Ortho Tribune U.S.

Polishing up your orthodontic finishDTI launch campaign (entry) / Specializing - sub-specializing and integrating / California orthodontist wins second Levin Group Ortho Practice Makeover / Make 2010 the year to ‘go green’ / Polishing up your orthodontic finishDTI launch campaign / Facing the facts / 2009 ortho practice makeover: Oh - what a year it has been! / A plan B for tough times / Motivating employees in a tough economy / Mystery and controversy are directly proportional / Products

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

February 2010 supplement

www.ortho-tribune.com

Meet our winner

Motivate your staff

New on the market

And the practice
makeover goes to ...

Tips for keeping your
team happy, productive

Products solve space,
comfort issues

uPage

FDI, FOLA,
DTI launch
campaign
for Haitian
dentists
By Javier M. de Bison, DT Latin America

PANAMA CITY, Panama — The
president of the Haitian Dental
Association, Dr. Samuel Prophet,
has told Dental Tribune Latin
America that he and several colleagues are fine after the devastating earthquake in his country.
“So far, we have reports of
only two missing dentists,”
Prophet wrote in an e-mail a
couple weeks after the quake.
The earthquake not only devastated Haiti’s meager health
resources, but also most dental
practices. In a country where
there were only 500 dentists for
9 million people before Jan. 12,
the extent of the devastation has
affected everyone.
The president of the Latin
American Dental Federation
(FOLA), Dr. Adolfo Rodríguez,
launched a campaign immediately after the quake to help both
the general population and dental professionals in Haiti.
Rodríguez, who’s also the
g OT page 4

uPage

Polishing up your
orthodontic finish
Simple, three-step system improves clinical efficiency
By S. Jay Bowman, DMD, MSD

he Axis Orthodontic Adhesive
Removal Set* (featuring a series
of three polishing devices) was
designed to both effectively and
efficiently remove adhesives and
cements after the completion of
orthodontic treatment and to produce a smooth final enamel finish.
This set consists of the following components: 1) H375R-016 (7675)
Red Carbide, a gross adhesive removal bur; 2) H246L-012UF White Finishing Carbide, a 30-fluted finishing
bur; and 3) P0153-031 Polisher, a
green polishing point. All are conveniently maintained in an aluminum
bur block that can be sterilized.
These three devices can be used
with either low- or high-speed friction-grip dental handpieces (including electric handpieces). Using a
high-speed handpiece to remove
adhesives is more comfortable for
patients due to reduced vibration
compared to that from a slow speed.
Lower vibration also produces a
smoother surface finish.1
Clinical efficiency is improved

Fig. 1: After orthodontic appliances have been removed, a (red) carbide bur
(H375R-106-7675), installed in a high-speed dental handpiece, is used to
dislodge gross, residual resin.
with this simple, three-step system
as a single contra-angle handpiece
can be employed for the entire
removal/finishing process.
After orthodontic appliances have
been removed, the 7675 Carbide
(Red) is used in a contra-angle dental
handpiece to dislodge gross residual
resin tags from the enamel (Fig. 1).

This round-end, tapered 12-blade
bur is ideal for removing both orthodontic bonding adhesives and also
cements that remain on the teeth
after de-bracketing and de-banding.
Eliades et al.2 concluded that, “carbide burs are ideal cutting tools for
g OT page 6

Facing the facts
Differences between dental
CBCT and medical CT scans
By Dr. Bruce Howerton

efore a practitioner performs
surgery, he or she should be
equipped
with
up-to-date
knowledge regarding the possible
conditions located under soft tissue
within the oral cavity.
Three-dimensional data generated by cone-beam computed tomog-

raphy (CBCT) technology offers a
“surgical view” or slices of the entire
field of view from the front, side and
under the patient. Cone-beam scans
assist with determining bone structure, tooth orientation, nerve canals
and pathology; in some cases it may
preclude the necessity for a surgical
procedure.
In past months, media sources
have published articles regarding
high exposure of radiation from
medical CT scans.
g OT page 7

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[2] =>

From the Editor

Specializing,
sub-specializing
and integrating
By Dennis J. Tartakow, DMD, MEd, PhD,
Editor in Chief

ell, another year has come
and gone, but it will not
be forgotten. Our country is
climbing out of a recession the likes
of which has never been encountered at any one moment in time,
and on so many fronts.
We were hit with a wake-up call,
facing one new issue after another,
from global warming to the downward spiraling economy and stock
market, to the energy and gas crisis,
to the decline and freezing of the
housing market, and now to the rise
in unemployment.
This planet indeed experienced
unprecedented and uncertain
events to the point where our ubiquitous future had been shaken up
and was uncertain. The voice of
America said, “OK, we can’t continue with business as usual. Take a
real hard look at what changes are
essential, what changes are necessary and be frugal to survive.”
Hard economic times are not
over yet. However, out of darkness sometimes a glimmer of light
appears; there are new and auspicious vistas of opportunity right
now in orthodontics. With the new
year, we have a great opportunity
to reflect on our accomplishments
of the year past and refocus on personal goals for the journey ahead.
In the realm of social sciences,
organizations are social arrangements that pursue collective goals
and control performance. Researchers often examine the organization
from several different modalities,
the most common of which are:
sociology, psychology, economics,
political science, resource management and communication.
In his primary approach to formal organizations, Argyris (1960)
regarded the central theme of the
organization to be in the lap of the
individual; people create and maintain the health of the organization
(p. 276).

Organizational human resources
management (HRM) professionals
are responsible for educating all
levels of administration, management and individual employees
regarding the principles of social
justice. There are many local, state
and federal laws that affect HRM,
which have been created to eliminate discrimination for non-jobrelated reasons in the workplace
(Pynes, 2004, p.72).
A strategic development plan
includes many essential factors.
Critical decisions for future growth,
development and expansion of institutions, companies and especially
individuals might require much
thought and consideration in order
to experience future success in
whatever the ultimate endeavor is.
Orthodontics is an organization
in some ways similar and in other
ways different from the example
above. Job opportunities are present. Many orthodontists who came
out of the workforce during the last
decade may find employment in
education.
Moving into a new career or
position, however, is never without
the need for change, modification,
training or learning new job skills.
Career changes, such as from clinician to educator, must include
reflection and reconsideration of
one’s attitude and behavior. A new
job or position change is a new ball
game with new rules, policies and
conditions.
Orthodontists who reinvent
themselves must glean understanding in order to assess the requirements and develop a plan for the
future.
As the 21st century evolves,
new scientific technology, industrial integration and new skills are
essential in order for such career
changes to be successful. Even with
all elements and factors already in
place, IT staff, administrative staff,
faculty and user-orthodontists must
also learn and develop new skills.
In the educational milieu of
orthodontics, a strategic development plan might serve as a tool
for general exploration of educational goals, determining skill levels, which required greater faculty
expertise, and discovering faculty
needs. Setting direction and planning are two separated activities.
The function of educational leadership in orthodontics is to maintain change or set a new direction
for departmental goals. One must
devote time and enthusiasm to strategically plan in order to (a) synchronize visions and aspirations,
(b) provide a blueprint for a viable

Ortho Tribune | February Supplement
future to anticipate change, and (c)
hold constant the reason for being
— the education of students and
care of patients.
An assessment of one’s strengths,
weaknesses, opportunities and
threats is also important in order
to develop a strategic development
plan. It provides a valuable reflection and analysis, which might also
yield high priorities that will be
essential and critical for future success. Such priorities will allow progression to the next or higher level.
No longer can it be business as
usual, but rather take the attitude of
carpe diem, and take this opportunity to utilize the dynamics of intelligence. Leave emotion and fear out
of the equation and make the necessary changes to think and practice
within this financial Katrina and
general discomfort zone. The willingness to learn is what is important, not preserving the moniker of
what is already known.
Those of us who reach our
dreams and successes always
remain focused on smaller accomplishable goals in succession; it
leads us to the ultimate picture of
our vision and aspiration. The start
of a new year is a great time to
reflect, analyze, gain clarity and
recharge for the road ahead. The
secret of our future is hidden in our
daily practice. OT

References

1. Argyris, C. (1960). The impact of
the formal organization upon the
individual. Behaviour in organizations: Understanding organizational behavior, Tavistock. 7-24.
longings (pp. 87–111). New York,
NY: University Press of America,
Inc.
2. Pynes, J. (2004). Human resources
management for public and nonprofit organizations (2nd edition).
Jossey-Bass, John Wiley and Sons.

Corrections

Ortho Tribune strives to maintain
the utmost accuracy in its news and
clinical reports. If you find a factual error or content that requires
clarification, please report the details
to Managing Editor Kristine Colker at
k.colker@dental-tribune.com.

Image courtesy of Dr. Earl Broker.

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

Publisher & Chairman
Torsten Oemus
t.oemus@dental-tribune.com
Vice President Global Sales
Peter Witteczek
p.witteczek@dental-tribune.com
Chief Operating Officer
Eric Seid, e.seid@dental-tribune.com
Group Editor & Designer
Robin Goodman
r.goodman@dental-tribune.com
Editor in Chief Ortho Tribune
Prof. Dennis Tartakow
d.tartakow@dental-tribune.com
International Editor Ortho Tribune
Dr. Reiner Oemus
r.oemus@dental-tribune.com
Managing Editor/Designer
Ortho Tribune & Show Dailies
Kristine Colker
k.colker@dental-tribune.com
Managing Editor/Designer
Implant & Endo Tribunes
Sierra Rendon
s.rendon@dental-tribune.com
Online Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Product & Account Manager
Humberto Estrada
h.estrada@dental-tribune.com
Product & Account Manager
Mark Eisen, m.eisen@dental-tribune.com
Marketing Manager
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a.wlodarczyk@dental-tribune.com
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C.E. Manager
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Dental Tribune America, LLC
213 West 35th Street, Suite 801
New York, NY 10001
Phone: (212) 244-7181, Fax: (212) 244-7185

Published by Dental Tribune America
© 2010, Dental Tribune International GmbH.
All rights reserved.
Dental Tribune makes every effort to report
clinical information and manufacturer’s
product news accurately, but cannot assume
responsibility for the validity of product claims,
or for typographical errors. The publishers
also do not assume responsibility for product names or claims, or statements made by
advertisers. Opinions expressed by authors are
their own and may not reflect those of Dental
Tribune International.

OT Editorial Advisory Board
Jay Bowman, DMD, MSD
(Journalism & Education)
Robert Boyd, DDS, MEd
(Periodontics & Education)
Earl Broker, DDS
(T.M.D. & Orofacial Pain)
Tarek El-Baily, BDS, MS, MS, PhD
(Research, Bioengineering & Education)
Donald Giddon, DMD, PhD
(Psychology & Education)
Donald Machen, DMD, MSD, MD, JD, MBA
(Medicine, Law & Business)
James Mah, DDS, MSc, MRCD, DMSc
(Craniofacial Imaging & Education)
Richard Masella, DMD (Education)
Malcolm Meister, DDS, MSM, JD
(Law & Education)
Harold Middleberg, DDS
(Practice Management)
Elliott Moskowitz, DDS, MSd
(Journalism & Education)
James Mulick, DDS, MSD
(Craniofacial Research & Education)
Ravindra Nanda, BDS, MDS, PhD
(Biomechanics & Education)
Edward O’Neil, MD (Internal Medicine)
Donald Picard, DDS, MS (Accounting)
Howard Sacks, DMD (Orthodontics)
Glenn Sameshima, DDS, PhD
(Research & Education)
Daniel Sarya, DDS, MPH (Public Health)
Keith Sherwood, DDS (Oral Surgery)
James Souers, DDS (Orthodontics)
Gregg Tartakow, DMD (Orthodontics)
& Ortho Tribune Associate Editor

[3] =>

News

Ortho Tribune | February Supplement

3

California orthodontist wins second
Levin Group Ortho Practice Makeover

L

evin Group has selected the winner of the second Levin Group
Total Ortho Success™ Practice
Makeover. Dr. Michelle Gonzalez of
San Rafael, Calif., has been chosen
to receive free yearlong management and marketing consulting programs from Levin Group, one of the
country’s leading dental consulting
firms.
Gonzalez, who started her own
practice in 1996, is looking forward
to increasing production, increasing
referrals and decreasing stress in
the practice.
“This opportunity to work with
Levin Group is going to help me get
the right systems in place so that
my practice can continue to grow,”
Gonzalez said. “These are my prime
years in practice, and I need guidance to take us to that next level
so that we can practice more effectively.”
During the yearlong journey,
Gonzalez will work closely with two
Levin Group consultants: one who
will focus solely on the management systems in the practice and
the other who will focus on referral-based marketing systems. Doing
both consulting programs simultaneously will increase Gonzalez’
practice’s production, profitability
and referrals while also lowering
the stress level in the practice and
enhancing Gonzalez’s professional
satisfaction. All of these improvements will pave the way for her
to achieve financial independence
sooner.
While the economy is on the road
to recovery, Gonzalez is on the road
to having a higher performance
practice with exciting growth.
Throughout 2010, Ortho Tribune
readers can follow Gonzalez’s progress every other month with a new
installment profiling the changes
being made and their effect on the
practice. In this uncertain time, it is
more important than ever for orthodontic practices to update their
systems, properly train the staff,
keep morale high and stress low,
and deliver “red carpet” customer
service to every patient. Gonzalez
and her team are ready to meet
these challenges head on!
Here is a sneak peek at the Levin
Group Total Ortho Success Practice
Makeover experience

Management consulting
program

Using the Levin Group Method™,
Gonzalez and her Levin Group
management consultant will focus
on the following practice areas to
grow practice production and profitability:
• scheduling,
• vision, goals and LifeMap,™
• change management,
• case acceptance and patient
finance,

• the orthodontic treatment coordinator,
• executive coaching, communication and team building,
• financial planning.

Referral marketing program
Gonzalez and her staff will engage

in Levin Group’s Total Ortho Success — Referral Marketing Program
simultaneously with the management consulting program described
above.
During this 12-month period, she
will work with another Levin Group
consultant who will provide her
practice with customized referral
marketing strategies.
They will work together to create
a strategic marketing plan. Through
weekly telephone calls with their
Levin Group consultant, the practice’s designated professional relations coordinator (more on that

topic in future articles) will implement at least 15 referring dentist
and 15 patient referral marketing
strategies to increase referrals to
the practice.
Stay tuned for the first article
in the series when you’ll find
out what Gonzalez’s goals are
for her practice as well as her challenges and how she and Levin
Group will approach their next
steps together.
You will also meet the Levin
Group consultants who will be guiding her through her practice makeover journey. OT
AD

[4] =>

News

Ortho Tribune | February Supplement

Make 2010 the year to ‘go green’
By Fred Michmershuizen, Online Editor

re you green? Not green with
envy or green with food poisoning — we’re talking green for
the environment.
The Eco-Dentistry Association
(EDA), an organization that offers
dental professionals practical tips
on reducing waste and pollution and
conserving resources, is urging clinicians to make 2010 the year to “go
green” and “save green.”
After all, it’s a new year and a
chance for a fresh start. Not only
can you help save the planet, but
according to the EDA, you can save
lots of money as well — as much as
$50,000 a year.
According to the EDA, the green
movement in dentistry is gathering
steam. Since its international launch
in the spring of 2009, the EDA has
enrolled hundreds of members in
42 states and 11 countries. In addition, many companies have recently
introduced green dental innovations, including such things as LED
operatory lights that use less energy
to operate.
“Dental professionals can pow-

erfully differentiate themselves by
going green, making them a magnet
for the millions of values-based consumers who seek service providers
who share their environmental and
wellness values,” the EDA explained.
“Even small changes, such as
switching from chemical sterilization processes to steam, yield operating savings of $828 a year, while
making the switch to digital imaging — including the initial costs of
the equipment investment — yields
more than $8,700 in yearly supply
and other savings,” the EDA said.
Here are a few more things you
should know about the EDA:
• The EDA offers dental professionals advice that is practical and
easy to implement, such as setting photocopiers to make doublesided copies, properly disposing of
mercury-containing dental waste
and using planet-friendly building
and office methods, such as nontoxic paint and electronic patient
communications.
• The EDA also provides the public with information about such
things as digital X-ray systems,
which reduce radiation exposure

Dr. Fred Pockrass, brainchild behind the Eco-Dentistry Association, with a
patient in his eco-friendly practice.
by up to 90 percent, and dental appliances that are free from
the hormone-disrupting chemical
bisphenol-A, which is found in
many plastics, as well as offering them questions to ask their
practitioners about environmental stewardship. In addition, the
association’s Web site allows ecoconscious consumers to search for

f OT page 1

president of the Dominican Dental
Association (AOP), is asking companies and dental professionals to
donate dental instruments, materials and equipment.
He’s organizing the campaign for
Haiti with the help of FDI World
Dental Federation and Dental Tribune International.
Rodríguez is also putting together
teams of dental volunteers to travel
to Haiti once the major health and
humanitarian crisis is under control
to attend to the dental needs of the
population. The hub for this effort
would be the headquarters of AOP
in Santo Domingo.
“We also need to show our support for our colleagues in Haiti,
most of whom have lost everything,” Rodriguez said. “We need to
get them back on their feet by helping them to rebuild their practices.”

Lost practices
Prophet said in his e-mail that
“many of our colleagues have lost
AD

FOLA president Adolfo Rodríguez, center, asks for help for Haiti at a meeting
in Panama. He’s surrounded by the president, right, and vice president of the
Panama Dental Association.
their practices and we were thinking about how to help them. It’s
very good news to know that FOLA,
FDI and Dental Tribune are trying
to help Haitian dentists.” If dentists
know “that help is on the way, they
can have hope!”

Dental Tribune is publicizing in
its worldwide print and online editions the campaign for Haiti.
At a meeting in Panama, Rodríguez received the support of the
presidents of Central American
dental associations, and made an
emotional appeal to dental manufacturers to donate much needed supplies. He said Colgate has
already agreed to donate brushes
and toothpaste.
Rodríguez added he was moved
to witness dental professionals from
countries with little resources, such
as Honduras, Nicaragua or El Salvador, say they will collect funds,
second-hand equipment and dental
supplies to help their Haitian colleagues.
Some prominent Latin American
dental professionals from Brazil,
Uruguay and Costa Rica, among

eco-friendly dental professionals
in their area.
• The EDA’s members hail from
all over, including places such as
Waxahachie, Texas; Beachwood,
Ohio; and Fort Bragg, N.C.
For more information about the
Eco-Dentistry Association, visit the
Web site at www.ecodentistry.org. OT

others, have already expressed their
interest in participating in dental
teams to help with the most urgent
needs of the Haitian population.
Conditions on the ground seem
to indicate that these teams would
operate in mobile units at the
Dominican–Haiti border, once the
most pressing health emergencies
and needs are somewhat controlled.
The reason for this is that most of
Port-au-Prince is in ruins, and the
Dominican government has moved
the majority of its mobile health
resources to the border in an effort
to treat Haitians and avoid a migratory exodus.
The president of FOLA said that
this tragedy “is also an opportunity
to build a public health service that
includes dental care. We have asked
the Pan American Health Organization, FDI, all Latin American dental associations, companies and
other institutions for help in putting
together teams of dental professionals to travel to Haiti and start working there and leave in place basic
dental treatment centers.”
Rodríguez said this will be a longterm program that includes rebuilding the dental school at the university, as well as private practices. It
also will take some time to start,
and he said the priorities would
be treating children and pregnant
women.
The Latin American dental leader said he has also asked for funding from the government of the
Dominican Republic.
Companies and dentists interested in helping Haiti should contact
Rodriguez at arn@codetel.net.do or
by phone at (809) 519-0789. OT

[5] =>

[6] =>

Trends

Ortho Tribune | February Supplement

f OT page 1

ductile substrates such as resins.”
Phil Campbell’s Angle Research
Award publication1 reported the
“tungsten carbide bur appeared
to be the most efficient method of
removing highly filled resin, and it
produced the least amount of scarring.”
The tapered design of this bur
makes it easy to manipulate on
facial surfaces of enamel while
reducing the potential for gingival impingement. Enamoplasty of
uneven incisal edges is also done at
the same time (Fig. 2).
This bur is ideal to remove composite attachments that are often
employed with Invisalign.
Gross removal of residual adhesives and cements should be accomplished without disturbing enamel
anatomy by over-polishing the surface. Residual resin is often visible
on enamel surfaces after the air
exhaust from the high-speed contra-angle desiccates the surface of
the tooth. The consistent torque and
low vibration of an electric dental
handpiece (at 35,000-40,000 rpm)
can also help to provide a more
comfortable and consistent result.
After gross residual composite or
cement is removed, the White Finishing Carbide, a long, flame-shaped
30-blade bur, is used to remove the
last remnants of adhesives while also
finishing the enamel to a smooth
surface.1,2 The versatile, pointed
shape of this bur allows positioning
at the gingival margin (Fig. 3).
The 30-blade carbide produces
a very smooth surface during the
finishing process that is followed
with the P0153-031 Polisher, a green
friction-grip (FG) silicone point, to
refine the enamel (Fig. 4). These
polishers can be used in the same
high-speed handpiece as the previous carbides, but at slow revolutions
as the silicone will degrade quickly.
A feathering, light touch is
required to reduce the buildup of
heat and to avoid degradation of the
polisher. After a suitable enamel
surface is achieved, any additional
final finishing can be performed
using polishing pastes or slurry of
fine pumice, if needed (Fig. 5).
* Dr. Jay Bowman developed the
AXIS Orthodontic Adhesive Removal Set; available from Axis Sybron
Dental Specialties (800 W. Sandy
Lake Road, Suite 100, Coppell,
Texas 75019; (888) 452-8879; e-mail:
custser@axisdental.com). OT
AD

Fig. 2: Incisal edge irregularities and mammelons can be
addressed with the same (red) carbide bur.

Fig. 3: Refinement and polishing of the enamel surface is
accomplished with a long, flame-shaped 30-fluted (white)
carbide bur (H246L-012UF) in the same high-speed
handpiece.

Fig. 5: After the completion of adhesive removal and
enamel polishing with the Axis Orthodontic Adhesive
Removal Set.
Fig. 4: Further polishing of the enamel surface is done
with a P0153-031 Polisher, a green friction-grip (FG)
silicone point.

OT About the author
Dr. S. Jay Bowman is a diplomate of the
American Board
of Orthodontics,
member of the
Angle Society
of Orthodontists
and Pierre Fauchard Academy, and
a fellow of the American College of
Dentists. He is an adjunct associate
professor at Saint Louis University, an
instructor at The University of Michigan and adjunct clinical professor at
Case Western Reserve University.
Bowman has developed and patented a number of innovations for
clinical orthodontics, including his
own Butterfly Bracket System and
other appliances. He has published
more than 85 articles, book chapters and a textbook on mini-screw
anchorage, has lectured in 27 countries, and has maintained a private
practice for more than 25 years.

Fig. 6: All of the devices in the Axis Orthodontic Adhesive Removal Set are
conveniently maintained in an aluminum bur block that can be sterilized.
They may all be used in either slow- or high-speed handpieces (including
electric high speed).

References

1. Campbell, PM. Enamel surfaces
after orthodontic bracket debonding. Angle Orthod. 1995;65(2):103–
110.
2. Eliades, T; Gioka, C; Eliades, G;
Makou, M. Enamel surface roughness following debonding using
two resin-grinding methods. Eur J
Orthod. 2004;26:333–338

[7] =>

Trends

Ortho Tribune | February Supplement
f OT page 1

Unfortunately, these have generated misconceptions about dental
CBCT, or 3-D cone-beam computed
tomography scans.
The dental CBCT imaging method allows orthodontists and dentists
to obtain vital three-dimensional
information without exposing
patients to high levels of radiation
that come from medical CT scans.
An in-office imaging method
is more convenient; it saves the
patient travel time to and from the
hospital and for follow-up examinations after treatment.
Orthodontists and other medical
professionals ascribe to the ALARA
(as low as reasonably achievable)
protocol concerning radiation levels. This protocol guides practitioners to expose patients to the least
amount of radiation possible while
still gaining the most pertinent
information for proper diagnosis.
The differences between dental
and hospital scans derive, in part,
from the method of capturing the
information.
The average medical CT scan of
the oral and maxillofacial area can
reach levels of 1,200–3,300 microsieverts, the measurement of radiation absorbed by the body’s tissue.
These significant levels are attributed to the method of exposing tissues to radiation. With the hospital
scan, the anatomy is exposed in
small fan-shaped or flat slices as the
machine makes multiple revolutions around the patient’s head. To
collect adequate formation, there
is overlapping of radiation. In contrast, the dental scan captures all
the anatomy in one single coneshaped beam rotation, decreasing
the exposure to the patient of up to
10 times less radiation.
For example, radiation exposure
using the standard full field of view
from an i-CAT® CBCT machine
(Imaging Sciences International) is
36 microsieverts. These machines
are also available in different fields
of view, thereby reducing radiation
exposure even more, depending
upon the needs of the patient.

OT About the author
Dr. Bruce Howerton is a boardcertified oral and maxillofacial radiologist who practices privately in
Raleigh, N.C. He received a DDS from
the West Virginia University School of
Dentistry in 1985.
He completed a certificate in endodontics in 1987 from the University
of North Carolina School of Dentistry
and practiced surgical and non-surgical endodontics in Asheville, N.C. for
eight years.
In 1999, he entered the UNC Oral
and Maxillofacial Radiology graduate
program and completed the master of
science program. Howerton became
a diplomate of the American Academy of Oral and Maxillofacial Radiology in 2003.
For more information, see
www.carolinaomfimaging.com.

For other comparisons of exposure, consider that a typical 2-D
full mouth series runs 150 microsieverts while a 2-D digital panoramic image ranges between 4.714.9 microsieverts.
Researchers who have developed
this technology have achieved the
goal of allowing dentists to achieve
the same information gained from a
medical CT, without the additional

radiation exposure.
Orthodontists who do not own
their own CBCT machines can take
advantage of this imaging method by referring patients to imaging centers to acquire this valuable
information.
The knowledge obtained from
capturing 3-D scans has the ability
to influence the effectiveness and
efficiency of dental treatment.

A dental CBCT scan offers the
views and detail needed to perform
the latest procedures, while avoiding the unnecessary higher levels
of radiation emitted from hospital
scans.
As the technology continues to
evolve, the possibilities for improved
dental care can only increase.
Increased software compatibility
with surgical guides and orthodontic
applications has made CBCT scanners an imperative for some dental
offices.
As an oral maxillofacial radiologist and an educator, I firmly believe
that with knowledge comes responsibility to provide patients with the
best dental care in the safest way
possible — a dental CBCT accomplishes this goal without the additional risks involved with hospital
scans. OT
AD

[8] =>

Practice Matters

Ortho Tribune | February Supplement

2009 ortho practice makeover:
Oh, what a year it has been!
By Kevin Johnson and Emily Ely

Total Ortho Success

hen Dr. Brian Hardy of
Hardy Orthodontics won
the 2009 Levin Group Total
Ortho Success™ Practice Makeover,
he wasn’t sure exactly what he’d be
able to accomplish. What he experienced by year’s end went far beyond
his expectations. Let us review Dr.
Hardy’s case file for 2009:

Office profile
Locations: 1
Orthodontists: 1
Staff: 3 (a scheduling/insurance
coordinator, a treatment coordinator and a clinical assistant)
Treatment Chairs: 3

Orthodontist profile
Age: 36
Dental school: University of Kentucky, 2002
Years in practice: 6
Years in this practice: 2½ (started
from scratch in 2006)
Status: married, two children
When Dr. Hardy began his consulting programs, he had four primary concerns.

The economy
Specifically, he was concerned
about patients’ continued ability to
make a 25 percent down payment
on ortho treatment in the midst of a
down economy.

The schedule
Dr. Hardy readily admitted his
scheduling system was not as disciplined as it should have been.
He said he was, “reaching a point
where hard and fast scheduling
rules need to be implemented.”

A small staff
He wanted to create a professional
relations coordinator (PRC) position. He also felt his staff was not
large enough for him to delegate
responsibilities. Staff members
agreed the office was understaffed.

Stress
He reported stress was high in his
AD

Pr actice

office. Dr. Hardy felt with the implementation of new and improved
systems, the stress level would be
much better.

Triumphs, achievements and
new possibilities

In his yearlong continuing journey,
Dr. Hardy participated in both consulting programs simultaneously,
which dramatically enhanced his
practice’s ability to increase production — even in 2009’s uncooperative
economy. He and his staff were
actively involved with us in making
critical changes to the management
and marketing in the practice.
As with all change, a small level
of hesitation was apparent at first.
The team, however, quickly stepped
up to the plate and began re-building how the practice operated.
“Although we were apprehensive
about some suggested changes,”
said Treatment Coordinator Lee
Anne, “our consultants helped us
see the benefits and worked with us
until we felt comfortable and could
‘own’ it.”
Through management consulting, Dr. Hardy and Levin Group
Senior Consultant Kevin Johnson
worked on several key initiatives for
Hardy Orthodontics, including:
• Greenlight Case Presentation™
and PowerScripting™ skills.
• A concerted effort to open consult
and treatment start slots to ensure
the practice would see as many
patients as possible.
• A more efficient approach to collections.
For the marketing portion of his
consulting with Levin Group Consultant Emily Ely, Dr. Hardy knew
he had to radically invigorate his
referral marketing efforts. However,
he certainly did not have the time,
knowledge or interest to implement

or maintain a comprehensive referral marketing program himself.
To operate one successfully, Ely
worked with Dr. Hardy to create
a PRC position that would handle
marketing activities efficiently. As
a result, referral marketing soon
took off.
In the latter part of the year, Dr.
Hardy was introduced to the critical function of financial planning.
In conjunction with Levin Group,
RG Capital President Robert Graham provided Dr. Hardy with an indepth look at current market conditions based on historical trends
and pending legislation. Graham
emphasized that financial security
has two stages: the accumulation
phase and distribution phase.
Achieving the most in the accumulation phase requires effective
investment strategies that maximize tax and cost efficiencies while
minimizing risk. The accumulation
phase is crucial to a long, prosperous distribution phase.
“As Dr. Hardy was striving to
grow his practice,” Graham said,
“I emphasized that he must bring
the same energy to rebalancing his
portfolio, especially after a period of
economic turmoil.”
Financial planning was indeed a
timely subject for Dr. Hardy. 2009
had turned out to be an extraordinary production generator.

The end of his first year
As 2009 drew to a close, Levin
Group’s Total Ortho Success Consulting Programs enabled Hardy
Orthodontics to take great pride in
a plethora of remarkable achievements:
• Starts doubled compared to a year
ago.
• Production increased 33 percent
for the 2009 calendar year.
• Set a record in the practice for the
most starts in a single month.
• Experienced a 63 percent production increase in a single quarter.
• Converted 70 percent of his occa-

sional referrers into frequent
referrers.
• Collections went up 38 percent.

Conclusion
Dr. Hardy’s production increase in
2009 was astounding. “I just had the
best production ever in the worst
year imaginable!” he said. “Our
Levin Group orthodontic consultants used their expertise to put in
the business systems we needed
to grow and progress to the next
level.”
Results like this represent only
the beginning of Total Ortho Success. Orthodontists entering years
two and three of their consulting
experience are well positioned to
achieve extraordinary results over
the course of their entire careers.
As orthodontic consultants, we
experience no greater satisfaction
than helping orthodontists like
Dr. Hardy discover the potential
we knew existed. The Levin Group
Total Ortho Success Practice Makeover is a remarkable opportunity
for us to help orthodontists realize a
practice’s true potential.
Be sure to check the April issue
of Ortho Tribune when we begin
the journey of Dr. Michelle Gonzalez, winner of the 2010 Levin
Group Total Ortho Success Practice
Makeover. We will report on Dr.
Gonzalez’s practice goals and the
challenges that lie ahead.
Get ready. It’s going to be another year of great ortho accomplishments!
To jumpstart your own Total Success Ortho Practice Makeover, experience Dr. Roger Levin’s next Total
Ortho Success Seminar being held
April 8 and 9 in Chicago. Ortho Tribune readers are entitled to receive a
20 percent courtesy. To receive this
courtesy, call (888) 973-0000 and
mention “Ortho Tribune” or e-mail
customerservice@levingroup.com
with “Ortho Tribune Courtesy” in the
subject line. OT

OT About the authors
Levin Group Senior Consultant
Kevin Johnson has spent the last
eight years working as a Levin
Group orthodontic management
and marketing consultant. He
manages a team of consultants
and is a frequent lecturer at the
Levin Advanced Learning Institute. Johnson earned his degree
from Towson University in 1996.
With many years of marketing experience, Levin Group Consultant Emily Ely joined Levin
Group in 2005. Ely uses her unique
knowledge and experience to provide
marketing solutions for orthodontic
practices. She earned her degree in
business from Towson University.
Both Ely and Johnson are members

of the Ortho Expert Team, a specialized
group of consultants who are trained in
the needs of orthodontic practices.
Visit Levin Group at www.levingroup
ortho.com, call (888) 973-0000 or e-mail
customerservice@levingroup.com.

[9] =>

[10] =>

Practice Matters

Ortho Tribune | February Supplement

A plan B for tough times
By Chris Roussos, CEO of OrthoSynetics

emember when being a good
orthodontist was enough? You
could hang a sign and the
patients would find you. The game
has certainly changed, and the
clinicians who are thriving have
implemented a plan B to aggressively recruit new patients. These
orthodontists are not only surviving,
they are thriving.
It is critical to your longevity
that you fully accept and adapt to
economic conditions. Some prac-

ADS

tices have been too slow to reign in
expenses, which are continuing to
rise for many practitioners. If your
revenue is flat or, worse yet, declining and expenses remain the same
or are even increasing, you will not
be able to survive. It is that simple.

The cost of not advertising
One expense you cannot afford to
cut is advertising. Cutting advertising will have a negative effect on
your practice’s performance both
now and in the future. A sophisticated advertising strategy that leverag-

es the cost efficiencies of technology
and social media will provide you a
tremendous bang for your buck.
An online marketing strategy can
deliver hundreds of leads to your
door. With the fading economic situation where most practices have
tightened their marketing budgets,
search engine optimization provides
major benefits, primarily because it
is the cheapest form of advertising
with an extremely high conversion
rate.
Unlike direct mail and other
forms of advertising, your Web site
is constantly advertising for you
24/7, 365 days a year. Customers
can find you anytime, anywhere.
Imagine 150 new visitors finding
out about you from your Web site.
Compare that with the cost involved
in mass media acquisition for each
new customer.

Reap what you sow
Every time your phone rings, there
is an associated cost. Your goal
should be to convert every phone
call and consult into a banding.
Focus on what we call the “contract
to banding gap.”
Take a look at how many contracts you have signed in the past six
months versus how many patients
have begun treatment. Currently
we are seeing many patients signing contracts, but they are getting
“buyers’ remorse” and not following
through with bandings.
Many clinicians are moving
aggressively to address this gap.
Are you? A potential solution is to
provide opportunities for the patient
to get started (banded) the same day
the contract is signed.
You probably are questioning the
logistics of this suggestion. How do
you band same day when the schedule is probably already set? This
brings me to my next point.

time frame, if your practice has not
seen an increase in profits, then
where will you get the funds for
merit increases?
It is your job to set the expectation from the start. Team performance and goals should be aligned
with practice performance.
A team fully engaged in the practice will put the practice needs
above its own. Cutting short a lunch
hour or staying later in the evening
to fit in a banding becomes your
team’s reality. With the right incentive in place, there is nothing you
and your team cannot do.

Managing your managed care
If you are already participating in
managed care plans, it is critical to
review the reimbursements specific
to HMO and carriers that will negotiate PPO fee schedules. An immediate review would be warranted if
you have had a significant increase
in fees.
Having the right payer mix is
crucial to a successful practice.
Utilizing managed care plans can
increase patient base, increase revenue and ensure less empty chair
time during down periods in the
schedule.
Demographic
research
of
employers and knowing what plans
are offered is a key component to
increasing or enhancing your payer
mix. Looking at national carriers
initially is recommended as the
majority of the groups signed are
on a corporate level capturing the
largest employee base.
During this economic downturn,
it is possible to grow your practice if
you recognize the situation and act
accordingly by implementing a plan
B. If you need assistance with your
plan B, call one of our business
development specialists today at
(888) 622-7645. OT

Team motivation
Make no mistake: money is a big
motivator. If you are giving regular
pay increases regardless of practice
performance, you are missing out
on an opportunity to motivate your
team and align team goals with the
practice goals. A motivated team
with clear goals can accomplish
many tasks that seem difficult to
reach today.
Everyone needs feedback as it
allows the employee and the supervisor an opportunity to share expectations and observations, clarify
objectives and plan for future development.
However, it is extremely important to remember a performance
appraisal is not always accompanied by a salary increase. Contrary
to popular belief, it is not standard
practice to automatically give every
employee another dollar per hour
just because it is January. No matter how exceptional an employee’s
performance is during any given

OT About the author
Chris Roussos is CEO of
OrthoSynetics Inc. (OSI),
a
business
service company in the
orthodontic
and
dental
industries.
He has more
than 20 years
of management experience with top
companies,
such as PepsiCo and Newell Rubbermaid, and
in the health-care industry running
national hospice, home health and
outpatient physical therapy companies as president. For more information, visit www.orthosynetics.com.

[11] =>

[12] =>

12

Practice Matters

Ortho Tribune | February Supplement

Motivating employees
in a tough economy
Ownership, empowerment and appreciation can do the trick
just as well as, or even more than, money
By Scarlett Thomas, President,
Orthodontic Management Solutions

T

imes are tight and so are orthodontic budgets. Staff raises
were low or non-existent last
year. Bonuses that employees have
always looked forward to were not
given. Employees are downcast,
and some are outright angry. The
work still needs to be done, and
productivity has decreased.
So what can you do as their boss
to get them motivated again?
First, always keep them in the
loop. Communication cannot be
underestimated. Hold meetings.
Keep them apprised of the state
of the practice to whatever degree
is permitted. Keeping them in the
dark is only going to cause more
resentment and anxiety. Be as open
as company policy allows.
Find cost-effective motivators.
Money is the primary reason most
get out of bed and head to work in
the morning, but it is not the only
motivator. Hold contests. Plan lowcost parties. Try to have fun.
Show empathy. Listen to your
employees. This is an uncertain
time for them, and perhaps for you
too. Show them you care by listening to their concerns and acknowledging their fears.
Thank them. Tell them you
appreciate their hard work. Most
employees’ job complaints are that
they are treated poorly, not that they
are underpaid. Treat them well,
respect them and make sure they
know you appreciate them.
Motivate your employees by delegating tasks. Delegation is one
of the most powerful motivation
tools for empowering employees
in the workplace. The sheer act of
your delegating a task shows your
employees that you have the confidence in them that they can do the
job.
Ask your employees their opinions. Many times during our busy
AD

‘Find cost-effective
motivators. Money
is the primary
reason most get
out of bed and
head to work in
the morning, but
it is not the only
motivator.’
work days, we find it difficult to ask
for opinions from our employees.
But just the act of asking for their
opinions tells your employees you
value their input, which motivates
them to accomplish more.
Motivate your employees by letting them run your meetings. One
of the best ways to motivate and
empower them is to involve them in
running your meetings. Of course,
you will set the agenda, but there
are many opportunities for you as
a leader to let your employees run
portions of, if not the entire, meeting.
Always give your employees
credit for the ideas they express.
Nothing will decrease employee
motivation and dry up the flow of
ideas quicker than having managers take credit for their employees’
ideas.
If your employees are coming up
with ideas, reward them publicly.
You will be amazed how the flow
of ideas from motivated employees
will increase with each public recognition.
Motivate your employees by
rewarding initiative. Create rewards
for employees who take initiative.
Publicly recognize employees during meetings, with reward boards,
etc., so that other employees are

motivated to take the initiative.
One of the biggest things you
can do to motivate your employees is create and set goals. Your
employees will be far more motivated to achieve your goals if they are
allowed to help develop those goals.
Involve your employees in the
goal-setting process and get their
input so it becomes believable for
them. Once your employees feel
ownership of your goals, they will
be motivated to move quickly to
help accomplish them.
Motivating your employees
doesn’t always have to be money
related. Often times, employees
are more motivated when they feel
ownership, empowerment, appreciation and respect for their input
and ideas. Try a few of the previous
ideas and welcome the changes you
will experience within your practice.
To learn more regarding motivating employees, increasing case
acceptance, marketing your practice and management issues, visit
orthoconsulting.com and sign up for
one of the monthly Webinars. OT

OT About the author

Scarlett Thomas is an orthodontic
practice consultant who has been in
the field for more than 23 years, specializing in case acceptance, team
building, office management and
marketing. As a speaker and practice
consultant, she has an exceptional
talent to inform, motivate and excite.

OT Contact
Scarlett Thomas
Orthodontic Management Solutions
Phone: (858) 435-2149
scarlett@orthoconsulting.com
www.orthoconsulting.com

[13] =>

Industry 13

Ortho Tribune | February Supplement

Mystery and controversy
are directly proportional
The less we know
about a topic, the
more clamorous are
the polemics and the
sharper the schism
is between them
AD

By Rohan Wijey BOralH, Grad Dip Dent

he orthodontic tradition is no
different and has seen a familiar
quarrel rumbling for more than
a century.
In broad terms, two faculties of
thought have evolved. The first, traditional school (Angle 1907) works
under the premise that certain skeletal dimensions are intransigent
(Cross 1977), and uses fixed appli-

ances to render predominately dentoalveolar movements.
The second, historically European school (Andreson & Haupl
1936), is predicated on the belief
that muscle function affects the size
of jaws and dental arches, and that
functional appliances can fix form
by treating dysfunction.
This article will not subscribe to
the heavily flogged corpse that is
the debate between the two sides.

It is simply unscientific to enlist
ourselves to either cause; rather, we
must be directed by the flow of evidence, and be willing to jettison past
beliefs in favor of new evidence.

Traditionalism exhumed,
progress buried?

“Providing early orthodontic treatment for children with upper front
teeth is no more effective than providing one course of orthodontic
treatment when the child is in early
adolescence” (Cochrane Review
2007).
Turpin (2007) claims this news
“will help the clinician feel less
pressure to begin early correction of
this malocclusion.”
It must be noted, however, that
the Review’s conclusion was based
simply on overjet, peer assessment
rating (PAR) scores and ANB angle;
the first and second criteria concern
dentoalveolar relationships, while
the third describes how the maxilla
and mandible approximate to each
other, and not to the rest of the
cranium.
There is no assessment of softtissue profile, and these scores are
simply not indicative of how the
face looks.
Moreover, there is no mention of
such complications as root resorption (Ballard et al. 2009), incisor
trauma (Justus 2008), white spot
lesions (Willmot 2008) and damaging of facial profiles with premolar
extractions that are all associated
with later intervention.
“Whenever there is a struggle
between muscle and bone, bone
yields” (Graber 1963)
The role of muscles in fashioning
bone and dental arches is an immutable fact. Many studies have shown
that masticatory muscle function
increases sutural growth in the craniofacial complex and stimulates
bone apposition (Kiliaridis 2006).
Furthermore, it is not simply mastication but the whole spectrum
of muscle function that influences
bone, such as deglutition, respiration, sucking and speech.
Electromyographical
studies
have also revealed that muscles
have the power to remodel bone
and arches even at postural resting position, as compensatory myofunctional alterations for structural
discrepancies (de Souza et al. 2008).
The studies have cast a retrospective glow on Graber’s prescient
1963 sentiment that any hope of a
stable result rests on restoring the
myofunctional balance of the stomatognathic system.
g OT page 14

[14] =>

Industry & Products

Invisalign adds
new features
A
lign Technology has introduced
new features to the Invisalign
product line that are designed
to improve extrusions, rotations and
root movements. Optimized attachments, Power Ridges™, and velocity
optimization help provide greater
control and precision for specific
tooth movements across a broader
range of patients.
Optimized
attachments
are
designed to improve extrusions of
anterior teeth and canine rotations
by optimizing aligner forces. These
next-generation attachments are
customized to a patient’s unique
tooth anatomy and create a patientspecific solution for each case.
Power Ridges, formerly available
only on Invisalign Teen®, help deliver lingual root torque by optimizing forces on upper incisors. They

can be used when up-righting retroclined upper incisors, such as in
Class II Division 2 cases.
Velocity optimization provides
more controlled movements for the
entire tooth, including the root, and
works with improved ClinCheck®
protocols to limit the speed of crown
and root movements to optimal
ranges.
In addition, IPR improvements
now allow IPR to be set up in later
stages of treatment when crowded
teeth are more aligned and may be
easier to access. A new Invisalign
Attachment Kit also helps achieve
better bond strength, wear resistance and dimensional accuracy
when used to create attachments,
including the optimized attachments. To learn more, visit www.
invisalign.com. OT

Ortho Tribune | February Supplement
KODAK 9500 Cone Beam 3-D System
The KODAK 9500 Cone Beam 3-D System is now one of only a few advanced
3-D dental imaging systems certified by OraMetrix for use with its SureSmile®
technology, which transforms cone-beam scans of the mouth and teeth into 3-D
computer models for orthodontic planning and treatment.
This new integration enables orthodontists to submit 3-D scans acquired by the
KODAK 9500 3-D System to SureSmile for the manufacture of customized wires
for patients.
The SureSmile system is a digital therapeutic solution for orthodontics that
replaces conventional manual treatment. Orthodontists can take a 3-D scan of
the patient’s mouth, face and jaw and use this data in the SureSmile system for
unprecedented control of treatment through virtual diagnostic simulations, instant
quality grading tools, prescriptive planning capabilities and robotic arch-wire
customization.
The KODAK 9500 3-D System enables practitioners to quickly produce magnificent 3-D images — ranging from single jaw to full craniofacial images — at
the lowest possible dose. With high-quality, anatomically correct 3-D images up
to 0.2 mm voxel size, practitioners are able to provide more accurate diagnoses,
improved treatment planning and better patient care.
SureSmile
www.suresmile.com
PracticeWorks Systems
(800) 944-6365
www.kodakdental.com

f OT page 13

This overwhelming evidence
clearly indicates the need for treatment to be geared toward correcting function, because it is function
that affects form.

Evidence-based orthodontics
Since the epidemiologist Sackett
(1986) observed that orthodontics was on par with scientology
in terms of scientific legitimacy,
the industry has made a concerted effort to transform itself. More
orthodontists are embracing this
paradigm-shift toward the weight
of evidence, which rests firmly with
early treatment and treating muscle
function.
A case in point is this 9-year-old
girl with a narrow, retrusive maxilla and mandible, crowding of the
upper arch and anterior flattening
of the lower arch. An expansion
appliance was used for the maxilla to create enough room for the
tongue to posture correctly in the
palate, together with a myofunctional appliance.
By simply treating function, after
only four months the overbite has
reduced significantly, the lost lower
right c-space has begun to re-open
and the dental alignment has also
improved.
Obviously, the myofunctional
phase of treatment is yet incomplete and the dental phase has not
even begun; however, the improvement in the facial profile is already
remarkable. (Figs. 1, 2)
There is always going to be an
important place for fixed appliances, because it is still the most
efficient way to move a tooth. However, the two worlds are far from
mutually exclusive: We can shorten
the time needed for braces and
greatly improve the stability of the
result and fullness of the face if we

Fig. 1: October 2009
intervene early with myofunctional
therapy.
A new dawn is breaking in the
industry, one in which we can now
use the best of both worlds for better faces as well as teeth. OT

References
1.
2.
3.

Andresen V, Haupl K, 1936.
Functions-Kiefer Orthopadie.
Berlin, Hermann Meusser.
Angle EH, 1907. Treatment of
Malocclusion of the Teeth, Philadelphia, SS White, 7th ed.
Ballard DJ, Jones, AS, Petocz P,
Derebdeliler MA, 2009. Physical
properties of root cementum:
Part 11. Continuous vs intermittent controlled orthodontic forces on root resorption.
A microcomputed-tomography
study. Am Journal of Orthod
and Dentofacial Orthopaedics.
Burr DB, 1997. Muscle strength,
bone mass, and age-related
bone loss. J Bone Miner Res, 12:
1547–1551.
Cross JJ, 1977. Facial growth:
Before, during and following
orthodontic treatment. Am J
Orthod, 71:68–78.
De Souza DR, Semeghini TA,
Kroll LB, Berzin F, 2008. Oral
myofunctional and electromyographic evaluation of the

Fig. 2: January 2010
orbicularis oris and mentalis
muscles in patients with Class
II/1 malocclusion submitted to
first premolar extraction. J Appl
Oral Sci, 16(3):226–31.
7. Frost HM, 1997. Perspective:
On our age-related bone loss:
Insights from a new paradigm. J
Bone Miner Res, 12:1539–1546.
8. Graber TM, 1963. The “three
M’s”: Muscles, malformation
and malocclusion. Am J Orthodontics, 19(6):418–450.
9. Harrison JE, O’Brien KD,
Worthington HV. Orthodontic treatment for prominent
upper front teeth in children.
Cochrane Database of Systematic Reviews 2007, Issue
3. Art. No.: CD003452. DOI:
10.1002/14651858.CD00345
2.pub2.
10. Justus R, 2008. Are there any
advantages of early Class II
treatment? Am J Orthod Dentofacial Orthop, 134:717–8.
11. Kiliaridis S, Bresin A, Holm
J, Strid K-G, 1996. Effects of
masticatory muscle function on
bone mass in mandibles of the
growing rat. Acta Anatomica,
155: 200–205.
12. Kiliaridis S, 2006. The importance of masticatory muscle
function in dentofacial growth.

Seminars in Orthodontics,
12:110–119.
13. Lu T-W, O’Connor JJ, Taylor
SJD, Walker PS, 1997. Influence
of muscle activity on the forces in the femur: Comparison
between in vivo measurement
and calculation. Trans Orthop
Res Soc, 22:721.
14. Turpin DL, 2007. The longawaited Cochrane review of
2-phase treatment. Am J Orthod
Dentofacial Orthop, 132:423–
424.
15. Willmot D, 2008. White spot
lesions after orthodontic treatment. Seminars in Orthodontics, 14(3):2009–219.

OT About the author
Dr. Rohan Wijey graduated in 2009
from Griffith University (Gold Coast,
Queensland) where he took a special
interest in orthodontics and especially in myofunctional orthodontics. He
started working with Myofucntional
Research in 2007, researching and
writing articles on both traditional and myofunctional orthodontics.
Wijey is now embarking on an extensive program of post-graduate studies in traditional and myofunctional
orthodontics and TMJ disorder.

[15] =>

Ortho Tribune | February Supplement
MiniAnts
Problems of space will soon be a
thing of the past with the MiniAnts,
a new bracket design incorporated
in the FORESTADENT 2-D lingual
bracket system.
Up until now, twin-wing brackets
in the lower anterior region have had
to be placed very close together due
to their width, but now there is much
more space available with the MiniAnts. This is because MiniAnts have
a considerably reduced width while
maintaining their twin-wing design.
This type of design, which has
been adapted to ensure an even better fit to the anatomy of the tooth,
greatly facilitates the compensation
bends that are mainly required during the finishing phase.
Use of the MiniAnts also significantly increases the intraoral comfort for the patient, as the patient
experiences less pressure due to
reduced application of force. Another
advantage of the optimized design is
the improved rotation control in the
lower anterior region.
MiniAnts were first presented by
their designer, Dr. Thomas Banach,
at the inaugural FORESTADENT 2-D
Lingual User Meeting in the German
city of Frankfurt. They are available
in two versions — with a gingival
hook for torquing individual teeth
and without a hook — and now
extend the range of the FORESTADENT 2-D lingual bracket system.
The uncomplicated technique of this
self-ligating system makes it particularly suitable for new orthodontists as
well as for treatment of simple cases.
Two-dimensional lingual brackets
are extremely flat, comfortable and
are a cost-effective addition to any
orthodontic practice, as laboratory
work is no longer required.
Forestadent USA
2315 Weldon Parkway
St. Louis, Mo. 63146
Phone: (800) 721-4940, (314) 878-5985
Fax: (314) 878-7604
E-mail: info@forestadentusa.com
www.forestadentusa.com

The new MiniAnts not only enable
improved rotation control but
also ensure much more space for
adjustment bends.

Products 15

Gishy Goo

Gishy Goo is a specially formulated poly-vinyl-siloxane
elastomer that enhances patients’ comfort with orthodontic
appliances. Available in multiple colors, Gishy Goo is a fun
and effective way to relieve the discomfort of brackets, poking
wires and fixed/functional appliances.
Once mixed, the thixotropic properties of Gishy Goo allow
for hours of relief without wearing away like silicone or
wax. Gishy Goo will help the orthodontist, staff and patients

avoid the inconveniences and hassles caused by emergency
appointments.
Gishy Goo is available in single patient kits, 10 syringe
packs or 50 syringe economy packs.
Opal Orthodontics
(888) 863-5883
www.opalorthodontics.com

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