
the Middle Atlantic Society of
Orthodontists annual session from
Sept. 20–23.
(Photo/Provided by MASO)
20 I ortho
2_ 2012
_The Middle Atlantic Society of Orthodontists
(MASO) will host its annual session from Sept. 20–23
at the Hilton Baltimore on Baltimore’s inner harbor.
During this time, you and your colleagues will be
“Charting a Course for the Future.”
Annual session speakers include: Drs. David Sarver,
Roger Levin, Neal Kravitz, Jeffrey Posnick, Normand
Boucher, Jeff Behan and Chris Bentson. MASO’s staff
program will include Char Eash and Tina Byrne.
At this annual session, MASO will present its Lifetime Achievement Award to Dr. David Paolini. Paolini
graduated from La Salle College in Philadelphia and
the University of Pittsburgh School of Dental Medicine in 1964. He received a three-year fellowship in
orthodontics at the start of his sophomore year in
dental school, which started him on the career path
of this specialty. After completing dental school,
Paolini married his wife, Caroline, and began his orthodontic training at Pitt. He received his certificate
in orthodontics and his master’s in dentistry, and
then entered military service, spending two years at
Fort Benning, Ga.
In 1972, he established his first office in Gettysburg, Pa., and opened a satellite office in Waynesboro
a year later. He retired in 2010. During his 38 years of
practice, Paolini has served as president of both the
Pennsylvania State and Middle Atlantic Society of Orthodontists. During his service on, and chairmanship
of, the AAO’s Council on Insurance, he achieved the
highlight of his AAO career when he was instrumental
in establishing the current malpractice program. He
served on the council for an additional five years. He
has served two eight-year terms in the AAO House of
Delegates and eight years on the Council on Orthodontic Practice.
_Session schedule
Thursday, Sept. 20
• 7–11 a.m.: MASO Board Meeting (invitation
only)
• 1–5:30 p.m.: Golf outing at the Country Club of
Maryland
• 1–6 p.m.: Registration/exhibitor set-up
Friday, Sept. 21
• 7:30–8:30 a.m.: Continental breakfast in exhibit
hall (complimentary)
• 7:30 a.m.–4 p.m.: Registration/exhibit hall open
• 7:30 a.m.–4 p.m.: ABO case displays
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[22] =>
I events_ MASO
• 8–9:30 a.m.: Staff session, Dr. Neal Kravitz, “Developing the ‘Dream Team’: 10 Characteristics of an
Elite and Irreplaceable Orthodontic Team Member”
• 8:30–10 a.m.: Doctor session, Dr. Roger Levin,
“Create the Ideal Ortho Practice, Part One” (cosponsored by Levin Group)
• 9:30–10:30 a.m.: Beverage break in exhibit hall
(complimentary)
• 10 a.m.–noon: Staff session, Tina Byrne, “Navigating as Part of the Ortho Crew: Winning May Be
As Simple As Adjusting Your Sails, Part One” (cosponsored by Byrne Consulting Group)
• 10:30 a.m.–noon: Doctor session, Dr. Roger
Levin, “Create the Ideal Ortho Practice, Part Two” (cosponsored by Levin Group)
• Noon–1:30 p.m.: Box lunch in exhibit hall (complimentary)
• Noon–1 p.m: MASO delegates meeting with
MASO Board (invitation only)
• 12:15–1:30 p.m.: ABO certification information
meeting
• 1–2 p.m.: Doctor session, Dr. Neal Kravitz, “Creating an Elite Orthodontics Office: A comprehensive review on how to increase case-starts, brand your office
and develop a reputation within your community”
• 1:30–3 p.m.: Staff session, Tina Byrne, “Navigating as Part of the Ortho Crew: Winning May
Be As Simple As Adjusting Your Sails, Part Two”
(co-sponsored by Byrne Consulting Group)
• 2–3 p.m.: Doctor session, Dr. Normand Boucher,
“Diagnosis and Management of Joint Related Malocclusion”
• 3–4 p.m.: Beverage break in exhibit hall (complimentary)
• 4–5 p.m.: MASO member/business meeting (all
members welcome)
• 6–7 p.m.: Welcome reception in exhibit hall
(complimentary; co-sponsored by Maryland State
Society of Orthodontists)
Saturday, Sept. 22
• 6:30–7:30 a.m.: Fun run and historical walking
tour of Baltimore Harbor
• 7:30–8:30 a.m.: Continental breakfast in exhibit hall (complimentary; sponsored by Invisalign/
OrthoCAD)
• 7:30 a.m.–4 p.m.: Registration/exhibit hall open
• 7:30 a.m.– 4 p.m.: ABO case displays
• 8–9:30 a.m.: Staff session, Char Eash, “Taking Back the Specialty — Game On! Part One” (cosponsored by Profit Marketing Systems)
• 8:15–8:30 a.m: AAOF presentation
• 8:30–10 a.m.: Doctor session, Dr. David Sarver,
“Goal-Oriented Treatment Planning and Technological Advancements, Part One”
• 9:30–10:30 a.m.: Beverage break in exhibit hall
(complimentary)
22 I ortho
2_ 2012
• 10 a.m.–noon: Staff session, Char Eash, “Taking Back the Specialty — Game On! Part Two” (cosponsored by Profit Marketing Systems)
• 10:30 a.m.–noon: Doctor session, Dr. David
Sarver, “Goal-Oriented Treatment Planning and
Technological Advancements, Part Two”
• Noon–1:30 p.m.: Box lunch in exhibit hall (complimentary)
• Noon–1:30 p.m.: Component roundtable discussions
• Noon–1:30 p.m.: Educators luncheon (invitation only)
• 1:30–3 p.m.: Staff session, Char Eash, “Marketing — No Gimmicks, Just a Lesson in Building the
Network from Within, Part One” (co-sponsored by
Profit Marketing Systems)
• 1:30–3 p.m.: Doctor session, Dr. David Sarver,
“Goal-Oriented Treatment Planning and Technological Advancements, Part Three”
• 3–3:30 p.m.: Beverage break in exhibit hall
(complimentary)
• 3:30–4:30 p.m.: Staff session, Char Eash, “Marketing — No Gimmicks, Just a Lesson in Building the
Network from Within, Part Two” (co-sponsored by
Profit Marketing Systems)
• 3:30 p.m.–4:30 p.m.: Doctor session, Dr. Jeffrey
Posnick, “Contemporary Management of Chronic
Upper Airway Obstruction in a Dentofacial Deformity”
• 4:30–5:30 p.m.: Resident session (mandatory to
receive grant), Chris Bentson, “The Process of Locating a Practice to Build, Join, Partner or Purchase” (cosponsored by Bentson, Clark & Copple, LLC)
• 4:30–5:30 p.m.: Component business meetings/
Delaware, District of Columbia, Maryland
• 6–10 p.m.: President’s party — Geppi’s Museum
of Pop Culture (Sponsored by 3M Unitek)
Sunday, Sept. 23
• 7–8 a.m.: MASO board meeting (invitation only)
• 7:30–8:30 a.m.: Continental breakfast in exhibit
hall (complimentary)
• 7:30 a.m.–noon: Registration/exhibit hall open
• 7:30 a.m.–noon: ABO case displays
• 8:30–9:45 a.m.: Doctor session, Chris Bentson, “Benchmarking the Orthodontic Practice” (cosponsored by Bentson, Clark & Copple)
• 9:45–10:30 a.m.: Beverage break in exhibit hall
(complimentary)
• 10:30 a.m.–12:30 p.m.: Doctor/staff session, Jeff
Behan, “Using the Power of Story to Grow Your Members” (co-sponsored by VisualTrust Communications)
_Information/registration
Go to www.MASO.org to register or to seek out
additional information._
[23] =>
[24] =>
I events_ OrthoVOICE
The OrthoVOICE 2012
will take place Oct.
11-13 at Paris & Bally’s
Resort in Las Vegas.
OrthoVOICE 2012
on slate for October
_Enhanced social events and a focus on
presenting clinical and entrepreneurial ideas in a
fresh environment have attendees and the event
organizers preparing for another dynamic “social
meeting” experience with the OrthoVOICE 2012,
which takes place Oct. 11–13 at Paris & Bally’s
Resort in Las Vegas.
Leading off with an entertaining and educational talk with Dr. Lysle Johnston, OrthoVOICE
attendees are in for a wild ride of mind-stretching
ideas for practice growth, according to organizers.
With a unique take on building the speaker
lineup and creative social events, OrthoVOICE is set
to be orthodontics’ most innovative and socially
interactive meeting of the year, its organizers say.
“For OrthoVOICE, it’s about education, fun and
24 I ortho
2_ 2012
giving back,” according to the event organizers.
Plan to attend the meeting’s second charity golf
event on Thursday morning, Oct. 11. This year’s
event will be held at Desert Pines Golf Club to benefit Smile for a Lifetime Foundation (S4L).
The $229 registration is open online at www.
orthovoice.com and includes a donation to S4L,
breakfast and lunch, round-trip transportation,
green fees, carts and range balls.
To learn more about the full range of events
and lectures at OrthoVOICE 2012, visit www.
orthovoice.com.
Twelve C.E. credits are offered and doctor/team
registration is only $399 per person, through Sept.
30. Registration is open now at www.orthovoice.
com._
[25] =>
education_ NYUCD
I
Dr. Cristina Teixeira named
chair of the department of
orthodontics at NYUCD
_Dr. Cristina Teixeira, associate professor of
orthodontics and of basic science and craniofacial
biology, has been appointed chair of the department
of orthodontics at New York University College of
Dentistry (NYUCD), effective immediately. Teixeira
had been serving as the interim chair of the department of orthodontics since September 2011.
The announcement was made by Dr. Charles N.
Bertolami, Herman Robert Fox Dean and Dr. Richard
I. Vogel, executive vice dean of New York University
College of Dentistry.
“As interim chair, Dr. Teixeira has demonstrated
leadership in research, teaching and patient care,”
Bertolami said. “Her accomplishments include formulating a comprehensive new curriculum for the
advanced education program in orthodontics and
co-founding CTOR, the Consortium for Translational
Orthodontic Research, at New York University. CTOR
has facilitated research, development and clinical
testing of new orthodontic treatments and technologies.”
“Dr. Teixeira’s appointment as chair offers profound academic recognition of a world-renowned
scholar and researcher and experienced clinician
who undoubtedly will lead the department of orthodontics into new areas of clinical, educational and
research excellence,” said Dr. Elliott M. Moskowitz,
clinical professor of orthodontics at NYUCD and
former editor of The New York State Dental Journal.
Teixeira joined NYUCD in 2001 and has won NIH
funding and other national and international recognition for research in bone and cartilage biology.
In the past few years, she has received the Outstanding Research Award from the University of
Pennsylvania, the Young Investigator Award at the
First International Conference on the Growth Plate,
the B. F. Dewell Memorial Research Award from the
American Association of Orthodontics Foundation
and the Young Investigator Award at Conferences
in Orthodontic Advances in Science and Technology.
Teixeira has published extensively in peerreviewed journals, served as
a mentor to numerous postgraduate and predoctoral
students and presented her
work at national and international conferences. As a
founding member of CTOR,
the first consortium of its
kind dedicated to translational research in the field
of orthodontics, her efforts
have produced two patents.
Among other accomplishments of the department of orthodontics
during Teixeira’s tenure
as interim chair was the
formulation of a comprehensive curriculum for the
new three-year advanced
education program in orthodontics and the introduction of new patient care
initiatives.
Teixeira is a graduate of the University of Pennsylvania, where she obtained a DMD degree, a certificate
in orthodontics, a master’s in oral biology and a PhD
in developmental biology.
Dr. Cristina Teixeira
(Photo/Provided by NYUCD)
_About New York University College of
Dentistry
Founded in 1865, New York University College of
Dentistry is the third oldest and the largest dental
school in the US, educating more than 8 percent of
all dentists. NYUCD has a significant global reach
and provides a level of national and international
diversity among its students that is unmatched by
any other dental school, according to the university._
ortho
I 25
3
_ 2012
[26] =>
I research_ bib clip contamination
Study: 20-30 percent
of bib clips harbor bacteria
even after disinfection
Photo/Provided by DUX Dental
26 I ortho
2_ 2012
_Researchers at Tufts University School of
Dental Medicine, in collaboration with researchers
at the Forsyth Institute, published a study recently
that found 20 to 30 percent of dental bib clips still
harbor bacterial contaminants even after proper
disinfection procedures.
Rubber-faced metal bib clips were found to retain more bacteria than bib clips made only of metal
before disinfection. The study also found that before
disinfection, bib clips used during orthodontic procedures had three times the bacterial load of those
used during endodontic procedures, suggesting
that the nature of dental treatment impacts the
number of bacteria present on the clips. The full
study, “Do Bib Clips Pose a Cross-Contamination
Risk at the Dental Clinic?” is now available for download at www.duxdental.com/bibclipstudy.
The study is believed to be the first peer-reviewed
study to be published on bib clip contamination.
Four other research reports have found bacterial
contamination on dental bib holders, including research conducted by U.S. infection control specialist
Dr. John Molinari, the University of North Carolina
at Chapel Hill’s School of Dentistry Oral Microbiology lab and the University of Witten/Herdecke in
Germany.
“Our study included statistical analysis and, to
the best of our knowledge, is the most comprehensive study to date analyzing the bacterial load
on dental bib clips before and after disinfection in
two specialized clinics,” said Addy Alt-Holland, MSc,
PhD, assistant professor at Tufts University School
of Dental Medicine and the lead researcher on the
study.
“The study found that disinfecting reduced
bacterial contamination by 92 percent, but some
bacteria remained on several bib clips even after
disinfection,” she said. “Further research is under
way to identify the bacterial species in samples
from both pre- and post-disinfected bib clips to determine whether or not they retain disease-causing
bacteria and if they pose contamination risks.”
The study analyzed bacterial loads on bib clips
from a total of 80 dental bib holders — 40 collected
from Tufts University School of Dental Medicine’s
endodontics clinic and another 40 collected from
the school’s orthodontics clinic.
From each chain, both clips that hold the dental
bib were sampled before and after practitioners
disinfected the bib holder following the school’s
disinfection protocol, which requires the holder to
be wiped down with an EPA-approved disinfectant
wipe, according to the manufacturer’s instruction.
Disinfection was found to reduce bacteria on the
[27] =>
[28] =>
I research_ bib clip contamination
‘... 20 percent of those collected from the
orthodontics clinic were still contaminated
with bacteria after disinfection.’
bib clips but did not completely eliminate it, leaving
20 to 30 percent of the bib clips contaminated with
bacteria.
Thirty percent of the metal bib clips collected
from the endodontics clinic and 25 percent of those
collected from the orthodontics clinic were still
contaminated with bacteria after disinfection.
Twenty-five percent of the rubber-faced metal
bib clips collected from the endodontics clinic and
20 percent of those collected from the orthodontics
clinic were still contaminated with bacteria after
disinfection.
“The findings of the study translate into private
practice,” said Gerard Kugel, DMD, MS, PhD, professor at Tufts University School of Dental Medicine and
senior author on the paper. “In a busy practice, you
are doing a lot of different procedures and bringing
patients in and out quickly. It is time-consuming to
properly clean bib clips by autoclave, and spray is not
an effective way to disinfect bib clips.
“If you are using bib holders, make sure the chains
and clips are being disinfected after every patient,
or consider moving to using disposable bib holders,”
said Kugel, associate dean for research at Tufts.
_Nature of dental treatment and style of
clips impact level of bacteria on bib clips
When the bib clips were sampled before disinfection, the study found a significant difference
in the presence of bacteria on the clips depending
on which clinics the clips were sampled from and
the style of the bib clip. Before disinfection, metal
and rubber-faced metal bib clips collected from the
orthodontics clinic had 149 percent to 205 percent
more bacteria, respectively, than clips collected
from the endodontics clinic.
The authors speculate that the use of rubber
dams during endodontic treatment may limit the
contamination of bib clips while orthodontic treatment may result in higher bacterial presence on
clips because it involves entering and re-entering
the mouth multiple times which could lead to more
bacterial contamination from the practitioner’s
gloves; or adolescent and teenage patients, common to orthodontics, may be more prone to touch
28 I ortho
2_ 2012
and handle the bib clip during treatment. After
disinfection, the bacterial counts on clips from both
clinics were similarly reduced.
Before disinfection, rubber-faced metal bib clips
were found to have more than double the number of
bacteria on average than metal clips had.
“The surface of rubber and metal is different
in composition and may explain the difference in
bacterial loads on them,” Alt-Holland said. Rubberfaced metal bib clips collected from the endodontics
clinic had 119 percent higher bacterial count than
metal bib clips and 167 percent higher bacterial
count on those from the orthodontics clinic before
disinfection. After disinfection, the bacterial counts
on both styles of clips were found to be similar.
_Continuation study under way to
identify bacteria strains
A continuation study is already under way by
researchers at Tufts University School of Dental
Medicine and the Forsyth Institute to identify the
type of bacteria present on dental bib clips before
and after disinfection to help determine if there are
cross-contamination risks to patients.
Visit www.duxdental.com/bibclipstudy to
download a full transcript of the research paper,
“Do Bib Clips Pose a Cross-Contamination Risk at
the Dental Clinic?”
_About DUX Dental
DUX Dental has been manufacturing and distributing the highest level of dental products worldwide
for more than 50 years. Based in the coastal city of
Oxnard, Calif., with additional manufacturing and
distribution facilities in Europe, DUX Dental is home
to a world-class team of innovators who produce
and service a portfolio of hundreds of dental products and supplies. DUX Dental is well-known for its
series of industry firsts including Zone Temporary
Cement, Identic™ Alginate and Bib-ezedisposable
bib holders, as well as its award-winning PeelVue+
sterilization pouches. Visit www.duxdental.com or
contact duxoffice@duxdental.com for more information about DUX Dental products._
[29] =>
[30] =>
I charity_ ClearCorrect
ClearCorrect reaches new
milestone with charitable
clean water project
_ClearCorrect, a leading manufacturer of clear
aligners, recently reached a milestone in its charitable
project, Phase Out. Since the launch of its first initiative
with “charity: water” (phase out unsafe drinking water)
on Jan. 1, ClearCorrect has raised more than $60,000,
which will help about 3,000 people gain access to clean
and safe drinking water.
Of the $60,000 raised so far, $36,555 has been allocated to funding the first five projects with charity
water in the Democratic Republic of the Congo. The
funding will help create spring protections, rainwater
catchments and large-scale gravity-fed water systems
that will have dozens of distribution points to serve a
large population.
These projects are planned for a mix of villages,
schools and clinics with a strong focus on hygiene,
sanitation training and community buy-in to ensure
sustainability and prevention of water-borne diseases.
“It is hard to believe that there are still people out
there who don’t have safe drinking water. Phase Out
is an amazing effort and an amazing project, and I’m
proud to be a part of it,” said Dr. Annette Murphy, a
ClearCorrect provider.
When asked how long the company intends to
run the Phase Out project, Jarrett Pumphrey, Clear
Correct CEO, responded, “For as long as we can make
a difference.”
To see the video, please visit www.
clearcorrect.com/phaseout.
se out unsafe drinking water
Photo/Provided by ClearCorrect
‘It is hard to believe that there are still
people out there who don’t have safe
drinking water. Phase Out is an amazing
effort and an amazing project, and I’m
proud to be a part of it.’
30 I ortho
2_ 2012
About ClearCorrect
charity: water
ClearCorrect works with more than 11,000 clinicians, making it a leading manufacturer of clear aligners. The company offers an affordable and doctorfriendly approach, including a phase-based system to
enhance flexibility and control for clinicians. For more
information, visit www.clearcorrect.com or call (888)
331-3323._
[31] =>
[32] =>
I industry_ Ortho2
Edge management, imaging,
communication system from
Ortho2: It’s all you really need
Edge portal shown on an iPad.
(Photo/Provided
by Ortho2)
32 I ortho
2_ 2012
_Edge from Ortho2 delivers the ideal all-encompassing practice management, imaging and communication system with robust features, unmatched
capabilities and integrated programs — all supported
by the industry-leading Ortho2 customer service team,
the company said.
Ortho2 Edge provides secure cloud computing
technology, an offsite data hosting system that replaces your onsite network servers. This feature allows you to fully access your secure web-based data
infrastructure from anywhere, even tablets and smart
phones. Now used by more than 100 orthodontists,
Edge features innovative imaging, reminders, patient
education animations and more.
Edge Imaging is one of the most robust imaging
technologies available today, the company said. With
an intuitive interface, comprehensive features and
easy functionality, Edge Imaging can help efficiently
manage all of your patient image files.
It includes features such as card flow presentation,
drag-and-drop layout customization, unlimited undo
and redo, silhouette image alignment and much more.
Edge Imaging can be used with all Ortho2 management
systems, with other management systems or by itself.
Premier Imaging is an optional upgrade for Edge Imaging and includes comprehensive image morphing,
cephalometric analysis and Bolton Standards.
Edge Animations is a set of patient education
animations for improved compliance and case presentation. Edge includes a set of patient compliance animations at no charge and an optional extended set of
treatment-based animations. With Edge Animations,
you have the ability to easily edit and customize videos,
including surgical and 3-D animations, using annotation and audio controls. Virtually any image or movie
can be included with drag-and-drop capabilities. Give
patients, responsible parties and referrers access to
your videos with ease through disc, e-mail or YouTube.
Edge Animations is available for Edge, ViewPoint and
as a standalone product.
Edge Reminders is an easy-to-use, efficient system
for automating your patient reminders via phone, text
and/or e-mail. Phone messages are delivered with a human voice. Patient responses automatically appear as
icons in the scheduler. Edge Reminders is cost effective
with a low, flat fee and no minimum monthly charge.
Edge Reminders is available for Edge and ViewPoint
users. Edge Portal adds online account access to appropriate information for you, your patients, responsible
parties and consulting professionals from any computer, tablet or smartphone. You can view or schedule
appointments, view patient information or quickly and
easily access treatment chart data and much more, all
from Edge Portal. Optionally, accept credit card payments that are automatically posted for you.
The Edge system also includes comprehensive
features such as dynamic dashboard and widget library, smart scheduler, workflows, online forms, edge
reports, electronic insurance and much more. Edge is
compatible with PCs, Macs or a mixed environment and
can even support multiple monitors for a power user.
One Edge user, Dr. Andy Trosien (Tracy, Calif.), says:
“The Edge software system is a true revelation in orthodontic practice management software. The system
features all of the imaging and communication features, financial applications and practice tools that can
help any practice thrive. It’s simple to install and easy
for the staff to learn, and Ortho2’s customer support
is absolutely amazing. Switching to Edge was an easy
decision — it’s everything I need to take my practice to
the next level.”
_About Ortho2
For more than 30 years, Ortho2 has designed,
developed and provided all software and services
exclusively to the orthodontic market. Nearly 1,700
orthodontists have discovered Ortho2’s software,
effective conversion process, quality training, industry-leading support and optional equipment
services. Discover the Ortho2 difference for yourself.
Discover Edge. For more information, contact Ortho2
at (800) 678-4644, sales@ortho2.com, or www.
ortho2.com._
[33] =>
[34] =>
I industry_ Planmeca
Planmeca introduces a new
analysis tool for planning
orthodontic treatments
Planmeca introduces a new
cephalometric anaylsis module to its
Romexis software.
(Photo/Provided by Planmeca Oy)
34 I ortho
2_ 2012
_Planmeca Romexis® is a comprehensive software used by dental clinicians for acquiring, viewing
and processing 2-D and 3-D images. Planmeca now
introduces a new cephalometric analysis module to the
software in order to facilitate the daily work of orthodontists around the world. The new and easy-to-use
analysis tool brings valuable benefits to orthodontic
planning and treatment, the company said.
A cephalometric analysis is a study of the craniofacial relationships used particularly by orthodontists
for orthodontic growth analysis, diagnosis, planning,
follow-up and treatment outcome evaluation. The new
Planmeca Romexis Cephalometric Analysis module
provides flexible and easy-to-use features for creating
cephalometric analyses and composing superimpositions of 2-D cephalometric images, facial photos and
images of the dental arch.
The Planmeca Romexis Cephalometric module
renders routine analyses fast and easy. An analysis can
be performed in minutes, and the results are displayed
and shared effortlessly. During a treatment process,
superimposing patient images from different time
points can be used for follow-up purposes. The unique
concept also offers various possibilities for customizing the analysis and software properties in order
to meet the needs and requirements of each dental
professional.
The cephalometric analysis module is a seamless
part of the comprehensive Planmeca Romexis software. Images are captured in Planmeca Romexis, and
the cephalometric analysis can be started with just one
click. The mobile Planmeca iRomexis application and
Planmeca’s cloud service allow for sharing images and
viewing results anywhere.
”We believe that with the Planmeca Romexis
Cephalometric Analysis module, we can serve our orthodontics customers better than ever,” said Helianna
Puhlin-Nurminen, vice president of digital imaging
and applications division at Planmeca Oy. ”Using the
same system for capturing cephalometric images,
CBCT images, 3-D facial photos and now for creating
cephalometric analyses, the customers can work more
efficiently toward a better patient treatment.”
_About Planmeca Oy
Planmeca Oy, established in 1971, designs and
manufactures a full line of high-technology dental
equipment, including dental care units, panoramic
and intraoral X-ray units and digital imaging products.
Planmeca Oy, the parent company of the Finnish Planmeca Group, is strongly committed to research and
development. The company says it is the U.S. market
leader in dental imaging and one of the world’s leading
manufacturers in dental technology. Planmeca is the
largest privately owned company in the field and the
third largest dental equipment manufacturer in Europe. Ninety-eight percent of Planmeca’s production
is exported to more than 100 countries. The group’s
estimated turnover for 2012 is approximately EUR 750
million with more than 2,400 employees. Visit www.
planmeca.com._
[35] =>
[36] =>
I industry_ 3Shape
The age of digital
orthodontics is here
Photos/Provided by 3Shape
36 I ortho
2_ 2012
_After having radically transformed
dental restorations, the CAD/CAM revolution is finally reaching the orthodontic market.
3Shape, a world leader in digital dentistry,
is bringing its technology and development
power to the orthodontic market with a
digital-age solution for orthodontic labs and
clinics.
Ortho System™ brings together accurate
3-D scanning, archiving, intuitive treatment
planning and analysis, efficient patient management, communication tools and appliance
design — all providing streamlined workflows
that increase efficiency and productivity for
labs and practices, the company said.
The introduction of 3Shape’s TRIOS
intra-oral scanner marks a new era
for digital orthodontics. This groundbreaking technology offers a more productive,
accurate and comfortable way to capture the
patient’s impressions at the start of or during the
orthodontic treatment, while reducing chair time
compared to traditional impression taking.
Digital study models captured with the TRIOS,
or with 3Shape’s R700 desktop 3D scanner, become
ready for further processing and manufacturing in
3Shape’s Ortho System, thanks to tight scanner and
software integration. With OrthoAnalyzer, orthodontists can perform full treatment planning and
fully customized analysis protocols, using advanced
2-D and 3-D tools.
Simulation of extractions, interproximal reductions, full treatment planning with detailed movement overview and realistic virtual articulators are all
possible in a user-friendly environment, the company
said. Full analysis or validation protocols, such as PAR
or ABO, can also be implemented, allowing consistent and more efficient workflows. The unique insight
provided by 3-D study models make the assessment
of treatment results both easy and accurate.
Appliance Designer is the first complete digital
toolbox dedicated to all types of orthodontic ap-
pliances. A host of intuitive and accurate tools
enables users to create even the most demanding designs. Appliances such as nightguards, retainers, customized bands, splints, surgical bites,
palatal expanders, bionators, Twin blocks, Herbst
appliances, Planas tracks and much more can easily be created on screen and made ready for
computer-driven manufacturing.
Appliance Designer’s open STL format guarantees
complete freedom of choice in relation to materials
and 3-D-driven equipment, such as 3-D printers or
milling machines. 3Shape’s solutions also allow full
integration and file preparation for the equipment
chosen.
All tools and design parameters can be combined
in any way, and these can be stored as reusable and
unique workflows to ensure consistency and efficiency. A tight integration between the treatment
planning tools in OrthoAnalyzer and the use of realistic virtual articulators allows optimal CAD design and
maximum efficiency of the orthodontic treatment,
the company said.
3Shape Ortho System is the only fully integrated
CAD/CAM system dedicated to orthodontics, which
allows full freedom of choice in terms of equipment,
material and manufacturing partners —thanks to
its open format. It is easy and fast to transfer digital
files, and the communication tools offered by 3-D
study models enable tighter cooperation between
orthodontic professionals.
The applications of CAD/CAM in orthodontics
offer a host of new opportunities for more efficient
treatments and follow-up. The technology also
enables improved communication between orthodontists, technicians and patients, higher accuracy
and repeatability, better control of costs and material consumption, and increased patient comfort.
Through improved consistency and efficiency in
manufacturing, CAD/CAM technologies allow the
orthodontic professional to concentrate his or her
resources on value-adding activities.
For more information, visit www.3shape.com._
[37] =>
about the publisher _ submissions
I
submissions
formatting requirements
Please note that all the textual elements
of your submission:
• complete article
• figure captions
• literature list
• contact info (e-mail addy please)
• author bio
must be combined into one Microsoft Word
document. Please do not submit multiple files
for each of these items. In addition, images
(tables, charts, photographs, etc.) must not
be embedded in the text document.
All images must be submitted separately, and details about how to do this
appear below.
If you are interested in submitting a C.E.
article, please contact us for additional instructions before you make your submission.
_Text length
Article lengths can vary greatly — from a
mere 1,500 to 5,500 words — depending on
the subject matter. Our approach is that if
you need more or less words to do the topic
justice, then please make the article as long or
as short as necessary.
We can run an extra long article in multiple parts, but this is usually discussing a subject matter where each part can stand alone
because it contains so much information. In
addition, we do run multi-part series on various topics. In short, we do not want to limit
you in terms of article length, so please use
the word count above as a general guideline
and if you have specific questions, please do
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Please use single spacing and do not put extra
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Boldface should be reserved for article headlines, headers and subheads please.
Please do not “center” text on the page,
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If you need to make a list or add footnotes
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There are menus in every program that
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_Image requirements
Please number images consecutively by
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imperative that certain images are grouped
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Insert figure references in your article
wherever they are appropriate, whether that
is in the middle or end of a sentence, but
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helps the readers to orient themselves when
moving through the article. In addition,
please note:
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If you have an image that is greater than
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Also, please remember that you should
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text document you submit. Images must
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You may submit images through a
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files via e-mail or post a CD containing your
images directly to us (please contact us for
the mailing address as this will depend upon
where you will be mailing them from).
Please do not forget to send us a head
shot photo of yourself that also fits the
image requirements noted above so that it
can be printed along with your article.
_Abstracts
An abstract of your article is not required.
However, if you choose to provide us with
one, we will print it in a separate box.
_Contact info
At the end of every article is a contact info
box with contact information along with a
head shot of the author.
Please note at the end of your article the
exact information you would like to appear
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previously mentioned standards.
A short bio (50 words or less) may precede the contact info if you provide us with
the necessary text.
_Questions? Comments?
Please do not hesitate to contact us for our
International C.E. Magazine Author Kit or if
you have other questions/comments about
the article submission process:
Group Editor Robin Goodman
r.goodman@dental-tribune.com
Ortho Managing Editor Sierra Rendon
s.rendon@dental-tribune.com
Managing Editor Fred Michmershuizen
f.michmershuizen@dental-tribune.com
ortho
I 37
2
_ 2012
[38] =>
I about the publisher _ imprint
ortho
the international C.E. magazine of laser dentistry
U.S. Headquarters
Dental Tribune America
116 West 23rd Street, Ste. 500
New York, NY 10011
Tel.: (212) 244-7181
Fax: (212) 244-7185
feedback@dental-tribune.com
www.dental-tribune.com
Publisher
Torsten R. Oemus
t.oemus@dental-tribune.com
Chief Operating Officer
Eric Seid
e.seid@dental-tribune.com
Ortho Managing Editor
Sierra Rendon
s.rendon@dental-tribune.com
Account Manager
Humberto Estrada
e.estrada@dental-tribune.com
Managing Editor
Robert Selleck
r.selleck@dental-tribune.com
Account Manager
Mara Zimmerman
m.zimmerman@dental-tribune.
com
Designer
Kristine Colker
k.colker@dental-tribune.com
Director of International
Education
Christiane Ferret
c.ferret@dtstudyclub.com
Marketing Manager
Group Editor
Anna Wlodarczyk-Kataoka
Robin Goodman
r.goodman@dental-tribune.com a.wlodarczyk@dental-tribune.
com
Managing Editor
Project & Events Manager
Fred Michmershuizen
Lorrie Young
f.michmershuizen
l.young@dental-tribune.com
@dental-tribune.com
Account Manager
Will Kenyon
w.kenyon@dental-tribune.com
Account Manager & Interactive
Gina Davison
g.davison@dental-tribune.com
International Account Manager
Jan Agostaro
j.agostaro@dental-tribune.com
Feedback & General Inquiries
feedback@dental-tribune.com
Editorial Board
Marcia Martins Marques, Leonardo
Silberman, Emina Ibrahimi, Igor Cernavin,
Daniel Heysselaer, Roeland de Moor, Julia
Kamenova, T. Dostalova, Christliebe Pasini,
Peter Steen Hansen, Aisha Sultan, Ahmed
A Hassan, Marita Luomanen, Patrick Maher,
Marie France Bertrand, Frederic Gaultier,
Antonis Kallis, Dimitris Strakas, Kenneth Luk,
Mukul Jain, Reza Fekrazad, Sharonit
Sahar-Helft, Lajos Gaspar, Paolo Vescovi,
Marina Vitale, Carlo Fornaini, Kenji Yoshida,
Hideaki Suda, Ki-Suk Kim, Liang Ling Seow,
Shaymant Singh Makhan, Enrique Trevino,
Ahmed Kabir, Blanca de Grande, José Correia
de Campos, Carmen Todea, Saleh Ghabban
Stephen Hsu, Antoni Espana Tost, Josep
Arnabat, Ahmed Abdullah, Boris Gaspirc,
Peter Fahlstedt, Claes Larsson, Michel Vock,
Hsin-Cheng Liu, Sajee Sattayut, Ferda Tasar,
Sevil Gurgan, Cem Sener, Christopher Mercer,
Valentin Preve, Ali Obeidi, Anna-Maria
Yannikou, Suchetan Pradhan, Ryan Seto, Joyce
Fong, Ingmar Ingenegeren, Peter Kleemann,
Iris Brader, Masoud Mojahedi, Gerd Volland,
Gabriele Schindler, Ralf Borchers, Stefan
Grümer, Joachim Schiffer, Detlef Klotz,
Herbert Deppe, Friedrich Lampert, Jörg
Meister, Rene Franzen, Andreas Braun, Sabine
Sennhenn-Kirchner, Siegfried Jänicke, Olaf
Oberhofer and Thorsten Kleinert
Dental Tribune America is the official media partner of:
ortho_Copyright Regulations
_the international C.E. magazine of ortho published by Dental Tribune America is printed quarterly. The magazine’s articles and illustrations are protected by copyright. Reprints of any kind, including digital mediums, without the prior consent of the publisher are inadmissible
and liable to prosecution. This also applies to duplicate copies, translations, microfilms and storage and processing in electronic systems.
Reproductions, including excerpts, may only be made with the permission of the publisher.
All submissions to the editorial department are understood to be the original work of the author, meaning that he or she is the sole copyright
holder and no other individual(s) or publisher(s) holds the copyright to the material. The editorial department reserves the right to review all
editorial submissions for factual errors and to make amendments if necessary.
Dental Tribune America does not accept the submission of unsolicited books and manuscripts in printed or electronic form and such items
will be disposed of unread should they be received.
Dental Tribune strives to maintain the utmost accuracy in its clinical articles. If you find a factual error or content that requires clarification, please contact Group Editor Robin Goodman at r.goodman@dental-tribune.com. Opinions expressed by authors are their own and
may not reflect those of Dental Tribune America and its employees.
Dental Tribune cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not
assume responsibility for product names or statements made by advertisers.
The responsibility for advertisements and other specially labeled items shall not be borne by the editorial department. Likewise, no responsibility shall be assumed for information published about associations, companies and commercial markets. All cases of consequential liability
arising from inaccurate or faulty representation are excluded. General terms and conditions apply, and the legal venue is New York, New York.
38 I ortho
2_ 2012
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Cover
01 - 01
view
-
Editorial
03 - 03
view
-
Content
04 - 04
view
-
A review of the original Combination Technique and philosophy
06 - 11
view
-
How to avoid extractions when treating malocclusions
12 - 19
view
-
Events
20 - 24
view
-
Dr. Cristina Teixeira named chair of the department of orthodontics at NYUCD
25 - 25
view
-
Study: 20-30 percent of bib clips harbor bacteria even after disinfection
26 - 28
view
-
ClearCorrect reaches new milestone with charitable clean water project
30 - 30
view
-
Industry
32 - 36
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-
Submissions
37 - 37
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Imprint
38 - 38
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[toc_titles] => Cover
/ Editorial
/ Content
/ A review of the original Combination Technique and philosophy
/ How to avoid extractions when treating malocclusions
/ Events
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/ Study: 20-30 percent of bib clips harbor bacteria even after disinfection
/ ClearCorrect reaches new milestone with charitable clean water project
/ Industry
/ Submissions
/ Imprint
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