ortho international No. 2, 2018
Cover
/ Editorial
/ Content
/ Anti-ageing medicine and orthodontic appliance therapy treatment: An interdisciplinary approach
/ Non-extraction treatment of severe crowding with the aid of cyclic forces and corticotomy
/ Tooth whitening and orthodontics: The icing on the cake
/ New concepts in aligner therapy with the orthocaps system
/ Embracing Sagittal First treatment—The Carriere Motion 3D Appliance: Revolutionising Class II and Class III corrections
/ ICD—Honouring the world’s leading dentists since 1920
/ Planmeca orthodontics—Choose the right tools for you
/ Manufacturer news
/ Meetings
/ Submission Guidelines
/ Imprint
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[1] =>
ortho_2_2018_web.pdf
ortho
issn 1868-3207 • Vol. 3 • Issue 2/2018
international magazine of orthodontics
case report
Anti-ageing medicine and orthodontic appliance
therapy treatment: An interdisciplinary approach
technique
Tooth whitening and orthodontics:
The icing on the cake
interview
The Carriere Motion 3D Appliance:
Revolutionising Class II and Class III corrections
2/18
[2] =>
ortho_2_2018_web.pdf
EXPERIENCE WORLD-CLASS LUXURY
AT THE HABTOOR PALACE
NOVEMBER 2 - 3, 2018
MIDDLE EASTERN CARRIERE SYMPOSIUM DUBAI, UAE
Join Henry Schein ® Orthodontics ™ for the industry’s top-notch educational experience! Distinguished speakers
will share proven strategies that increase clinical efficiency and achieve optimal clinical results.
.
.
.
Ground-breaking SAGITTAL FIRST ™ Philosophy, providing greater efficiencies, shorter treatment times and
long-term aesthetic results.
Strategies to help you treat complex cases which will revolutionize the long-term aesthetics for your patients.
Innovative concepts to help diagnose and establish treatment plans, and achieve remarkable results on time, every time.
Our Distinguished Speakers
Program Chairman
Dr. Luis
CARRIÈRE
Co-Keynote Speaker
Dr. John
GRAHAM
Co-Keynote Speaker
Dr. Dave
PAQUETTE
Dr. Khaled Hazem
ATTIA
Dr. Francesco
GARINO
Dr. Bruce
MCFARLANE
Learn and Enjoy Yourself in Style
The Habtoor Palace is a European-style palace of refined opulence; an oasis of refreshing comforts,
where uncompromising quality and innovation enhance a guest’s stay. The hotel boasts the highest standards
of bespoke service and facilities, including eight restaurants, Iridium Spa, and grand event spaces.
(24 hr. Butler Service included in room rate)
Register online today at: CarriereSymposium.com/Dubai
INNOVATION
happens here
SYMPOSIA
© 2018 Ortho Organizers Inc. All rights Reserved M1416 8/18
[3] =>
ortho_2_2018_web.pdf
editorial
|
Prof. Mauro Labanca
MD, DDS, is an oral
surgeon, and a fellow
of the registrar of the
European section
of, and a councillor of the
International Council
of the International College
of Dentists.
The best is often the enemy
of the good
Dear readers,
A teacher of mine and a talented chief physician of general surgery taught me that “the best is the enemy of the
good”. I am referring to when we were young and ambitious surgeons looking to achieve perfect final closure of
the wound. Insisting on placing the last stitch, though not
essential, resulted in damaging a blood vessel, forcing us
to reopen the patient.
A nice article I read recently (“Teeth within an hour” by
Dr Göran Urde, Implant Tribune, Middle East & Africa Edition, November/December 2017) leads me to paraphrase
the aphorism of my teacher as I do in the title and to reconfirm what I have repeated constantly all over the world. I
see more and more that we are witness to an increasing and often unmotivated tendency to have everything
and to want it immediately, even healing processes. As Dr
Deepak Chopra, a physician and contemporary biologist,
has said: “We are the only creatures on earth who can
change our biology by what we think and feel.”
Therefore, in an era in which the Internet and smartphones render waiting obsolete and Dr Google has the
solution to all our problems, our patients expect biology
to follow this trend, adapting the length of healing to their
changed expectations. In this new scenario, patients
have the same expectations when it comes to dental
treatment—and this applies to every type of treatment,
from implantology to orthodontics. Knowing that new
procedures and offerings are continually being developed, patients are asking for solutions that meet their
expectations more than their biological needs—and of
course with no discomfort or problems.
many adherents) to a dramatic fallout in terms of failures,
insurance problems and renewed distrust of our already
mistreated specialty, for which many are responsible.
Companies, in doing their work, try to convince us to
adopt new techniques and new protocols less and less
validated by time and numbers. Unknown companies
offer cheaper and innovative systems not supported by
studies and research, and dentists (together with their
patients) will act as human guinea pigs.
As professionals, we are too often prone to external
pressures: instead of safeguarding the independence of
our decision-making processes, to avoid the risk of losing
the case to be treated, we can be tempted not to do what
science and our conscience would suggest is needed,
and rather let ourselves be influenced by what the external world imposes on us, often personally facing the consequences for it.
I would like to conclude by quoting George Bernard
Shaw: “Science is always wrong. It never solves a problem without creating ten more.” Let us go back to treating
cases only after serious and careful evaluation and using
validated protocols that we have mastered. Gaining a few
months to later lose teeth moved wrongly or too quickly
is not always the best ethical choice.
Yours faithfully,
Prof. Mauro Labanca
In this crazy race among specialists to see who is
quicker to place implants or align teeth, that will soon
lead us (unfortunately an obvious prophecy that has
ortho
2 2018
03
[4] =>
ortho_2_2018_web.pdf
| content
editorial
The best is often the enemy of the good
03
Prof. Mauro Labanca
case report
Anti-ageing medicine and orthodontic appliance
therapy treatment: An interdisciplinary approach
06
Dr Derek Mahony & Dr Theodore R. Belfor
page 09
Non-extraction treatment of severe crowding
with the aid of cyclic forces and corticotomy
12
Dr Gaetano Turatti, Dr Amedeo Salomone & Dr Luca Giordano
technique
Tooth whitening and orthodontics:
The icing on the cake
18
Dr Yassine Harichane
page 13
industry report
New concepts in aligner therapy
with the orthocaps system
24
Dr Wajeeh Khan
interview
Embracing Sagittal First treatment—The Carriere Motion
3D Appliance: Revolutionising Class II and Class III corrections
page 19
30
Interview with Dr Luis Carrière & Dr John Graham
ICD—Honouring the world’s leading dentists since 1920
34
Interview with Dr Dov Sydney
manufacturer news
36
meetings
Cover image courtesy of Dr Luis Carrière
ortho
issn 1868-3207 • Vol. 3 • Issue 2/2018
2/18
international magazine of orthodontics
Survey: What attracted you to the EOS Congress?
40
Nice, Hamburg, Oslo, Limassol and Athens to host
upcoming EOS congresses
41
BOC interview: “There will be a strong emphasis
on interdisciplinary care”
42
International events
44
about the publisher
submission guidelines
45
international imprint
46
case report
Anti-ageing medicine and orthodontic appliance
therapy treatment: An interdisciplinary approach
technique
Tooth whitening and orthodontics:
The icing on the cake
interview
The Carriere Motion 3D Appliance:
Revolutionising Class II and Class III corrections
04
ortho
2 2018
[5] =>
ortho_2_2018_web.pdf
Planmeca Emerald™ intraoral scanner
Smooth and fast
ZRUNȵRZIRU
orthodontics
• Fast and accurate full arch scanning with Planmeca Emerald™
• Comprehensive orthodontic design software
• Compatibility with several orthodontic solutions
Orthodontic solutions:
Full list of compatible providers:
planmeca.com/orthocompliance
Find more info and your local dealer!
www.planmeca.com
Planmeca Oy Asentajankatu 6, 00880 Helsinki, Finland. Tel. +358 20 7795 500, fax +358 20 7795 555, sales@planmeca.com, www.planmeca.com
[6] =>
ortho_2_2018_web.pdf
| case report
Anti-ageing medicine
and orthodontic appliance therapy
treatment: An interdisciplinary
approach
By Dr Derek Mahony, Australia, & Dr Theodore R. Belfor, US
Introduction
Anti-ageing is a branch of medicine focused on how
to prevent, slow or reverse the effects of ageing, thus
helping people to live longer and healthier lives. Recently,
however, more evidence-based medicine has led to antiageing becoming a multi-billion-dollar industry. In the past
few decades, the market for anti-ageing products and
services has grown into a global industry valued at an estimated US$261.9 billion in 2013, up from US$162 billion
just five years before, according to BCC Research, a
publisher of technology market research reports based
in Wellesley in the US.1
The recent medical literature and evidence-based
medicine show that, as we age, there seems to be
a loss of fat volume in some areas of the face, as well
as a change in the morphology of the facial skeleton.
Facial soft-tissue augmentation by injection has become
increasingly popular as a minimally invasive option for
patients seeking cosmetic facial enhancement. Replacing lost soft-tissue volume allowed for a more comprehensive approach to total facial rejuvenation. It has been
demonstrated that orthodontic treatment with an intraoral orthopaedic dental appliance (Homeoblock, OrthoSmile) increases soft-tissue volume and enhances facial
symmetry, producing soft-tissue changes consistent with
improved facial esthetics.2 This appliance can be added
to the treatment protocol of facial injection to create a relatively non-invasive interdisciplinary approach to midface
enhancement.
With this article, we show how orthopaedic/orthodontic appliance therapy, in conjunction with the placement of dermal fillers for the reduction of lines/wrinkles
and depressions in the face, can produce desirable facial
soft-tissue enhancement. Furthermore, we show that the
volumetric changes achieved by this combined treatment
06
ortho
2 2018
approach can produce a desirable result, namely a more
youthful appearance.
Case study
A healthy woman in her mid-sixties presented for treatment with a strong desire to improve her facial appearance (Fig. 1). Her oral hygiene was good and there was no
active periodontal disease. She had headache symptoms
and clinical examination showed a disc displacement with
reduction on her right side, with a maximum jaw opening of 38 mm. Her centre line was displaced 2 mm to the
right and lined up when she opened < 10 mm, indicating that she had a mandibular displacement to the same
side. A Homeoblock appliance, with a 5 mm bite block
on the right side (to decompress her temporomandibular
joint), was fabricated and delivered (Fig. 2). When she
closed on the bite block, her occlusion freed up and the
muscles realigned the mandible so that her centre line
lined up correctly. Her headache symptoms were relieved
in three weeks and her maximum opening was improved
to 42 mm. The patient continued Homeoblock treatment
for nine months.
Intra-oral and extra-oral photographs were taken to
monitor treatment, and 3-D stereophotogrammetry was
performed. Extra-oral 3-D digital photographs were taken
with a facial capture system (3dMD). A facial capture
system (3dMD/Kodak) and stereophotogrammetry were
used to generate a clinically accurate digital model of the
patient’s facial surface. It uses a technique of stereotriangulation to identify external surface features viewed
from at least two cameras. This approach incorporates
the projection of a unique, random light pattern that is
used as the foundation for triangulating the geometry
in 3-D. The capture takes < 2 ms per frame. The data
is processed and a highly precise < 0.5 mm root mean
square of the distance measured is calculated, creating
[7] =>
ortho_2_2018_web.pdf
case report
|
Fig. 1
Fig. 2
Fig. 1 Pretreatment facial and anterior intra-oral photographs (note deep dental overbite). Fig. 2 The Homeoblock appliance.
ortho
2 2018
07
[8] =>
ortho_2_2018_web.pdf
| case report
Fig. 3
Fig. 3: The pretreatment face, the post-treatment face at six months and nine months, and finally, a morphometric evaluation of the change.
08
ortho
2 2018
[9] =>
ortho_2_2018_web.pdf
case report
Fig. 4
Fig. 5
|
Fig. 6
Fig. 4: Morphometric evaluation of the final results: finite element analysis showed increased facial volume with a directional change of almost 4 mm, indicated
by the red to orange colour. Fig. 5: Superimposing the red post-treatment face over the blue pretreatment face, we can graphically illustrate the volumetric
changes that occurred during our treatment. There was an increase in volume in the frontal, supraorbital, inferior orbital, zygomatic, nasal base, upper lip,
nasolabial depression, and marionette and pre-jowl areas. Fig. 6: Morphological facial changes in the lips, zygoma and jowl area after the placement of 1 ml
Restylane and 1.3 cc Radiesse. Note the deeper red to orange colour in the areas where the injections were placed.
a digital model of the patient that is ready for immediate
clinical use. Stereophotogrammetry for quantifying
facial morphology was introduced in a study published
in the Journal of Dentistry in 1996.3 It was concluded
that “stereophotogrammetry is a suitable 3-D registration method for quantifying and detecting development
changes in facial morphology”.3
Results
Post-treatment, the patient’s face appeared more youthful with better defined cheekbones and a firmer jaw line.
The skin appeared smoother with fewer lines, wrinkles
and depressions (Figs. 7a & b).
Discussion
Evaluating the patient’s face over the nine months of
Homeoblock treatment for her temporomandibular dysfunction showed a change in the morphology of the
face (Fig. 3). Morphometric analysis was performed by
superimposing before and after 3-D images and using
finite element modelling. Thousands of triangular reference points were used to establish the change. The blue
area indicated no change and the red to orange areas
showed an increased dimension of up to 2.9 mm. We
saw an increased volume above and under the eyes, the
zygomatic region, the upper lip, and the marionette and
pre-jowl areas. From the facial photographs, we could
see a reduction in the lines, wrinkles and depressions
(Figs. 4 & 5).
After nine months, the patient’s facial changes
prompted her to go forward with injections of dermal
fillers. She was given 1 ml of Restylane (Galderma) for lip
enhancement and two 1.3 cc corrections with Radiesse
(Merz Aesthetics) in the pre-jowl and marionette areas
and along the inferior border of the mandible, and the
inferior and lateral borders of the zygoma (Fig. 6).
Facial changes related to palatal expansion are clearly outlined in Singh: “The maxillary complex shows a change in
size (and/or mass) allied with an increase in structural complexity, in association with biological processes.”4 Palatal
expansion presumably, switches on osteoblastic genes
associated with active boney deposition and concomitant
remodeling of the spatial matrix ensues.”4 In relation to the
changes around the eyes, we must recall that the maxilla forms the floor of the orbit and skeletal changes may
become apparent after expansion;4 specifically, changes
in orbital morphology may be reflected on the skin of the
face: as the lower eyelids become tighter, the lateral canthus becomes more horizontal; facial width increases, particularly at the zygomatico-maxillary sutures; and the craniofacial form, putatively, not only functions better, but looks
more attractive.4 These changes have been documented
in children, where palatal expansion is an everyday occurrence. The current article documents similar changes in a
non-growing adult. Combining the results of palatal expansion and the placement of dermal fillers, we obtained a
very satisfactory improvement in facial aesthetics.
ortho
2 2018
09
[10] =>
ortho_2_2018_web.pdf
| case report
Fig. 7a
Fig. 7b
Figs. 7a & b: Before and after facial photographs.
Editorial note: A list of references is available from the publisher.
about
Dr Derek Mahony
is a Sydney-based specialist orthodontist
who has spoken to thousands of practitioners about the benefits of interceptive
orthodontic treatment. Early in his
career, he learnt from leading clinicians
the dramatic effect functional appliance
therapy can afford patients in orthodontic
treatment, and he has been combining
the fixed and functional appliance
approach ever since. His lectures are
based on the positive impact such a combined treatment approach has had on his
orthodontic results and the benefits this
philosophy provides from a practice management viewpoint. He can be contacted
at info@derekmahony.com. His website
address is www.fullfaceglobal.com.
10
ortho
2 2018
Theodore R. Belfor, DDS
Dr Theodore R. Belfor graduated from the
New York University College of Dentistry
in the US in 1966. He is a senior certified
instructor for the International Association
for Orthodontics, lectures internationally,
was Chairman and President of OrthoSmile, and is the inventor of the patented
Homeoblock orthopaedic/orthodontic
appliance. He has been published in the
New York State Dental Journal, the Journal
of Cosmetic Dentistry, Aesthetic Dentistry
Today, Dentistry Today, the Journal of
the American Academy of Gnathologic
Orthopedics, the Functional Orthodontist,
International Journal of Orthodontics, and
Sleep Diagnosis and Therapy.
[11] =>
ortho_2_2018_web.pdf
COURSES
2018
Certification Courses
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Language: German
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Language: English with
Russian translation
Online Certification Courses
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22ⁿ September 2018 . . .. . .. . .. . .. . . Paris
Language: French
User Meetings
21 October 2018 ..... .. . .. . .. . .. . .. . . Moscow
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Language: German
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Language: French
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Certification Course
11ʰ – 12ʰ January 2019 .. . .. . .. . .. . Istanbul
Language: English with
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Courses for dental assistants/orthodontic therapists
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18ʰ – 19ʰ January 2019.. . .. . .. . .. . Frankfurt on the Main
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Language: German
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[12] =>
ortho_2_2018_web.pdf
| case report
Non-extraction treatment of
severe crowding with the aid of
cyclic forces and corticotomy
By Dr Gaetano Turatti, Dr Amedeo Salomone & Dr Luca Giordano, Italy
Introduction
The reduction of orthodontic treatment time represents
one of the more common requests by patients. However,
while we attend to the patient’s request, safely moving
teeth and stability of our results are very important and
must be stressed. The acceleration of dental movement
and treatment time also may help in reducing the risk of
caries resulting from difficulties in maintaining adequate
hygiene, in reducing the effort on the part of the patient
and in allowing the orthodontist to obtain complex orthodontic movement using simple biomechanics. Especially
from a biological point of view, there is a reduction of
stress on the dental roots and on the supporting surface
and deep tissue.1
In medical literature, various non-surgical approaches
have been reported to achieve the acceleration of orthodontic movement, for instance laser biostimulation and
photo-biomodulation,2 the application of magnetic fields,3
as well as the targeted injection of prostaglandin E24 and
vitamin D.5 The surgical approach is instead represented
by the dentoalveolar corticotomy procedure6 in which
the acceleration of dental movement is achieved owing
to an induced state of transient osteopenia, defined by
Frost as the “Regional Acceleratory Process”,7 which
results immediately from surgical wounding of the bone
caused by the corticotomy procedure. Other surgical
techniques used to induce transient osteopenia (accelerated osteogenic orthodontics,8 periodontally accelerated
osteogenic orthodontics,9 corticision,10 piezocision11 and
micro-osteoperforations12) may be considered as variations in invasive approaches, but are nonetheless based
on the induction of cortical lesions.
More recently, devices (AcceleDent Optima, OrthoAccel
Technologies) have been described that can accelerate tooth movement through the transmission of cyclic
vibratory forces or cyclic loading of 0.25 N (25 g) at low
frequency (30 Hz). Such a device includes a mouthpiece
and is to be used by the patient for 20 minutes per day.
In a randomised clinical trial, Pavlin et al. found that
the application of vibrations by means of the AcceleDent
12
ortho
2 2018
Optima device associated with fixed orthodontic treatment
considerably increased the rate of dental movement.13 In
fact, the rate of tooth movement per month in the group
of patients who used AcceleDent (1.16 mm/month) was
48.1% faster than in the control group (0.79 mm/month).
A retrospective study by Bowman showed that the alignment and levelling time of the lower jaw was faster in
the group using AcceleDent (93 days) than in the control
group (120 days).14 This is equivalent to a 30% reduction in treatment time. A study by Orton-Gibbs and Kim
found that fixed orthodontic treatment in combination
with AcceleDent was 38.2% faster and aligner treatment
in combination with AcceleDent was 37.2% faster.15
The purpose of this report is to present a case of a
patient with severe crowding. Treatment included interradicular corticotomies in conjunction with the AcceleDent
device.
Case report
The 17-year-old male patient came for an examination
in December 2014. The objective intra-oral examination
revealed a bilateral Class I molar relationship and a canine
relation of Class I and Class II on the right. The transverse trans-molar diameter of the upper dental arch was
normal, while there was a reduction in the inter-premolar
diameter associated with severe crowding in the intercanine region. In the lower dental arch (narrow, parabolic shape), there was dental crowding with complete
deficiency for tooth #42, which was in an ectopic lingual
position. Complete deep bite with masticatory trauma to
the adjacent gingiva was observed in the lower incisal
region. The teeth of the upper arch were slightly larger
than average, with a minor moderation of Bolton’s index.
The objective extra-oral examination revealed that the
subject had a long face, the development of the middle
third of the face was normal, and the nasal pyramid was
wide and associated with mild mandibular retrusion
(Figs. 1a–h).
The cephalometric analysis confirmed a Class I skeletal pattern (ANB angle: 4°), meso-divergent facial pattern
(SN–GoGn angle: 35°) with retroclination of the mandib-
[13] =>
ortho_2_2018_web.pdf
case report
Fig. 1a
Fig. 1b
Fig. 1d
Fig. 1e
Fig. 1f
|
Fig. 1c
Fig. 1g
ular incisor (incisor mandibular plane angle [IMPA]: 84°)
and proclination of the maxillary incisor (U1–SN angle:
117°; Figs. 10a & 11a).
The following treatment options based upon treatment
goals were considered:
1. If facial balance and airway extension were paramount
to the patient, orthognathic surgery would be the plan
of choice.
2. If tooth alignment was the only goal, an orthodontic
plan in conjunction with corticotomies and AcceleDent
would be followed.
The case could also have had a maxillofacial surgical resolution after extracting two premolars in the lower
arch and closing the spaces to allow greater mandibular
advancement. The patient was not ready to accept this
treatment method. The decision was, therefore, taken to
proceed without extractions with the help of the interradicular corticotomies in the upper arch and the use of the
AcceleDent device for the alignment of the lower arch.
Surgery was performed under local anaesthesia on the
upper dental arch with the incision and detachment of a
Fig. 1h
full-thickness flap from tooth #16 to 26. After performing interradicular corticotomies, an antigen-free porcine
bone graft was applied and covered with a platelet-rich
fibrin membrane (Figs. 2a & b).16 The flap was repositioned with detached sutures.
Seven days after surgery, the suture was removed and
a quadhelix appliance was applied with the aim of molar
de-rotation and rapid palatal expansion. At the same
time, the upper arch was bonded with self-ligating brackets (Damon Q; Figs. 3a–d). Alignment and levelling of the
upper arch were achieved using nickel-titanium archwires
in the following sequence: 0.014, 0.018, 0.016 × 0.022,
0.019 × 0.025 in.
Six months after the intervention, a mandibular bi-helix
expander was cemented with the aim of transverse expansion of the posterior and mandibular sections (Fig. 4). At
the same time, the AcceleDent device was delivered and
the patient was advised to use it for 20 minutes per day.
Two months later, following uprighting of the posterior and
mandibular sections, the lower arch was bonded with
self-ligating brackets (Damon Q), with the exception of
tooth #42. Alignment and levelling of the lower arch were
ortho
2 2018
13
[14] =>
ortho_2_2018_web.pdf
| case report
Fig. 2a
Fig. 2b
Fig. 3a
Fig. 3b
Fig. 3c
Fig. 3d
Fig. 4
Fig. 5a
Fig. 5b
Fig. 5c
Fig. 5d
Fig. 5e
Fig. 6a
Fig. 6b
Fig. 6c
Fig. 6d
Fig. 6f
14
ortho
2 2018
Fig. 6e
Fig. 7
Fig. 6g
Fig. 6h
[15] =>
ortho_2_2018_web.pdf
case report
Fig. 8a
Fig. 8b
Fig. 8c
Fig. 8d
Fig. 8e
Fig. 8f
Fig. 9a
Fig. 9b
Fig. 9c
achieved using nickel-titanium archwires in the following
sequence: 0.014, 0.016, 0.018, 0.019 × 0.025 in. The space
required for tooth #42 in the ectopic lingual position was
obtained within eight months after the lower bi-helix application and six months after the bonding of the lower arch.
The space was reached by inserting from the first archwire
an open spring coil between teeth #41 and 43 and retrieving it in the arch by initially introducing a ligature for closure
and subsequently, upon attaining the correct fit, bonding
and engaging tooth #42 with a 0.016 in. nickel-titanium
archwire (Figs. 5a–e). After the alignment and levelling of
the mandibular right lateral incisor, the final treatment step
involved the correction of the Class II left canine using
Class II intermaxillary elastic bands with 0.019 × 0.022 in.
stainless-steel upper and lower archwires.
The objectives of the treatment plan were achieved in
21 months by attaining a Class I molar and canine relationship with ideal overjet and overbite. A fixed mandibular retainer and a maxillary Hawley retainer (Figs. 6a–h)
were used for retention.
|
Fig. 9d
Discussion
After collecting and analysing the records, it became
clear that the case was particularly complex because,
while the lack of space in the upper arch did not require
extraction, the lack of space in the lower arch would
require extraction, which would prevent the patient from
achieving an ideal overjet and overbite. Obviously, the
complexity of the case could give rise to different and
varied treatment interpretations, such as extraction of
two premolars and closure of spaces and subsequent
mandibular advancement, increase of the inter-canine
diameter through the transmandibular distraction surgical treatment method, extraction of tooth #42 and the final
phase of the case without a centred midline with overjet and increased overbite. The initial retroclined position
(IMPA: 87°) and the presence of a well-represented symphysis allowed satisfactory vestibularisation of the incisors (IMPA: 104°) with an excellent response of the soft
tissue (Fig. 7) and bone (Figs. 10b & 11b). At the level of
the upper arch, the CBCT scan revealed an improvement
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Fig. 10a
Fig. 11a
Fig. 10b
Fig. 11b
about
in bone tropism in the premolar area due to the bone graft
inserted during the corticotomy procedure (Figs. 8a-8f &
9a-9d). The decision to treat the lower arch without a
corticotomy procedure and with only the vibration forces
induced by cyclic loading was due to the fact that the
patient did not want to undergo a second surgery, which
would have been complicated given the ectopic position
of tooth #42 and on the basis of confirmed cases in the
medical literature15 about faster alignment and levelling of
the lower arch in patients treated with AcceleDent.
Conclusion
This case report has demonstrated the use and effectiveness of AcceleDent in a challenging environment
(crowding, little bone and narrow arches). Future work
by the authors and others can pool data to demonstrate
the effectiveness of non-invasive accelerated technology
to provide patients with not only accelerated tooth movement, but more importantly predictable tooth movement
where teeth can be moved safely.
Editorial note: A list of references is available from the publisher.
16
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Dr Gaetano Turatti
is an orthodontist in the department of
dentistry and orthodontics of
the Martini hospital in Turin in Italy.
He can be contacted at
gaetanoturatti@live.com.
Dr Amedeo Salomone
runs a private orthodontic practice in
Turin. He can be contacted
at amedeo.salomone90@gmail.com.
Dr Luca Giordano
runs a private orthodontic practice
in Turin. He can be contacted
at luca_giordano@live.com.
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| case report
Tooth whitening and orthodontics:
The icing on the cake
By Dr Yassine Harichane, Canada
Tooth whitening is a therapeutic procedure that provides the final touch to orthodontic treatment. The
objectives in orthodontics are both functional—restore
masticatory function, swallowing, breathing and phonation—and aesthetic—balance and harmonise the face,
and improve the smile. To achieve the last goal, various
criteria are taken into account: tooth alignment, shade
and shape, and even the shape of the lips. All these
parameters are important; however, the most visible
aspect of the smile is the dental shade. One can restore
function, correct an occlusal dysfunction, close a diastema or even inject dermal fillers, but if the teeth are left
yellowish, the smile remains unattractive. Tooth whitening
is a therapeutic solution that restores the natural lustre of
the teeth by removing organic stains, which means it is
not tooth bleaching. For the orthodontist, there are only
advantages. It is easy to perform, non-invasive, requires
no anaesthesia and produces no irreversible destruction of the tooth. This procedure is rewarding for the
dental team, since the dental assistant can be involved
in all steps of the process. It is suitable for the majority of patients. Tooth whitening is a cost-effective technique that requires little material and time, and is efficient
if the practitioner is rigorous. Finally, the main concern for
patients, it is painless.
How does it work?
The enamel shade can change because of tobacco
stains, food or trauma, for instance. The protocol involves
the application of a tooth whitening product, such as
hydrogen peroxide, carbamide peroxide or sodium perborate. The last one must be avoided, since it is classified
as repro-toxic. The first two are efficient and safe. The
difference between them lies in the fact that hydrogen
peroxide is the active ingredient and carbamide peroxide is a derivative that degrades into hydrogen peroxide.
This release is progressive and slow. This process is suitable when the practitioner desires a soft and progressive
effect. Regarding dosage, the percentage provided by
the manufacturer reflects the concentration: 1% of hydrogen peroxide is equivalent to 3% of carbamide peroxide.
In Europe, the maximum limit for vital teeth is 6% hydrogen peroxide or 18% carbamide peroxide.
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What are the indications?
There are two main indications: intrinsic post-eruptive
stains and extrinsic stains. Intrinsic post-eruptive stains
concern mostly clinical cases involving pulp necrosis
(trauma, endodontic treatment, endodontic calcification).
Among extrinsic stains, there are tobacco stains, discoloration due to ageing and physiological stains. It is in the
last category to which most post-orthodontic treatment
applies. Indeed, tooth whitening will allow beautiful finishing by complimenting the orthodontic result. The patient
will notice the difference—the teeth are well-aligned and
whiter—and forget that the orthodontic process took so
much time, as the tooth whitening needs just a few days.
The treatment is of benefit to the practice too, since the
orthodontist not only restores the function, but improves
the aesthetic outcome painlessly too.
How to perform tooth whitening
The different techniques will be demonstrated through
clinical cases. In the first case, the patient was being
treated with a lingual appliance (Fig. 1) and wished to
whiten her teeth. In-office tooth whitening was deemed
the most suitable. The soft tissue—gingivae, tongue and
lips—must be protected (Fig. 2). The product is applied
to the vestibular aspects of the teeth (Fig. 3) and renewed
every 15–20 minutes. A good result can be obtained
(Fig. 4) with a gentle and efficient product containing 6%
hydrogen peroxide (Opalescence Office, Ultradent Products; Fig. 5). Hydrogen peroxide was chosen because,
being the active ingredient, its efficacy is immediate. A
6% concentration is the limit, but it is strong enough to
observe a difference and low enough to avoid temporary
thermic hypersensitivity.
A take-home whitening process entails the use of
trays loaded with tooth whitening gel. After an orthodontic treatment, two options are available. An impression of
both arches is taken, then stone models are prepared. A
soft tray sheet is thermoformed, which allows the making
of custom whitening trays (Fig. 6). At the second appointment, the patient receives the trays and the product,
together with the user instructions for one or two weeks
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Fig. 1
Fig. 2
Fig. 3
Fig. 4
|
Fig. 1: Patient undergoing lingual orthodontic treatment. Fig. 2: Soft-tissue protection during the in-office tooth whitening procedure. Fig. 3: Application of
tooth whitening gel to the vestibular aspects of the teeth. Fig. 4: Before and after in-office tooth whitening on a patient wearing a lingual appliance.
on the basis of daily use for 60–120 minutes (Fig. 7). For
this application, carbamide peroxide of 10% or 16% is
chosen (Opalescence PF, Ultradent Products; Fig. 8).
The choice of carbamide peroxide is suitable for at-home
application, since the gel releases hydrogen peroxide
progressively. The choice of concentration depends on
the clinical case. A young patient or a patient with already
treated thermic hypersensitivity should use 10% carbamide peroxide. Any other patient or a former smoker should
use 16% carbamide peroxide. For at-home application,
if the practitioner does not wish to prepare trays in-office
or through the laboratory, an already prepared kit containing ready-to-wear trays can be used (Opalescence
Go, Ultradent Products; Fig. 9). In this case, at the first
appointment, the patient receives a kit containing a tray
pre-filled with tooth whitening product. Once at home,
over ten days approximatively, the patient applies the tray
into the mouth and leaves the gel to work for 60–90 minutes (Figs. 10 & 11). It is a huge time-saving approach
for the patient and the orthodontist, with an uncompromised result.
Cost of materials and treatment fee
For in-office application, an Opalescence Office kit
costs approximatively €90. Generally, the kit contains
two syringes, enough for two appointments with the
same patient or two different patients. For at-home application, if the office owns a thermoforming machine, the
dental assistant prepares the trays, and two thermoforming sheets cost €2. Otherwise, a dental technician usually charges €50 to produce a pair of custom trays. The
Opalescence PF kit with carbamide peroxide costs about
€60 for the 10% or 16% concentration. If the orthodontist
does not wish to spend time and money on custom trays,
the ready-to-use kit should be used. It costs €70 for the
trays already loaded with tooth whitening gel.
In-office application requires one hour. The practitioner
does not need to be with the patient throughout the entire
procedure, but applies the gel and leaves it to complete
its cycle. For custom trays, a first appointment is necessary for the impressions and another to deliver the trays
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Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 5: Opalescence Office kit for in-office whitening. Fig. 6: Custom trays. Fig. 7: Clinical case before and after at-home tooth whitening using custom trays.
Fig. 8: Opalescence PF kit for at-home whitening.
and the product, taking altogether less than 15 minutes.
Otherwise, the pre-filled trays are delivered to the patient
and the dental assistant explains the process in a short
appointment. In my experience, having custom trays with
good fit will significantly reduce any saliva ingress and
always provide optimal results.
The fee depends on the financial strategy of the office.
The treatment may be free, in order to offer a gift after a
long and/or expensive orthodontic procedure, or to compensate for an imperfect final result. If this is a gift, the
patient feels privileged. Otherwise, the fees are calculated according to the hourly cost of the office, based
on the time spent on the process as estimated by the
specialist. A final possibility is for the practice owner to
determine the fee based on that charged by competing
practices. The mean cost is €700 for in-office application,
€400 for at-home application with custom trays and €200
for the Opalescence Go kit.
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Tips and tricks
Previously, it was noted that thermic hypersensitivity
can occur. It is better to prevent this, and to this end, the
specialist has a great deal of choice. Among the plethora of products on the market, we have found Profluorid Varnish (VOCO; Fig. 12) to offer particular stability.
This varnish, which is applied to the tooth surface, has
desensitising properties. Its use is entirely suitable for
tooth whitening. We also recommend sending the patient
home with a prophylaxis kit (Remin Pro or Remin Pro
Forte, VOCO; Figs. 13 & 14).
Another tip is to use orthodontic aligners to perform
the at-home whitening. The only disadvantage is that the
whitening product will be squeezed between the tray and
the teeth and can flow to the gingivae when positioning the tray in the mouth. That is the reason to prefer
custom trays. The limits follow the gingival margin in order
to avoid potential excess. Moreover, we strongly recom-
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Fig. 9
Fig. 10
Fig. 11
Fig. 12
|
Fig. 9: Opalescence Go kit for at-home whitening. Fig. 10: Clinical case before and after tooth whitening using ready-to-wear trays.
Fig. 11: Pre-filled trays on the teeth. Fig. 12: Profluorid Varnish for dental hypersensitivity treatment.
mend reading the manufacturer’s instructions and preparing a reservoir in the tray according to the manufacturer’s instructions. To this end, one need only add some
resin to the vestibular aspects of the teeth on the stone
model (Fig. 15). The advantage is double, since the reservoirs will guide the patient to put the exact quantity of gel
in the correct place with no excess.
During the whitening, the patient should not smoke or
consume staining drinks like coffee and tea to avoid any
re-coloration of the teeth. The best solution is to perform
fluoride application after the treatment. The fluoride kit
(Bifluorid 10, VOCO; Fig. 16) contains single doses to
apply to the vestibular aspects of the teeth. This fluoride
varnish will protect the tooth surface against staining in
order to maintain a long-term result.
What about the law?
In Europe, hydrogen peroxide is limited to 6% (18%
carbamide peroxide) for vital teeth. This concentration
is really enough for a tooth whitening, but not sufficient
if the patient comes to the office expecting a Hollywood
smile. Since hydrogen and carbamide peroxide are efficient, there is no reason to use sodium perborate, but it
is not prohibited. Finally, the dental assistant is allowed
to be involved in the process. He or she can take the
photographs, measure the dental shade before and
after the treatment, prepare the trays and even explain
the instructions of use. All of this is simple and accessible. The orthodontist should refer to national regulations to determine whether the dental assistant can
take impressions or apply the gel to the teeth. However, diagnosis and responsibility remain the duties of
the practitioner.
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Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 13: Remin Pro for home use. Fig. 14: Remin Pro Forte for home use. Fig. 15: Stone model with resin on the vestibular aspects of the teeth for tray reservoirs.
Fig. 16: Bifluorid 10 for in-office fluoride application.
Conclusion
Tooth whitening is a procedure that complements
orthodontic finishing. It is a final touch that makes a visible
difference. The technique is simple and does not require
long and fastidious training, only strict adherence to the
protocol. The practitioner’s rigour is enough to understand the protocol. This aesthetic dentistry tool adds
value to the orthodontic office and to the dental team
involved in the process, from the front desk to the chair,
not to mention that it significantly improves the before and
after photographs. Finally, everybody, the patient and the
team, is satisfied at the end of the treatment.
Conflict of interest
and acknowledgements
The author has no disclosures to make. The author
would like to thank Dr Shiraz Khan for the proofreading
and friendly support.
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about
Dr Yassine Harichane
graduated from Paris Descartes
University in France and completed
his MSc and PhD on dental pulp stem
cells. He maintains a private practice
in Canada and can be contacted
at yassine.harichane@gmail.com
[23] =>
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Recommended by dentists
- loved by their patients
[24] =>
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| case report
New concepts in aligner therapy
with the orthocaps system
By Dr Wajeeh Khan, Germany
Historical background
Aligner mechanics
Overlay appliances have been used in orthodontics for
more than 90 years. In the early days, such appliances
were shaped like positioners, that is formed as single-unit
appliances with tooth cavities to receive both maxillary
and mandibular teeth. For minor orthodontic tooth movement, Remensnyder in 1923 described a rubber gingival
massaging appliance that he later patented as an “orthodontic appliance”.1
The mechano-transduction (transmission of force) of
orthodontic forces triggers a tissue response that results
in orthodontic tooth movement. Teeth and the surrounding tissue do not differentiate between force generated by
aligners or any other type of appliances. The factors that
determine the quality and quantity of orthodontic tooth
movement depend greatly on the force system that is used,
including the amount of force, its duration and dynamics,
and the underlying tissue response. It is therefore imperative that the design of the appliances, the material property
of the thermoplastics, and the interface between the tooth
and the appliance are conducive to creating a force system
that ensures controlled, effective and safe tooth movement.
In 1945, Kesling published a landmark article in the
American Journal of Orthodontics and Oral Surgery titled
“The philosophy of the tooth positioning appliance”.2 In this
article, Kesling described the making of a set-up model
after teeth had been cut out from a plaster cast and repositioned in wax on the model base. The “positioner” was
thus formed as a negative of the model created by repositioning teeth in wax. Kesling, in a patent that was granted
in 1945, stated that, if the extent of tooth movement was
beyond the scope of a single appliance, more than one
appliance could be used in sequence to move teeth.
McNamara et al., Ponitz, Nahoum, Sheridan et al., Rinchuse and Rinchuse, and others also described the use
of overlay appliances that took the form of modern-day
aligners to achieve orthodontic tooth movement.3–7
As the use of CAD/CAM became common in dentistry
in the 1990s, the concept of using digital 3-D scanners
and rapid prototyping technology became apparent in
the manufacturing of aligners. François Duret, a French
innovator and dentist, used CAD/CAM techniques to
construct dental prosthetic and restorative units as early
as 1983.8 In 1996, researchers like Alcañiz et al. and
Hemayed et al. separately described in detail the use of
CAD/CAM techniques to create computerised set-ups
and rapid prototyping models for diagnostic and therapeutic purposes in orthodontics.9, 10
In 1998, Align Technology commercialised the production of aligners using such CAD/CAM techniques.
Although the Invisalign system is the most widely used,
some companies, including Ortho Caps, offer alternative
aligner techniques, such as the orthocaps system.
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Aligner design
Aligners are removable appliances and are therefore
inherently at a disadvantage when compared with fixed
appliances. The aligner–tooth interface is mechanically
less efficient in transmitting orthodontic force to the surrounding tissue as compared with systems based on
brackets and wires. In order to overcome this disadvantage, it is important that the appliance design incorporates features that enable the aligners to have a good grip
on teeth and allow the aligners to have maximum surface
contact with teeth.
Material properties of thermoplastics
A variety of thermoplastic materials are available that
can be used for manufacturing aligners. These materials
not only differ in their composition and thickness, but also
differ in properties such as elasticity, which is essential
for tooth movement. The choice of material essentially
depends on the type and amount of tooth movement,
the required force levels, and the condition and health of
the underlying tissue.
The aligner–tooth interface
As already mentioned, in order to transmit force effectively, it is important to create an interface (contact area)
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|
Fig. 1
Fig. 1: Pressure points are counter-productive.
that allows the transmission of force without loss of magnitude, directional control, or both. This requires an exact
aligner fit, as well as an accurate reproduction of the tooth
surface and the interdental areas in models that are used
to manufacture aligners. Aligners manufactured on such
models have the required fit on the teeth to achieve a
good grip.
The orthocaps system
The orthocaps system is designed to address the core
problem that many aligner systems have, namely, the
lack of ability to transmit force to teeth without mechanical or directional loss, and the lack of adequate control
while delivering forces that move teeth accurately in all six
degrees of freedom (x-, y- and z-axis translation and x-,
y- and z-axis rotation) in 3-D space.
For this reason, the system emphasises the use of
elastic materials in the fabrication of aligners. The orthocaps system (TwinAligner) also uses two different types
of aligners for each treatment step throughout the treatment. This technique ensures the use of optimal forces
that can be generated by selecting different thicknesses
of elastic materials that are used for aligners that are worn
at night or during the day (DayCaps/NightCaps).
Aligner design
In the orthocaps system, an exact aligner fit is of paramount importance. Modifications to aligner design, like
pressure points, dents, divots or certain types of structures, such as power ridges, that are used in some other
systems to direct force to certain areas on clinical tooth
crowns are thought to be counter-productive. These
modifications result in spaces and voids (Fig. 1) that are
created between the teeth and aligners and therefore
reduce the grip of the aligners on teeth. The main design
feature for the orthocaps aligners is thus the ability to
encapsulate the teeth completely. This allows the maximum surface of the teeth to be in contact with the soft
inner aligner layer, which is more elastic than the outer
rigid aligner shell (layer). High-pressure thermoforming
techniques also facilitate flow of the aligner material into
the interdental areas, thereby increasing the surface contact area with the aligners.
Thermoplastic materials
Material elasticity is the foremost property that is
needed in achieving controlled tooth movements. Elastic deformation of aligner materials generates the force
that is required to move teeth. Elastic materials can be
deflected or deformed to a greater extent without losing
their shape or form. This deformation is generated owing
to the difference in the position of teeth between the
set-up model on which the aligners are fabricated and the
actual position of the patient’s teeth. If the aligner material is elastic, the aligner regains its original shape completely when it is removed from the mouth. This means
that the aligner remains active and continues to exert a
force until it returns to its original form and thereby moves
the teeth effectively. In contrast, inelastic and rigid materials undergo a plastic deformation even at lower deflection
levels (strain) and thus lose their form and therefore are
unable to move teeth. This is why inelastic materials for
aligners are not as effective as elastic materials.
In Figure 2, the material stress is plotted along the
y-axis. The amount of stress is the force (F) in newtons
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Fig. 2
Fig. 3
Fig. 2: Difference in elasticity in two materials. Fig. 3: Attachment types.
divided by area (A) in m2. The material strain or deformation is measured as a percentage of deflection from the
original state of rest. For linear deformation, this is calculated as the increase in length (l) divided by the initial
length (L). The elasticity (modulus of elasticity, E) of a
material is shown by the gradient of the curve and is calculated by dividing stress by strain as shown in the following equation: E = (F/A) / (∂l/L).
Bending, stretching or deforming a material beyond
its elastic limit results in plastic deformation of the material. It is important to remember that elasticity is a material constant and does not depend upon the thickness
or geometry of the material. The same degree (%) of
deflection or strain would result in permanent deformation of a given material regardless of its thickness
or shape.
Orthodontic movement is thus caused by the rebound
force that makes the elastic material regain its original
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ortho
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state or shape. This force is directly proportional to the
area, modulus of elasticity, and the deflection or strain
the material is undergoing, provided that the material is
not strained beyond its elastic limit as shown in Figure 2:
F = AE(∂l/L).
Attachments
Many types of attachments can be used to increase
the efficacy of tooth movement with orthocaps. The use
of soft and elastic materials also makes it easier to use
attachment types that would otherwise be impossible to
use with rigid or hard materials. Some of the attachment
types are shown in Figure 3.
Friction pads
Apart from normal attachments, a new type of attachment, a friction pad, was developed at the Ortho Caps
centre in Germany. This friction pad consists of a flat
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Fig. 4
|
Fig. 5
Fig. 4: CAD model of the friction pads on two teeth. Fig. 5: Friction pads bonded to several teeth.
textured surface that is bonded to the tooth in order to
increase the friction between the inner aligner surface
and the tooth. The advantage of using friction pads is that
these textured surfaces are only a fraction of a millimetre thick, making them almost invisible under normal circumstances and therefore more acceptable to patients.
Figure 4 shows the CAD model of the friction pads on
two teeth.
Case 4
The treatment for this 12-year-old was started in the
mixed dentition with orthocaps Kids (Fig. 9). The last
phase of the treatment was completed with orthocaps
Pro. No auxiliaries were used in the entire treatment,
which took 30 months.
Case 5
The attachments or friction pads are bonded to the
teeth by indirect bonding techniques. Preformed attachments or friction pads are sent to the clinician placed
in the first aligners ready for indirect bonding. Figure 5
shows the friction pads bonded to several teeth. As can
be seen in the photographs, the friction pads are only
visible on close inspection. This aesthetic advantage of
friction pads over regular attachments makes this type of
bonded retention aid much more acceptable to patients
seeking an invisible treatment option.
Clinical cases: Before and after records
This 33-year-old female patient was treated for posterior crowding over 28 months (Fig. 10). The maxillary
right first molar was extracted and the space closed by
moving the second molar into the extraction space with
orthocaps aligners. At the end of the treatment, Ortho
Caps provided a lingual auxiliary, consisting of four lingual
brackets and a pre-ligated nickel-titanium wire within an
indirect bonding tray to bond the appliance. Subsequent
aligners were designed to immobilise the two premolars,
while allowing the second molar to upright. This design
created the necessary anchorage in order to upright the
second molar effectively.
Case 1
Conclusion
This young adult female patient was treated for maxillary and mandibular crowding and deep bite over
18 months (Fig. 6). The orthocaps Pro system was used
without any auxiliaries.
The mechanical limitations of aligners can be overcome, and satisfactory orthodontic tooth movement,
even in complex cases, can be achieved to a certain
extent provided the following conditions are met:
Case 2
This young female teenager was treated for a Class II
bite and deep bite over 24 months (Fig. 7). The orthocaps
Pro system was used without any auxiliaries. Towards
the end of the treatment, a BiteMaintainer was used as
an active retainer.
Case 3
This 45-year-old female patient was treated over a total
of 28 months with a distalising apparatus based on temporary anchorage devices, followed by orthocaps aligners, to correct the overjet and a midline deviation (Fig. 8).
1. knowledge of the limitations of aligner mechanics;
2. use of auxiliaries (mini-screws, expansion appliances
and partial fixed appliances) in conjunction with aligner
treatment;
3. use of elastic thermoplastic materials to avoid plastic
deformation of aligners during treatment and to optimise force levels (light forces);
4. accurate reproduction of interdental areas in digital
scans to allow maximum aligner–tooth contact;
5. high-pressure thermoforming techniques to achieve
better aligner adaptation;
6. sound planning (regulation of the amount of movement
per stage) in the treatment staging process;
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Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 6: Case 1. Fig. 7: Case 2. Fig. 8: Case 3. Fig. 9: Case 4. Fig. 10: Case 5.
7. use and placement of suitable attachments and friction
pads to increase aligner grip;
8. clinician’s experience and ability to recognise problems
during the treatment process;
9. division of treatment into phases and the evaluation
of treatment progress (superimpositions and deviation
analyses) at regular intervals during treatment; and
patient motivation and cooperation.
As the demand and need for aesthetic orthodontic
treatment alternatives have grown, aligners have secured
a firm place in the orthodontic repertoire. However, the
inherent disadvantages associated with the use of removable appliances such as aligners for orthodontic tooth
movement pose great challenges in improving their efficacy. The orthocaps system is an effort in that direction.
Editorial note: A list of references is available from the publisher.
28
ortho
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Fig. 10
about
Dr Wajeeh Khan
is a specialist in orthodontics and runs
a private orthodontic practice in
Hamm in Germany. He is the Managing
Director and Chief Executive of Ortho
Caps. Khan is a member of the German
Orthodontic Society, French Orthodontic Society, Deutsche Gesellschaft für
Linguale Orthodontie [German society
for lingual orthodontics] and American Association of Orthodontists. He is a Fellow of the World Federation of Orthodontists.
Khan regularly conducts lectures at symposia and universities
in Europe. He can be contacted at info@orthocaps.de. |
www.orthocaps.de
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DECODE. DISCOVER. TRANSFORM
22 – 24 FEBRUARY 2019
Pre-congress Day: 21 February 2019
Post-congress Day: 25 February 2019
Level 4, Marina Bay Sands, Singapore
ONLINE REGISTRATION OPENS IN AUGUST 2018
KEYNOTES
David Sarver
United States of America
WELCOME RECEPTION
Birte Melsen
Denmark
EXHIBITION
Organised by:
Rolf Behrents
United States of America
AOS GARDENS
BY THE BAY RUN
Event manager:
Connect with us:
aoscongress
aoscongress
www.aoscongress.com
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| interview
Embracing Sagittal First
treatment—The Carriere Motion
3D Appliance: Revolutionising
Class II and Class III corrections
By John Lannon
In talks with John Lannon, orthodontists Dr Luis Carrière and Dr John Graham discuss the “sagittal-first”
philosophy and the science behind Henry Schein
Orthodontics’ Carriere Motion 3D Appliance, which
facilitates orthodontic treatment and shortens treatment times.
Dr Luis Carrière, who invented the Carriere SLX Self-Ligating Bracket System and the Carriere Motion 3D Appliance, lectures internationally on these products, as well
as other topics. Carrière is a member of the editorial
review board for the American Journal of Orthodontics
and Dentofacial Orthopedics and a visiting professor at
several orthodontic departments throughout the world.
He maintains a private practice in Barcelona in Spain.
30
tion. This prevents over-rotation and unwanted tipping
and can be an effective means of increasing a patient’s
airway.
It’s been astounding and exciting to watch the progression of airway-friendly orthodontics in our industry. Orthodontists everywhere are realising how they’re able to provide patients with more than just beautiful smiles—they
also can provide the opportunity for patients to live healthier, happier lives, which is a strong aspect of Henry Schein
Orthodontics’ culture.
How does the appliance shorten treatment time?
Class II or Class III correction takes place at the beginning of the orthodontic treatment, when there are no
competing forces in the mouth caused by brackets or
other appliances. This is also when the patient is the most
motivated and compliance is at its highest. Treating to
the Class I platform is made simple and usually completed in three to four months. Each Motion 3D Appliance addresses its intended sagittal dimension to reduce
the need for extractions or surgery, and also helps reposition the jaws in better relation to one another, balancing
the relationship between the nose, lips and chin for facial
harmony. Both are biomimetic in function and consist of
a small single-part design. This offers patients considerable freedom of movement for significantly greater comfort than conventional anterior–posterior correctors.
John Lannon: What features of the Motion 3D Appliance make it so effective?
Dr Luis Carrière: Its sleek, non-invasive design has
allowed it to revolutionise Class II and Class III correction. The appliance attaches to only three teeth, so it’s
comfortable and discreet, while it also allows for the use
of the progressive Sagittal First philosophy to correct the
anterior– posterior discrepancy at the beginning of treatment, when patients are most compliant. It delivers a gentler, more natural force for tooth movement, controlling
the movement of the tooth and providing crucial corrections to the bite and tooth alignment, in preparation for
treatment with fixed orthodontic appliances or clear aligners. The appliance provides shorter treatment times for
mixed dentition in adolescents and adults.
Changing the patient experience
for the better
How does the appliance fit into Henry Schein Orthodontics’ tenet of airway-friendly orthodontics?
The appliance, based on the action of the human hip
ball and socket joint, repositions the mandible forward as
a unit for those patients who need it and controls it with
built-in stops for direct molar movement to the ideal posi-
Dr John Graham is an innovator and educator who lectures internationally to both orthodontists and the practice
team on orthodontic treatment philosophies. He holds
faculty appointments at the University of the Pacific’s
Arthur A. Dugoni School of Dentistry and the University
of Rochester’s Eastman Institute for Oral Health, both in
ortho
2 2018
[31] =>
ortho_2_2018_web.pdf
interview
|
With the Motion 3D Colors Class II Appliances, patients can personalise their orthodontic treatment.
the US. Graham serves on the editorial board for orthotown and is a contributing editor for the Journal of Clinical Orthodontics.
John Lannon: The Carriere Motion 3D Appliance fits
into the Henry Schein Orthodontics’ tenets of airway-friendly orthodontics, shorter treatment times
and the Sagittal First philosophy. Could you explain
how it’s used in your practice and the results you’ve
seen?
Dr John Graham: The Sagittal First philosophy using the
Motion 3D Appliance is a real paradigm shift in the way
orthodontists treat patients. It helps me reduce patient
treatment times—sometimes by up to one year. It’s so
rewarding to offer this treatment concept because I no
longer receive hesitation from patients, especially adults,
about moving forward with treatment. I get to explain that
they won’t be making a commitment to wearing fixed
appliances for two years—most likely, it will be around
a year or less.
How do the appliances work with clear aligner therapy?
The orthodontist and the patient don’t have to decide
between fixed appliances or aligners before the patient
starts treatment; we can think about it while the anterior–
posterior discrepancy is being corrected. This new treatment method allows me to treat more cases with clear
aligners. The Motion 3D Appliance allows me to easily
turn complex Class II patients into Class I patients; previously, a complex case would not have been suitable for
aligner treatment. Also, using the appliance allows you to
empower patients to be compliant. As you monitor them
through the anterior–posterior correction, you can see if
they’re a good fit for aligners.
How did you gain your staff’s acceptance with this
shift?
For an orthodontist to succeed with any new treatment
philosophy, you need to have buy-in from your staff. The
great thing for me when I introduced the Sagittal First
concept to my staff is that it made total sense to them
that the heaviest lifting we do in ortho, which is generally the anterior–posterior correction, should take place
at the beginning of treatment, rather than after the patient
has already been in fixed appliances for a year or longer.
What benefits does the Motion 3D Appliance offer
that haven’t been previously experienced?
I’m able to confidently tell my patients that their treatment time should take a year or less. With the Sagittal
First philosophy, I am able to achieve anterior–posterior
correction on average in just three months! Anterior–posterior correction used to take a year and at the end of
treatment, when no patient was interested in being compliant any more. Also, because the Motion 3D Appliance
is so discreet, patients don’t think of themselves in treatment even though they are. You’re able to get patients to
commit to being cooperative at the beginning of treatment, when they are excited about the impact fixed appliances will make on their lives.
ortho
2 2018
31
[32] =>
ortho_2_2018_web.pdf
| interview
Dr. Luis Carrière runs his own practice in Barcelona and lectures internationally on a regular basis.
Corporate profile
—Going straight to the source
Henry Schein Orthodontics’ mission is to provide stateof-the-art orthodontic products and innovative clinical
solutions that enable its customers to offer exceptional
patient care while expanding the scope and profitability
of their practices. The company continues to grow as a
global orthodontic solutions provider by not only providing high-quality products but also going beyond the typical supplier–client relationship, instead cultivating partnerships with its customers so they can deliver positive patient
outcomes and maintain healthy, successful businesses.
The company’s wide orthodontic range includes brackets and bands, intra-oral appliances, elastomeric modules, archwires and temporary anchorage devices. Other
solutions include innovative orthodontic products and
progressive continuing education opportunities to help
fuel the growth and success of orthodontic practices in
more than 75 countries.
32
ortho
2 2018
For more than 40 years, Henry Schein Orthodontics
has manufactured most of its products in the US, including at its over 6,000 m2 corporate building in north San
Diego. Among its offerings is the Carriere System, which
incorporates the latest advances in orthodontic technology with gentle forces that work with natural physiology
to correct a bite at the beginning of treatment. By utilising the Carriere Motion 3D Appliance in the beginning
stage and then transitioning to Carriere SLX Self-Ligating
Brackets to complete treatment, the total time in treatment is greatly reduced when compared with conventional approaches.
“Shifting to the Carriere Motion 3D Appliance has been
one of the most significant treatment advances I have
implemented during the past five years,” said Dr Ron
Maddox, an orthodontist based in San Dimas in California. “I’ve been able to reduce the overall treatment time
and significantly reduce the time that my patients are in
braces.”
[33] =>
ortho_2_2018_web.pdf
interview
|
Dr. Luis Carrière is the developer of the unique Carriere System, which consists of the Motion Class II Correction Appliance, Motion Class III Correction
Appliance and SLX Bracket System.
Dr John Graham is not just an orthodontist but also an innovator and educator. (Photographs: Henry Schein Orthodontics)
Editorial note: This article originally appeared in the April 2018
issue of Orthotown.
ortho
2 2018
33
[34] =>
ortho_2_2018_web.pdf
| interview
ICD—Honouring the world’s
leading dentists since 1920
By Nathalie Schüller
34
The International College of Dentists (ICD) will
celebrate its centennial in 2020. The ICD is the
oldest and largest honour society for dentists in
the world and was conceived by Drs Louis Ottofy
and Tsurukichi Okumura with the vision to start an
organisation of outstanding dentists to maintain
professional collegiality and friendship, monitor
and evaluate the progress of dentistry internationally, and disseminate such information to dentists
worldwide. Today, the ICD has 12,000 fellows in
122 affiliated countries. Managing Editor of ortho
Nathalie Schüller spoke with Dr Dov Sydney, ICD
International Editor and Director of Communications, as well as the Chair of the College Centennial Committee, about his motivation, the college’s
success and the 100-year anniversary.
demia or teaching, research, humanitarian programmes,
leadership or service projects.
Dr Sydney, tell me how and why you became involved
in the ICD.
It was in a manner very typical of the ICD. I had a
patient who was a dentist and told me about the voluntary work he was doing for an ICD clinic for blind people.
I had no idea then what the ICD was about. He told me
more about the ICD and asked whether I would like to
become involved in the clinic to help the patients, and
based on my background and CV, said he would like to
nominate me to become a fellow. That was in 1996 and I
was proud to agree. I was active in the Israel District and
then moved to the European Section board as regent,
editor and website manager. Later, I was asked to serve
on the worldwide executive of the organisation as the
International Editor and Director of Communications for
the ICD.
Is dental care the main thing we should worry about
in parts of the world that are so destitute?
I recall reporting on a group that went to Nepal to help
children in great need of dental care. When the team
arrived, they encountered unexpected problems. The
community was suffering from mass diarrhoea, a major
disease in the Third World. People can become extremely
ill and die from not having access to clean running water.
The water used to brush the children’s teeth was contaminated. The team developed a programme to bring
running water into the village for toilets and sinks for toothbrushing. The rate of diarrhoea went from 75 per cent to
5 per cent. Children were able to go back to school. The
adults could work. This is a good example of how ICD
dental projects can have a major impact on a community and the overall health of the project site’s population.
Are all potential members nominated by fellows and
what is the basic requirement to be nominated?
Yes, one has to be nominated by two fellows in good
standing. Let’s say a candidate lives in Germany. Two
members of the college would have to recommend the
person to the German District committee, who, following
recommendation from the credential review committee,
would pass the recommendation on to the full European
Section board, consisting of all 35 European member
countries, for a vote on the nomination. The decision
would then be passed on to the ICD world headquarters
for completion of the process and preparation of certificates. Nominees have to have made major contributions
to dentistry in more than one of the following areas: aca-
How are ICD projects initiated?
There are many kinds of projects. Some are directly
funded through the ICD’s Global Visionary Fund. Also,
there are 15 sections of the college and they have their
own foundations or funds to initiate their own projects.
Many fellows are also involved in individual ICD projects.
Soon, we will be introducing an interactive map of hundreds of projects on our website where a visitor can see
educational projects, student exchange programmes,
humanitarian missions and more. We currently have a
major programme on antibiotic resistance owing to the
fact that antibiotics today are becoming less and less
effective. We work with the Centers for Disease Control
and Prevention in Atlanta in the US and the World Health
ortho
2 2018
What is your major joy, your main motivation, in being
part of the ICD?
As the International Editor and Director of Communications, I see all of the reports and images of ICD events
and projects that take place around the world. I have to
select the ones that will appear online and in our journal.
In a photo from the 2015 issue of The Globe, the ICD
journal, one truly sees the kind of impact so many of our
projects have on the people who are the recipients of ICD
compassion and dedication. It is evident in their eyes—
a palpable image of someone’s unselfishness, caring for
another human being, some receiving care for the very
first time in their lives.
[35] =>
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interview
Organization to put on programmes teaching dentists
how to deal with antibiotic resistance. We also provide
programmes on sepsis and sterilisation.
2020 will mark the 100-year anniversary of the ICD.
What are the changes, progress and developments
you are the happiest about today?
The fact that we grew from a concept first established
by a Japanese dentist and an American dentist meeting
a 100 years ago endeavouring to have an international
organisation to today, with the largest footprint of any
dental honour society in the world, says a great deal. The
integrity of the organisation throughout our 100 years in
recognising those dentists who truly demonstrate having
made major contributions to dentistry and society has
been consistent. We are not a very well-known organisation; in fact, many dentists are unaware of the ICD. We
realise that, in order to honour our motto of “recognizing
service as well as the opportunity to serve” and to be true
to the vision of our founding fathers, we do have to make
ourselves better known in order to ensure that deserving
dentists are recognised by the college.
The centennial is a watershed moment for the college
and validates that the ICD core values are sustainable
and worthy. The projects, the organisation and the dedication of our members to improving oral health care are
only possible because our fellows deeply believe in what
they are doing; had they not, the ICD would have disappeared long ago.
I remember a dentist who did not want sponsors
because he aimed to stay objective. In financing all
these projects and your collaborations with companies, can you still stay independent?
We have various levels of sponsorship. We collaborate
with companies like Henry Schein, Modern Dental Group,
Dentsply Sirona, Spident, Hu-Friedy and EMS, as well
as organisations like the International Congress of Oral
Implantologists, that provide us with their generous support. When we take on a sponsor, it is not as an advertiser, but as a partner in a strategic alliance of shared
values. That alliance has various parameters and mutual
responsibilities that create a unique symbiotic relationship between the college and our corporate sponsors.
What do you think are the major challenges facing
the college today?
All major organisations in dentistry are seeking new
members. Some have little or no oversight or require
little, if any, performance evidence as a prerequisite to
membership, unlike the ICD, whose requirements are
considered of the most stringent of all recognition-based
international dental honour societies. Quite frankly, some
try to imitate how the ICD operates, and why not? The ICD
is in the enviable and unique position of having recorded
sustained membership growth for the last ten years. We
|
have a strong and consistent contact relationship with
our members by focusing on meeting fellows’ needs,
Taiwan Minister of Health and Welfare Chen Shih-Chung (left) receiving the
#ICD100 hashtag from Dr Dov Sydney (right) as part of the kick-off to the
centennial campaign. (Photograph: Taiwan ICD)
staying relevant and consistently seeking out new and
innovative methods to enhance our communications and
connection with them. But, with the constant bombardment of information via the Internet and e-mails, there are
many challenges and media competition for our members’ attention. We are meeting those challenges with
innovative communication packaging, but it’s a constant
and unending endeavour.
We have already touched on the ideas of friendship
and passion of ICD Fellows. What is the main ingredient of the ICD’s success to you?
Dedication and commitment to ICD core values is the
common denominator; ICD Fellows are driven as individuals and as a group to improving dentistry and the life of
those being underserved. One sees that everywhere we
have an ICD presence.
The celebration of the 100-year anniversary is
planned to be a worldwide event; every section, district and region will be holding events. Can you tell us
a bit more about what we can expect?
As mentioned earlier, we have 15 sections, 70 districts
and 15 regions worldwide, and they will be participating in
different ways to acknowledge the 100-year anniversary.
Every ICD jurisdiction will have an event during 2020 that
will memorialise that special year and will lead up to the
very special finale in Nagoya in November 2020. There
will be a ceremony in Nagoya in which new inductees
from all over the world will participate in an Olympic-style
event, in addition to a gala banquet, special entertainment and many surprises!
ortho
2 2018
35
[36] =>
ortho_2_2018_web.pdf
| manufacturer news
Planmeca orthodontics—Choose
the right tools for you
When planning a treatment, a cephalometric analysis
is usually performed to obtain information about the dentition’s status and its relation to the skull. This is simplified by our software, which performs cephalometric analysis automatically in seconds. Stone model analyses can
also be done digitally using intra-oral scans and our model
analyser software, which is also a marvellous tool for comparing scans captured at different points in time.
Planmeca’s digital orthodontic workflow provides
unmatched freedom and flexibility. After collecting imaging
data, the necessary appliances can be ordered from an
orthodontic solution provider or treatment planning can be
done in-house with the appropriate software. The choice
is yours—our workflow is completely open.
We at Planmeca like to be at the forefront of new technologies, but also understand that many still prefer to work
with more conventional tools and methods. We strive to
serve all users in the best possible way and to provide
several types of solutions and services that add value to
everyday dentistry—making clinical work more efficient
and satisfying.
A visit to the orthodontist generally begins with an oral
examination, with visual inspection of the extra-oral and
intra-oral situation performed. Our smile design software
allows for quick visual representations of treatment possibilities to also be done.
Once a mutual decision on the orthodontic treatment
for the patient has been reached, further clinical records
are typically taken. These can include radiographs, such
as lateral cephalometric and panoramic images, as well
as physical impressions. A clinic with advanced technology might take only 3-D records—ultra-low-dose CBCT
images and digital impressions directly scanned in the
patient’s mouth. All records can be obtained directly with
Planmeca devices and visualised in our software.
36
ortho
2 2018
Next, the treatment path best suited for the patient
and the clinical indication is determined, including where
to obtain the required appliances from. There are many
ways to make work easier when using digital impressions.
We collaborate with several third-party providers for clear
aligners and customised brackets to ensure your preferred
company appears in our growing list of supported partners. Our cloud service allows easy and secure sending
of digital impressions to a laboratory or external provider.
Alternatively, clear aligners can be designed and fabricated in-house using our software and 3-D printer. This
convenient workflow allows the user to include tooth roots
from the CBCT scan in the plan and to track their positions while simulating tooth movement. Moreover, for
treating early mixed dentition, our LM-Activator appliance
is a cost-efficient alternative that benefits clinicians and
patients alike.
Orthodontics is closely connected to orthognathic surgery, another area we are rapidly advancing in. When
patients need corrective jaw surgery, Planmeca’s powerful tools allow easy and efficient surgical planning using
the same software.
With our offering, planning becomes simulation with
real-life realisation by the production of surgical splints that
are printed on-site and used to transfer the virtual operation to the actual surgery room. The splints and even the
entire surgical planning can also be ordered as a service
from the Planmeca ProModel surgical planning team.
[37] =>
ortho_2_2018_web.pdf
register for
FREE
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Join the largest
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ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
[38] =>
ortho_2_2018_web.pdf
| manufacturer news
Introducing the Carriere SLX 3D
Bracket System
When Henry Schein Orthodontics’ highly acclaimed
engineers teamed up with world-renowned orthodontists,
Drs Luis Carrière, Lou Chmura, Dave Paquette and Jep
Paschal, they produced an all-new, patent-pending metal
and ceramic bracket system that goes beyond the boundaries of any bracket system we have ever produced. The
dedication to practice efficiencies and to advancing the
state-of-the-art of patient care will be evident when you
experience the beauty, comfort and extraordinary performance of the all-new Carriere SLX 3D System.
Do the twist—with a feather touch
and slight twist of the instrument, the
slide is propelled to the open or locked
position.
Cove
Cover it up—full M/D slot coverage prodes unmatched rotational control to help
vides
ensure that you finish faster.
ensu
One
ne size doesn’t
d
fit all—the SLX 3D Bracket System has
narrow brackets for narrow teeth, and wide brackets for
wide teeth—because size matters when it comes to rapidly
securing rotational control and ideal tooth positioning.
Don’t bend wire, like a pro—with proven and precise
torque values, in/out thicknesses and slot depths, the SLX
3D Bracket is designed to ensure less wire bending so that
you can spend more time doing anything but wire bending.
Feel this—the smoothest brackets we’ve ever made—
oh so incredibly smooth, oh so comfortable!
Got you in our sights—our proprietary cross-hair colour
coding provides a new level of visual cues for fast, precise
bracket positioning.
Easy on, easy off—our compound contour bases are
designed to “fit like a glove”, while the bevelled base edges
aid in quick and clean removal.
Guard rails aren’t just for highways—our exclusive
Adhesive Guard Rail Technology (AGR) directs excess
adhesive to the sides for fast, easy clean-up.
“SLX 3D represents nothing less than a true engineering
and design phenomenon. Whether you’re using another
self-ligating system, or twin brackets, when you try SLX
3D, you too will be convinced it’s time to switch.”—Dr John
Graham
Designed for you, your staff and your patients
—with no compromises.
Henry Schein Orthodontics is a brand of Ortho Organizers.
www.henryscheinortho.com
38
ortho
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[39] =>
ortho_2_2018_web.pdf
International Magazines
ortho
international magazine
of orthodontics
www. dental-tribune.com
issn 1868-3207 • Vol. 3 • Issue 1/2018
ortho
1/18
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per year (2 issues per year; incl. shipping for customers outside Germany).
Your subscription will be renewed automatically every year until a written cancellation is sent to Dental
Tribune International GmbH, Holbeinstr. 29, 04229 Leipzig, Germany, six weeks prior to the renewal date.
international magazine of orthodontics
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[40] =>
ortho_2_2018_web.pdf
| meetings
Survey: What attracted you to
the EOS Congress?
By Yvonne Bachmann
This year’s European Orthodontic Society (EOS)
Congress was hosted in Edinburgh, Scotland. The
event, which gathered around 2,300 orthodontists,
aimed to inform the community about the latest
developments in the field and traditionally featured
a number of prominent keynote speakers presenting their latest research and findings. ortho spoke
with congress-goers to learn what makes the event
so popular among orthodontists.
Azzah Alhazmi, Sweden
I am a postgraduate student
at Karolinska Institutet, a
university in Huddinge near
Stockholm. Attending this
congress is part of our postgraduate programme; all students are here. It’s my first
time at the congress and I
think it’s really nice. Some of
the lectures are really interesting. Summer is also a
great time to host this event. I will graduate in 2020, so I
think I’ll come back for another EOS Congress.
Dr Roland Zettel,
Switzerland
I have my own practice
in Teufen and have so far
attended four or five EOS
congresses over the years.
I am now planning to attend
every year, as it is a great
oppor tunity to combine education and sightseeing. I
attended the opening ceremony and saw the Red Hot
Chilli Pipers play. I also went on the Red Bus Tour to
Holyrood Palace. The congress has a very relaxed atmosphere and it’s a great event for networking.
40
ortho
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Dr Pongsri Brudvik,
Norway
I used to work for the University of Bergen. I retired two
years ago as a lecturer, but
kept working on a private
basis for one day a week
because I wanted to finish off
my patients. I have attended
many EOS congresses, probably more than ten. It is
always a pleasure to meet
other colleagues and get the latest updates in orthodontics. This may be my last congress, as I am now planning
to fully retire; however, I have already met a number of
colleagues from other countries who have already retired,
but are here anyway.
Dr Masanori Yasui, Japan
This is my second EOS Congress. I have my own practice
in Kawasaki and flew 12 hours
to Edinburgh. My research is
being displayed in this year’s
poster session. I think it’s a
great congress. It’s smaller
than other congresses, like
AAO, but small and compact
is good.
Dr Milla Mörönen, Finland
I work at a public health care
centre in Alavus. As I am the
only orthodontist in a region
of 25,000 people, treating
all of its children, I must see
what is going on in orthodontics. I need scientific facts to
support my own decisionmaking. I am an EOS member
and this is the fourth congress
I am attending, after Venice,
Warsaw and Stockholm. I think the EOS congresses are
always well organised and besides being informative they
are also fun. I am already thinking about attending the congress of the World Federation of Orthodontists, which will
be held in Yokohama in 2020. I have never been to Japan.
[41] =>
ortho_2_2018_web.pdf
| meetings
Nice, Hamburg, Oslo, Limassol
and Athens to host upcoming EOS
congresses
While attendees are still raving about Edinburgh, where
this year’s European Orthodontic Society (EOS) Congress was held, the members of the EOS have already
planned far ahead. With Nice in France, Hamburg in
Germany, Oslo in Norway, Limassol in Cyprus and
Athens in Greece, the organisers have chosen to take
participating orthodontists to extraordinary places that
are world-famous for their flair and hospitality.
In 2019, the EOS Congress will take place in Nice. To
be held from 17 to 22 June at the Nice Acropolis Convention Centre, the event will address genetic research,
among other topics. In Nice, on the French Riviera,
visitors will find various places of interest. The Promenade
des Anglais is a pedestrian area that follows the curve of
the Baie des Anges beaches. The seaside esplanade is
lined with palm trees. Other attractions include the Musée
d’art moderne et d’art contemporain [museum of modern
and contemporary art], the monastery Monastère Notre
Dame de Cimiez and the Colline du Château park.
th
The 96 Congress of the European Orthodontic
Society will be held in Hamburg from 10 to 14 June 2020
and focus on the role of orthodontics and dentofacial
orthopaedics and on bones in orthodontics. The venue,
the Congress Center Hamburg, is centrally located and
enables participants not only to take part in the event’s
social programme but also to explore the city and its
famous sights on their own. Highlights of the Hanseatic
city are the harbour and the famous, only recently inaugurated, Elbphilharmonie concert hall.
“For many, Hamburg is Germany’s finest city—a
cosmopolitan host open to change. It is a great honour
for me and our organising committee to host this event
in Germany for the 12th time,” stated Prof. Bärbel
Kahl-Nieke, Director of the Department of Orthodontics
at the University Medical Center Hamburg-Eppendorf
and EOS President-elect 2020.
For 2021, the EOS is inviting members and nonmembers to Limassol. From 31 May to 5 June, the Spyros
Kyprianou Palais des Sports will be open to international
orthodontists looking for educational and networking
opportunities. The cosmopolitan hub of Cyprus is located
41
ortho
2 2018
The 2019 European Orthodontic Society Congress will be held in Nice in
France. (Photograph: Boris Stroujko/Shutterstock)
on the Mediterranean Sea and well known for its restored
old town centre.
Oslo will be welcoming the orthodontic community in
2022. Although the dates have not been announced yet,
regular congress attendees may already want to do some
research on the city, which offers a variety of attractions,
including the Viking Ship Museum, Norwegian National
Opera and Ballet, TusenFryd amusement park, and
Holmenkollen ski museum and tower.
Taking place in 2023 in Athens, one of the oldest cities
in the world, the 99th edition of the EOS Congress should
be on the event list of all orthodontists who are history
buffs. Must-see places include the famous Acropolis, a
large hill that lies in the centre of the city and contains
a cluster of ancient ruins, the Panathenaic Stadium, an
ancient multi-purpose stadium that hosted the first-ever
Olympic Games in 1896, and Plaka, a historic district of
Athens known as the “Neighbourhood of the Gods” with
small labyrinthine streets.
[42] =>
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| meetings
BOC interview: “There was a
strong emphasis on interdisciplinary care”
By Brendan Day
The 31st British Orthodontic Conference (BOC) is took
place in London from 27 to
29 September and featured a
number of innovative sessions
under the umbrella of the dental specialty. Ortho spoke with
BOC 2018 Chairman Dr Richard
Jones about the first conference
in 1986 and asked him about his
2018 congress highlights.
Dr Richard Jones is a specialist
orthodontist and a specialist
in oral surgery.
(Photograph: Dr Richard Jones)
What did the theme of “Orthodontics 360°” mean for attendees of this year’s BOC?
The theme neatly summed
up our goal to not only explore the full circle of orthodontic
topics during the congress, but also focus outwardly on
the wider dental world that surrounds us and how we can
work closer and better with our dental colleagues. Hence,
there was a strong emphasis on interdisciplinary care with
a number of themed sessions.
Are there any particular speakers or events that you
were looking forward to?
It is impossible, and probably unfair, to single out any
individual presentations or lecturers, bearing in mind that
we have had a record 66 presentations from speakers from
home and abroad. We also had a record number of parallel sessions, with three full days of parallel sessions and
two half-day sessions running alongside the main scientific programme. There really was something for everyone,
with dedicated sessions for therapists, nurses, managers and support staff. There was a large number of dedicated interdisciplinary sessions within the main scientific
programme, including presentations on ortho-restorative
treatment, orthognathic treatment, the ortho-periodontal
interface, the role of orthodontics in the management of
temporomandibular joint disorders, and the role and challenges for orthodontics in association with trauma.
There were also themed sessions dedicated to aligner
treatment, a modality that is becoming increasingly popular, and also to lingual orthodontic treatment. If I were
42
ortho
2 2018
to highlight one single lecture, it would be the prestigious
Northcroft Memorial Lecture. The honour of delivering it fell
to the UK’s own Prof. Martyn Cobourne, who discussed
his career-long research into craniofacial development.
An essential and very enjoyable aspect of any conference is the networking that accompanies the social programme. This year’s BOC was no exception, with our
“Rule, Britannia!” gala reception that took place at Church
House, adjacent to Westminster Abbey. The conference-closing black tie banquet, the Glitter Ball, took place
at the iconic Connaught rooms in Covent Garden.
How has the BOC developed over the years? Were
there any new features at this year’s conference?
This year was the 31st BOC, but, remarkably, the first in
London. The very first BOC took place at a hotel in Bournemouth in 1986 and was the first joint venture of the then
multiple national orthodontic organisations. The BOC was,
in many ways, the precursor to the now unified society
that is the British Orthodontic Society. That first conference had a few hundred attendees, but has now grown
into arguably the largest specialist dental conference in the
UK, with regular attendances of over 1,200 people.
Unlike most large conferences, the BOC is not organised by professional conference organisers, but by a
team of society members on a voluntary basis supported
by a dedicated HQ team. These teams look to constantly
innovate and improve the BOC experience for attendees and this year is no exception. This year, we held the
first parallel session dedicated to secondary care with a
focus on orthognathic treatment and 3-D surgical planning. TED Talks have taken the business world by storm
and so this year we introduced our own take on this with
the OrthoTED session, showcasing a number of dynamic
short talks with a focus on new technology and how this
is influencing education and treatment. With so much to
choose from, attendees were hopefully torn in terms of
which session to attend. Fortunately, this year we made
that dilemma a little easier with the introduction of the
BOC catch-up session, in which video recordings of
many presentations were shown in a cinema-style session at a later time during the conference.
[43] =>
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[44] =>
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| meetings
International events
Northeastern Society of Orthodontists – NESO 2018 Annual
Meeting
2018
Southern Association of Orthodontists 2018 – SAO
Annual Meeting
4–6 October 2018
New Orleans, US
www.saortho.org
Pacific Coast Society of Orthodontists – PCSO
82nd Annual Session
11–14 October 2018
Monterey, US
www.pcsortho.org/Educational-opportunities/annual-session.aspx
Italian Society of Orthodontics – 49th SIDO International Congress
2018
11–13 October 2018
Florence, Italy
http://congressosido2018.sido.it/en
16th Congress of the Turkish Orthodontic Society
13–17 October 2018
Izmir, Turkey
www.tod2018.org/eng
Egyptian Orthodontic Society – Mediterranean Orthodontics
Congress
26–28 October 2018
Alexandria, Egypt
www.moip2018.com
77th Joint Meeting of the Japanese Orthodontic Society
and the Korean Association of Orthodontists
30 October–1 November 2018
Yokohama, Japan
www.congre.co.jp/jos2018/en
2–3 November 2018
Uncasville, US
www.neso.org
German Association for Aligner Orthodontics – 5th Scientific Conference for Aligner Orthodontics
23–24 November 2018
Cologne, Germany
www.dgao.com
18th International Orthodontic Symposium and
6th EAO Academy
29 November–1 December 2018
Prague, Czech Republic
www.ios-prague.com
2019
American Association of Orthodontists
– AAO Winter Conference
25–27 January 2019
Marco Island, US
www.aaoinfo.org/meetings
AEEDC World Orthodontic Conference
3–4 February 2019
Dubai, UAE
https://aeedc.com/aeedc-dubai-world-orthodontic-conference-2018
Association of Orthodontists Singapore
– AOSC 2019 Scientific Conference
22–24 February 2019
Singapore
https://aoscongress.com
International Dental Show – IDS
12–16 March 2019
Cologne, Germany
https://english.ids-cologne.de
44
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submission guidelines
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ortho
2 2018
45
[46] =>
ortho_2_2018_web.pdf
| international imprint
Imprint
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Publisher/President/CEO
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ortho international magazine of orthodontics is published by Dental Tribune International (DTI). The magazine and all articles and illustrations therein are protected by copyright. Any
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46
ortho
2 2018
[47] =>
ortho_2_2018_web.pdf
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/ New concepts in aligner therapy with the orthocaps system
/ Embracing Sagittal First treatment—The Carriere Motion 3D Appliance: Revolutionising Class II and Class III corrections
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