Ortho Tribune U.S. No. 2, 2014

Big smiles in the Big Easy / How to improve our diagnostic acumen: Teach it to our residents – Part II / Myobrace System: An evolution in orthodontics / Ormco Corporation offers its new Damon Clear2 bracket at the AAO / Ultradent introduces new Class II corrector - Esprit / Healthgrades: Where prospective patients are searching in 2014 / How well do you know your practice’s business fundamentals? / Process challenges in pre-cleaning instruments / Thinking outside the metal box: Why wait?

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ORTHO TRIBUNE
The World’s Orthodontic Newspaper · U.S. Edition

aao EDITION 2014 — Vol. 9, No. 2

www.ortho-tribune.com

Big smiles in
the Big Easy
AAO Annual
Session takes
place April 25–29
in New Orleans
By Sierra Rendon, Managing Editor
The American Association of Orthodontists will host its 2014 annual session at the Ernest N. Morial Convention Center in New Orleans,
featuring keynote speaker Peyton Manning and Opening Ceremonies’ musical guest Kenny Loggins. Photo/www.sxc.hu

excitement about the Excellence in Orthodontics Awards Luncheon keynote
speaker, Denver Broncos Quarterback
Peyton Manning.
With a Doctors Program reflecting
the AAO’s reputation for outstanding
conferences and a host city equated
with unparalleled fun, the 2014 annual
session will be a meeting no orthodontist will want to miss, the AAO team
asserts.
In addition to the extensive educational elements, the AAO will feature
more than 300 companies exhibiting
their newest products and services at

Tribune America
116 West 23rd Street
Suite #500
New York, N.Y. 10011

he American Association
of Orthodontists will host
its 114th annual session in
New Orleans April 25–29,
featuring Big Easy-style
fun and a cutting-edge
education program.
AAO President Gayle Glenn, DDS,
MSD, says the AAO team, “has been
working extremely hard to develop outstanding doctors’ and staff programs
and finalizing arrangements for worldclass entertainment.”
To kick off the week, the AAO’s Annual Session Opening Ceremonies will
feature Kenny Loggins on Saturday,
April 26. In addition, the AAO team expects many attendees will share in the

the Ernest N. Morial Convention Center
in New Orleans.
New Orleans was recently voted “Best
American City to Visit” in a Travel +
Leisure magazine readers’ poll and also
ranked No. 1 in 13 other categories. For
music lovers, the news gets even better:
The 2014 annual session is scheduled at
the same time as the 2014 New Orleans
Jazz & Heritage Festival (Jazz Fest). The
world-renowned musical celebration

takes place April 25–May 4 and features
music in a variety of styles indigenous
to Louisiana, including R&B, gospel, Cajun, zydeco, Afro-Caribbean, jazz, blues
and bluegrass.
For sports lovers, also taking place
at the same time as the AAO Annual
Meeting is the Zurich Classic of New
Orleans, in which golf fans will have a
” See BIG EASY, page 8
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[2] =>

From the Editor

2

How to improve our
diagnostic acumen: Teach
it to our residents – Part II
By Dennis J. Tartakow,
DMD, MEd, EdD, PhD, Editor in Chief

To continue the discussion regarding what our residents are missing in
his or her orthodontic training, nothing is a better teacher than personal
experience(s) regarding what we do and
AD

how we do it in our practices. Expert
training is a reflection on the educators
and mentors in postgraduate residency
programs. The following considerations
are important subjects in the diagnostic
process and examination; they are especially valuable and significant for the
” See RESIDENTS, page 6

Ortho Tribune U.S. Edition | AAO EDITION 2014

ORTHO TRIBUNE
Publisher & Chairman
Torsten Oemus t.oemus@dental-tribune.com
President/Chief Executive Officer
Eric Seid e.seid@dental-tribune.com
Editor in Chief ORTHO Tribune
Prof. Dennis Tartakow
d.tartakow@dental-tribune.com
International Editor Ortho Tribune
Dr. Reiner Oemus r.oemus@dental-tribune.com
group editor
Kristine Colker k.colker@dental-tribune.com
Managing Editor ORTHO Tribune
Sierra Rendon s.rendon@dental-tribune.com
Managing Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Managing Editor
Robert Selleck, r.selleck@dental-tribune.com
product/Account Manager
Humberto Estrada h.estrada@dental-tribune.com
product/Account Manager
Will Kenyon w.kenyon@dental-tribune.com
Marketing director
Anna Kataoka
a.kataoka@dental-tribune.com
Accounting coordinator
Nirmala Singh n.singh@dental-tribune.com
Education DIRECTOR
Christiane Ferret c.ferret@dtstudyclub.com
Tribune America, LLC
116 West 23rd Street, Suite 500
New York, NY 10011
Phone (212) 244-7181
Fax (212) 244-7185
Published by Tribune America
© 2014 Tribune America, LLC
All rights reserved.
Tribune America strives to maintain the utmost accuracy in its news and clinical reports. If you find a
factual error or content that requires clarification,
please contact Managing Editor Sierra Rendon at
s.rendon@dental-tribune.com.
Tribune America 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. Opinions expressed by authors are their
own and may not reflect those of Tribune America.

Editorial Board

Jay Bowman, DMD, MSD (Journalism &
Education)
Robert Boyd, DDS, MEd (Periodontics &
Education)
Earl Broker, DDS (TMD & Orofacial Pain)
Tarek El-Bialy, BDS, MS, MS, PhD
(Research, Bioengineering and Education)
Donald Giddon, DMD, PhD (Psychology and
Education)
Donald Machen, DMD, MSD, MD, JD, MBA
(Medicine, Law and Business)
James Mah, DDS, MSc, MRCD, DMSc
(Craniofacial Imaging and Education)
Richard Masella, DMD (Education)
Malcolm Meister, DDS, MSM, JD (Law and
Education)
Harold Middleberg, DDS (Practice Management)
Elliott Moskowitz, DDS, MSd (Journalism and
Education)
James Mulick, DDS, MSD
(Craniofacial Research and Education)
Ravindra Nanda, BDS, MDS, PhD
(Biomechanics & Education)
Edward O’Neil, MD (Internal Medicine)
Donald Picard, DDS, MS (Accounting)
Glenn Sameshima, DDS, PhD (Research and
Education)
Daniel Sarya, DDS, MPH (Public Health)
Keith Sherwood, DDS (Oral Surgery)
James Souers, DDS (Orthodontics)
Gregg Tartakow, DMD (Orthodontics) and
Ortho Tribune Associate Editor

[3] =>

Ortho Tribune U.S. Edition | WINTER 2013

from the editor

Ortho Classic

3

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industry clinical

Ortho Tribune U.S. Edition | AAO EDITION 2014

Myobrace System:
An evolution in
orthodontics
By Rohan Wijey, B Oral H (Dent. Sci.),
Grad. Dip. Dent. (Griffith), OM

Fig. 1: A case study.
Photo/Provided by Myofunctional Orthodontics
AD

Many have now accepted The Myobrace
System™ is peerless in terms of the potential to cajole the orofacial muscles into
widening arches and allowing good dental
alignment.
There exists a common misconception

amongst dentofacial orthopedists, however, that although The Myobrace System
is proficient at straightening teeth, traditional functional appliance systems are
better for facial development.
This was a belief to which even I subscribed before I began to actually use the
system myself. Although I paid lip service to role of muscles in malocclusion, I
had not truly appreciated the potential to
correct malocclusion by re-training these
muscles.
Indeed, most experienced Myobrace
practitioners have come to regard traditional functional appliance therapy as
simply another allotropic form of traditional orthodontics: Mechanical interventions that ignore the role of muscles.
To be fair, much of the skepticism leveled
at The Myobrace System seems to be borne
out of misgivings about myofunctional
therapy.
Myofunctional therapy (MT) as a science
has been extant for more than 100 years,
enjoying great popularity, especially in
the 1970s. Although it has been proven to
be able to elicit impressive results, Smithpeter and Covell (2010)1 have cited a number of reasons for a general lack of enthusiasm:
1. Limited office space for providing
therapy.
2. Absence of MT providers.
3. Difficulty and amount of time required.2
4. Inadequate training.
5. Hope that function will follow form.
6. Belief that there is insufficient scientific evidence to support orofacial MT.3
7. Observations that not all MT providers
have the same expertise, so successful results are unpredictable.4
The Myobrace System has managed to
package traditional myofunctional therapy into a system that has ensured easily
reproducible, better results, in less time,
with less effort.5
The system, thus, represents a confluence and evolution of fixed appliance
therapy, functional appliance therapy and
myofunctional therapy.
The case (Fig. 1) is a prime example of
treatment outcomes satisfying the goals
of proper alignment, facial development
and treating muscle dysfunction for a
more stable result. She was treated with an
upper Farrell Bent Wire System™, together
with a K1 Myobrace®, followed by a K2 and
the Myobrace T1 and T3 for final alignment.
From a dental perspective, of note is
the space recovered for the upper right
and lower left canine teeth. From a facial
perspective, the naso-labial angle has improved significantly, while it is clear that
the vertical clockwise direction of growth
has been re-orientated to a more horizontal direction. These outcomes have been
achieved by harnessing the power of the
muscles with a system that is more time
” See MYOBRACE, page 8

[5] =>

OrthoSynetics

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industry

Ortho Tribune U.S. Edition | AAO EDITION 2014

Ormco Corporation offers its new
Damon Clear2 bracket at the AAO
By Ormco Corporation Staff

survey conducted by
the American Association of Orthodontists
(AAO) found that when
meeting someone new,
37 percent of Americans
notice a person’s smile before anything
else. This comes as little surprise to the
orthodontic community, but it speaks
directly to the growing importance of
esthetically pleasing orthodontic solutions that deliver extraordinary results.
At the 2014 AAO Annual Session,
Ormco™ Corporation’s booth (No. 1805)
will feature the newly announced, and
now shipping, Damon™ Clear2 bracket.
An enhancement to Ormco’s popular
Damon Clear product — the only 100
percent clear SL bracket on the market —
Damon Clear2 provides clinicians with
more rotational control.
Building upon its progressive line of
Damon System products, Damon Clear2
features standard torque bracket enhancements and precision engineering
for treatment efficiency and consistency. With a new ultra-precision slot,
Damon Clear2 boasts two times the rotational control* for meticulous finishing
and efficient treatment.
In addition to optimized standard
torque brackets, Damon Clear2 features
the same core design as the original
Damon Clear passive self-ligating brackets, which are used with the Damon
System’s high-tech, light-force archwires
and minimally invasive treatment protocols.

“ RESIDENTS, Page 2
orthodontic resident to recognize.
• Clinical photography often demonstrates dermatological diseases, tumors and other pathology of the head
and neck. We can diagnose important
health issues by taking the time to look.
Diagnosing diseases of the skin in our
patients, e.g. squamous cell carcinoma,
basal cell carcinoma, melanoma, etc., is
an astute part of our responsibility and
demonstrates good judgment as a doctor. Because orthodontists take so many
clinical photographs, very little time is
required to scan for such pathology prior
to examining facial structures and the
dentition. Accuracy and precision are extremely important; for example, in the
intraoral photo (Fig.1), is this documentation of an aberrant occlusal plane cant or
just sloppy photography?
Clinical photography can identify
many diseases of facial expression or appearance. Facial diseases are often related to development or physiology and can
affect facial structure, facial behavior or
both. Through clinical photography, we
can teach the resident how to recognize

Damon Clear2 bracket offers an esthetically
pleasing, completely clear and self-ligating
option. Photo/Provided by Ormco Corporation

Completely esthetic with an unparalleled clear design, Damon Clear2 is the

various signs in the face that indicate
particular diseases. Signs of facial diseases include (a) changes in appearance, (b)
alterations of muscular movement, and
(c) behavioral expression. Facial signs
are often used to diagnose the presence
of certain diseases that can be diagnosed
via clinical photography.
The most obvious relationships between facial signs and disease are for the
genetic and congenital diseases. Specific
genetic abnormalities cause such diseases as Lesch-Nyhan, Down syndrome and
Cornelia DeLange syndrome, producing
specific patterns of facial abnormality.
Certain congenital diseases such as fetal
alcohol syndrome, cretinism and hydrocephaly also produce specific facial signs
and symptoms. Many infectious diseases can be diagnosed from facial signs,
including Lyme disease, Fifth disease,
shingles and HIV infections.
• Articulated Models are not as popular as hand-held models and most orthodontists never consider using an
articulator except for surgical cases.
However, they may be extremely helpful
in diagnosis, treatment planning and for
medical-legal protection. When docu-

only self-ligating bracket manufactured
with a completely clear body and door,
according to Ormco. With polycrystalline alumina (PCA) material, the bracket
is virtually invisible and resistant to
staining.
Additionally, Damon Clear’s optimized bond strength and innovative
SpinTek™ slide ensure durability as well
as comfortable and fast wire changes
and adjustments. Damon Clear2 —
an ideal solution for today’s imageconscious adults and teens — provides
the performance and control needed to
treat a wide range of cases, including patients with crowding, flat profiles, open
bites, cross bites and individuals in need
of space closure and arch development.
Clinicians treating with Damon Clear2
may also be featured on the Damon Doctor Locator advertised on Ormco’s consumer website, www.damonbraces.com.
Designed to help drive new patients to
Damon practices, the Damon Locator is
a powerful online directory for patients
to quickly and easily find their nearest
Damon System orthodontist via the
web, Facebook and other web-enabled
devices.
More than 56 million consumers have
been exposed to the Damon System
through Ormco’s outreach efforts, and
during a four-year period, damonbraces.
com has experienced a 113 percent increase in traffic, while the Damon Doctor Locator has experienced a 283 percent increase in searches. This translates
to more patients for Damon practices.
Purchases of Damon Clear2 also contribute to Ormco Lifetime Rewards, a
rewards program in which points never

At the AAO
Damon Clear2 brackets are now shipping to
doctors in North America and can be ordered
through Ormco sales representatives at the
AAO Annual Session or by completing the
Damon Clear2 interest form at www.ormco.
com. Stop by the Ormco AAO booth (No. 1805)
to learn more about Damon Clear2.

expire. With Ormco Lifetime Rewards,
clinicians earn points on every dollar
spent on Ormco appliances and redeem
them for numerous high-quality products and supplies. Research indicates
that, through the rewards program, the
average doctor earns up to $25,000 in
free products.
Additionally, doctors offering the
Damon System benefit from Ormco’s
industry-leading educational events and
a broad range of marketing assets and
staff training tools available at www.
marketing.ormco.com. This robust practice marketing website hosts a library
of patient imagery, consultation tools,
practice videos, press release templates,
webpage assets and more.
For doctors seeking continued learning, Ormco provides world-class C.E.
programs including the annual Damon
Forum, regional education events, inoffice courses, webinars, roadshows and
more.
* As compared to Damon Clear, data on
file. Standard torque, upper 3-3 brackets.

Fig. 1. Photo/Cobourne & DiBase, 2010, p. 25.

menting patients with asymmetry, such
as when the cant of the occlusal plane
is not level, hand-held models are often
prepared inaccurately without demonstrating the exact degree of incongruity
or anomaly (Fig. 2). Articulated models
provide excellent representation of the
patient’s condition and are extremely accurate.
There is much to reveal as we appraise
the past and contemplate the future.
Learning can be defined as useful changes in behavior resulting from reflection
and experience. How can we teach our
students to become better practitioners
and sharper diagnosticians? Will they
learn to focus on the dental problems in
the context of, and in concert with, a patient’s general health issues?

Fig. 2. Photo/Cobourne & DiBase, 2010, p. 16.

As orthodontists, we are still responsible for diagnosing pathology in the
head and neck, and treating or referring
the patient to someone who can provide
proper care. By example, we must demonstrate how to be the best orthodontist
possible and the consummate expert in
our field.

Reference
1)

Cobourne, MT & DiBase, AT. (2010). Handbook of Orthodontics. Mosby Elsevier.

[7] =>

Ormco

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industry

Ortho Tribune U.S. Edition | AAO EDITION 2014

Ultradent introduces new
Class II corrector, Esprit
By Opal Orthodontics Staff

At the AAO

pal®
Orthodontics
recently
introduced
TM
Esprit , a revolutionary Class II corrector.
This new corrector has
been specifically designed to address the overwhelming demand for everything missing in other
Class II correctors on the market today.
Developed with the innovative and
cutting-edge technology Opal Orthodontics has consistently built its reputation on, Esprit finally answers the call for
an easier-to-install, more comfortable,
highly durable Class II corrector, the
company asserts.
Esprit’s innovative strength and comfort will provide your patients with a
more pain-free orthodontic experience,
reducing emergency appointments and
frustration for clinicians and staff.
Esprit is the result of more than three
years of design and development. Developed and tested by Opal Orthodontics
— in collaboration with industry leaders such Dr. Richard McLaughlin, Dr.
Terry McDonald and Dr. Robert Miller

“ BIG EASY, Page 1
chance to support regional children’s
charities while watching top PGA tour
professionals. For more information
on this exciting event, check out www.
zurichgolfclassic.com.
In addition to its colorful music scene,
New Orleans is noted for the variety
and quality of its restaurants. Attendees can enjoy traditional favorites like
jambalaya, crawfish etouffee or seafood
gumbo, or choose from dozens of other
types of cuisine.
The New Orleans Convention and
Visitors Bureau has a website especially for AAO members. Visit www.
neworleanscvb.com/aaortho.

Scientific program highlights
• Three of the world’s top speakers,
Drs. Wick Alexander, Patrick Turley and
James McNamara, will be giving the latest information on three critical topics
in the AAO’s prestigious Salzmann, Mershon and Angle special awards lectures.
This is an excellent opportunity to learn
from these experienced reseachers and
clinicians, the AAO asserts.
• When a referring dentist mentions
an “abfraction lesion,” do you know
what it means or if it is real? What is the
most contemporary thinking on periodontal grafting techniques? What are
the options in cosmetic veneers, minimal preparations and materials? Moderated by Dr. David Sarver,the Interdisci-

Visit the Opal Orthodontics booth, No. 1037, to
learn more about Esprit. You may also visit the
website

opal-

orthodontics.com/esprit or call (888) 8635883.

Esprit is a new Class II corrector offered by
Opal Orthodontics. Photos/Provided by Opal

The mesial attachment for the Esprit
prevents rolling into the occlusion.

Orthodontics

— Esprit is undoubtedly the most technologically advanced corrector on the
market.
On using Esprit, Dr. Miller said: “The
Esprit has better patient acceptance and
tolerance because the spring is nested

plinary Esthetic Advances Symposium
is a full day of the world’s pre-eminent
cosmetic dental clinicians put together
to provide the latest current thinking in
interdisciplinary dentistry.
• A comprehensive practice management track with 12 speakers will present
three topics critical to today’s orthodontic practice: “Marketing for Income,”
“Managing for Profit” and “Monitoring
Your Money.”
• Do you know what to do if you just
found out you were given a bad review
on Yelp? Is it really possible to eliminate
impressions from your practice? If you
are not sure, come to the one-day session, “Technology for the Orthodontic
Office,” for both doctors and staff, to
find out the answers to these questions
and many more!
• Continuing the popular “Asking the
Expert” and “Point/Counterpoint” programs, this year’s sessions will address
topical questions, such as “Extraction
vs Non-extraction,” “Surgery First?” and
“Modern Approaches to Mechanics.”
• Eight master clinicians from around
the world will conduct special lectures
on transverse and vertical problems.

or internal.”
Esprit’s unique features include a
CNC-machined body that is smooth and
durable and a new innovative, patented
clip. This revolutionary clip is a breeze
to install and remove, but stays in place
without disengaging during treatment.
Esprit also features a mesial hook that

“ MYOBRACE Page 4

The Myobrace
System has
managed to
package
traditional
myofunctional
therapy into a
system that has
ensured easily
reproducible,
better results,
in less time,
with less effort,
the company
says.
Photo/Provided by
Myofunctional
Orthodontics

and cost-efficient than any other system
in the history of orthodontics.

References
1)

Event information
• What: The AAO’s 114th Annual Session
• When: April 25-29
• Where: Ernest N. Morial Convention
Center in New Orleans
• More information: www.aaoinfo.org

prevents rolling into the occlusion. The
hook is smooth for patient comfort and
can also be removed with ease — no cutting required.
Esprit’s enclosed stainless-steel spring
prevents painful pinching and unhygienic trapping of food. This unique enclosed spring also resists deformation
and maintains consistent force throughout the patient’s wear.
Esprit’s dual-telescoping feature increases range of motion, and its distal
body opening prevents bottoming out
and allows liquid flow to keep it clean.
The entire corrector is laser welded, allowing it to withstand even the toughest
treatment from any patient — 100 percent guaranteed.

Smith Peter J and Covell D. Relapse of anterior open bites treated with orthodontic
appliance with and without orofacial myofunctional therapy. AJODO May 2010, p
605-614.
Sim JM. Twelve rules of orthodontic treatment during mixed dentition. J Gen Orthod
1998;9:22–27.
Zuroff J. Orthodontic treatment of anterior
open-bite malocclusion: stability 10 years

post-retention. Cited by Shapiro PA. Stability of open bite treatment. Am J Orthod
Dentofacial Orthop 2002;121:566–568.
Ohno T, Yogosawa F, Nakamura K. An approach to openbite cases 48. Gugino CF,
Dus I. Unlocking orthodontic malocclusions: interplay between form and function. Semin Orthod 1998; 4:246–255.
Uysal T, Yagci A, Kara S, Okkesim S. Influence of Pre-Orthodontic Trainer treatment
on the perioral and masticatory muscles in
patients with Class II division 1 malocclusion. European Journal of Orthodontics
2011.

[9] =>

Ortho Tribune U.S. Edition | january 2014

industry

Ultradent

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[10] =>

industry

Ortho Tribune U.S. Edition | AAO EDITION 2014

Healthgrades: Where prospective
patients are searching in 2014
By Sesame Communications Staff
Healthgrades can
help patients find
you, and help you
book new clients.
Photo/Provided
by Sesame
Communications

hen consumers go
online, the vast
majority of them
start at a search engine. According to
research from Pew
Internet, 93 percent of online activities
begin with a search.1 When they search,
health care is a popular topic as 72 percent of Internet users looked online for

At the AAO
For more information about Healthgrades and
Sesame Communications, stop by booth
No. 1937 at the AAO.

health information within the last year.2
Today, the No. 1 source for new patients
searching and scheduling appointments
with health-care providers in the United
States is Healthgrades.
Each year, more than 225 million visitors use the Healthgrades.com website to
search, evaluate and connect with providers that best meet their treatment needs.
Healthgrades.com visitors represent the ideal demographic for dentistry: overwhelmingly female (72 percent), highly educated
(84 percent have some post-secondary education) and affluent (52 percent have annual
household incomes greater than $75,000).
Healthgrades offers orthodontic practices
a large, highly focused audience of prospective patients. During the past 12 months,
Healthgrades tracked more than 20 million searches for dental-care providers, with
orthodontists being one of the top searched
specialties. Most importantly, Healthgrades
users don’t just search — they schedule appointments. More than half (54 percent) of
Healthgrades visitors will schedule an appointment with a local provider.
Healthgrades has established a partnership with Sesame Communications, and
dentists can now secure an “Enhanced Profile,” which will offer several advantages
over a standard Healthgrades profile and
give your practice better access and exposure to prospective patients. Just a few of
the powerful benefits include:
• “Featured Provider” placement on
Healthgrades.com: A Healthgrades enhanced profile provides your practice with
greater visibility and exposure to prospective patients looking to schedule an appointment with an orthodontist in your
area.
•
Automatically
published
postappointment reviews: Leverages your highquality reviews to differentiate the value of
your practice and ensures all reviews are really patients.
• Premium phone number and online
appointment requests: Enhanced Profiles
allow patients to request an appointment
with your practice by simply clicking a button on your Healthgrades profile.
New case starts are core to your growth
and profitability. For many orthodontic
practices, online search has become a primary source for new patient opportunities.
Healthgrades is a highly compelling channel, with millions of prospective patients
ready to schedule an appointment the moment they find the right orthodontist.

References
1)

www.pewinternet.org/Reports/2012/
Search-Engine-Use-2012/Summary-of-findings.aspx
www.pewinternet.org/Reports/2013/
Health-online/Summary-of-Findings.aspx

[11] =>

Ortho Tribune U.S. Edition | fall 2013

Industry clinical

Dentronix

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[12] =>

industry

Ortho Tribune U.S. Edition | AAO EDITION 2014

How well do you know your
practice’s business fundamentals?
By Mark S. Sanchez, DDS, founder
and CEO of tops Software

Pop quiz: Do you know — right now —
the biggest pulse points affecting your
business in 2014?
If your answer is “Sure, I can figure that
out,” or “Yes, my treatment coordinator
works on that every month,” you may
want to think again. For every patient
who leaves your office today with an incorrectly projected completion date or
improperly set fee, so too leaves a revenue
opportunity. Can you really afford that
miscalculation dozens of times each day?
Most practices have a well-established
— and growing — set of reports that look
at their business from multiple angles.
We’re all getting better at capturing and
reporting on information about patient schedules, billing cycles, treatment
length, new starts, pending care, capital
expenditures, office leasing and patient
communications. Maybe some even capture a collection of patient “selfies” that
show how well we’ve trained our iPhonewielding tweens to position their new
elastics.
But the dirty little secret is that none
of us has a fast, easy way to connect the
dots between those reports to draw out
the good stuff: the insights. I’d guess that
you — or your already-overworked treatment coordinator — have logged countless hours compiling statistics on those
reports. Sadly, by the time you finish your

analysis, the data is already stale and incomplete, and the insights have lost their
potency.
You know what to report on, but how do
you look for what you don’t know?
I’m a bit of a movie buff. So when I think
of insight, I think of Laurence Fishburne’s
character, Morpheus, in “The Matrix.” As
Morpheus says to Neo, “No one can be
told what the Matrix is. You have to see it
for yourself.”
So here is just one way I see the profit
potential of real-time insight: It’s a game
changer for orthodontic practices. For example, wouldn’t it be cool to look at three
cuts of data around total treatment time
— by office, treatment type, treatment
coordinator and fee?
1. Individual level: Thomas Anderson required 20 visits at our Oak Street office to
complete his Invisalign treatment at a set
fee of $5,000.
2. Compare with a subgroup level: Treatment coordinator Anna Smith, who managed 25 Invisalign patients in our Main
Street satellite office, recorded an average
completion time of 15 visits.
3. Further compare against the total

population: We had 100 patients complete Invisalign treatment across all four
offices in our practice, at an average of 17
visits.
So here are some pulse points for the
practice insight and learning/reinvention: What was up with Mr. Anderson’s
treatment? Mr. Anderson’s team? And
what can we all learn from Anna?
Take the insight test: What have you
been missing?
If you need to have a more competitive
practice, test yourself to see how many
of the following seven profitable insights
you can put your fingers on — right now.
(No credit if you need a weekend, a treatment coordinator or an accountant to get
to the answers!)
• Profitability: Profitability, by patient or
procedure.
• Treatment time: Actual length of treatment versus the estimated range by doctor.
• Understanding the unplanned: Impact
of emergency visits on the overall cost of
treatment.
• Demographics: Correlation between
patient age and average office-visit length
• Setting fees: Whether you are undercompensated for any of the types of treatment you offer.
• Multispecialty tracking: Ability to
monitor patients efficiently through
multispecialty treatment.
• “What if” drill downs: Answer questions — on the fly — about the impacts of
the mix of patient load, treatment type,

At the AAO
For more information about tops Software,
stop by the booth, No. 2819 at the AAO.

age and local team on each of your satellite offices.
In truth, gaining real insight into how
your practice works requires a matrix
of patient data in many dimensions. We
need analytics and not just reports. Our
business systems need to properly handle this multidimensional matrix in real
time to show us how to chart our way to
profitability. Until now, we’ve all been
driving blindly.

About the author
MARK S. SANCHEZ, DDS, is the founder, CEO and
chief developer of tops Software. He practices in
one

Atlanta’s

leading orthodontic
offices and is the
only programmer of
orthodontic
tice

prac-

management

software who actually uses such a
product on a daily
basis. Sanchez developed

his

gramming

proskills

while pursuing a doctorate in physics at Georgia
Tech. He earned his dental degree and certificate in
orthodontics from Emory University.

Process challenges in pre-cleaning instruments
By Dentronix Staff

At the AAO
For more information about Dentronix prod-

In the recent past, there has been lots
of interest in implementing the use of
instrument washer/disinfectors in orthodontic offices.
The convenience of using a dishwashertype device for cleaning instruments has
become more attractive for offices wishing to clear up counter space and not recycle cleaning fluids. Our Dentronix repair department has received numerous
inquiries regarding the compatibility of
various washer units with dry heat sterilization and inserted-type orthodontic
pliers.
The sterilization aspect isn’t nearly as
important as the chemical exposure to instruments in the process. Remember that
these types of cleaners and solutions were
originally developed for medical instrument sterilization in large central hospital
sterilization facilities. These instruments
could be potentially contaminated with a
significant amount of bio-burden.
This technology was transferred to the
dental office in the late 1990s, still being
used on basically non-hinged stainlesssteel instruments.
Orthodontic instruments present spe-

ucts, stop by the company’s booth, No. 1945.

cial challenges as they are particularly
susceptible to chemical corrosion. Because of their multi-metals construction
(often featuring non-stainless materials)
and hinged joints, care must be taken in
the selection of cleaning agents. Aluminum sterilizer racks and their protective
anodized coatings are attacked by alkalines; tungsten carbides are attacked by
even mildly acidic solutions; and the silver
content in the bond that attaches the tips
to the stainless pliers can create a virtual
battery and cause electrolytic corrosion to
tips in an acidic environment.
When Dentronix’s MPUS ultrasonic
cleaning solution was originally developed in the late 1980s as a companion
product to dry heat sterilization, the correct chemical balance to afford efficient
cleaning and instrument protection was a
primary goal.
The learning curve with acidic and alkaline disinfectants used at that time gave
us a knowledge base on what to avoid.

The MPUS solution was formulated to be
as chemically neutral as possible. A nonionic base with a neutral pH was selected
as well as integrating phosphate-free surfactants. Because this was a “no-rinse” solution, enzymatic agents were left out to
avoid the potential of chemical reactions
with the dry-heat sterilization process and
offensive odors during evaporation.
A powerful rust inhibitor was also included to protect instruments through
the entire cleaning and sterilization process. Dentronix still manufactures and
sells an updated version of this formula.
Conversely, many cleaning solutions for
washer/disinfectors are not specifically
designed to overcome the challenges of
processing orthodontic pliers. They have
been formulated to remove blood and
organic debris by the sole action of pressurized, sprayed water rather than a more
complex method such as ultrasonic cleaning. Without other means, these solutions
must be more aggressive to be effective.
A very popular European solution uses
an alkaline cleaning agent so powerful
that it requires an acid rinse as a neutralizer. This can be a “double whammy” to
the materials used in your ortho pliers
and sterilizing racks. Alkaline detergents
are available for disinfector washers with

pH as high as 13. Typical formulations run
between 11-12 pH. These solutions are very
effective at removing organic debris; however, the level of organic debris on typical
orthodontic pliers is arguably minimal.
Without question, cleaning is the most
important phase of the disinfecting/ sterilization process as it reduces biological
material on the instruments that can act
as a barrier to the sterilization process. The
reality is that in the day-to-day practice of
orthodontics, the biological material most
often encountered on instruments and
pliers is saliva — a substance not requiring
particularly aggressive cleaning agents.
The bottom line in assessing any cleaning protocol is not so much the equipment
selected but the chemistry associated with
it. Get MSDS sheets, check the ingredients
in the formula, and ask your peers about
the experiences they have had with a specific product. When in doubt, call the manufacturer of your instruments for advice
before you commit to a chemical cleaning
agent that could potentially damage your
instrument inventory.
The cleaning and sterilization process
puts enough stress on your pliers and instruments under ideal conditions without
introducing damaging chemicals that
weren’t designed for your protocol.

[13] =>

Ortho Tribune U.S. Edition | AAO Preview

industry

13

[14] =>

industry

Ortho Tribune U.S. Edition | AAO EDITION 2014

Thinking outside the
metal box: Why wait?
By Coretta E. Morning, 3M Unitek
U.S. Marketing Manager, and
Alice M. Hill, 3M Unitek U.S. Marketing
Communications Supervisor

uring the course of the
last decade, the patient
pendulum has shifted
from “Do I have to wear
braces?” to wanting to
show off those braces
via a “selfie” (a self-portrait with a camera at arm’s distance) that is posted to the
Internet via a social media site. With this
pendulum shift, there is a much stronger
desire to show off a smile, face, body or
unique personality, and more importantly, to describe the experience. It is a
newfound freedom that all generations
are taking advantage of.
What’s interesting about this new
method of sharing is that data shows
that 67 percent of consumers read online business reviews and 70 percent
will trust a business review that has six
to 10 reviews. Further, when an online
review is read, 58 percent of readers say
that the positive customer reviews will
affect their decision making (http://
s o c i a l m e d i a to d a y. c o m /d o u g l a s
karr/561225/infographic-why-do-peoplewrite-online-reviews).
Dentists today offer their adult patients
tooth-colored fillings, tooth whitening,
veneers and caps. Dermatologists offer
skin resurfacing and peels, plus Botox™
to combat wrinkles. Plastic surgeons offer no end of surgical and non-surgical
body and face enhancements.
The common thread among these practitioners is the proactive and aggressive
approach to discussing esthetics with the
patient. In July 2011, a Los Angeles Times
article offered that orthodontic technology had advanced right alongside that of
cosmetic procedures and that there are
now options that provide that “esthetic
look” while in treatment, especially for
adult patients who are now “opening
wide” for braces (Mascarelli, Amanda
Leigh. Focus on Dental Health; Braces
Grow Up: Los Angeles Times, July 4, 2011,
Home Edition, E-1).
Cosmetic specialties, including orthodontics, are being impacted by this
wave of patrons who want to be seen and
heard. A visit to www.healthgrades.com,
or a review of your competitors’ websites,
will illustrate how positive testimonials
and/or referrals are a part of the equation to being successful, helping esthetic
services gain ground in consumer health
services. The other part of that equation
is setting your practice apart by offering
a differentiated product.
Historically, the metal bracket has been

Try on your braces now with PaintYourSmile.
com.

Clarity ADVANCED Ceramic Braces offer an esthetic treatment. Photos/Provided by 3M Unitek

No one will know you are wearing braces
with Incognito™ Hidden Braces.

the bracket of choice, primarily because
of functionality, durability and overall
legacy of dependability. However, ceramic and lingual brackets now interest
patients of all ages and especially the
ones who also want fashion and discretion. And because it is this generation of
consumer that will provide a testimony

of their orthodontic experience, who will
take that selfie of their smile and tweet
or send a message via Facebook, an orthodontic office with esthetic choices can
capitalize on an opportunity to differentiate themselves via the latest social media vehicle.
Today, it is 3M Unitek that offers the
orthodontic esthetic solutions to meet
the growing demand of consumers who
want treatment options that help them
be beautiful while becoming more beautiful.
• Clarity™ ADVANCED Ceramic Brackets are a revolutionary leap forward in
orthodontic ceramic brackets. These
brackets offer the ultimate combination
of brilliant esthetics and performance
with trusted strength, small bracket design, predictable and consistent debonding and enhanced patient comfort. APC™
Flash-Free Adhesive Coated Appliance
System lets you move directly from
bracket placement to bracket cure without removing adhesive flash. There is
no flash cleanup, saving valuable time
for orthodontists, staff and patients.
APC Flash-Free Adhesive is available on
Clarity ADVANCED Ceramic Brackets.
• Clarity SL Self-Ligating Brackets, incorporating SmartClip™ Self-Ligating
System technology, are the only ceramic

brackets that are passive self-ligating and
feature an open slot, true twin edgewise
design. You can feel confident that Clarity SL Self-Ligating Brackets will deliver
difference-making advantages throughout every phase of treatment.
• Incognito™ Appliance System redefines lingual treatment and provides
orthodontists with an efficient and effective treatment option. With the Incognito System, patients have a completely
esthetic, 100 percent customized lingual
system built for comfort and performance. The Incognito Lite Appliance System is an ideal treatment option for adult
relapse cases or for patients who need
only minor, anterior tooth movement.
• “The Source” at 3MMarketingSource.
com is your one-stop site for professional,
customizable marketing tools that will
help differentiate and grow your practice.
Use these Clarity and Incognito branded
resources to elevate your practice, attract
new patients and build your referral network.
• “PaintYourSmile.com” is the newest
tool from 3M Unitek for the orthodontic office. This interactive website application allows users to upload their
own picture and add Clarity ADVANCED
Ceramic Braces or Victory Series™ LowProfile Braces to their smile. Then they
can personalize the braces with colorful
Alastik™ Ligatures and send the image via
e-mail, Twitter and Facebook to friends
and family. The website app has also been
optimized for mobile and tablet use.
The 17th Annual 3M Unitek Summit
will address the shift to esthetic orthodontics and discuss how you can win in
orthodontics. Now offered in two great
locations, you can enjoy the desert or
the city while unlocking the secrets to
winning the patient game and “thinking outside the metal box.” For more information, contact your 3M Unitek sales
representative at (800) 423-4588.
Note: AlastiK, APC, Clarity, Incognito,
SmartClip and Victory Series are trademarks of 3M. All other trademarks are
property of their respective holders

[15] =>

Ortho Tribune U.S. Edition | Month 2012

xxxxx

3M

xx

[16] =>

Razorship Philadelphia

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[cover] => Ortho Tribune U.S. No. 2, 2014

[toc] => Array ( [0] => Array ( [title] => Big smiles in the Big Easy [page] => 01 ) [1] => Array ( [title] => How to improve our diagnostic acumen: Teach it to our residents – Part II [page] => 02 ) [2] => Array ( [title] => Myobrace System: An evolution in orthodontics [page] => 04 ) [3] => Array ( [title] => Ormco Corporation offers its new Damon Clear2 bracket at the AAO [page] => 06 ) [4] => Array ( [title] => Ultradent introduces new Class II corrector - Esprit [page] => 08 ) [5] => Array ( [title] => Healthgrades: Where prospective patients are searching in 2014 [page] => 10 ) [6] => Array ( [title] => How well do you know your practice’s business fundamentals? [page] => 12 ) [7] => Array ( [title] => Process challenges in pre-cleaning instruments [page] => 12 ) [8] => Array ( [title] => Thinking outside the metal box: Why wait? [page] => 14 ) ) [toc_html] =>

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