Ortho Tribune U.S.

Showing off at AAO / Ethical and moral scenario planning for orthodontics / Get ready for OTStudyClub.com / Study: Some brackets more bacteria prone / OSAP addresses flu pandemic / AAO Review / An interview with AAO speaker Dr. Timothy Wheeler / Elevating the standard of our care / Credit crisis - property value crash — what they teach us / Practice Management / Industry / Products

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Table of contents

ORTHO TRIBUNE
The World’s Orthodontic Newspaper · U.S. Edition
MAY 2009

VOL. 4, NO. 5

www.ortho-tribune.com
AAO snapshots

Meet Dr. Wheeler

Dr. Hardy’s check up

The annual meeting
in photographs.

The orthodontist gives his
take on using aligners.

He won our makeover
contest. See how it’s going.

XPage

Showing off at AAO
109th annual session unveils new insights, new technology, new products
By Kristine Colker, Managing Editor

y the time the attendees of the
American Association of Orthodontists’ 109th Annual Session,
held May 1-5 in Boston, headed
home, they were leaving with more
than they had come with. Some carried products — everything from
wires and brackets to toothpaste
and ﬂoss. Some carried souvenirs of
Boston — Red Sox hats and “Cheers”
pint glasses, to name a few.
One man, Dr. Paul McAllister
of Lincoln, Neb., had a brand new
Mini Cooper he won from Dentsply
GAC.
J OT page 8

A view of the exhibit hall ﬂoor during the AAO Annual Session. (Ortho Tribune photo/Fred Michmershuizen)

Elevating the standard of our care
Fig. 1:
SureSmile
has successfully
integrated
cone beam
CT images
into its 3-D
software
planning
tools.

By Mark Feinberg, DMD

Part 2 of 3

he fundamental basis of
medical/dental practice is predicated on treatment strategies
that are derived from an accurate
diagnosis.

Dental Tribune America
213 West 35th Street
Suite #801
New York, NY 10001

How using 3-D
treatment planning
software put
one doctor back
in control

With the exception of recent
innovations in the realm of 3-D
cone beam CT radiograpy, and to a
lesser extent digital cephalometric
analysis and static 3-D models, the
diagnostic landscape in orthodontics has not yielded much in the
way of innovation during the past
100 years.
Orametrix Inc., as the provider of
SureSmile technology, has proven
an anomaly in this regard. Under
the guiding inﬂuence of its vision-

ary founder, Dr. Rohit Sachdeva, the
company has established itself as
a patient-centric technology leader
dedicated to enhancing the quality
of patient care.
Its pioneering convergent technology not only advances diagnostics but connects this information
directly to the design of therapeutic
devices.

J OT page 14

PRSRT STD
U.S. Postage
PAID
Permit # 198
Mendota, IL

[2] => Ortho_0509_1-24_Final.pdf

From the Editor

ORTHO TRIBUNE | MAY 2009

Ethical and moral scenario
planning for orthodontics

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

Publisher
Torsten Oemus, t.oemus@dtamerica.com
President
Peter Witteczek, p.witteczek@dtamerica.com
Chief Operating Ofﬁcer
Eric Seid, e.seid@dtamerica.com

By Dennis J. Tartakow, DMD, MEd, PhD,
Editor in Chief

Part 2 of 3

et us continue looking into our
imaginary crystal ball from last
month to ﬁnd a glimpse of the
future. Now that we have explored
scenario-planning dimensions by
explaining their background and
reasoning, let’s review their intricacies and how they work.
In order to begin, we will examine ﬁve arbitrary, but timely, critical
uncertainties, which will be plotted
in 10 two-dimensional X/Y matrixes:
1. Education/faculty
2. Education/greenhouse effect
3. Education/global economy
4. Education/insecurity
5. Faculty/greenhouse effect
6. Faculty/global economy
7. Faculty/insecurity
8. Greenhouse effect/global economy
9. Greenhouse effect/insecurity
10. Education/global economy
Of these 10 possible two-dimensional views of the world, let us
narrow them down to the ﬁve
“highlighted” two-dimensional X/Y
matrixes:
1. Education/faculty
2. Education/insecurity
3. Faculty/global economy
4. Greenhouse effect/global economy
5. Education/global economy
Of these ﬁve possible two-dimensional views, let us select one twodimensional X/Y matrix considered
to be arbitrarily the most important

Tell us
what
you
think!

one: education/global economy.
This matrix was chosen as the
most important scenario logic in
2009 in order to predict what effects
the global economy will have on
the future of education, possibly 10
years from now.
Education is by far the most
important thread for human existence and survival. The world economy is the other most critical issue
supporting growth and development of almost everything that man
touches. This may or may not be a
pretty picture for the future, but it
will certainly play out.
Question: “How do we protect
our future generations to exist in a
happy and healthy environment?”
By ensuring that both these factors remain stable and strong, and
that the future of mankind will be
positive for a happy and healthy
existence.
To plot the X/Y coordinates, education (+) is placed at the top and (-)
at the bottom of the Y-axis. Global
economy (+) is placed on the right
side of the X-axis and (-) at the left
side of the X-axis. Thus, our four
named quadrants are:
U Upper right — rise of education:
Both education and global economy are strong and thriving.
U Upper left — decline of education:
Education is strong and global
economy is weak.
U Lower right — renaissance of
education: Education is high and
global economy is weak and in
trouble.
U Lower left — death of education:
Both education and global economy are weak and bleak.

‘Education is by far
the most important
thread for human
existence and
survival. The world
economy is the
other most critical
issue.’
dle and end possibilities that could
conceivably be developed by the
year 2019 and might continue to be
inﬂuential for the coming years and
centuries.
Next month we will discuss the
purpose of developing an archipelago for each of the four quadrants.
This information should be insightful for your own plausible scenario
planning. 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@dtamerica.com.

Editor in Chief Ortho Tribune
Prof. Dennis Tartakow
d.tartakow@dtamerica.com
International Editor Ortho Tribune
Dr. Reiner Oemus, r.oemus@dtamerica.com
Managing Editor/Designer Ortho Tribune
Kristine Colker
k.colker@dtamerica.com
Managing Editor Implant & Endo
Tribunes
Sierra Rendon
s.rendon@dtamerica.com
Online Editor
Fred Michmershuizen
f.michmershuizen@dtamerica.com
Product & Account Manager
Humberto Estrada
h.estrada@dtamerica.com
Product & Account Manager
Mark Eisen
m.eisen@dtamerica.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dtamerica.com
Marketing & Sales Assistant
Lorrie Young
l.young@dtamerica.com
C.E. Manager
Julia Wehkamp
j.wehkamp@dtamerica.com
Design Support
Yodit Tesfaye
y.tesfaye@dtamerica.com
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
In the April 2009 issue, the images
of Dr. William Harrell (below left)
and Dr. Richard L Bridgam (below
right) were inadvertently reversed in
the article, “Consider the extras of
cone beam.” Ortho Tribune regrets
the error.

The scenario narratives
Scenario planning helps provide
plausible futures that are the strategic technological decisions linked
to an institution’s goals for utilizing
IT in an innovative fashion.
By using inductive and abductive
abilities, we can imagine future scenarios that our technology decision
may have to play out by choosing
global economy and education as
the X- and Y-axis, respectively.
With the creation of an archipelago, some very interesting future
trends might be suggested; these
trends will explore beginning, mid-

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@dtamerica.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@dtamerica.com and be sure to
include which publication you are referring to. Also,
please note that subscription changes can take up to
6 weeks to process.

Group Editor
Robin Goodman, r.goodman@dtamerica.com

© 2009, 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

Image courtesy of Dr. Earl Broker.

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] => Ortho_0509_1-24_Final.pdf

News

ORTHO TRIBUNE | MAY 2009

Get ready for OTStudyClub.com
Ortho Tribune creates an online community speciﬁcally for orthodontists

rtho study clubs help increase
interaction, providing orthodontists with the opportunity
to gain knowledge about products
through their colleagues’ experimentation and analysis and to hear
from respected opinion leaders
directly. Focused study clubs provide an unparalleled opportunity for
orthodontists to “meet with” other
like-minded individuals and their
team members and to learn in a
friendly, non-threatening environment.
Ortho Tribune is taking this concept to the next level by bringing
the study club online, extending the
realm of interaction to a worldwide
arena. This allows for a variety
of fresh perspectives from different cultures to further enhance the
educational mix, inspiring new possibilities and creating higher expectations in online learning.
OTStudyClub.com
is
solely
focused on today’s orthodontist and
offers an exciting mix of possibilities, including:
U C.E. lectures that are live and
interactive, as well as archived,
bringing local events to national
audiences.
U Focused discussion forums that
allow orthodontists to stay up to
date.
U Ortho product reviews with
recordings of opinion leaders’
ﬁrst impressions.
U A growing database of case studies and articles featuring topics that are important to today’s
orthodontists.
U Networking possibilities that go
beyond borders to create a global
ortho village.
U Contests with chances to win free
tuition for ADA/CERP C.E. accredited Webinars; and much more!
Ortho Tribune is very excited
about ofﬁcially launching this initiative and would like to invite you
to join us in breaking new ground in
e-learning. On July 11, from 9 a.m.–
5 p.m., Ortho Tribune will introduce
the Ortho Tribune Study Club via a
full-day online symposium.
The OTSC Online C.E. Festival —
V.I.P Launch Party will feature ﬁve
one-hour Webinars in succession,
followed by a 20-minute live Q&A
session between the online audience and each speaker.
Participants will receive seven
ADA/CERP C.E. credits, and attendance is free for the ﬁrst 100 registrants. After the ﬁrst 100 spaces are
ﬁlled, the cost of the full-day symposium is only $49, a mere fraction of
what one would pay if traveling to
an event. Live attendees also have
30-day access to the recorded Webinars to review at their convenience.
Further details and registration can
be found at www.OTStudyClub.
com.

Registering as a Study Club member is free and provides access to
accredited C.E. Webinars and other
beneﬁcial tools catering directly
to orthodontics. For example, in
today’s world of orthodontics, new
products, concepts and techniques

are brought to light with amazing
speed, so it’s not surprising that
many orthodontists are ﬁnding it difﬁcult to stay up to date.
In an effort to make the most of
practitioners’ time, www.OTStudy
Club.com will feature “First Impres-

sions,” a series of ﬁve-minute video
vignettes. These will present various
ortho products with the support of
demo videos and will be archived
in an online product library to be
viewed at any time.
Please keep in mind that the site
will be ofﬁcially launched on July
11. Register early and mark the date
on your calendar!
Please contact Julia for full details
and for the OTSC launch registration
by phone at (416) 907-9836 or by
e-mail at j.wehkamp@otstudyclub.
com. OT
AD

[4] => Ortho_0509_1-24_Final.pdf

4

News

ORTHO TRIBUNE | MAY 2009

Study: Some brackets more bacteria prone
OHSU School of Dentistry
ﬁnds some self-ligating
brackets retain less plaque

R

esearchers at the Oregon Health
& Science University School of
Dentistry (www.ohsu.edu/sod)
have found the majority of patients
with self-ligating orthodontic brackets retain fewer bacteria in plaque
than patients with elastomeric orthodontic brackets.
The OHSU team also found that
a biochemical technique measuring adenosine triphosphate (ATP)
driven bioluminescence could be
a useful chairside tool in the rapid

AD

quantiﬁcation of oral bacteria and
in the assessment of oral hygiene
during orthodontic treatment.
The ﬁndings are published in
the April 2009 issue of the American Journal of Orthodontics and
Dentofacial Orthopedics, one of the
leading peer-reviewed orthodontia
journals.

Acid-producing bacteria that surround orthodontic appliances are a
common orthodontic problem. Such
bacteria can lead to tooth enamel
breakdown and potential discoloration of the tooth surface, and
these esthetic changes can persist
for many years after orthodontic
treatment.
While the newer bonded brackets
have many advantages over the old
metal bands that were ﬁtted around
each tooth, they do impede good
oral hygiene, resulting in plaque
accumulation and increased tooth
enamel breakdown.
Although several studies have
investigated the effects of ﬁxed
orthodontic appliances on bacterial

ﬂora, few studies have compared
the effects of bracket architecture
— speciﬁcally the archwire ligation method — or have evaluated
the accumulation of bacteria that
occurs with the bonding of ﬁxed
appliances.
The OHSU study also was diff
ferent from other studies in that it
was a randomized clinical study,
comparing the numbers of oral bacteria in plaque surrounding two distinct orthodontic appliances — selfligating versus elastomeric ligating,
using a split-mouth design.
The OHSU study examined
14 patients ages 11 to 17 — each
patient containing both self-ligating
and elastomeric orthodontic brackets on opposing sides of the mouth
— at both one week and ﬁve weeks
after bonding. The numbers of oral
bacteria in plaque surrounding the
brackets were evaluated at both
appointments, in addition to a prebonding appointment, using both
conventional plating techniques
enumerating bacterial colony number and the ATP-driven bioluminescence technique.
More bacteria, including oral
streptococci, were retained at tooth
surfaces in plaque in patients with
elastomeric orthodontic brackets at
both the one- and ﬁve-week postbonding appointments, and bacterial levels were particularly high
at the one-week visit. Higher ATPdriven bioluminescence levels also
were observed in plaque surrounding the elastomeric orthodontic
appliances.
“We were surprised that the manner of ligation promoted differences
in the levels of plaque bacteria surrounding the bonded tooth surfaces,” noted Curt Machida, PhD, OHSU
professor of integrative biosciences
and principal investigator, whose
lab was host for the study. “Our
results suggest that the use of the
self-ligating appliances promote
reduced retention of plaque bacteria on tooth surfaces surrounding
the appliances.” OT

New treatment
for TMJ dislocation
A recent study in the journal
Anesthesia Progress presents a
new technique for treating dislocation of the TMJ (temporomandibular joint) using a deep
temporal nerve block.
Traditional treatment has
been limited to the application
of force, where the jaw is forced
back and down into the joint, and
in severe cases, general anesthesia alone or combined with surgery is required.
For the new treatment, lidocaine and epinephrine are combined and administered to the
deep temporal nerve, which
reduces both the sensation of
pain and muscle spasms. OT

[5] => Ortho_0509_1-24_Final.pdf

News

ORTHO TRIBUNE | MAY 2009

OSAP addresses ﬂu pandemic
T

he Organization for Safety and
Asepsis Procedures (OSAP)
is providing special online
resources to help dental professionals protect themselves and their
patients from Inﬂuenza A (H1N1),
previously referred to as “swine ﬂu.”
The Swine Flu Resources section of
the OSAP Web site, www.osap.org,
includes an overview of the disease,
up-to-the-minute reports on the
current outbreak, tips for prevention and links to additional in-depth
information.
The site provides a quick and
easy way to stay current, as it is
constantly being updated as new
information is received. Links to
reports and updates from the Centers for Disease Control, American
Dental Association, Pan American
Health Organization, World Health
Organization and even the White
House Brieﬁng Room are available
for instant access to critically important information and advisories.

Symposium content added
OSAP has added bonus content to
its 2009 Symposium, “Infection Prevention: Spread the Word,” to be
held June 11–14 at the Marriott
at Legacy Town Center in Plano,
Texas. The OSAP Symposium will
now include up-to-the-minute
information on Inﬂuenza A (H1N1)
and on its potential impact now and
in the future.
The recent ﬂu outbreak is a
reminder of how important proper

www.ortho-tribune.com

The age of digital imaging: Part 1

Dr. Arthur Wool reﬂects on his
career

Utilizing ﬁxed orthodontics
to prepare cases for aligners

Companies unveil new products
at AAO meeting

infection control procedures are for
keeping dental professionals and
their patients safe. The OSAP Symposium is a must for anyone concerned with infection control and
safety in dentistry. Internationally

known experts will teach attendees
how to make infection control practices “stick” and help professionals
do things right the ﬁrst time.
The 2009 OSAP Symposium will
give attendees essential information on current and emerging diseases, disease prevention, “never”
events in dentistry, legal issues to
understand, “green” infection control, new infection control guidelines and more. Educators, speakers
and consultants can participate in
special workshops and breakout sessions. A new series, “InfoBites,” will
provide information on four popular and pragmatic asepsis topics in
digestible segments. Technical posters and product exhibits will inform

attendees of the latest advances and
newest products. Up to 20 hours of
C.E. credit are available.
The symposium provides many
opportunities for networking and
peer support. The agenda also
includes social events, such as the
John Molinari Charity Golf Tournament at the Tribute Golf Links in
The Colony.
The OSAP auction offers an array
of vacation packages, gourmet baskets, artwork, apparel, jewelry,
sporting goods and more.
Details of the symposium, as well
as a reservation form, are available
online at www.osap.org
g or can be
requested by calling (800) 298-OSAP
(6727). OT
AD

[6] => Ortho_0509_1-24_Final.pdf

AAO Review

6

ORTHO TRIBUNE | MAY 2009

Scenes from the AAO
With camera in hand, Ortho Tribune set out to capture all the little moments you didn’t see
Right, John
Lytle (from left),
John Bergman
and Cesar
Coral of Summit
Dental Systems.
Below,
Lindsay
Sinclair, left,
and Stacey
Marsden
of Kidzpace.
Nicole Simpson, right, of Cadent
OrthoCad talks about the iTero
digital impression system.

Dr. Chantal Gauthier of the University of Montreal presents the results
of her research on the periodontal
effects of SARPE.

Burke Spielmann, left, Karen Trumbo
and Jim Reed of Ortho Organizers.
Dr. Mark
Sanchez
and
Jonathan
Saggau
of tops.

Nick
Lulka,
president of
Fairﬁeld
Orthodontics.

Regina Goodin and Mike Sanders
of G&H Wire Co.

Above, attendees check their e-mail with the free Internet access offered
at 3M’s Cyber Cafe.
Left, Paul Revere is on hand to give away tote bags and cash prizes at the
OrthoTees booth. From left are Tony Richt, Paul Revere (also known as Mike
Beck), Kelly Loneman, Mike Arbataitis and Ryan Fry.
Rut Reynolds, president and CEO
of OrthoQuest.

Ortho Tribune photos/Kristine Colker & Fred Michmershuizen

[7] => Ortho_0509_1-24_Final.pdf

[8] => Ortho_0509_1-24_Final.pdf

AAO Review

ORTHO TRIBUNE | MAY 2009

I OT page 1

But one thing most everyone
left with was more knowledge and
insight than they had started with.
For four days, attendees — from
specialists to staff to students —
attended a myriad of lectures on
topics as wide ranging as communication with your patients to discussions of root resorption. Other
popular topics during the event
included Dr. Anthony A. Gianelly
on “Evidence-based Orthodontics:
Friend or Foe,” Ravindra Nanda on
“Achieving Treatment Goals with
Predictable Mechanics: A 40-year
Perspective,” Dr. Steven Jay Bowman on “Miniscrews: Be Careful
What You Wish For!,” Dr. Flavio
A. Uribe on “Enhancing the Speed
of Tooth Movement: Can We Alter
the Biology?,” Dr. Frank Celenza on
“Seeking Interdisciplinary Excellence,” Dr. Franco Mangini on “TMJ
and Craniofacial Pain: Legend and
Reality” and W. Eugene Roberts
on “Early Treatments and Clinical
Outcomes.”
Sessions were divided into courses for doctors as well as courses
for staff. On the staff side, topics
included everything from the ﬁrst
impressions you get from prospective patients to infection control to
surviving in the new world of 3-D
imaging. There were even a number of hands-on courses including
such topics as orthodontic photography, PVS impressions and wire
bending.
One new feature this year was
the clinical simulcasts where a doctor and dental assistant worked
live on a patient. During Dr. Mark
Yanosky’s May 3 presentation on
laser surgery, the room was packed
as attendees watched him demonstrate three laser procedures right
in front of them.

A patient is
prepared
for a laser
procedure
during
Dr. Mark
Yanosky’s
clinical
simulcast
at the AAO
meeting.

At the Ortho Technology booth,
Dr. Alex Lopes explains the beneﬁts
of the Lotus passive self-ligating
bracket system.

Dr. Paul McAllister of Lincoln, Neb., wins a brand new Mini Cooper at the
Dentsply GAC booth.

On the exhibit hall ﬂoor
When attendees weren’t busy
acquiring knowledge in the various
sessions, many of them could be
found over in the exhibit hall, where
brightly colored tote bags hung
from shoulders as a representation
of products purchased — black and
pink for Opal Orthodontics, blue for
Forestadent, red for 3M.
At OrthoSynetics, participating in
a practice challenge got you entered
in a drawing to win a trip for two to
anywhere. At ChaseHealthAdvance,
attendees could putt for prizes,
including the Golf Digest-rated No.
1 putter, the Nike 20-10. At GAC,
where six different stations offered
attendees a chance to learn more
about products to help promote efﬁciency in their practices, a visit to
the booth earned visitors a scratchoff card with a chance to become
one of 10 ﬁnalists. On Monday afternoon, those 10 ﬁnalists gathered
around a new Mini Cooper and
were given a key to put in a panel.
Dr. Paul McAllister’s key ﬁt the lock,
and he left Boston one car richer.
Many of the exhibiting companies unveiled new products.
ClassOne Orthodontics, based in

Dr. Julian E. Spallholz is a member of the team behind the SeLECT
Defense Orthodontic Products available from ClassOne Orthodontics.
As Spallholz explained, it’s the
element selenium that guards
against bacteria on patients who
wear ﬁxed appliances.
Lubbock, Texas, unveiled SeLECT
Defense orthodontic products that
are designed to offer added protection against bacteria for patients
with ﬁxed appliances. According to
Dr. Julian E. Spallholz, a member of
the educational team at Texas Tech
University where SeLECT Defense
was developed, the products use the
element selenium to inhibit bacterial growth. As Spallholz explained
to Ortho Tribune, the plaque barrier lasts for a patient’s entire treatment and does not leach into the
environment. Most importantly, he

said, SeLECT Defense reduces the
occurrence of decalciﬁcation and
white spots.
Another company unveiling a
product to offer protection against
bacteria was Opal Orthodontics
by Ultradent, with its Opal Seal
recharging orthodontic bonding.
Opal Seal is a 38 percent ﬁlled primer that releases and recharges ﬂuoride. Jeff Smith, marketing manager
at Opal Orthodontics, said that Opal
Seal releases ﬂuoride throughout a
patient’s treatment, thereby ﬁghting
bacteria along the way.
Ortho Technology unveiled its
new Lotus passive self-ligating
bracket system. Dr. Alex Lopes said
the system was designed for maximum patient comfort and hygiene,
and archwire changes are fast and
economical. Lotus features a unique,
patented clip made of wear-resistant, high-quality nickel titanium
designed for ﬂexibility throughout a
patient’s treatment. Perhaps best of
all, Lopes said, is the passive design
of the Lotus clip, which eliminates
friction and ultimately results in fast
and effective tooth movement.
Cadent OrthoCAD showed off its
new software package for the iTero,
the iTero Digital Impressions. The
iTero is capable of capturing a digital orthodontic impression in six to
eight minutes, or less, for a completed arch and bite registration. A
3-D model is available in minutes

for consultation with the patient.
Over at the tops booth, the company — which was handing out
bright pink buttons that had such
witty sayings as “Touch my app”
— was proudly showing off its new
topsEcho iPhone application, which
with just a touch can provide upto-the-minute access to patient
information and images, schedules, referrals, treatment notes and
more. And because the application
requires a secure password and is
only accessing information from a
server, rather than storing it on a
user’s cell phone, there is never any
worry about someone falsely gaining such private information.
“One of the great things about
the iPhone app is the live connectivity — the connection is direct and
speedy,” said tops founder and CEO
Dr. Mark Sanchez. “As an orthodontist, to me, it’s a nice follow-up tool
— I can call patients, I can check
the schedule. If something changes
on the schedule, I can see it. With
topsEcho, I know everything.”
For Proctor & Gamble, just
launching its new Ortho Essentials
program wasn’t enough. The company hosted a reception the night
of May 3 to discuss the idea behind
the three-step oral hygiene program. Ortho Essentials is a program designed to help orthodontists
streamline and strengthen their
oral hygiene control procedures by
standardizing their check ups, consistently reporting their results and
making sure patients improve their
oral hygiene at home. This is accomplished by the use of the Oral-B Triumph toothbrush with SmartGuard,
Crest PRO-HEALTH toothpaste and
rinse, a rating system, an assessment card and a contract for both
orthodontists and patients to sign.
“I saw patients in my practice
not ending up the way we wanted
them to in regards to hygiene,” said
Dr. Duncan Brown, the orthodontist
behind the Ortho Essentials program. “Hygiene is a great untapped
resource for orthodontists.”
Next year’s AAO Annual Session will be held April 30–May 4 in
Washington, D.C. For more on this
year’s AAO, including photos and
interviews, pick up the June issue
of Ortho Tribune and go online to
www.ortho-tribune.com.
— Additional reporting and
photos by Fred Michmershuizen,
Online Editor OT

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Interview

ORTHO TRIBUNE | MAY 2009

‘My interest now is in looking
at tooth movement itself’
An interview with AAO speaker Dr. Timothy Wheeler
By Kristine Colker, Managing Editor

r. Timothy Wheeler presented a
session, “Understanding Aligner Treatment,” during the AAO
Annual Session in Boston. He took
some time to sit down with Ortho
Tribune and talk about that session
as well as to discuss the research he
has been doing with aligners.
Please tell us a little about yourself, including your background and
what motivated you to become an
orthodontist.
It’s a little bit non-traditional, and
I tell this story often, because being
a program director and a chair of
a program, I hear of people having
the dream of always wanting to be a
dentist or an orthodontist, but that
wasn’t true of me.
I actually was involved in
research out of college, and the
area of research I was working in
was immunology. But when I got to
graduate school, you have to choose
a mentor in order to oversee your
dissertation. The person I ended
up working with was Bill Clark,
who was a periodontist who graduated from Forsyth/Harvard and had
just started down at University of
Florida. He was a periodontist, so
my research ended up being in the
area of periodontology.
He convinced me to go to dental
school because I would be more
marketable, and I would probably
end up with a better career.
But when I was in dental school,
I worked with Greg King, who was
chairman of the department of
orthodontics at Florida at that time,
and I did some research for him.
And the only area of dentistry I
enjoyed working in was orthodontics.
They maintained a position open
for me there at Florida. I went to
the ortho program, went on to the
faculty and then in ﬁve years, I was
program director and then later
became assistant dean for Advanced
and Graduate Education. Dr. King
left University of Florida back in
1996, and I became chair then.
Are there any special areas of orthodontics you are interested in?
Yes. That is another thing — as
opportunities have arisen, they kind
of lead you. I was a basic scientist
by training, as an immunologist, so
I did a lot of work on root resorption in orthodontics. We had some
funding for that in my earlier years.
Then Dr. King, Dr. Steve Keeling
and myself got involved in Class
II clinical trials, and that ran for
15 years. Dr. King left during that

Dr. Wheeler and his wife, Janet,
at Sea Island with children Tim Jr.,
Julia, Julia’s husband Andrew,
Morgan and Lynna.

Dr. Wheeler and his wife, Janet, in Costa Rica.

Dr. Wheeler at an AAO dinner with residents Ben Campbell, John Metz, Brion
Long and Yen Nguyen.
time and Dr. Keeling passed away,
so it was left with me for the last 10
years or so to really be involved in
that trial and run it. I really turned
then to clinical research rather than
basic science research.
What that has led me to now is
to do other clinical-type research in
different areas such as with Invisalign. In particular, my interest now
is in looking at tooth movement
itself, the variability of it, not just
with Invisalign but with any appliance.
The AAO session that you presented
dealt with understanding aligner
treatment. How did you become
interested in aligners and start to
use them?
Basically, what happened is that
around 2000, because we had been
involved in clinical research, Align
Technology had came to me because
they were interested in doing some
clinical trial work, looking at tooth

movement with aligners, particularly using different types of attachments. So we devised a clinical trial
with about 100 patients, and I really
learned a lot about Invisalign during that treatment period when we
were working with those patients.
Since then, I have done a number of trials with them, looking at
different things. One study was on
early treatment of aligners. We did
another study with Bas Medical,
using a hormone called relaxin to
try to facilitate tooth movement. We
developed at that time the model
I’m currently using, which is just
moving one individual tooth at a
time to study that movement.
The purpose of the relaxin was
two-fold: one to see if we could
speed up tooth movement and the
second to see if it helped with retention. The result of that trial was that
neither of those things happened.
But what we did do is develop this
very nice tooth movement model, as

I mentioned, and I subsequently
have used that to look at different
things. Particularly, this year, we
used it over an eight-week period —
taking impressions on our patients
on a weekly basis — to follow movement of one tooth in three dimensions of space in a very short time
period. So we now can manipulate
a lot of different variables in order
to examine tooth movement.
Aligners get criticism from some in
the industry, particularly in regard
to how well they work compared to
traditional braces. How would you
respond to that?
Aligners don’t work as well at
some things, but that’s true with
any bracket. But in some instances,
aligners do work better than using
brackets. All it is, is a method of
applying a force to a tooth, and you
can do that with your ﬁnger or you
can do that with plastic or you can
do that with a stainless steel wire.
The biggest trick is controlling that
force, so what we’re trying to do is
really learn, when you apply a force
to a tooth, what happens.
Is there reason to be critical of
aligner treatment? I think, for the
most part, orthodontists probably
felt threatened by it because they
thought maybe it was something
computers were going to take over
and allow the market to be dominated by GPs.
But it’s no different — you have to
know how to move teeth, you have
to know how to treatment plan, and
it really takes an orthodontist to
do the treatment. The things we’re
studying are to try and improve
those outcomes even more so.
Treatment with aligners has gotten a lot better in the last nine years
since I’ve worked with them. We
J OT page 12

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Interview

ORTHO TRIBUNE | MAY 2009

I OT page 10

OT About the doctor

do a lot of complicated cases with
them now.
There are a lot of different methods out there in order to move
teeth, but this is just a different
way. There’s a demand for this, but
I feel the role I’m playing is just to
get a better understanding of this
treatment and of tooth movement
and how we can then improve the
outcomes for our patients, because
I don’t think aligners are going to
go away.
In your session, you talked about
issues to consider in order to improve
the outcomes of tooth movements
with aligners. Please expand on
those a little.
Most orthodontists treatment plan
their patients independent of what
they’re using to move the teeth.
Based on what we were taught in
school, which is physical movement
of teeth and then certain parameters
we work around, such as impact on
the facial proﬁle and then the bony
conﬁnes and soft tissue conﬁnes of
the jaw, we use that information to
treatment plan.
When you have a wire and a
bracket in somebody’s mouth, we
are not really concerned on how
fast the tooth is moving in one
patient as compared to another.
AD

Dr. Wheeler at an AAO dinner with residents Katie Miller, Lacy Winford, Allison Harris and Camden Doughtie.

Dr. Wheeler with his grandchildren,
Bella and Patrick
If it’s not moving as fast, well, it’s
just going to take longer, and you’ll
eventually get there.
But when you’re dealing with
aligners or something that’s pro-

grammed to move at a set rate of
time, it is important, because the
aligner is programmed to move a
tooth at a certain rate.
What we found is there are huge
differences and individual variation
in rate of tooth movement, and so
the things I’m looking at are things
we need to think about when we’re
diagnosing, treatment planning and
staging our cases with aligners in
order to have better outcomes.
The easiest thing to think of is
age. The one thing we know is teeth
move slower with age, so when
we’re treating them with traditional
appliances and we put braces on a

Timothy Wheeler, DMD, PhD, is a
professor and chair of the University of Florida College of Dentistry’s
Department of Orthodontics and
is assistant dean for Advanced and
Graduate Education. He earned his
bachelor’s degree from Stetson University in DeLand, Fla., in 1976. He
attended the University of Florida,
earning his PhD, his DMD and his
certiﬁcate of orthodontics. He is a
diplomate of the American Board of
Orthodontics and has been involved
in clinical dentistry for 20 years.

patient and move the teeth, it’s just
going to take longer. But when you
have aligners, you need to know
that so you can stretch out your
treatment or program things a little
slower in order for your outcome to
be better. OT

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Trends

ORTHO TRIBUNE | MAY 2009

I OT page 1

Appliance-driven therapy
Traditionally, the major orthodontic
manufacturers have inﬂuenced and
driven the direction of advancements in patient care. Not surprisingly, the emphasis has focused
on appliances (ﬁxed or shrink
wrapped), with anchorage devices
as the latest example to ﬂood the
marketplace.
Selecting from the myriad of
anchorage devices can be both
daunting and bewildering. The current, trendiest treatment approaches
are predicated on expensive designer brackets bundled with lofty treatment philosophies that purport to
perform magical tooth gymnastics.
To observe “handle/bracket”
worship ﬁrst hand, one need only
witness the exhibitors’ ﬂoor at an
AAO convention. There you will
ﬁnd a predominance of the handles
with a sprinkling of practice management and novelty items thrown
into the mix. This is to be expected
as they are a major source of revenue, and we are a proﬁt-driven
economy.
Unfortunately, the DR, or “Do
Right,” component to this equation
has been relegated to a minor role.
My intent is not to diminish these
products, but rather to encourage
a de-emphasis in their importance
relative to the value of toolsets that
aid in proper diagnosis and treatment planning.

Fig. 3: SureSmile diagnostic models
are created from impressions or
scanned from study models.
Fig. 5: Is movement feasible?

Fig. 2: The robotic technology used
in the SureSmile system creates
custom archwires according to the
doctor’s prescription.

Fig. 4: SureSmile provides the
orthodontist complete control of
treatment.

and, therefore, avoiding continually rediagnosing cases throughout treatment. The beneﬁts to this
approach are greater control over
the tooth movement and signiﬁcantly greater treatment efﬁciency
as teeth are moved more directly
and more concurrently by the customized appliance.

Elevating my standard of care

Diagnostically driven therapy
Therefore, it is refreshing that OraMetrix provides through SureSmile
technology a comprehensive digital decision support system that
squarely positions the doctor in
the command and control position
where he/she rightfully belongs.
Incremental improvements in
speciﬁc areas of orthodontic practice have been achieved through
paperless practice management
systems, digital cephalometrics,
photography and radiography, but
one key piece has been missing — a
system to integrate diagnostics with
therapeutics.
The SureSmile 3-D diagnostic
and treatment planning software
provides the basis for high-quality
results because it is coupled with
powerful, customized, prescriptive,
superelastic archwires.

An end-to-end solution
Early on in the records-taking
process, 3-D diagnostic SureSmile
models are created from impressions or scanned from study models.
Sophisticated treatment planning
and diagnostic software toolsets are
employed using analytical and simulation modalities to assist in case
diagnosis and treatment strategy
development.
Mind’s eye orthodontics, based
on best guess, is supplanted by
incredibly realistic treatment simulations. The software is extremely
versatile and can be applied to all
types of cases: surgical, orthopedic,
asymmetric, extraction and non-

Fig. 7: Patients know what outcome
to expect with SureSmile treatment
planning software.

Fig. 6: Creating a 3-D visual treatment objective.
extraction, from the ordinary to the
most complex and involved.
This 3-D visual treatment objective (VTO) is created by virtually
moving teeth in three planes of
space and testing various approaches as deemed necessary. Signiﬁcant
information can be gleaned from
this process, and numerous outcomes can be made available for
comparison. “What if” scenarios can
be examined and problems anticipated, delineated and deﬁned.
Using this medium to collaborate
with patients and fellow professionals can be extremely helpful in gaining consensus on treatment options
and minimizing misunderstandings
that arise from mere discussion.
An additional computerized 3-D
model is created at a point during the patient care cycle when
the patient is in active treatment
(brackets placed). Treatment planning strategies can then be reﬁned
on this model, and ultimately, a
“targeted” setup is created.
The personalized wire prescription is reverse-engineered based
on this clinician prescribed setup.
Prior to establishing the prescription for the 3-D target setup, it is
instructive to perform a quick diagnostic re-analysis by superimposing
the pretreatment diagnostic model
over the mid-treatment therapeutic
model. This allows the clinician to

determine if the patient’s biological limits (quantitatively) have been
managed and to assess how treatment has progressed in order to
initiate any course adjustments.
Tables in the software indicate
the nature and magnitude of individual tooth movement designed
in the setup. This process allows
one to easily make determinations
about whether that movement is
appropriate and feasible (Fig. 5).
For example, SureSmile software allows planning to identify
the constraints of tooth movement
and speciﬁes where and how much
interproximal reduction to perform
as well as other space management
approaches. Once the boundary
positions have been established for
the anterior and posterior teeth, the
software aligns the teeth virtually
and determines how much IPR will
be required.
Based on the clinician’s parameters, if too much reduction is speciﬁed, one can modify the torque,
arch form or other conditions, as
deemed appropriate, with a couple
of keystrokes and have the software
modify the setup (Fig. 6).
Clearly, this approach to treatment, which is proactive vs. reactive, has several major beneﬁts,
foremost of which is the ability to
view patients “holistically” rather
than incrementally from visit to visit

Our practice credo is to leverage
technology to elevate the standard
of care for our patients. The
SureSmile 3-D diagnostic software
toolsets have enhanced my ability to
make better, informed treatment
decisions that can be reliably delivered via the customized appliances
and, in turn, have enhanced my
ability to “do right.” OT

OT About the author

Dr. Mark Feinberg graduated from
the University of Connecticut School
of Dental Medicine in 1982 and completed his orthodontic residency at
Columbia University in 1984. He is a
diplomate of the American Board of
Orthdontics and a member of the AAO
and NESO. He maintains a full-time
private practice in Stratford, Conn.

OT Contact
Mark P. Feinberg DMD
3272 Main St., Stratford, Conn. 06614
Phone: (203) 377-6335
E-mail: drdmd123@gmail.com

www.feinsmiles.com

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16

Investing

ORTHO TRIBUNE | MAY 2009

Credit crisis, property value
crash — what they teach us
By Paul Hanks

2

009 is a difﬁcult year for everyone, not just from the viewpoint
of an investor. Whether you
invested in the stock market or
in real estate, everyone has been
affected by the happenings on Wall
Street, and we will all suffer for it.
Just before Christmas, as if the
collapse of some of the world’s relatively honest ﬁnancial institutions
had not already been unsettling
enough, hedge fund boss Bernard
Madoff was accused of swindling
the world’s smartest investors out of
a grand total of $50 billion.
How, it was asked, could the
world’s smartest investors have fallen for this? The answer, surely, is
they were all like him. They thought
they had found a way of making
money out of nothing.
Unfortunately for them, the
ineffable Madoff appeared to have
found a way of making money out
of nothing. But most of them had
got their money the same way — by
promising vast returns on money
from other people who were trying
to make money out of nothing.
You cannot get something for
nothing. Surprised?
Now, reality has returned. One
hundred percent mortgages are
gone; 20 percent down payment is
the norm and a minimum requirement — as is the need to be able to
ﬁnancially afford to invest. Gone are
the days, thankfully, when I would
be contacted by a doctor explaining
he or she had $5,000 and wanted to
build a real estate portfolio.

Realism
I remember graduating from dental
school and preparing to embark on
a career that would make me ﬁnancially independent. Indeed, I knew I
was in the big league when the next
day a ﬁnancial advisor took everyone in my class out and “educated
us” on investments.
“Dentists are some of the highest
paid professionals. Invest and you
will be able to retire in 10 years,”
was the opening gambit. How many
dentists feel they can retire now?
Where are the ﬁnancial advisors
now?
Oh, I know. They will be knocking at my door soon, saying stocks
are low, invest now and you can
retire in 10 years!
“It is disappointing that, for so
many of us having worked hard
to prepare for our future, we see
all our plans and gains reduced
through no fault of our own.”
So wrote one client of mine. He
had become an orthodontic specialist and spent years building up his
practice. He had two practices and

was preparing for a fruitful retirement — looking at his 401(k) and
investments with pride.
Now, however, not only with
the economy in recession and his
retirement funds decimated, he also
has seen the attendance at his ofﬁce
fall (as a result of the economy).
Currently, he has to work on a daily
rate for a corporate body just to
keep aﬂoat.
You will appreciate how his investments are looking. Understandably,
he is bitter about having saved for
so many years, invested ﬁnancially
to prepare for a comfortable retirement, only to ﬁnd himself back on
the treadmill. The disillusionment
that you can work hard for so many
years just to have it taken away is
found not only in those who are near
the end of their careers, but also
from those recently qualiﬁed.
How many of you have bought
your own ofﬁce because it seemed
the thing to do (ﬁnancially) and it
will be a proﬁtable nest egg to sell
later?

Why bother?
For the majority of us, investing is
about establishing security for ourselves and our families when we no
longer choose to work and actively
bring in an income. What this year
has showed is that this conservative
philosophy was replaced by greed
— get rich quick.
People were blinded by making
obscene amounts of money. They
lost sight of the objective, which
was to become ﬁnancially independent. How much money is too
much? It’s too much when you’ve
already got all you could possibly
need, and there’s nothing to do with
it any more except count it.

What investing is about
Investing now is about cash ﬂow!

Whatever medium you choose to
invest in, you need to think about
what annual return you are getting
— not the end proﬁt with nothing
until then. Would you work in a
dental ofﬁce every day if you did not
expect any income until a point 10
years down the road?
Now is not about a return in ﬁve
or 10 years; it is about immediate
cash ﬂow. Future proﬁt is an additional bonus. Doing nothing and
hoping that over the next few years
you will recover lost ground is not
beneﬁcial.
Take static funds (any funds that
are not generating a good return
— this could be your 401(k), your
home equity, your savings) and consider putting them to use. Of course,
everything has to be part of an
overall ﬁnancial assessment, and
you don’t want to over commit. But
investments or 401(k)s that are losing money can be put to better use.
Now is the time to invest in quality, income-producing real estate
where you can choose the prime
investments and acquire them at
beneﬁcial prices. Commercial apartment buildings should give annual
returns of around 7 percent.
This annual return translates
into a monthly or annual cash ﬂow
— something I think will beneﬁt
every doctor who has seen a decline
in attendance at his ofﬁce.
I do not just mean go out and buy
real estate. It needs to be sourced,
and the rubbish removed. There is a
tremendous amount of poor quality
real estate out there. Sellers or their
agents may not always represent
the building ﬁnancials correctly. I
recently spent six months assembling a portfolio of four buildings for
a client after reviewing and analyzing more than 50 buildings.
In addition, pooling resources
adds to your armamentarium. I am
now working with groups of doctors
who want to pool resources with
colleagues they know and ones they
do not know. The advantages are
they have greater buying power, can
spread their investment funds over
several properties and, by working
together, are not over-exposed to
unforeseen expenses or problems.

Real estate market is not dead
You may have read many negative issues regarding mortgages and
real estate lately. The real estate
market is not dead. Yes, there has
been a major correction to many of
our nation’s markets, but that is just
the way that cycles work. The question becomes: Do you want to take
advantage of the buying opportunities or sit on the sideline and wait
for prices to head back up?
Investors who have cash are

making huge buys right now and
picking up some great deals. They
recognize good deals when they see
them and aren’t being frightened by
the media. You make money in real
estate when you buy it right. Buy
low and sell high, not the other way
around.
Remember, there is money out
there. Credit is still very much available, but lenders are just a lot pickier
about who can get it. A good credit
rating matters. To get an affordable
loan, you will probably need a FICO
credit-rating score of at least 700 —
but most likely higher.
Lenders today want to see substantial down payments on big-ticket
items such as cars and homes. The
days when you could buy a house
on a whim with “zero money down”
and mediocre credit are over. Be
prepared to put down 20 percent for
mortgages. The poorer your credit
rating, the larger the down payment
you’ll need.
So rather than let your investments or funds languish with little
gain for several years, now is a perfect opportunity to gain a better
return. OT

OT About the author

Dr. Paul Hanks, president of Portfolio Development Services, began his
professional career as an orthodontist. His knowledge and experience
with real estate was utilized on an
increasing scale by colleagues. He
became a real estate professional
and is a real estate broker in California and Washington, offering clinicians a trustworthy and safe way to
invest in real estate.

OT Contact
Dr. Paul Hanks, President
Portfolio Development Services, Inc.
Phone: (949) 226-1547
E-mail: paulhanks@us-pds.com
www.us-pds.com

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ORTHO TRIBUNE | MAY 2009

Practice Management 17

Case acceptance and the
orthodontist chairside manner
By Scarlett Thomas, Orthodontic Management
Solutions

casual “love ya” tossed at your
spouse in the morning, without
a warm hug and a loving look,
can feel like nothing more than an
empty gesture. But when you say it
like you mean it, the other person
can really feel the love, warmth and
a genuine sense of care.
Patients are no different. They,
too, can feel if you really care or
not. Genuine concern for their wellbeing and happiness can help you
win their hearts and their business. When it comes to people, you
really have to show that you care by
your actions and behavior, not just
words. A kind and caring demeanor
goes a long way in establishing
strong bonds and relationships.
Often it’s the simplest things that
matter. Here are some suggestions
that can make a world of difference
in how you are perceived by your
patients.
U Take the time to sit down in a
chair during the exam process.
I have observed many ofﬁces over
the years where doctors will stand
during the entire exam. Guess
what message you are giving out
when you do that? “I’m in a hurry
and I don’t have time for you.”
U Carefully review the health history form. It validates the patients’
time and effort in ﬁlling it out and
shows you are really concerned
about their well-being.
U Call out the clinical ﬁndings to
your treatment coordinator in
front of the patient. Don’t just
view the X-rays in the clinic and
then go into the exam room ready
to give your treatment recommendations within the ﬁrst few
seconds. It is more about how you
present the treatment plan than
what your actual recommendations are. Remember, you have to
sell it before you can do the treatment.
U Give ample time to the patients
and/or parents to express their
thoughts and concerns. Listen
actively and really try to understand what they are saying and
feeling instead of projecting your
own ideas or recommendations.
Forget about the task of diagnosing and treatment planning for
a moment and think about the
person.
If you go to the doctor because you
have a stomach ache, you don’t care
if he’s seen 3,000 other people with
stomach aches during the course of
his career. The last thing you want
is for him to rush in the room, look
you up and down, mumble some
technical phrase you’ve never heard
before and scratch something on
a prescription pad, before hustling
away again.
Asking the questions, even if you

know the answers, establishes rapport. The patients want to know you
care and that you are willing to take
the time to understand what brought
them into your ofﬁce. When a practitioner gives patients undivided attention, he not only makes the patients
feel comfortable and relaxed at the
moment but also gains their loyalty
and trust for the long term.
Another key element is patient
involvement. You should make an
effort to include the patient in your
diagnosis and treatment planning.
Doing so not only makes for a better atmosphere, but it also increases the likelihood that your patients

will have the positive attitude that
becomes the driving force behind
your case acceptance and the growth
of the practice.
To learn more about improving
case acceptance and the clinician’s
role during the new patient exam
process, you are invited to attend one
of Orthodontic Management Solutions’ Webinars. As a participant, you
can ask questions and get answers in
real time. Course materials are provided via e-mail, and participants are
able to view a PowerPoint presentation during the course, using a Web
conferencing tool. Webinars offer convenience and are very cost effective.

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

Visit www.Orthoconsulting.com for
more information or to register! OT
AD

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Practice Management

ORTHO TRIBUNE | MAY 2009

Early breakthroughs for
ortho makeover winner
By Kevin Johnson & Emily Ely

Total Ortho Success

“Y

ou know what? We’re operating in ﬁrst-year mode
when we’re in year three.
That’s a problem ...”
These were the words of Dr.
Brian Hardy of Hardy Orthodontics
as he and his team began their
Levin Experience™ at our Advanced
Learning Institute in Baltimore. As
the winner of the Total Ortho Success Makeover, Dr. Hardy was beginning his year of management and
marketing consulting with hopes of
kick-starting his production.
Dr. Hardy’s practice was suffering growing pains that many young
ortho practices experience. He is
ready to go to the next level, but
needs some tools to get him there.
The biggest issues addressed during Dr. Hardy’s and his staff’s visit to
Levin Group were vision, goals and
scheduling. These are key issues
that need to be handled early in
the consulting process. Vision, goals
and scheduling serve as the foundation for all further progress.
But we will have to wait to discuss these topics until our next column. An important tool was missing
from Dr. Hardy’s practice that had
to be addressed before we did anything else.

The importance of meetings
Early on, we discovered something
that was going to deprive Dr. Hardy’s
practice of the valuable progress it
wished to achieve — his practice
did not have regularly scheduled
meetings. Dr. Hardy couldn’t see
the value in meeting because his
practice didn’t have a good history
with them.
For awhile, he and his team had
late-day huddles, but these soon
ceased when Dr. Hardy discovered
little was getting accomplished. He
had come to realize that such late
afternoon meetings could never
really work because everyone wants
to go home, not rehash the day.
With a staff of three people, Dr.
Hardy believed that formal meetings in general didn’t seem very
necessary for his practice. After all,
at any given time, he could just pull
them aside to discuss an issue that
needed addressing.
We advised Dr. Hardy not to
throw the baby out with the bath
water. Meetings do matter. They
serve a critical function in the ofﬁce,
no matter what the size of the practice. They improve communication,
inspire cooperation and help build a
stronger team.
Staff meetings should be held
every four to six weeks, focus on
larger issues and last 60 to 90 minutes. Morning meetings, on the other
hand, should be held every day for
10 to 15 minutes and focus on the

Pr actice

current day’s patients, schedule,
opportunities and potential problems. If recurring issues are brought
up consistently in the morning meetings, they should be discussed and
handled at the staff meeting.
Levin Group teaches that there
are a number of steps that can be
taken to ensure staff meetings are
positive and results-oriented:
U Have a clear vision. It is critical the orthodontist lay out a
clear vision for staff meetings.
When staff members understand
the purpose, they become actively engaged in the process. As
the practice leader, orthodontists
need to be good communicators.
U Put together a written agenda.
If the staff meeting is to be considered worthwhile by team members, there should be a written
agenda for the entire meeting.
The agenda should be distributed
at least one day in advance so the
staff members can review it and
be prepared to participate.
U Maintain a respectful atmosphere. Run a meeting where
all team members have an equal
opportunity to participate when
they choose to do so. Set a simple
rule that when one person is talking no one else can interrupt.
Effective meetings are dialogues
— not a monologue.
As we discussed the importance
of implementing morning meetings,
we explained to Dr. Hardy and his
team that they shouldn’t expect the
ﬁrst several meetings to be highly
productive. It’s all about getting the
process started.

Dr. Hardy had two concerns
about these new meetings. He felt
somewhat apprehensive about our
request of turning over organizational responsibilities to one of his
staff members. In fact, without being
the one “in charge,” he jokingly said
he wasn’t sure what he was going to
do with himself.
Our advice was this — if you ﬁnd
yourself having free time, then you
have time to contact a referring doctor or two. Dr. Hardy and his staff
laughed, appreciating the message
we were trying to convey.

Conclusion
Much was accomplished in this ﬁrst
in-depth discussion with Dr. Hardy
and his staff. As Hardy Orthodontics’ experience at the Advanced
Learning Institute drew to a close,
an exhilarated Dr. Hardy admitted
to being slightly overwhelmed but
very upbeat and optimistic. As his
team prepared to leave, he looked
around the room at his team and
us and said, “This is a lot to digest!
But to achieve the end result, it’s
well worth it. This is deﬁnitely better than just doing what we’ve been
doing and getting the usual result.”
As consultants, we couldn’t agree
more. His path toward becoming
a Levin Practice™ is now ﬁrmly
rooted. Join us next time when Dr.
Hardy starts putting what he learned
into practice!
To jumpstart your own Total
Ortho Success Practice Makeover,
come experience Dr. Roger Levin’s
next Total Ortho Success™ Seminar,
July 24-25 in Las Vegas. Ortho Tribune readers are entitled to receive a
20
percent
courtesy;
call
(888) 973-0000 and mention “Ortho
Tribune” or e-mail customerservice
@levingroup.com
with
“Ortho
Tribune Courtesy” in the subject line.
For more information, go to www.
levingrouportho.com. 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.
For more than two decades, Levin
Group has been dedicated to improving the lives of orthodontists. Visit
Levin Group at www.levingrouportho.
com. Levin Group also can be reached
at (888) 973-0000 and by e-mail at
customerservice@levingroup.com.

[19] => Ortho_0509_1-24_Final.pdf

Industry 19

ORTHO TRIBUNE | MAY 2009

Product line targets oral hygiene
ClassOne Orthodontics’ new technology helps reduce plaque buildup

breakthrough new orthodontic product line — SeLECT
Defense™ — with implications
for improved oral hygiene was
released by ClassOne Orthodontics
during the AAO Annual Session in
Boston, with an international launch
scheduled for July 1.

technology was not removed by
tooth brushing within the period of
the study.

Product development — Texas
teamwork

Leading orthodontists
participation

In close collaboration with ClassOne Orthodontics, the revolutionary
product line was developed and patented by researchers at Texas Tech
University and Texas Tech University Health Sciences Center in
Lubbock, Texas, through licensing
and co-development with Selenium,
Ltd., and is now marketed exclusively by ClassOne Orthodontics.
“SeLECT Defense is the next big
advance in orthodontic treatment,”
said Kenny Gallagher, president of
ClassOne Orthodontics. “Research
shows that parents and their children are concerned about oral
hygiene during orthodontic treatment. This product is going to virtually alleviate that concern.”

In developing the product, ClassOne
invited some of the country’s leading orthodontists to take part in a
SeLECT Society Advisory Committee to provide expert opinion and
direction.
“As an orthodontist, you are always
looking for ways to improve the
patient experience and outcome,”
said Dr. Robert “Tito” Norris, DDS,
of San Antonio. “I am very excited
about the potential this product has
to improve overall hygiene in my
patients during orthodontic treatment.”
For more information, call (800)
343-5291 or visit www.selectdefense.
com. OT

Product performance
SeLECT Defense technology is used
in orthodontic treatment to enhance
brackets, ligature ties and closing
chain to help reduce plaque buildup
and improve oral hygiene.
The patented formula also is
mixed in with adhesives, cements
and primer to prevent tooth decalcification or demineralization.
SeLECT Defense products do not
require the doctor or staff to perform any special steps when applying them to patients — they are
used exactly as standard orthodontic products.
In laboratory tests, SeLECT
Defense technology has proven
to dramatically reduce microbial
development, commonly known as
plaque, and eliminate the appearance of white spots, which can form
during orthodontic treatment.

Regulation
ClassOne received FDA clearance
in July 2008 to market SeLECT
Defense.

A slide from Dr. Julian E. Spallholz’s presentation during the AAO Annual
Session in Boston shows a sample of survey questions about the SeLECT
Defense product line.

University of Texas Health
Science Center study
Researchers at the University of
Texas Health Science Center at San
Antonio, Texas, conducted a 28-day
mouth-simulation study of products with SeLECT Defense to determine the effectiveness of preventing
microbial formation on teeth.
The results were extraordinary.
SeLECT Defense technology offered
100 percent prevention of the development of clinically visible white spot
lesions around orthodontic brackets
with elastomeric rings, while 40 percent chlorhexidine varnish, a commonly used coating, offered limited
protection.
Microscopic examination of the
teeth surfaces showed that SeLECT
Defense technology reduced enamel
demineralization (or white spot formation) around orthodontic brackets by 86 percent when the tooth is
brushed twice daily and by 80 percent when the tooth is not brushed.
By comparison, the application of
40 percent chlorhexidine reduced

tops renames practice
management system
topsXtreme
becomes topsOrtho
tops™ recently announced a new
name for its orthodontic practice
management system.
During the next few months, the
topsXtreme™ name will be replaced
by topsOrtho™.

“tops will continue to offer the
fast, stable and secure software
known and loved by orthodontists
and their staffs,” said tops Founder
and CEO Dr. Mark Sanchez. “But
we think ‘ortho’ provides a better
idea of what our product does.”
tops also has freshened up its
company and product logos and
recently launched a new Web site,
www.topsOrtho.com.

demineralization only by 60 percent
even when the teeth are brushed
and by 66 percent without brushing.
Furthermore, SeLECT Defense

[20] => Ortho_0509_1-24_Final.pdf

Industry

ORTHO TRIBUNE | MAY 2009

Myofunctional Research Co. turns
to Class II interceptive appliance

ne would think there is little
more left to accomplish for
Myofunctional Research Co.
(MRC), after having produced a
wide range of myofunctional orthodontic appliances and changing
the way orthodontic treatment is
performed. MRC appliances, including the T4K®, the TRAINER System™, the 4-Braces Series™ and the
MYOBRACE®, cater to children of
all ages.
The Japanese Journal of Clinical Dentistry for Children1 recently
ran an 18-page article on the T4K
appliance. The study showed the
appliance can treat many different
malocclusions without the use of
ﬁxed appliances.
The common results in the cases
published showed anterior arch
development, opening of a deep bite,
Class II correction and improved
anterior dental alignment. This
concurs with the articles published
by Dr. German O. Ramirez-Yañez,
DDS, MDSc, PhD, on cases from
other ethnic groups.2

What about Class III?
For many years, Dr. Chris Farrell,
BDS (Sydney), founder and CEO of
MRC, had been asked by dentists
and orthodontists to develop a Class
III appliance. The T4K and Infant
Trainer had proven to be effective in very early Class III correction, but the maxillary development
and anterior cross-bite correction
was not quite complete — usually
requiring further maxillary expansion to obtain a positive anterior
overjet.
In 2007, Dr. Farrell responded to
this demand with the development
of the appliance for interceptive
Class III correction, or i-3™. This
incorporated the well-known principles of the Frankel appliance as
well as unique design elements for
ease of use.
Two design aspects were included — a Frankel cage using MRC’s
patented inner frame technology
and a tongue raiser to force the
tongue into the maxilla. The primary cause of most Class III is a low-

From left, the T4K, the i-3 and the i-2.

ered tongue position, which drives
excessive mandibular growth.
Two years ago, the i-3 was
released, and practitioners were
instantly reporting delight at how
well it corrected a Class III malocclusion in the late primary to early
mixed dentition. This conﬁrmed the
primary etiology of Class III is not
genetic mandibular overgrowth, but
lowered tongue posture — a theory
already understood by a minority.
CDEO Arturo Alvarado Rossano,
specialist and professor in orthodontics and prosthetics craniofacial
orthopedics in the faculty of dentistry, Universidad Nacional Autónoma
de México, was the ﬁrst to research
the i-3, and he published the ﬁrst
case study in 2008.3
Dr. Alvarado and others started
using the i-3 on secluded Class
II cases with deﬁcient maxillary
development. They experienced
successful results in treating Class
II correction as well as Class III.
This discovery then precipitated the
development of the new i-2™ appliance.

Interceptive treatment
for Class II — the i-2
The INTERCEPTIVE SERIES ™
appliances by MRC are designed
to be used around the time of a
child’s most rapid growth spurt —
described by Dr. Robert Ricketts as
being ages 5–8.
The i-2 features high sides and a
Frankel inner frame, which actively
expands the maxillary arch form.

The tongue raiser, a feature shared
with the i-3, actively raises tongue
posture in conjunction with the
tongue tag, which is common to all
MRC appliances incorporating the
Myofunctional Effect™.
For more extreme Class II malocclusion, there is the extended lower
ﬂange and lip bumper. This is an
improved feature to exploit another
of Frankel’s ideas from the FR-II.
This bumper extends further
into the sulcus than the TRAINER
appliances to deactivate the lower
ﬁbres of the orbicularis oris. Class II
malocclusions typically have strong
overactive musculature in the mentalis area. The i-2 targets this with
the extended lip bumper.
Farrell notes: “It is always interesting developing appliances for
more speciﬁc goals such as Class
III and Class II. Finding that sound
understanding and role of the oral
musculature, tongue and mode of
breathing allows for a very effective
appliance when combined with the
world-leading CAD design technology MRC has pioneered during the
last 20 years.”
An increasing demand from
orthodontists and dentists worldwide for more effective and easier to
use (myo)functional appliances has
driven MRC to lead the way with a
comprehensive range of appliances
for all ages and all malocclusions.
MRC has recently shifted its focus
into practice management systems
based on this newer “no braces”
approach.

While the increasing demand for
“no braces” treatment in the adult
market is being satisﬁed by Invisalign®, the focus for MRC is on the
early and conventional orthodonticage markets.
The way orthodontic treatment
is delivered will change over the
next two decades, just as the trend
toward less extractions has come
about. The era of less time in braces
is already here. Future generations
may not even know what “braces”
are.
MRC’s appliances with their
emphasis on early myofunctional
habit correction are already proving
the trend in many practices around
the world.

References
1. Akira Kanao, DDS, PhD; Masanori
Mashiko, DDS, PhD; and Kosho
Kanao, DDS, PhD, Functional
Appliance Therapy for Mandibular
Retrusion Cases Using the TRAINER SYSTEM. Japanese Journal of
Clinical Dentistry for Children.
(April 2009 Vol.14 No.4).
2. Ramirez-Yañez, German O., DDS.
Early Treatment of a Class II,
Division 2 Malocclusion with the
Trainer for Kids (T4K): A Case
Report. Journal of Clinical Pediatric Dentistry. 32(4): 325–330,
2008.
3. CDEO Arturo Alvarado Rossano.
Clinical Applications in Early
Orthodontic Treatment Using the
Interceptive Class III Appliance
from MRC. 2008. OT

ClearCorrect begins transparent aligner rollout
ClearCorrect, Inc., recently
began the national rollout of its
FDA-cleared transparent orthodontic aligners, also known as clear
braces or invisible braces. The company is supporting the rollout with
a series of local hands-on certiﬁcation workshops for orthodontists.
ClearCorrect provides clinicians
with the following advantages:
UÊ >Vi` ÌÀi>ÌiÌ VÌÀ

UÊ iÛi«i` LÞ i>`} `iÌÃÌÃ
clear aligner orthodontics
UÊ ÜiÀ >L viiÃ
UÊ `VÕÀÃi VÀÀiVÌ viiÃ
UÊ ÀiwiiÌ viiÃ
U ÌÀi>ÌiÌ «À`ÕVÌÃ VÕ`i
initial retention at no extra
charge
UÊ -Õ«iÀÀ ÌÀ>} >` ViÀÌwV>tion
UÊ ,iÃ«ÃÛi VÕÃÌiÀ ÃiÀÛVi

The company has carefully prepared for the launch by developing
an informative and user-friendly
Web site, www.ClearCorrect.com,
which has sections for clinicians
and patients alike.
The ClearCorrect certiﬁcation
workshops are scheduled throughout the country so orthodontists can
attend without losing valuable time
in their practices. Upon completing

the course, clinicians are not only
certiﬁed as ofﬁcial ClearCorrect
providers, but they earn eight hours
of continuing education credits as
well. For experienced ClearCorrect
practitioners seeking a fast track
to certiﬁcation, there are one-hour
online Webinars avaliable.
For a schedule and to enroll
online, visit www.clearcorrect.com/
doctors/becomeaprovider.html. OT

[21] => Ortho_0509_1-24_Final.pdf

ORTHO TRIBUNE | MAY 2009

Industry & Products 21

World-renowned orthodontist joins Opal
McLaughlin will lead
global orthodontic
education program

pal Orthodontics, a division of Ultradent Products,
Inc., announced that worldrenowned orthodontist Dr. Richard
P. McLaughlin has recently joined
the company as an advocate and
consultant. McLaughlin will lead
the global orthodontic education
program and will begin contributing to new product development
and design.
McLaughlin, who graduated
from Georgetown University Dental
School and received his orthodontic degree from the University of
Southern California, has lectured
all across the world and is rec-

BW1 and BW2
for ORTHOPHOS
XGPlus and XG 5

Sirona Dental Systems, maker of
innovative dental digital radiography
technology, announces the addition
of two new panoramic bitewing programs, BW1 and BW2. The programs
are available for the ORTHOPHOS®
XGPlus and XG 5 panoramic units
and allow the practitioner to take a
diagnostic image quickly and easily.
The programs provide practitioners with the option of taking an
extraoral bitewing image when an
intraoral image is difﬁcult or not feasible. The programs are easy to use
and are a low-dose alternative for
diagnosis in the posterior and anterior regions.
The BW1 posterior program allows
for additional diagnostic information
compared to standard intraoral bitewings. It is the perfect alternative for
patients with challenging intraoral
anatomy. With the XG 5, both sides
are imaged while the right, left or
both sides can be selected on the
XGPlus units.
The BW2 anterior program provides a detailed overview image of
the anterior area. It can be used with
the edentulous positioning guide for
anterior trauma patients.
Sirona Dental Systems
Phone: (800) 659-5977
www.sirona.com

ognized for his
advancements in
the pre-adjusted
appliance prescription. As Dr.
Larry Andrews’
(inventor of the
“straight-wire”
appliance) associate, McLaughlin
Dr. Richard P.
learned the intriMcLaughlin
cacies of design
and performance
of the pre-adjusted system.
Later in his career, McLaughlin
opened a private practice in San
Diego and leveraged the knowledge
and teachings of Dr. Ron Roth to
reﬁne his approach; this, along with
his collaboration with Dr. Jon Ben-

nett and Dr. Hugo Trevisi, resulted
in what is widely accepted today
as the most advanced pre-adjusted
prescription in the history of orthodontics.
McLaughlin’s passion for continuous improvement of the pre-adjusted appliance is what has drawn him
to Ultradent and Dr. Dan Fischer,
its president and founder. Ultradent
has a trusted reputation in the dental community and a 30-year history
of progressive improvements in the
ﬁeld of dentistry. The addition of the
orthodontic division has created the
opportunity for extraordinary synergies in oral health care.
McLaughlin’s history of excellence in treating patients with superior esthetics, optimal occlusion and

treatment efﬁciency complement
Fischer’s reputation for industry
advancement, innovation and preservation of healthy, natural tooth
anatomy.
Additionally, the environment at
Opal Orthodontics fosters a forum to
improve the level of care for patients
and clinicians, which coincides with
McLaughlin’s personal philosophy.
With the support of McLaughlin,
Opal Orthodontics is poised to service the orthodontic market with
experienced professionals in sales,
marketing and continuing education.
For more information about Opal
Orthodontics, please contact Dwight
Schnaitter at (801) 553-4430 or visit
at www.opalorthodontics.com. OT
AD

[22] => Ortho_0509_1-24_Final.pdf

Events & Products

ORTHO TRIBUNE | MAY 2009

Congress on 3-D Dental Imaging
features interdisciplinary approach
Imaging Sciences,
Gendex sponsor
third annual event

he third International Congress on 3-D Dental Imaging,
sponsored by Imaging Sciences
International and Gendex Dental
Systems and held this year in Chicago on June 19–20, features a variety of clinicians and professionals
from nearly all dental specialties.
These 11 leaders in education offer
their expertise on practical applications of this technology as well
as an interdisciplinary teamwork
approach to 3-D treatment that can
beneﬁt both patients and practices.
“Born of a vision to help cli-

nicians better understand patient
anatomy in three dimensions, i-CAT
technology changed the landscape
of treatment planning in dentistry,”
said Scott D. Ganz, DMD, a twoyear veteran of the congress and a
recognized expert in the ﬁeld. “The
congress carries on the vision this
year as it showcases interdisciplinary relationships involving 3-D.”
As general dentists and specialists, novices and experts, continue
to explore the evolving world of
3-D imaging, they seek guidance on
how to utilize it for a wide variety
of treatment modalities, including
implants, bone grafting, oral surgery, orthodontics and endodontics.

“It is clear that this state-ofthe-art imaging method acts as
the bridge between specialities,
enhances communication among
clinicians and provides the ﬁnest
diagnostic foundation for deﬁning treatment alternatives for our
patients,” said Ganz.
As the interest in cone beam escalated, the International Congress on
3-D Dental Imaging was instituted
in response to the demand for peerto-peer education.
“The adoption of 3-D radiography
continues to grow at an astounding
pace. Dentists are eager to learn
about its beneﬁts and how to apply
it to their practices,” said Chuck
Ravetto, vice president of marketing for Imaging Sciences and Gendex. “We are proud to offer such
a powerfully informative program

Finally, there is a mask that ﬁts small
faces! It’s ¾ of an inch shorter to eliminate gapping for a more comfortable,
protective ﬁt.
The masks are “Priority Pink,” which
means Crosstex donates 5 percent of
the proceeds to fund women’s cancer
research at Memorial Sloan-Kettering
Cancer Center.

The outer layer is ﬂuid resistant and
the inside is soft, white spunbond.
The masks meet American Society
for Testing and Materials F2101-07 standard as a low (primary) barrier face
mask based on ﬂuid resistance, ﬁltration
value, breathability and ﬂammability.
They are available at dealers worldwide.

that provides real-world clinical
and practical advice.”
This two-day course utilizes not
only lectures but discussion formats
as well.
“One of the most appreciated
aspects of the congress is the chance
for lecturers and attendees to participate in an open exchange of ideas,”
said Steven Guttenberg, DDS, MD, a
returning featured speaker.
Participants also have the opportunity to interact with a variety of
vendors that offer 3-D supportive
products, including imaging and
implant systems as well as 3-D
treatment planning software.
For more information on the third
International Congress on 3-D Dental Imaging, including the agenda,
speakers and lecture topics, please
visit www.i-CAT3D.com. OT

Le Petit Masque

SureGrip Universal Photographic
Mirror Handle

Crosstex
Phone: (631) 582-6777
or toll-free (888) CROSSTEX
Fax: (631) 582-1726
E-mail: Crosstex@crosstex.com
www.crosstex.com

Lotus Passive Self-Ligating Bracket System

G&H® introduces a new mirror handle design
that is clinically functional and user friendly.
The SureGrip™ universal photographic mirror
handle engages mirrors quickly and easily with a twist of the handle. SureGrip is
fully adjustable, allowing the mirror to be adjusted and locked at any angle.
One design ﬁts all glass mirrors (3 mm thick), and one design ﬁts all stainless
steel mirrors (1 mm thick) — simply specify which design you prefer.
The SureGrip handle is constructed of heavy-duty anodized aluminum for long
life, and is easy to clean and sterilize. It also is fully autoclavable.

Ortho Technology, Inc., introduces the Lotus™ Passive Self-Ligating Bracket System. The Lotus bracket
is designed to provide passive engagement while
reducing friction and improving sliding mechanics.
It features a patented, convertible clip that allows for
easy opening with an explorer and secure closing
with a tweezer or utility plier. No special instruments
are required.
The clip is made of high quality nickel titanium
for ﬂexibility and long life and can be removed if
ligature ties are desired during the ﬁnishing phase.
The Lotus bracket features a rhomboid shape and
contoured tie wings for maximum patient comfort.
The 80-gauge, foil, mesh-contoured base ensures
maximum bond strength and simpliﬁed, accurate
placement. The Lotus bracket comes in the .022inch slot Roth Prescription.
Other features and beneﬁts include:
U Design provides passive engagement to reduce
friction and improve sliding mechanics.
U It has a low-proﬁle, mini-twin design with a rhomboid shape for easy placement.
U The mandibular arch clips open gingivally to minimize occlusal interference while the maxillary arch clips open occlusally.

G&H Wire Company
2165 Earlywood Drive
Franklin, Ind. 46131
Phone: (800) 526-1026 or (317) 346-6655
E-mail: ghmail@ghwire.com
www.ghwire.com

Ortho Technology
17401 Commerce Park Blvd.
Tampa, Fla., 33647
Phone: (813) 991-5896 or toll-free (800) 999-3161
Fax: (813) 864-9605
www.orthotechnology.com

[23] => Ortho_0509_1-24_Final.pdf

[24] => Ortho_0509_1-24_Final.pdf

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[cover] => Ortho Tribune U.S.

[toc] => Array ( [0] => Array ( [title] => Showing off at AAO [page] => 01 ) [1] => Array ( [title] => Ethical and moral scenario planning for orthodontics [page] => 02 ) [2] => Array ( [title] => Get ready for OTStudyClub.com [page] => 03 ) [3] => Array ( [title] => Study: Some brackets more bacteria prone [page] => 04 ) [4] => Array ( [title] => OSAP addresses flu pandemic [page] => 05 ) [5] => Array ( [title] => AAO Review [page] => 06 ) [6] => Array ( [title] => An interview with AAO speaker Dr. Timothy Wheeler [page] => 10 ) [7] => Array ( [title] => Elevating the standard of our care [page] => 14 ) [8] => Array ( [title] => Credit crisis - property value crash — what they teach us [page] => 16 ) [9] => Array ( [title] => Practice Management [page] => 17 ) [10] => Array ( [title] => Industry [page] => 19 ) [11] => Array ( [title] => Products [page] => 21 ) ) [toc_html] =>

Table of contents

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