Ortho Tribune U.S.

Destination: D.C. / What makes an orthodontist educated? / AAO Preview / Miniscrews: a focal point in practice (Part 1 of 6) / Embracing online communities / Did you survive the 2009 Google Maps restructuring? / Preparing for the Total Ortho Success Practice Makeover / Truths and consequences of orthodontic diagnostics / AAO Exhibitors / Soft-tissue lasers offer what you need / Orthodontic highlights on the Seine

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

April 2010

www.ortho-tribune.com

Vol. 5, No. 4

Get out and see D.C.

Meet Dr. Gonzalez

Coming to the AAO

9 places you’ll want
to see for sure

California orthodontist
is ready to be made over

Ortho2 to launch
new software system

uPage

Destination: D.C.
AAO’s 110th Annual Session makes
itself at home in the nation’s capital
By Kristine Colker, Managing Editor

here are going to be rallies,
there are going to be congressional visits and there are going
to be tours of monuments. And
that’s not even including the educational courses and hands-on workshops, the live clinical procedures
or the exhibit hall teeming with
new products and technology, all of
which signal that the 110th Annual
Session of the American Association of Orthodontists is about to get
under way.
From April 30–May 4, orthodontists from across the country and
the world, their staffs, orthodontic
residents and guests will be taking

The Capitol Dome. (Photo/Jake McGuire)

Miniscrews: a focal point in practice
Part 1 of 6: The
basis and history
of anchorage — the
selection of screws

By Dr. Björn Ludwig, Dr. Bettina Glasl,
Dr. Thomas Lietz and Prof. Jörg A. Lisson

n view of the plethora of publications, courses and advertising material on this subject, it
would seem that miniscrews are
widely used. Once some candid
questions have been asked and

answered, however, it becomes
apparent that the reality is quite different.
It seems evident that there are
valid reasons that miniscrews are
not yet in daily use in many practices. With this series, the authors
intend to encourage those practitioners who are hesitant to use miniscrews to use them routinely, by
providing a compendium of experiences and new findings in this field.

over Washington, D.C., as the AAO
pulls out all the stops to make this
year’s meeting better than ever.
There will be a variety of new
course topics to engage in, including
an examination of how stem cells
and tissue engineering may impact
the future of orthodontics, a look
at current issues surrounding oral
bisphosphonates and a discussion
regarding the issue of access to orthodontic treatment.
Other topics include the use of
aligners, clinical guidelines for miniscrews, the past and future of imaging, esthetics, practice management
and orthodontics for adults.
g OT page 4

Put your practice
where it belongs —
on Google Maps

Anchorage in general
Moving a body requires anchorage
in the form of a counter support. The
force required for the movement acts
on both body and abutment. In his
“Third Law” (1687), Newton specified that every action has an equal
and opposite reaction. In dentofacial orthopaedics, this means that
the force acts on all teeth involved
in the case of the dental support of
a tooth movement. Thus, both bodies ultimately move.

Google is constantly
changing its policies
regarding local business
services. Mary Kay Miller
shows you how to keep
on top of the changes and
keep your listing where
people can see it.
uPage

g OT page 6

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[2] =>

From the Editor

Ortho Tribune | April 2010

What makes an
orthodontist educated?
By Dennis J. Tartakow, DMD, MEd, PhD,
Editor in Chief

n orthodontic education often
requires rote learning. Dentists, for whom wholeness is
so uniquely important, are almost
distinctively un-whole, a remediable
consequence of their training.
Perhaps dentistry attracts individualists or encourages them to
become individual in nature. Memory objectionably insists that even
when the learning was without bias
and restricted to a certain workload
without prejudice, it was simply more
esoteric in comparison to other brain
functions. The field of orthodontics
incorporates the entire human existence. Whatever the reason, it can
lead to unsuccessful behavior.
Doctors are great technicians
with exceptional etiquette and skillful hands, but personal philosophy
should be left outside the office
door like his or her shoes, which
for the same reason would seriously contaminate the realistic and
theoretical nature of the business of
orthodontics. Amid intense appearance of professional self-respect,
there is an overriding theme: orthodontics is not about realistically and
theoretically untainted business,
but rather about individuals who
are not pragmatically pure. Orthodontists are not merely concerned
with protocols or techniques — they
are infinitely more diverse.
In the past few years, communication skills have become essential
parts of undergraduate dental curricula. That is admirable and noteworthy but simply not enough.
To recognize ethics and morality as a distinct subject implies that
there are times when individuals
act ethically and, accordingly, times
when individuals act unethically.
Ethics and morality do not exist in
a box to be carried around like a
knife or microscope and whipped
out when required.
This might imply that ethics and
morality are not intrinsic to everything that doctors do or say. Teaching ethics and communication skills
to individuals who do not know
what or why they believe is like
teaching pathology to those who
have not endured the experience

of preclinical sciences; students
might be very good at listing signs
and symptoms or reciting the treatment protocols, but in practice they
would be dangerous without understanding the fundamentals of why
something occurred. Those individuals would be unable to modify
or adapt their practice skills to new
situations.
Teaching undergraduate students ethics and morality is not
necessarily the answer. Teaching
non-medical courses at the undergraduate level would undoubtedly
be extremely helpful. There is no
question the undergraduate curriculum is crowded, but if the only
way to seed exhausted and bored
brains with Plato or Aristotle is to
sacrifice a detailed and utterly irrelevant knowledge of the origin and
insertion of the flexor pollicis brevis, then by all means do it.
Perhaps more could be required
at the stage of selecting dental students. Dental schools would most
likely admit that all the serious
candidates have “A” grades and that
determining factors include other
distinguishing characteristics such
as being president of the debate
team, captain of the baseball team
or a spectacular interview. There is
no doubt the academicians would
be right, but maybe the problem is
in getting the right candidates to
apply.
Other criterion might be considered or required such as courses in
civil rights, ethics and principles of
social justice. The individuals who
should be accepted may be those
who strive to understand human
beings and behavior, and only want
to understand the DNA molecule or
the function of cellular mitochondria because it’s a tiny but important part of the human cocktail. The
moment someone sees the DNA molecule mainly as a money- or statusgenerating machine, the brakes
should go on! Orthodontics can be a
self-perpetuating geek-ocracy.
Humanities and historians are
other ascending disciplines, but
until now they have been confined
to the province of a beleaguered
minority of those who read such
epics as Victor E. Frankl’s “Man’s
Search for Meaning” rather than
those whose uncles were GPs. It
needs to be understood for its own
importance, receiving sycophantic
tribute from the secondary disciplines such as physiology, neurology and cariology.
Accreditation should demand
that doctors do not snore their way
through a day of drug-company
sponsored propaganda on new
NSAIDs, but rather that they also
attend their local book club or public interest groups. The patients’
best interests are wider than his or

her “medical” best interests; they
should insist that their clinicians
who conduct those best interest
resolves are doctors who work at
more than just orthodontic techniques and their golf scores.
This is not a plea for a sniffily
intellectual orthodontic salon ethos.
It is not an assertion that orthodontists who listen to Beethoven at Lincoln Center are better people than
those who listen to Gary Null over
breakfast. It is a tentative suggestion
that because Beethoven was and
Gary Null is a member of the human
race, knowledge of both of them are
indices that the doctor is appropriately keeping up with the milieu of
his or her profession via the need of
the community and society.
Somerset Maugham wrote, “I do
not know a better training for a
writer than to spend some years in
the medical profession.” The converse of this is also true: there
are few better ways for an orthodontist to appreciate the scope of
his or her subject matter than to
keep the company of musicians, artists, writers and philosophers who
have struggled to understand the
nature of what homo sapiens are
about and what makes them tick.
True evidence-based orthodontics
involves consideration of all available evidence about human beings
and their place in the universe.
(This editorial was inspired by an
original essay: Foster, C. (2009).
Why doctors should get a life. Journal of the Royal Society of Medicine,
102, pp. 518–520.) OT

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
Gregg Willinger
g.willinger@dental-tribune.com
Product & Account Manager
Humberto Estrada
h.estrada@dental-tribune.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dental-tribune.com
Marketing & Sales Assistant
Lorrie Young, l.young@dental-tribune.com
C.E. Manager
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Dental Tribune America, LLC
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Phone: (212) 244-7181, Fax: (212) 244-7185

Published by Dental Tribune America
© 2010, Dental Tribune America, LLC
All rights reserved.
Dental Tribune makes every effort to report
clinical information and manufacturers’
product news accurately, but cannot assume
responsibility for the validity of product claims,
or for typographical errors. The publisher
also does 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 America.

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] =>

AAO Preview

Ortho Tribune | April 2010

3

Going to AAO? What to know
What

American Association of Orthondontists’ 110th Annual Session

AAOF Breakfast

Online

Places were still available as of press
time at $25 per person for the AAOF
Breakfast, taking place at 7 a.m.
Monday in the Renaissance Ballroom, West A. Breakfast includes
the presentation of Blair Award to
John Pershing for his service to the
AAOF. Complimentary tickets will
be offered to current orthodontic
residents who sign up on site at the
meeting. See the AAOF display at
the meeting for more details.

www.aaomembers.org/mtgs/2010
-AAO-Annual-Session.cfm

Audio recordings

Exhibit hall hours

Pre-order an audio DVD-ROM of
conference lectures for a pre-event
discount price of $85. Details can be

When
Friday, April 30–Tuesday, May 4

Where
Walter E. Washington Convention
Center (WWCC), 801 Mount Vernon
Place, Washington, D.C., 20001

• 9:30 a.m.–5 p.m. Saturday
• 9:30 a.m.–5 p.m. Sunday and Monday
• 9:30 a.m.–2 p.m. Tuesday
The exhibit hall is located in the
WWCC Lower Level, Halls A and
B. Dedicated hours are from 11:15
a.m.–1:15 p.m. daily.

Table clinics
2–5 p.m. Sunday in WWCC Hall C

Scientific posterboard exhibits
10 a.m.–5 p.m. Monday in WWCC
Hall C

Attire
The official dress code of the AAO
is business casual, which includes
slacks and skirts.

C.E. pavilion
While attending the AAO, record
the lectures you attend and print
your C.E. hours report. The pavilion
can be found at east registration on
street level.

Shuttle schedule
Daily shuttle service will be provided between the WWCC and all
AAO-designated hotels. Washington, D.C., rush-hour traffic is heavy,
so make sure you leave ample time
for your commute. Shuttle hours
are as follows:
• 7:30 a.m.–6:30 p.m. Friday and
Saturday
• 7 a.m.–6 p.m. Sunday and Monday
• 7 a.m.–2:30 p.m. Tuesday
Shuttles operate at 15-minute
intervals in the mornings from 7–10
a.m. and in the late afternoons from
3:30–6:30 p.m. and at 45-minute
intervals from 10 a.m.–3:30 p.m.
Friday–Monday. On Tuesday, intervals are 30 minutes all day.

Airport shuttle discounts
Two shuttle services, Shuttlefare
and SuperShuttle/ExecuCar, are
offering discounts to AAO attendees
arriving at all three Washington,
D.C.-area airports. Reservations are
required to receive the discounts.
To receive discounted pricing on your airport transportation,
your reservation needs to be placed
online through the links provided
at www.aaomembers.org and you
must use the coupon code at checkout.

found at www.aaomembers.org.

Tours
Tickets are still available, as of
press time, for many of the AAO
activity programs. Choices include:
• “A Special Look at Washington,”
9 a.m.–1 p.m. Saturday, $32
• Mount Vernon with lunch at
Gadsby’s Tavern, 9:30 a.m.–3:30
p.m. Saturday, $99
• Shopping in Georgetown with
lunch at Filomena’s, 1–5 p.m. Saturday, $75
• “A Special Look at Washington”
with boxed lunches, 9 a.m.–3 p.m.
Sunday, $65
• Historic Annapolis with lunch at

Treaty of Paris, 9 a.m.–5 p.m. Sunday, $126
• Arlington National Cemetery, 1–5
p.m. Sunday, $32
• “A Splashing Good Time! Aboard
the DC Duck,” 1–5 p.m. Sunday,
$74
• Capitol Hill, 9 a.m.–1 p.m. Monday, $66
• “Lincoln’s Life and Legacy” with
lunch at Old Ebbitt Grill, 9:30
a.m.–3:30 p.m. Monday, $132
• “Monuments by Moonlight” with
champagne and dessert, 8–11 p.m.,
$48
• Old Town Alexandria with lunch
at Indigo Landing, 9 a.m.–3 p.m.
Tuesday, $110. OT
AD

[4] =>

AAO Preview

A view of the
Walter E.
Washington
Convention
Center from 7th
Street, NW and
Mount Vernon
Place/New
York Avenue.
The convention
center is where
this year’s
AAO Annual
Session is
taking place.
(Photo/
Destination
DC)

Ortho Tribune | April 2010
f OT page 1

One course highlight is a special
risk-management program that will
focus on common concerns at the
beginning of an orthodontic career.
This seminar, featuring legal and
insurance expert panelists, will take
place the afternoon of April 30.
In addition, there will also be
live clinical procedures by orthodontists on patients and filmed and
broadcast live to both doctor and
staff seminars. Topics include miniimplant insertion and application of
laser technology.
The hands-on workshops are
always a popular attraction. As of
press time, two sessions still have
openings: “New Lingual Straight
Wire Method: A Look at the Future”
(8 a.m. Sunday) and “TADs Applications for Invisible Orthodontics in
Adults” (1:15 p.m. Sunday). You can
register for these sessions online at
www.aaomembers.org.

Social activities
The AAO Annual Session is full of
activities that will keep you busy
when you aren’t attending classes
or checking out the exhibit hall.
One such activity is the AAO Opening Ceremonies on Saturday, May 1.
Come listen to the music of Frankie
Valli and the Four Seasons and
see a performance of the comedy
“Defending the Caveman,” the longest running solo play that has ever
appeared on Broadway, where it
opened in 1995.
There is also still plenty of space
available for many of the AAO tours.
Activities include such things as a
“Monuments by Moonlight” tour,
shopping in Georgetown, a ride on
the DC Duck, a congressional visit
and a tour of historic Annapolis.
For a complete description of all
AAO’s tours and to register, visit
www.capitalcityevents.net/aao2010.

Exhibit hall and more
More than 300 companies will show
off their newest and best products
in the exhibit hall from Saturday
to Tuesday, and you don’t have to
skip class to go shopping. Each day,
11:15 a.m. to 1:15 p.m. has been set
aside as dedicated exhibit hall time.
Many companies are offering discounts, launching new products or
putting on entertainment, such as
political rallies, in their booths. (For
more information on what will be
in the exhibit hall, turn to Page 16.)
One company you’ll want to check
out is Alliance Tech, which is providing smart phone applications
that will enable attendees to review
conference information and create schedules on their phones. Alliance Tech will rent iPod Touches to
those who do not have smart phones
but wish to use the technology. See
www.aaomembers.org for details.

Ortho Tribune at the AAO
For plenty more information on this
year’s AAO, including a look at new
products and can’t-miss events,
don’t miss the Ortho Tribune Daily
Edition, available exclusively during the AAO Annual Session. OT

[5] =>

Ortho Tribune | April 2010

AAO Preview

Find money, monuments, more in D.C.

Neighborhood exploration

Passport D.C.

D.C. from above

Dozens of embassies and cultural
centers open their doors to showcase their traditions, art, music,
dance and cuisine in Cultural Tourism D.C.’s annual international celebration. It kicks off May 1 with 30
embassies offering various events
and programs through Around the
World Open Houses.

For a great and inspiring aerial view
of the city (without the wait you’ll
find at the Washington Monument),
visit the Old Post Office Pavilion on
Pennsylvania Avenue. OT

inding something to do in Washington, D.C., is not a problem.
Everywhere you look you can
find an array of museums, monuments, outdoor activities and more.
The real question is how to narrow
it down.
Here are some destinations you
might want to consider as you take
in the sights of our nation’s capital.

Celebrate Elvis
In honor of Elvis and the 75th anniversary of his birth, the exhibition,
“Elvis! His Groundbreaking, HipShaking, Newsmaking Story,” at The
Newseum tells the story of Presley as
he was portrayed in the news media
and explores how his music and
physicality pushed the boundaries of
mainstream taste and free expression during a time when America
was experiencing deep generational shifts. Produced in collaboration
with Elvis Presley Enterprises, the
display includes rare objects from
the Graceland vaults that have never
before been publicly displayed.

Millennium Stage performance
Take in a free performance at The
Kennedy Center’s Millennium Stage
every evening at 6 p.m. Acts include
everything from performances by
the National Symphony Orchestra
to gospel groups to jazz musicians
to poetry slams.

Making money
Make money (or see money made)
with a free tour of the Bureau of
Engraving and Printing.

Gargoyle Tour
Explore the beautiful grounds of
the National Cathedral, then take a
Gargoyle Tour ($10/adult, $5/child
or $30/family), and see how these
whimsical creatures reflect history
in stone. There’s even one fashioned after Darth Vader.

National Archives
See the original Declaration of Independence, U.S. Constitution and Bill
of Rights at the National Archives,
then stick around to research your
own family’s immigration records.

Relive history
Sit in the lobby of the Willard InterContinental Hotel to imagine history unfolding. The hotel is where
Julia Ward Howe wrote “The Battle
Hymn of the Republic,” where President Ulysses S. Grant popularized
the term “lobbyist” and where Rev.
Dr. Martin Luther King Jr. wrote his
“I Have a Dream” speech.

Get out into D.C.’s neighborhoods
to learn about history beyond the
National Mall by experiencing Cultural Tourism D.C.’s free self-guided walking trails.
They are marked with illustrated
signs revealing the stories behind
Washington’s historic neighborhoods.

Head out into Washington, D.C.’s neighborhoods to see sights such as these
rowhouses on Capitol Hill. (Photo/Destination DC)

(Source: Destination DC)
AD

[6] =>

6

Trends

Ortho Tribune | April 2010

f OT page 1

The extent of movement and
countermovement does, however,
depend on the anchorage strength
of the individual teeth, i.e., on the
number and length of the roots, the
root surface, and the structure of
the surrounding bone.
Anchorage quality can be divided
into three categories:
1. minimum anchorage;
2. medium anchorage; and
3. maximum anchorage.
These three categories can be
described using the example of
a conventional canine retraction
after removal of a first premolar
(Fig. 1).
In the case of minimal anchorage, the support is provided by the
individual teeth. Figure 1a shows
that a single premolar is not sufficient as an abutment to distalise
a canine. The premolar is clearly
mesialised in reaction to the application of force.
Figure 1b shows how two, equally strong, anchorage segments are
formed. Action and reaction are
comparable in this case; the result
is reciprocal tooth movement.
In the case of maximum anchorage (Fig. 1c), the posterior group of
teeth is secured and held stationary
by using a miniscrew. The canine
can be retracted by the complete
force vector, as the reactive force is
completely absorbed by the anchorage block formed.
Apart from anchorage quality,
the basis, i.e., the type of anchorage
location, plays a role:
Dental or desmodontal support:
•	use of additional intra-oral devices (nance, palatinal arch, lingual
arch, lip bumper);
•	modification of fixed appliance
(buccal root torque, blocking);
and
•	incorporation of the teeth of the
other jaw (Class II or III elastic
bands).
Extra-oral support:
• headgear; and
• face mask.
Enossal support:
• implants, miniscrews, etc.
This article only deals with
anchorage in bony structures. The
terms skeletal or cortical anchorage
are used interchangeably in this
case.
AD

1a.

1b.

1c.

Figs. 1a–c: After removal of the first premolar, the canine is to be retracted; results for a) minimum, b) medium or
reciprocal and c) maximum anchorage.

3a.

3b.

Figs. 3a, 3b: Clinical example of two typical miniscrew treatment applications: gap closure (3a) and straightening of tooth
No. 7.

4a.

Figs. 4a, 4b: One-sided gap closure in the left lower jaw. Miniscrews prevented the expected reactive side effect of subsequent
shifting of the middle line.

Fig. 2: Overview of the range of cortical
anchorage options.

5a.

5b.

5c.

4b.

5d.

5e

5f.

5g

5h.

Figs. 5a–5h: Eight examples of the more than 700 different forms of miniscrews currently available: a) Ortho
easy (FORESTADENT), b) Aarhus Mini Implant (Medicon), c) AbsoAnchor (Dentos), d) Dual-Top (Jeil Medical),
e) LOMAS (Mondeal), f) Osas (Dewimed), g) Spider Screw (HDC) and h) tomas-pin SD (DENTAURUM).

History and overview
of skeletal anchorage

Bony anchorage has its roots
in
Gainsforth’s
unsuccessful
attempt to insert screws into the
jawbone as load anchors in 1945.
Many later experiments were
unsuccessful and the method had
become obsolete by the late 1970s.

From 1980 onward, various
research groups (such as Creekmore, Roberts, and Turley2–7)
took up the subject once more.
Creekmore published the first, clinically successful patient treatment
case.
There are now numerous
options for cortical anchorage
(Fig. 2), including (artificial or
pathologically) ankylosed teeth on
the basis of miniplates normal
ly used in cranio-maxillo-facial
surgery and the use of prosthetic
implants.
Wehrbein and Glatzmaier were
the first to present an implant system specifically designed for jaw
orthopaedics (Orthosystem, Straumann8–10). These orthopaedic jaw
implants, which also included Midplant (HDC), are mainly inserted
into the palate. This method has
been found to be both safe and successful.

In recent years, the requirements
for cortical anchorage techniques
have been defined in the literature.
However, upon closer inspection,
only orthopaedic mini-implants met
these requirements favourably, in
terms of:
• biocompatibility;
• small size;
• simplicity of insertion and use;
• primary stability;
• immediate load capacity;
• adequate resistance against orthodontic forces;
• usability with standard orthopaedic appliances;
• independence of patient cooperation;
• clinically superior results in
comparison
with
standard
alternatives;
• ease of removal; and
• cost-effectiveness.
g OT page 8

[7] =>

[8] =>

Trends

f OT page 6

Mini-implants
Any form of skeletal anchorage,
including miniscrews, is by definition an implant: “An implant is
an artificial material implanted
into the body, which is to remain
there either permanently or for an
extended period.”
More than 30 different terms for
orthodontic screws are used in the
international literature. The most
common of these are mini-implant
and miniscrew, while the terms
minipin or pin are preferred when
speaking to patients.
At present, there are more than
30 manufacturers of miniscrew systems (Fig. 5a–h). The number of
screws per system ranges from two
to 154 different types.
In order to assist practitioners in
selecting such devices according
to their practice’s needs, the most
important decision-making criteria
for choosing implant systems are
discussed below.

Material
All miniscrews are made from
pure titanium or from an alloy
of titanium with aluminium or
vanadium. The biocompatibility of
such materials, the metal surface
of which is in direct contact with
the bone, has been firmly established.11–14
AD

Ortho Tribune | April 2010
Osseointegration
Brånemark was the first to
define the concept of osseointegration, which he described as
“a direct functional and structural
link between living bone tissue and
the surface of a force-absorbing
implant.”15–17
Several authors, such as Costa
and Maino, view anchoring a miniscrew not as osseointegration, but as
a skeletal resistance block.18,19 In the
opinion of Cope and Bumann, miniscrews are anchored by mechanical
stabilisation and not by osseointegration.20,21

Diameter of the miniscrew
The diameter of the miniscrews on
the market varies between 1.2 and
2.3 mm. Diameter specifications of
a screw normally refer to its outer
diameter, i.e., the size of the shaft,
including the thread.
For secure and primarily
mechanical anchorage, a certain
amount of bone is required around
the screw. To date there have been
no studies on the amount of bone
actually required; the information
available suggests 0.5 to 2 mm. At
an interradicular level, the amount
of space available prescribes the
maximum diameter of the screw.
Poggio et al.22, Schnelle et
23
al. , and Costa et al.24–25 provide
some suggestions as to the vertical space required, i.e., the space

Fig. 6: The stress resistance (fracture level in Ncm) depends on the
diameter of the miniscrew (according to Kyung, modification by the
authors).

7a.

7b.

Figs. 7a, 7a: Interradicular X-ray image showing spatial ratios.
between the enamel/cement interface and the mucogingival line.
These investigations clearly indicate that the diameter of a mini
screw should not exceed 1.6 mm.
It should be noted that the stability of a miniscrew in the bone
depends on its diameter and not on
its length.26–27

Length of the miniscrew
The length of the miniscrews
on the market varies between
5 and 14 mm. Length specifications
of a miniscrew usually refer to the
shaft, i.e., the threaded section.
Like the diameter, the length
of the screw selected depends
on the amount of bone available.
Depending on the region, the total
thickness of the bone is between
4 and 16 mm.28
The length of a screw is of secondary importance to the diameter
when it comes to secure anchorage, as mentioned above. Various
studies have shown that it is the
thickness of the cortical section that
plays a more important role.29–31 As

far as the distribution of force over
the body of the screw is concerned,
FEM analyses have shown that the
load is applied only in the region of
the cortical bone.32–33
When selecting the length of the
screw, the depth of the gingiva must
also be taken into account, with an
average layer depth of 1.25 mm.
Thus, the ratio between the length
of the head (the part of the screw
outside the bone) and the length of
the threaded section (the part of the
screw inside the bone) should be at
least 1:1.
Poggio et al.22 recommend lengths
of 6 to 8 mm. Costa24,25 suggests
miniscrews with a length of between
6 and 10 mm. Based on these studies, it would appear that it’s not necessary to use longer screws. This
has been confirmed by numerous
clinical studies.
Easy identification of length and
diameter through colour-coding of
the screws can be accomplished
by means of anodisation, using for
example, Ortho easy (FORESTADENT).
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[9] =>

Trends

Ortho Tribune | April 2010

the perforation wound, as a cork
would seal a bottle, thus reducing
bleeding.

Conclusion

8a.

8b.

8c.

8d.

Figs. 8a–8d: For practical reasons, it is advisable to use systems that offer only one universally applicable head variant. This single head should allow for the attachment of all types of coupling elements (threads, elastic chains, round
wires and square wires).

OT Contact
Dr. Björn Ludwig can be reached
at bludwig@kieferorthopaedie-mosel.de.

The correct method of anchorage
with regard to shape and quality
is crucial for successful treatment.
Maximum anchorage is not necessary in all cases, and thus, neither is
the use of a miniscrew necessarily
essential.
From an historical point of view,
the cortical anchorage system is, in
common with other jaw orthodontic
techniques, not new at all. The idea
was conceived more than 75 years
ago.
Of all forms of skeletal anchorage, the mini-implant is the most
universally used and is the most
suitable for routine use.
However, before practitioners
can select the most appropriate
miniscrew for use in their practice
from the large range on offer, they
will need to review the literature
thoroughly. OT
Editorial note: A complete list of
references is available from the publisher. This article first appeared in
Dental Tribune Asia Pacific, Nos. 1
& 2, 2009. The next edition of Ortho
Tribune will feature “Part II — Basic
information on the insertion of miniscrews.” All photos were provided by
the authors.
AD

Figs. 9a, 9b (above and right):
Height difference of the screw
head in two clinical situations.
A positive side effect of this is
that the oxide layer formed results
in firmer anchorage of the implant
in the bone.34

Screw head
Some suppliers have a special head
variant for each potential application in their range, such as:
• hook tops;
• ball-shaped heads;
• eyelets;
• simple slots;
• cross-shaped slots; and
• universal heads (Figs. 8a–8d).
The screw head should be very
small and compact, to ensure that
the patient experiences minimal
discomfort. However, it must be
large enough for the coupling elements to be securely fastened to it
(Figs. 9a, 9b).

Transgingival portion
The transgingival portion, also
known as the gingival neck, is
the most vulnerable part of an

implant or a miniscrew. Perforation of the gingiva provides a
potential access point for microorganisms, posing the risk of perimucositis or peri-implantitis. This
is one of the main causes of the premature loss of miniscrews.35–36
During the immediate post-operative phase, the mucosa should be
as close as possible to the screw, to
seal the area.37 The most advantageous shape transgingival collum
is that of a cone, as this shape naturally results in safe sealing without a pressure zone. This makes it
more difficult for micro-organisms
to penetrate, thus preventing infections. The cone shape also seals

[10] =>

[11] =>

Ortho Tribune | April 2010

Practice Matters 11

Embracing online communities
Find patients
on Facebook

OT At the AAO
Interested in learning more about
how social networking can help your
practice? Visit OrthoSynetics at booth
No. 1813. At the booth, learn how
to set up a Facebook page for free.
Not attending the AAO? Call Angela
Weber at (888) 622-7645 for a oneon-one tutorial.

By Angela Weber, OrthoSynetics

an an orthodontist build a practice without word-of-mouth?
It’s not likely.
At Orthosynetics, a business service firm for orthodontic practices,
we find that at least half — and
often much more — of our clients’
new patients come from personal and professional referrals. As
Americans increasingly gravitate to
online communities for their social
connections, the word-of-mouth
referral stream is moving online,
too.
Orthodontists need to position
their practices within social networks in order to make referrals
easy to pass along.
LinkedIn is a good platform to
network among other professionals, and Twitter is for more involved
users. But because of its widespread
popularity, Facebook is the ideal
place for orthodontists interested in
social networking to start.
More than 100 million Americans
had Facebook accounts at the end
of last year, representing a 141 percent annual growth.
Although Facebook focuses
on connecting people with their
friends, families and colleagues,
businesses are welcome, too. The
site allows companies large and
small to set up their own Facebook
pages for free. Somewhat different
than profiles, which are for individuals, Facebook pages are designed
especially for businesses to interact
with their customers in a new way.
Before the Internet, the advertising model was top down. Companies controlled the message and
hoped to convince consumers to
think great things about a product
or service. Now, social networking
encourages conversations across
the business-customer divide to
create personal ties and forge connections. Your office won’t be just
a place for your patients to come
every so often; it will become part
of the fabric of their lives.
Once you set up a page for your
orthodontia practice, your next step
is to build a following. Through
Facebook, patients can become a
“fan” of your practice, and once they
do, their friends will become aware
of your page. They may choose to
become fans, too. Even if they don’t
right away, Facebook pages allow
your patients to give your practice a
seal of approval.
It’s simpler than a traditional
referral in which two parties have
to have an actual conversation
about your practice. With Facebook,
a prospective patient looking for an
orthodontist can happen upon your
practice even when the referral
source is off doing something else.

OT About the author

Angela Weber is the director of marketing for OrthoSynetics, Inc. (OSI), a
business service company in the orthodontic and dental industries. She
has more than 10 years experience
in health-care marketing, working
with practices throughout the United
States. She knows her way around a
profit-and-loss statement; the focus
of her marketing strategies is to make
a positive impact on the practice’s
profitability.
OSI has helped numerous practices achieve marketing success through
strategy, creativity and implementation. Expertise includes generating
new patient revenue through Internet, mass media and traditional marketing efforts.

An example of a Facebook page. (Photo/Provided by OrthoSynetics)
A bit of effort is needed to build
a sizable following, however. We
recommend adding Facebook page
links to your Web site and e-mails.
Mention it in your mailings, on print
advertisements and when talking
with patients on the phone or in
person.
What’s more, simply having a
Facebook page isn’t enough. For
it to work as a marketing tool, you
need to actively update it. On individual profiles, users type in status
updates about what they’re doing or
thinking, and the same goes true for
a business’s page.
Dental tips and practical reminders work well as content, but we
recommend mixing it up with casual comments. It is social networking
after all, so keep things social.
You and your staff should feel
free to post vacation pictures and
to use a conversational tone. And
your practice’s daily updates might
include, “The office is ordering
pizza for lunch” or “We saw that
Target is having a sale on Waterpiks.”
Your patients can respond to your

postings (and their networks will all
know about it). Also, the next day
when patients come in, you might
be asked about how that pizza lunch
went or thanked for posting about
that sale.
Some orthodontists worry that
bringing Facebook into their offices
will distract from their practice. A
professional approach can manage
this concern. One idea is to assign a
single staff member to be in charge
of the page and to confine all Facebook activity to certain times of day.

At the same time, bear in mind that
Facebook might also spur productivity. Social networking can be a
more effective communication tool
than a round of phone calls.
When used properly, social networking is an inexpensive way to
generate referrals while strengthening ties between your patients
and your practice. Right now, some
orthodontists may see it as a nice
but unnecessary component of a
marketing program; however, as
social networks continue to move
online, a presence on these platforms will become essential. OT
AD

[12] =>

Practice Matters

Ortho Tribune | April 2010

Did you survive the 2009
Google Maps restructuring?
By Mary Kay Miller

OT At the AAO

To learn more about Internet marketing, stop by the Orthopreneur booth,
No. 317, during the AAO.

n September 2009, the Google
Local Business Center (Maps)
began a major overhaul that
kicked more than 50 percent
of all local businesses off the maps,
including orthodontists, eliminating
a large source of free advertising in
local areas.
Today, six months later, a strategic reduction in local listings is still
taking place. The dust hasn’t yet
settled on local business listings on
the maps.
With a half billion searches
occurring every month in local
areas, you can’t afford not to pay
attention to local business Internet
marketing.
Since September, I have spent
more hours than I want to count
researching the aftermath for my
clients. This is what I found:
• All practices lost exposure in surrounding areas on the maps.
• Most survived the cut in local
towns and cities on page one
maps if originally set up correctly
• Some practices lost ground with a
few major new patient orthodontic keywords
• Some disappeared completely
At first, I speculated on why
these practices disappeared or were
bumped off in their town or city.
However, over a period of months,
I found a consistent pattern causing
problems among current and new
clients. Improper setup, duplicate
verified listings, multiple Google
accounts and multiple locations
with centralized phone systems
topped the list.
Guidelines are strict and the
updated search algorithm penalizes
spammers with duplicate listings,
whether deliberate or not.
When taking advantage of any
free services offered by the search
engines, local business listings or
natural page ranking, “they” are in
control.
Because Google is king of the
Internet with 75 percent of consum-

Google search results for July 2009
show 10 orthodontic practices.

Google search results for November
2009 show seven practices.

advertise with pay-per-click (PPC)
campaigns, especially in metropolitan areas, as a way to obtain a page
one listing. If you are already on
page one of the maps and natural
page ranking in your area, PPC programs are redundant.
The update was an attempt to
appease current PPC customers
upset with free local listings competing with their paid advertising.
Statistics report that at least 70 percent of consumers will not click on
a “pay per ad” when searching in
local areas.
However, the maps area is one of
the first areas visitors see and use
as a research tool. From a business
standpoint, restructuring solved
multiple issues and forces more
businesses to sign up for PPC advertising to gain exposure.

How was Google Maps
restructured?

Google search results for April 2010
show just two orthodontic practices.
(Photos/Provided by Mary Kay
Miller)
ers visiting its site for information
and research, you must play by
its rules, which change constantly,
without notice, to stay ahead of professional spammers.

Google prospers with
pay-per-click advertising

Google and the other search
engines are in business to make
money, just as you are. Business
advertising is their main source
of income. By reducing the exposure of businesses on the maps,
it encourages more businesses to

Google originally reduced the number of listings from 10 to seven or
less in all local areas throughout
the country. Over a period of a few
months, in some areas, the maps listings were reduced from 10 to three
or less. This was a 70 percent or
more reduction (see examples).
If your practice was one of the
businesses booted off the maps, can
prospective new patients easily find
your business or your competitors’
in the area?
Map visibility and Web site ranking play a critical role when promoting your business in today’s
tech-savvy society. The Internet is
the No. 1 source of information
gathering by consumers looking for
products and services today.
Whether friends, family or dental
professionals refer new patients to
you, statistics report that 74 percent
of consumers research products
and services online prior to making
purchases or contacting businesses
regarding services.
During information gathering,
they also check out competitors,
opening the door for other practices
to grab the attention of interested
new patients.
Your Web site, whether accessed
off the maps, natural page ranking
or through PPC, is the first contact
new patients have with your practice. The first contact is no longer
the new patient phone call. It is the
Internet. Your local map listing is
an important piece of the Internet
marketing puzzle.

Local business services
worth their weight in gold
The map is the first area visitors see
when searching in local areas for
businesses.
You have no control over your
positioning on the maps, and I have
found SEO not to be a major factor. Listings are based on location,
correct setup, reviews and other
unknown factors known only to
Google.
Count your blessings if your listing is visible on “page one maps”
for top orthodontic consumer keywords: orthodontist, braces, Invisalign and orthodontics. Many practices are not so lucky.
Your best strategy to be competitive in Internet marketing is
to proactively stay on top of the
ever-changing Internet marketing
opportunities.
Whether you do it yourself, or
outsource services to Internet marketing vendors, regularly test for
success using major consumer keywords to determine Internet visibility in your local area.
Free video training on how to
test your Web site and local business maps listing is available
on www.orthopreneur.com and
www.youtube.com/user/Orthodontic
Marketing.
Continual monitoring of your
Internet marketing presence is critical to your online marketing success today and for the future growth
of your practice. Don’t be left in the
dust by your online competitors. Be
proactive for maximum Internetmarketing results. OT

OT About the author
Mary Kay Miller
is an Internet
marketing consultant specializing in local business marketing,
exclusive social
networking programs,
search
engine optimization of orthodontic
Web sites and Web site setup. With
more than 30 years experience in
orthodontic practice management
and 12 years experience in Internet
marketing, Miller has developed the
attitudes, skills, and knowledge necessary to guide doctors and their staff
on how to market their practice in
today’s tech-savvy society.
For more information, call tollfree (877) 295-5611 to schedule a free
half-hour consultation to review your
Internet marketing efforts or visit
Miller’s blog at www.orthopreneur.
com for free training.

[13] =>

[14] =>

Practice Matters

Ortho Tribune | April 2010

Preparing for the Total Ortho
Success Practice Makeover
often inconsistent and only occurs
at certain times of the year. A
structured referral program is
crucial to expanding the referral
base and increasing production.
• Systems: Many of the practice’s
major systems are not fully documented in a step-by-step manner.
Without clear guidelines, it can be
challenging to train new staff.

By Jennifer Van Gramins and Cheri Bleyer

he process of practice transformation has begun for Dr.
Michelle Gonzalez, a San Rafael, Calif., orthodontist who won the
second Levin Group Total Ortho
Success Practice Makeover. She and
her team are ready to implement
Levin Group’s patented management and marketing systems that
lead to increased production, starts
and referrals while improving efficiency and reducing stress.
“I have an amazing practice,”
Gonzalez said. “I feel very fortunate
to have won this opportunity to
learn how to improve my practice. I
love what I do, and I want to be the
best I can be.”
For the next 12 months, we will
be taking a journey with Gonzalez and her team, guiding them to
reach their practice’s full potential.
During this yearlong process, Jen
Van Gramins will work with the
team to incorporate documented
management systems throughout
the practice. Cheri Bleyer will concentrate on implementing a consistent referral marketing program
and devising appropriate strategies.
Participating in both management and marketing consulting programs simultaneously will dramatically enhance the practice’s ability
to increase production while reducing stress. Gonzalez and her staff
will be actively involved in making
the critical management and marketing changes to grow the practice.
Throughout 2010, Gonzalez’s
progress will be profiled in the
pages of Ortho Tribune, allowing
readers to get an insider’s view of
the consulting process and its positive impact on orthodontic practice
success.
As the months go by, we will give
you an in-depth look at Gonzalez’s
practice. It is the hope of Levin
Group and Ortho Tribune that the
strategies and ideas that we share
with you will inspire you to jumpstart your own practice makeover.
Let us introduce you to Dr. Gonzalez and her practice.

Location profile: San Rafael,
Calif.

• Type of community: suburban
• Population: 55,6021
• Median
household
income:
$69,4521
• Description: Northern suburb of
San Francisco

Office profile
• Locations: One
• In operation: Since 1996
• Orthodontists: One
• Staff: Six — Four full-time, two
part-time team members. Full-

The staff’s concerns
• The schedule: Developing a more
even patient flow is the primary
concern for most of the team.
• Communication: During busy
times, keeping the entire team on
the same page can be challenging.

What’s next for Gonzalez
and her team?

Dr. Michelle Gonzalez, center, with
Cheri Bleyer, left, and Jen Van
Gramins. (Photos/© Bruce Cook
Photography 2010)
time staff includes two clinical
assistants and two front desk
coordinators.
• Treatment chairs: Four
• Days open: Three — Practice is
open on a fourth day to complete
administrative paperwork.

Orthodontist profile
• Dental school: University of California, San Francisco
• Years in practice: 18
• Years in this practice: 15
• Status: Married with two children
• Practice aspirations: More efficient
operations with additional referring dentists, leading to greater
productivity and increased profit
in a low-stress environment.

Gonzalez’s chief concerns
• The economy: The area has
been hit by slowdowns in several employment sectors, though
things have improved in the last
year. Still, orthodontics is a significant investment for any patient
or parent, and a sluggish economy can cause potential patients to
postpone treatment.
• The schedule: A more balanced
and efficient schedule to create
less stressful days.
• Collections: A more effective system that reduces overdue account
receivables, which have grown
recently in the slower economy.
• Stress: Some days (or parts of
days) are extremely stressful.
Implementing step-by-step systems, including Power Cell Scheduling™, will go a long way toward
reducing unnecessary stress.
• Marketing: Referral marketing is

Gonzalez’s 12-month program
consists of three phases with each
phase featuring interactive workshops and private conferences to
discuss individual practice issues.
Her practice will benefit from Levin
Group’s Practice Production Generators™ — state-of-the-art practice
management tools that allow offices
to smoothly implement high-performance systems.
This month, Gonzalez’s office
will begin Phase I of her consulting
program.
• Develop a vision for the practice
• Learn Levin Group’s Power Cell
Scheduling
• Identify the goals to achieve during the yearlong program
• Create an Ortho LifeMap™
• Begin implementing Practice Production Generators
In our next article, we will document our two-day visit to Dr. Gonzalez’s office. On the first day, we
observe a normal day of practice
operations to evaluate first-hand the
office’s assets and challenges. The
second day is devoted to teaching the

critical systems and processes that
will lay the groundwork for a year of
growth and success.

Conclusion
Gonzalez starts her Total Ortho Success Practice Makeover in a great
position. She already has a successful practice and a strong team. With
Levin Group’s expert management
and marketing systems, she is in
position to become even more successful.
She opened her practice nearly
15 years ago and has a strong reputation in the community. The next
10 years are prime years for growing her practice, but this period is
also a time when many orthodontic
practices hit a plateau. Some clinicians rely on the same systems they
had when they were starting out.
Unfortunately, as practices
mature, systems age and become
inundated with inefficiencies. Practice management consulting can
help practices avoid the pitfalls
of outdated systems and maintain
steady growth for years to come.
Gonzalez realizes that she and
her team have not tapped into the
practice’s full potential. “The foundation is there — we just need guidance and systems in place to take
us to the next level so that we can
practice more effectively.”
To jumpstart your own Total Success Ortho Practice Makeover, come
experience Dr. Roger Levin’s next
Total Ortho Success™ Seminar being
held June 17–18 in Las Vegas. Ortho
Tribune readers are entitled to 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
(1U.S. Census.)

OT About the authors
Cheri Bleyer, Levin Group senior
consultant
Bleyer joined Levin Group in
2003 as a Levin Group orthodontic management and marketing
consultant. As a senior consultant,
Bleyer has played a key role in
the development of Levin Group’s
ever-expanding marketing program, and she regularly lectures
at the Levin Advanced Learning
Institute.

Cheri Bleyer, left, and Jen Van Gramins

Jen Van Gramins, Levin Group
consultant
Van Gramins has spent the last four
years working as a Levin Group orthodontic management consultant. Prior
to that, she managed medical and dental practices for 12 years. She served
as practice manager for Oral Health

Clinic at Loyola University Medical
Center in Maywood, Ill.
Visit Levin Group on the Web at www.
levingrouportho.com. Levin Group also
can be reached at (888) 973-0000 and
customerservice@levingroup.com.

[15] =>

[16] =>

AAO Exhibitors

Ortho Tribune | April 2010

Truths and consequences
of orthodontic diagnostics
C

one-beam radiography is steering orthodontists in the right
direction — leading straight to
the most effective diagnosis for the
patient. Treatment planning can
only begin if the practitioner has a
true picture of all of the facts, and
cone-beam radiography provides
those details that may be missed on
2-D images.
For diagnostics and treatment
planning, 3-D images can be sliced
and rotated to discover such vital
information as precise tooth positions and bone dimension and
quality. Many orthodontists report
extraordinary findings that alter the
original perception of necessary
treatment. The scope of information gained from a 3-D image is not
available with 2-D radiography.
The opportunity to capture these
dental structures with such precision is also invaluable for a range
of dental practitioners — oral surgeons, periodontists and general
dentists.
Here are some eyewitness examples of how cone-beam scans uncovered the “truth” of the patients’
dental mysteries, avoiding the possible “consequences” of alternative
treatments.
Bradford Edgren, DDS, MS, (Orthodontic Associates of Greeley, PC,
Greeley, Colo.)
“In this case [Fig. 1], before starting
phase II treatment, we were waiting
patiently for the second permanent
molars to erupt. Between finishing phase I treatment and the time
at which the other three second
molars erupted, we acquired our

Tell us
what
you
think!
AD

Fig. 1: Edgren

OT At the AAO
For more information on the i-CAT,
stop by the Imaging Sciences booth,
No. 2645, during the AAO.

3-D cone-beam scanner (i-CAT®)
and took an EFOV [extended field
of view] scan as part of our progress
records.
“The scan showed that an
impacted third molar was impeding the eruption of the maxillary
right second molar. The fourth third
molar was not evident on previous
pan X-ray because of its perfect
superimposition palatally to the second molar. This second molar may
never have erupted, or worse yet,
could have been presumed to be
ankylosed. To date, all four thirds
have been extracted and the right
second molar has fully erupted.”
John Graham, DDS, MS, (Graham
Orthodontics, Litchfield Park,
Ariz)
“This patient [Fig. 2] was referred to
my office for an orthodontic evalu-

Do you have general comments or criticism you
would like to share? Is there a particular topic you
would like to see more articles about? Let us know
by e-mailing us at feedback@dental-tribune.com.
If you would like to make any change to your
subscription (name, address or to opt out) please
send us an e-mail at database@dental-tribune.
com and be sure to include which publication you
are referring to. Also, please note that subscription
changes can take up to six weeks to process.

Fig. 2: Graham
ation by her general dentist. Her
2-D panoramic X-ray demonstrates
an impacted maxillary right cuspid
located horizontally above the incisors. CBCT cross-section images
reveal the relationship between the
impacted and adjacent teeth, as well
as any associated root involvement.
“While the 2-D pan shows the
impaction as a mere superimposition, with the i-CAT scan, it is possible to discern the exact location of
the tooth relative to the surrounding teeth and bone as well as the
pre-existing apical root resorption.
This vital information allowed for a
less-invasive surgery and guided me
to the most appropriate treatment
plan.”
Edward Y. Lin, DDS, MS, (Apple
Creek Orthodontics, Appleton,
Wis.)
“This patient [Fig. 3] lived with an
abscess that had gone undetected
for some time. I received this 2-D
panoramic image from the patient’s
pediatric dentist. If you look really
closely, you can see what appears

Fig. 3: Lin (Photos/Provided by
Imaging Sciences)
to be a radiolucency under the LR5,
LR4 (mandibular first molar and
second premolar), but the same
could be said for his LL5, LL4 area.
“However, a year later when we
took the i-CAT scan, it is clearly
evident that there is a large radiolucency. With a cone-beam scan,
the condition would probably have
been detected and treated much
more quickly.”
All of these cases underscore the
importance of utilizing precise and
detailed 3-D images in orthodontics.
This truth in imaging can save the
patient from unforeseen consequences — the pain of unnecessary
surgery, undiagnosed conditions
and more. CBCT puts the most concise information at the orthodontist’s fingertips and on the computer
screen. OT

Get rallied up for
OrthoBanc at AAO

f you are going to the American Association of Orthodontists
Annual Session in Washington, D.C., you’ll want to stop by
the OrthoBanc booth (No. 2535).
OrthoBanc, a payment drafting
and management company, always
creates a buzz at the AAO with its
city-themed booth activities.
Last year, OrthoBanc’s Boston
Tea Parties were standing room
only. Clever giveaways and attention to detail landed OrthoBanc’s
Marla Merritt an All Star Award
in Exhibitor Magazine, a national
publication directed at the trade
show industry.
Merritt says D.C. promises to

be even more exciting and informative as she delivers campaign
promises in a political rally setting.
“OrthoBanc can provide real
change for a practice looking to
become more efficient and profitable. We love telling our story in
a fun setting, and we have some
great plans for our D.C. rallies in
the ‘Choose OrthoBanc’ booth.”

At the AAO
For a presentation schedule and
to reserve a space at one of the
rallies, call OrthoBanc at (888)
758-0585, then be sure to stop by
the booth, No. 2535, during the
AAO. OT

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[18] =>

AAO Exhibitors

Ortho Tribune | April 2010

Ortho2 launches Edge at AAO
New comprehensive practice management, imaging and communications software system
provides state-of-the-art technology to address the complex needs of orthodontic practices

rtho
Computer
Systems
announces the launch of
Edge™, its new comprehensive orthodontic practice management, imaging and communications
system, which will debut at the
American Association of Orthodontists’ 2010 Annual Session. Attendees will have exclusive, first-time
access to live demonstrations of the
new Edge software modules and
features presented throughout the
Ortho2 booth.
The Edge system provides a fast
and convenient software integration process where orthodontic
practices can quickly experience a
drastic improvement in efficiency
and profitability. Edge incorporates leading technology, including
secure, Web-based data hosting and
back-up, dynamic dashboard and
widget library, Edge Imaging and
patient education animations.
Advanced
features
include
patient reminders, workflow autosequenced tasks, Edge reports and
an HR manager designed to optimize the efficiency of the practice.
Also, orthodontists can track practice statistics and profitability with
goal tracker, collections assistant
and smart scheduler, along with
several other features.
“The Edge software system is a
true revelation in orthodontic practice management software. The

OT At the AAO
For more information about Ortho2,
visit www.ortho2.com. For details
about the new Edge System, visit
www.TheEdgeRevolution.com or stop
by the Ortho2 booth, No. 2405, during
the AAO.

The Edge software system with some of its features: animation (left), dashboard and imaging card flow. (Photos/Ortho2)
system features all of the imaging,
communications features, financial
applications and practice tools that
can help any practice thrive,” says
Andrew Trosien, DDS, MS, Trosien
Orthodontics, Tracy, Calif.
“It’s simple to install and easy
for the staff to learn, and the customer support is absolutely amazing. Switching to Edge was an easy
decision — it’s everything I need to
take my practice to the next level.”
The Edge software is the latest
offering from Ortho2, which also

offers the widely adopted ViewPoint
Practice Management Software.
Orthodontic practices familiar with
the features of ViewPoint 7.0 will
appreciate the improved functionality, interface and user experience of
the new Edge software.
“I am excited about what we’ve
been able to provide orthodontists
with our new Edge software,” says
Dan Sargent, president and cofounder of Ortho2.
“The modern technology found
in Edge demonstrates our com-

mitment and focus on helping our
orthodontic partners succeed. I
am proud of the dedication of the
Ortho2 team in creating a software
system that greatly increases efficiency and profitability for orthodontic practices.
“At Ortho2, we have a long history of listening to our customers
and providing innovative solutions
for the challenges of building a successful orthodontic practice.”

About Ortho2
Ortho2 is the largest independently
owned provider of comprehensive
orthodontic practice management
software and has been serving
orthodontists exclusively for nearly
30 years.
Ortho2 is deeply committed to
improving the efficiency and profitability of orthodontic practices
across the country through continuous research and innovation
of practice management technologies. OT

Invisalign Teen helps orthodontist brand practice

r. David Carter considers himself a pretty savvy marketer in
these times of digital communications and social media. He uses
the Web a lot, advertising on AOL
and other channels. He knows that
a modest investment with Google
Ads can attract a more-than-modest
number of people to schedule a newexam appointment. He’s also very
active on Facebook and Twitter.
But Carter realizes the most powerful tool in his marketing arsenal
is his offering of Invisalign Teen™,
which effectively makes his practice
the place for adolescents to go in
the Augusta, Ga., area. The kids,
after all, see Carter’s ads on TV, and
current patients refer many of their
friends and classmates at school.
“Think about it,” Carter says.
“How many orthodontic products
that appeal to teens have the word
‘teen’ in it?”
Carter finds that if there’s any
initial resistance to the product, it
tends to come from parents, who
— knowing their own kids — may
be skeptical that their children will
wear Invisalign Teen’s clear aligners as much as they’re supposed to,
or that they’ll brush and floss regularly. But in Carter’s experience, for

‘With Invisalign Teen,
you brand your
practice; it’s as if
you own the brand,
and that makes you
unique.’
— Dr. David Carter, Carter
Orthodontics, Augusta, Ga.
those who have chosen Invisalign
Teen, the opposite has been the
case.
“The compliance indicators work
like a charm,” he says, “putting just
a little bit of fear into the kids,
because they know I’ll know. And
when it comes to hygiene, the teens
feel like they’ve got something to
prove to their parents. I haven’t had
any problems, in either their dental
health or their compliance, with my
Invisalign Teen patients.”
Carter is also sold on Invisalign
Teen’s efficacy, which he believes
is just as good as that of traditional
braces. One advantage of Invisalign
Teen has been the introduction of
the product’s power ridges, a fea-

OT At the AAO
Dr. David Carter practices orthodontics in August, Ga. Visit Invisalign
booth No. 1527 during the AAO to
meet Carter and learn more about
his success with Invisalign. During a
20-minute in-booth presentation, he’ll
share how you can recession-proof
your practice with Invisalign Teen.
Carter will divulge his own experience leveraging new media and an
aggressive Invisalign Teen marketing strategy that helped him succeed
in one of the worst economies in
decades. For more information on
this program or for the complete
schedule of Invisalign-related events
at the AAO, please visit www.aligntechinstitute.com/AAO2010.

ture that allows Carter to get better
torque on a tooth, making it easier
to change to the proper angle in the
gum.
He also takes full advantage of
Align’s Best Practices Protocol, a
program that allows him to access
tips and techniques from orthodontists around the country on a variety
of technical aspects, from how much
to move a particular tooth to how

quickly — or slowly — it should be
moved.
All of this has allowed Carter to
discover his own innovative best
practices, such as in a recent case
in which he employed the aligners
to help pull down, using reciprocal
force, a permanent eye tooth in the
top palette. He covered the resulting cosmetically unattractive gap by
placing a fake tooth in the aligner
— a simple yet elegant solution that
would not have been possible with
traditional braces.
In the course of his normal work,
Carter says he notices significant
efficiencies in speed (“I can see
three Invisalign Teen patients in the
time it takes to see one patient with
traditional braces,” he notes) and
time, because there are none of the
emergencies that accompany metal
braces, such as having to repair
wires and brackets.
Add to this the discount he
receives based on his Invisalign
Teen volume, for which he gets preferred placement on the doctor locator feature of Invisalign’s Web site,
and the result has been a 10 percent
increase in his business over the
last year.
It’s branding that works. OT

[19] =>

[20] =>

[21] =>

Ortho Tribune | April 2010

AAO Exhibitors 21

Soft-tissue lasers offer what you need

MD LASERS™, the manufacturer of Picasso™ and Picasso
Lite™ soft-tissue diode lasers,
has taken the industry by storm,
much to the delight of many orthodontists. Alan Miller, CEO of AMD
LASERS, has developed a company
model that is built around offering the most affordable, easy-touse soft-tissue laser supported by a
comprehensive warranty, outstanding training and supreme customer
support.
Orthodontists who have incorporated Picasso into their practice are
enthusiastic about the results.
“The Picasso is a great laser
for orthodontic use,” said Dr. Lou
Chmura, DDS, Marshall, Mich.
“With it, you can do all the normal procedures an orthodontist
would normally perform. The pulse
lengths are adjustable, which makes
it easy to produce great results in a
shorter time.”
Picasso and Picasso Lite offer
the perfect solution to creating
exposure for bracket placement.
Another application of use includes
the removal of hyperplasic tissue
in cases where the patients’ gums
grow over the existing bracket.
Orthodontists also appreciate
Picasso’s ability to perform gingivectomies with no patient discomfort and no post-operative sensitivity. On occasions when patients
experience issues with their brackets creating gum irritations, Picasso
can be utilized as a desensitizing
device.
Why have Picasso and Picasso
Lite become the world’s best-selling
lasers? Many orthodontists claim
the unit’s success is due to its portability as the Picasso’s streamline
design makes it easy to migrate
from operatory to operatory.
For those orthodontists making
the transition to lasers, many report
the Picasso is easy to learn and easy
to use. The unit offers 7.0 watts
of power and eight customizable
presets. The Picasso Lite offers 2.5
watts and three customizable presets.
As a result, AMD LASERS has created a laser that is safe, easy-to-use
and quite affordable. Orthodontists
can integrate the Picasso into their
practice for $4,995 and the Picasso
Lite for $2,495.
“Pricing is a key part of our strategy, and we certainly pride ourselves on the outstanding value
offered by Picasso and Picasso Lite,”
said Bart Waclawik, COO of AMD
LASERS. “Yet, as much as offering
the best price of any laser manufacturer is important, our commitment
to quality is equally important.”
Picasso is supported by an industry-leading, three-year comprehensive warranty, and the Picasso Lite
is supported by a two-year warranty.
AMD LASERS ensures that each
office is properly trained upon purchase of the laser unit. Training is
facilitated by the International Cen-

The Picasso,
left, and
the Picasso
Lite. (Photo:
AMD
LASERS)

OT At the AAO
To learn more about AMD LASERS’
Picasso and/or Picasso Lite laser
units, visit the company’s booth, No.
907, during the AAO. You may also
visit AMD LASERS online at www.
amdlasers.com or call (317) 202-9530
or toll-free at (866) 999-2635.

ter for Laser Education (ICLE), and
additionally, each dental practice is
assigned a company dental professional to contact for clinical advice
and instruction.
AMD LASERS’ most recent
accomplishment is the introduction
of disposable tips, which positions

the company as the only laser manufacturer to offer orthodontists the

choice of utilizing strippable fiber or
disposable single-patient use tips. OT
AD

[22] =>

Events & Products

Ortho Tribune | April 2010

Orthodontic highlights on the Seine
FORESTADENT
offers two events
this September

ORESTADENT would like to
invite you to not just one but two
advanced training events this
September. The third FORESTADENT Symposium will be held Sept.
24–25 in Paris — right in the heart
of the metropolis. In addition, the
first International 2D Lingual User
Meeting will take place on Sept. 23,
giving you three days packed with
orthodontic highlights in one of the
most beautiful cities of the world.

OT At the AAO
For more information on the
FORESTADENT events, call toll-free
(800) 721-4940, e-mail symposium@
forestadent.com, go online to www.
forestadentusa.com or stop by the
booth, No. 2627, during the AAO.

Following on the great success of
the first two FORESTADENT Symposiums in Palma de Mallorca and
Athens, the third symposium will be
held under the motto “The Aesthetic
Smile”. Internationally renowned
speakers such as Dr. Seong Hun
Kim (Korea), Dr. Elie Amm (Lebanon) and Prof. Dr. Gero Kinzinger

(Germany) will focus particularly
on aspects of diagnosis, levelling,
main treatment phase and finishing.
Participants can look forward
to the presentation of the latest
findings and in-depth knowledge
regarding the use of the most modern treatment techniques as well as
the latest materials.
There will also be the chance to
take part in an exchange of ideas on
the topic of miniscrews in an expert
forum.
If you are a user of the 2-D lingual bracket system from FORESTADENT or would maybe like to
become a user, then you are also
cordially invited to the first International 2D Lingual User Meeting.

The FORESTADENT Symposium
and the International 2D Lingual
User Meeting will be held in the
heart of Paris, between the Champs
Elysée, Arc de Triumph and Eiffel
Tower. (Photo/FORESTADENT)
Take the opportunity to exchange
ideas between colleagues, obtain
valuable suggestions or reveal one
or two tips of your own. Excellent
speakers, such as Dr. Vittorio Cacciafesta, are also expected at the
meeting.
The venue for the two events will
be the Les Salons de la Maison des
Arts & Métiers between the Arc de
Triumph and the Eiffel Tower in the
center of Paris. A social program
with a dinner cruise on the Bateaux
Parisiens, disco party in the Palace
Élysée and a golf tournament also
will be available. OT

AquaSplint

(Photo/Medidenta.com)
Medidenta.com is pleased to
announce the introduction of
AquaSplint, a newly patented selfadjusting splint for patients suffering
from TMD. AquaSplint is the only
self-adjusting splint that does not
require an impression or bite registration and will offer immediate relief
to the patient. Some other features
and benefits are:
• immediate comfort
• no grinding or contouring required
• universal and applicable in minutes
• saves time for orthodontist and
patient
With the introduction of
AquaSplint, Medidenta.com continues
to stay on the cutting edge of product
innovations. You can view a video
demonstration on this product by visiting www.Medidenta.com for more
information.
Medidenta.com
AAO booth No. 2914

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[cover] => Ortho Tribune U.S.

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Table of contents

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