Miniscrews: a focal point in practice (Continued on page 3) / What does it mean to be scholarly? / Miniscrews: a focal point in practice / Proven strategies for ortho growth / Defining a profitable office / New version of imaging software allows clinicians to capture - diagnose and plan / Products
Miniscrews: a focal point in practice (Continued on page 3)
01 - 01 viewWhat does it mean to be scholarly?
02 - 02 viewMiniscrews: a focal point in practice
03 - 08 viewProven strategies for ortho growth
09 - 09 viewDefining a profitable office
10 - 10 viewNew version of imaging software allows clinicians to capture - diagnose and plan
12 - 12 viewProducts
14 - 14 viewArray
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[1] =>
SS
UE
EI
IA
LO
RT
HO
VO
IC
ORTHO TRIBUNE
SP
EC
The World’s Orthodontic Newspaper · U.S. Edition
August 2010 Supplement
www.ortho-tribune.com
Stop losing money
Do more in 3-D
Fun for all ages
Two proven ways
to grow your practice
New version of imaging
software adds features
New product brings
gaming to the office
uPage
9
uPage
12
uPage
14
What
happens
in Vegas
… could change your
practice for the better
By Kristine Colker, Managing Editor
I
f you are not yet headed to Las
Vegas from Sept. 16–18 for the
first OrthoVOICE orthodontic
meeting, there is still time to get in
on the action.
The Las Vegas Strip. (Photo/Provided by stock.xchng)
g OT page 3
Miniscrews: a focal point in practice
By Dr. Björn Ludwig, Dr. Bettina Glasl,
Dr. Thomas Lietz and Prof. Jörg A. Lisson
T
he straightening of mesially
tipped (second) molars in a full
dentition represents a therapeu-
Dental Tribune America
213 West 35th Street
Suite #801
New York, NY 10001
Part 4 of 6: More
clinical examples
tic challenge. The treatment is further complicated if the tooth is not
only tipped but also partly impacted.
The presence of a non-erupted
third molar does not simplify the
process (Fig. 1a). When planning
the required appliance, it is important to consider whether it is necessary, for example, to reshape the
entire dental arch (Figs. 1a–d) or
just upright the tipped tooth.
If miniscrews with bracket heads
are used, it is possible to employ a
special NiTi uprighting spring (such
as the Memory Titanol spring,
FORESTADENT).
A standard multi-bracket appliance can be used to reshape the
dental arch.
g OT page 4
AD
PRSRT STD
U.S. Postage
PAID
Permit # 306
Mechanicsburg, PA
[2] =>
2
From the Editor
Ortho Tribune | August Supplement
What does it mean
to be scholarly?
By Dennis J. Tartakow, DMD, MEd, PhD,
Editor in Chief
Q
uoting Nathan Pusey’s “The
Age of the Scholar” (1963),
“We live in a time of such
rapid change and growth of knowledge that only he who is in a fundamental sense a scholar — that is, a
person who continues to learn and
inquire — can hope to keep pace, let
alone play the role of guide” (Howe,
2003, p. 19).
Dr. Pusey’s quote is almost 50
years old but is as important, if not
more important, today as it was
then. The concepts and principles
for which his words stand for also
apply to the goals and direction set
forth by our orthodontic training
programs.
To be scholarly and erudite
requires a fundamental understanding of ethics or moral philosophy,
which addresses questions about
morality, justice and virtue.
These concepts are clearly not
(a) a matter of following one’s feelings, (b) identified with religion, (c)
the same as following the law or (d)
the same as doing whatever society
accepts.
Most individuals accept standards that are, in fact, ethical. However, societal standards of behavior
can deviate from what is ethical; an
entire society can become ethically
corrupt.
With these thoughts under the
Tell us
what
you
think!
microscope, ethics must satisfy two
concepts or principles:
• Ethics must refer to right and
wrong — standards that prescribe what humans should do
in terms of rights, obligations,
fairness, specific virtues or benefits to society, such as standards
that (a) impose the reasonable
obligations of values that include
enjoining virtues of honesty, compassion and loyalty; and (b) relate
to rights, such as the right to life,
freedom from injury and privacy.
Consistent, well-founded reasoning supports these ethical standards.
• Ethics must refer to the study and
development of moral standards
— feelings, laws and social norms
that deviate from what is considered to be ethical. It is necessary to continually examine one’s
standards to ensure they are well
founded and reasonable. It also
means the continuous effort of
studying our own moral beliefs
and conduct, striving to ensure
that we and the institutions we
help to shape live up to standards
that are reasonable and solidly
based.
According to Webster’s Online
Dictionary (2010), there are many
other applied definitions, explanations and descriptions of scholarly
communication. In general, scholarly communication is an umbrella
term illustrating the process of academics, intellectuals and researchers publishing and contributing
their findings to the wider academic
community and beyond.
It is simply the creation and dissemination of knowledge related
to research, education and erudite
endeavors.
There has been widespread
belief that the dissemination of
scholarship in the traditional system
has reached a state of crisis in
recent years, which has also been
referred to as the publishing crisis (UConn Libraries Spring Forum,
2008).
Such concepts must be encouraged and promoted as goals and
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.
directions for all students in colleges and universities.
Our orthodontic residents in
undergraduate, postgraduate or
continuing education must also
be encouraged to seek these principles of scholarship to maintain
quality guidelines and to improve
the standards of orthodontic education. OT
References
1. Pusey, N. (1963). The Age of the
scholar. In R. Howe (Ed.), The
quotable teacher (p. 19). The
Lyons Press: Guilford Connecticut.
2. UConn Libraries Spring Forum.
(2008). Scholarly Communication Crisis. Retrieved from: www.
lib.uconn.edu/about/publica
tions/scholarlycommunication.
html#Whatis.
3. Webster’s Online Dictionary.
(2010). Scholarly communication. Retrieved from: www.
websters-online-dictionary.
org/definitions/Scholarly+
communication?cx=partner-pub
-0939450753529744%3Av0qd01
-tdlq&cof=FORID%3A9&ie=UTF
-8&q=Scholarly+communication&
sa=Search#906.
OT
Corrections
“Miniscews: a focal point in practice,” on Page 1 of the June/July issue
of Ortho Tribune, was Part 3 in a series
of 6.
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, Lab & Endo Tribunes
Sierra Rendon, s.rendon@dental-tribune.com
Online Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Product & Account Manager
Humberto Estrada
h.estrada@dental-tribune.com
Product & Account Manager
Mark Eisen, m.eisen@dental-tribune.com
Product & Account Manager
Gregg Willinger
g.willinger@dental-tribune.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dental-tribune.com
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Dental Tribune America, LLC
213 West 35th Street, Suite 801
New York, NY 10001
Phone: (212) 244-7181, Fax: (212) 244-7185
Published by Dental Tribune America
© 2010, Dental Tribune International
All rights reserved.
Dental Tribune makes every effort to report
clinical information and manufacturer’s
product news accurately, but cannot assume
responsibility for the validity of product claims,
or for typographical errors. The publishers
also do not assume responsibility for product names or claims, or statements made by
advertisers. Opinions expressed by authors are
their own and may not reflect those of Dental
Tribune International.
OT Editorial Advisory Board
Jay Bowman, DMD, MSD
(Journalism & Education)
Robert Boyd, DDS, MEd
(Periodontics & Education)
Earl Broker, DDS
(T.M.D. & Orofacial Pain)
Tarek El-Baily, BDS, MS, MS, PhD
(Research, Bioengineering & Education)
Donald Giddon, DMD, PhD
(Psychology & Education)
Donald Machen, DMD, MSD, MD, JD, MBA
(Medicine, Law & Business)
James Mah, DDS, MSc, MRCD, DMSc
(Craniofacial Imaging & Education)
Richard Masella, DMD (Education)
Malcolm Meister, DDS, MSM, JD
(Law & Education)
Harold Middleberg, DDS
(Practice Management)
Elliott Moskowitz, DDS, MSd
(Journalism & Education)
James Mulick, DDS, MSD
(Craniofacial Research & Education)
Ravindra Nanda, BDS, MDS, PhD
(Biomechanics & Education)
Edward O’Neil, MD (Internal Medicine)
Donald Picard, DDS, MS (Accounting)
Howard Sacks, DMD (Orthodontics)
Glenn Sameshima, DDS, PhD
(Research & Education)
Daniel Sarya, DDS, MPH (Public Health)
Keith Sherwood, DDS (Oral Surgery)
James Souers, DDS (Orthodontics)
Gregg Tartakow, DMD (Orthodontics)
& Ortho Tribune Associate Editor
[3] =>
Ortho Tribune | August Supplement
f OT page 1
The three-day event is shaping
up to be different from most other
conventions out there, including
giving attendees more time in the
exhibit hall without having to worry
about conflicting educational sessions, a new generation of speakers
who haven’t yet shared their stories with meeting attendees and a
simple way to have dinner at some
great restaurants and meet some
new friends.
“I’ve been to several orthodontic
meetings around the world and seen
the different ways people have presented academic programs,” said
Dr. Clarke Stevens, the man behind
OrthoVOICE. “European meetings
often have more people involved
than the regular list of speakers.
We thought it would be interesting
and creative to invite different types
of people.”
Some of these people include Dr.
Scott Law, a practicing orthodontist
in Killeen, Texas, who just finished
his residency in 2009. He will speak
on “Hit the Ground Running While
Training for a Marathon — Know
When to Pass the Baton and Win
the Relay.”
It also includes Dr. Jennifer J.
Garza, who started her career as an
orthodontic assistant and now has
her own paperless practice and is a
biologic orthodontist. She will share
how her experiences have shaped
the philosophies she is determined
to uphold in her practice.
Each day of the meeting, there
will be sessions for orthodontists
and sessions for staff, with two to
three tracks going at the same time.
However, attendees aren’t limited
by their job descriptions — if an
orthodontist wants to attend a stafffocused presentation or vice versa,
he or she is more than welcome to
do so.
Another idea taken from European meetings, Stevens said, will be
a more creative use of exhibit hall
space. Not only will attendees have
one-hour breaks to explore the
exhibits, but vendors are encouraged to have entertainment or
themes in their booths. One exhibitor, Stevens said, is considering
offering a coffee bar in the morning
with pastries.
Of course, a meeting is never
complete without an array of social
activities, and OrthoVOICE has
plenty of those. A cocktail party
kicks off the first night with entertainment, while a cocktail party the
second night is more of a wine-andcheese affair.
Two unique events are the
breakfast roundtable and Dinner
With Strangers. For breakfast, every
table will have a moderator and
a topic, from how one conducts
a new patient exam to how one
closes spaces where there’s been an
extraction. Orthodontists and staff
are encouraged to pick a topic they
want to discuss and spend their
meal sharing information with others.
For Dinner With Strangers,
attendees will find a list in their reg-
istration materials of various restaurants around Las Vegas where
OrthoVOICE has made reservations
for eight to 10 people.
Attendees will pick a restaurant they would like to go to and
will then show up for dinner with
other attendees who they haven’t
yet met.
“Sometimes I go to a meeting
alone, and I wonder where I’m
going to eat,” Stevens said. “But this
way, you can go to a great restaurant and have a great evening with
some new friends.”
Stevens said he likes that
OrthoVOICE is being held in Las
Vegas and plans to keep it there
every fall.
“Vegas is a great place to have
a meeting because it’s sort of an
entertainment capital, and people
love to come there,” he said.
Event Preview
3
OT OrthoVOICE registration & information
When
Sept. 16–18. Check-in begins at 2 p.m. Thursday. The opening party will be
held that night at 6 p.m. Breakfast roundtables begin at 7 a.m. on both Friday and
Saturday.
Where
Planet Hollywood Hotel and Casino, 3667 Las Vegas Blvd. South, Las Vegas,
89109
Registration
To register for OrthoVOICE, go online to www.orthovoice.com. Orthodontists
and staff members are $250 each and residents are $200. To make reservations at
Planet Hollywood, call (877) 244-9474.
Registration includes admission to all lectures during the event, admission into
the opening party Thursday and the cocktail party Friday and food/beverage service at four breaks daily on Friday and Saturday.
“It’s also nice to have stability
and have a meeting in one place
every year, so if someone can’t
make it to the AAO one year, they
know they will have this nice alternative.” OT
AD
[4] =>
4
Trends
Fig. 1a
Ortho Tribune | August Supplement
Fig. 1b
Figs. 1a, 1b: The uprighting of a second molar with simultaneous reshaping
of the dental arch. The problem is clearly visible in the X-ray. The uprighting
spring is fixed to a miniscrew
Fig. 2a
Fig. 1c
Fig. 1d
Fig. 1c, 1d: Status after five months without reactivation of the arch section.
Fig. 2: The uprighting spring fixed to the main arch not only affects the
molars, but also causes displacement of the premolars (loss of anchorage).
Fig. 3b
Fig. 3a
Fig. 3c
Figs. 3a–c: The alignment of a displaced canine using a miniscrew. After the canines have been exposed, they are attached to a bracket by means of a
miniscrew (a). After removal of the screw, the dental arch can be reshaped using a conventional technique (b, c).
f OT page 1
At the same time, a second force
element can be applied with the aid
of a miniscrew and an uprighting
spring (Figs. 1b–d). This avoids the
loss of anchorage that inevitably
occurs when only an uprighting
spring is fixed to the multi-bracket
appliance (Fig. 2).
The straightening of an individual tooth may become necessary
for periodontological, prosthetic
or orthodontic reasons. This is a
very simple procedure if a mini
screw and uprighting spring are
used and the appliance remains
invisible to the observer. The
tooth need only be fitted with an
appropriate attachment system
that makes it possible to fix this
to the uprighting spring.
Depending on how the spring is
set, it is even possible to achieve
intrusion or extrusion of the
tooth. This form of treatment is
inexpensive for the patient and
the orthodontist will find it highly
effective.
Alignment of retinated teeth
The alignment of retained or displaced teeth, particularly in the case
of canines, is one of the most common forms of surgical intervention
in the field of orthodontic techniques. Numerous appliances are
available — rubber bands, springs,
orthodontic chains — that are effective to a greater or lesser extent.
All these mechanisms have the
Fig. 4a
Fig. 4b
Fig. 4c
Figs. 4a–c: Obtaining additional transverse space by means of ‘hybrid RPE.’ The initial diagnosis is an asymmetrical
narrow jaw with insufficient space for tooth 13 (a). After fixture of the brackets, two miniscrews (OrthoEasy) were
inserted during the same session (b). The hybrid RPE appliance was attached to the miniscrews and molar bands
using laboratory abutments (FORESTADENT; c).
same underlying problem: the
neighboring teeth must be used —
directly or indirectly — to provide
an anchorage so that the required
traction forces can be applied.
Ideally, the neighboring teeth will
offer the greater resistance so that
only the retained tooth moves. Realistically, however, both components
tend to move toward each other.
In the worst-case scenario, only
the group providing anchorage is
displaced from its original position.
This can occur if there is ankylosis
of the retinated tooth, something
that is difficult to evaluate during
initial examination.
If an attempt is made to move
an ankylosed canine toward insufficient dental anchorage, the result
will be the worst-case scenario.
This can lead to an open bite in
the region of the anterior teeth and
premolars.
Fig. 4d
Fig. 4e
Figs. 4d, 4e: The diastema shows the effect of the appliance after 10 days’
use (d). Status after transverse expansion and concurrent reshaping of the
dental arch (e).
Miniscrews provide the definitive
form of anchorage for the alignment
of displaced teeth (Figs. 3a–c). If
sufficient space is available, brackets will not be needed in the initial
phase of treatment.
Skeletal adjustments: palatine
suture expansion
Rapid palatal expansion (RPE)
is one of the most effective and
g OT page 6
[5] =>
[6] =>
6
Trends
Ortho Tribune | August Supplement
Fig. 6a
Fig. 6b
Figs. 6a, 6b: Bilateral cross-bite in a 7-year-old boy (a). X-ray of the hybrid
RPE appliance in situ (b).
Fig. 5: The hybrid RPE appliance with adjuvant anterior hooks for the
attachment of a Delaire mask.
f OT page 4
stable methods of acquiring more
transverse space in the upper
jaw. The targeted screw rate
should be in the range of 0.2 to
0.6 mm/day.
As a rule, the appliance is fixed
by means of bands to the molars and
premolars. The desired transverse
width can generally be achieved
within 10 to 20 days. Thereafter,
a three-month stabilization phase
should be observed, in order to
allow ossification of the ruptured
palatine suture.
The standard anchorage technique — with dental support only
— has several disadvantages. The
most significant is the risk of tipping
the anchor teeth.
Many appliances have been
described that distribute the
force over more than one tooth.
A further problem is apparent here: as it is necessary to
leave the appliance in place for
a longer period after the active
phase, it is only possible to com-
Fig. 8a
mence further corrective treatment for teeth in the anterior
region.
It is possible to overcome
these problems by using the
hybrid RPE (Figs. 4–6).
Bands are employed as usual in
the molar region. In the anterior
region, the RPE appliance is fixed
using two miniscrews. These should
be placed on a notional transverse
line connecting the canine/premolar contact points paramedially.
Distraction is achieved using the
same method as in standard techniques.
There are several advantages
to hybrid RPE. Preparation of the
apparatus is much simpler and
cheaper, whilst the dental arch,
including the premolars, is accessible for additional tooth correction
measures.
Class II corrections
In the case of patients with Class II
malocclusion who have completed
or are near completing their growth
g OT page 8
Fig. 6c
Fig. 6c
Fig. 6c, 6d: Status after 10 days’ use: cross-bite has disappeared and vertical
bite has remained stable (c, d).
Fig. 7a
Fig. 7b
Fig. 7c
Fig. 7d
Figs. 7a–d: Anchorage of the canine using a miniscrew avoids protrusion of
the anterior teeth when using a fixed Class II correction appliance (here:
Williams appliance, FORESTADENT).
Fig. 8b
Figs. 8a, 8b: The miniscrew stabilizes the position of the molars to which the Kinzinger FMA is attached. This counteracts any protrusion of the premolars
and anterior teeth (a). Class I dental status on completion of treatment (b).
[7] =>
[8] =>
8
Trends
f OT page 6
phase, simple techniques for the
forward positioning of the lower jaw
are usually ineffective.
Following a thorough initial
examination and diagnosis, there
are three possible therapeutic
approaches: camouflage, fixed
Class II correctional appliances
(Herbst splint, Sabbagh Universal
Spring, FMA, Jasper Jumper, etc.)
or orthognathic surgery.
The patient must be informed of
the advantages and disadvantages
of each approach.
All fixed Class II correctional
appliances — irrespective of whether these use the Herbst splint or
canted plane principle — have the
same problem and the same undesirable side effects. There is a risk
of protrusion of the lower frontal teeth and/or distalization of the
upper molars.
By means of passive stabilization with the aid of two miniscrews
(Figs. 7, 8), these effects can be
readily avoided.
Orthognathic surgery
After surgical intervention to relocate or reposition the jaw (for orthodontic or traumatological reasons), it is important to maintain
a stable correlation between the
bone fragments and the jaw in the
postoperative phase.
This promotes healing and prevents relapse.
The occlusion appliance is fixed
intraorally, using intermaxilliary
elastic or wire ligatures, depending on the situation. It is essential
to use the appropriate fixing
options, whether this is a splint
(Schuchardt splint) or a multibracket appliance.
Where these are really only
needed in one jaw or jaw section,
the question arises of whether,
in the era of the miniscrew, it is
necessary to involve the other jaw
in the stabilization of the surgical
effect.
If
miniscrews
are
used
in the opposing jaw (Fig. 9), the
same effect is achieved — but with
considerably less restriction from
the point of view of the patient.
Pre-prosthetics
It is the aim of pre-prosthetic
orthodontics to position the teeth
optimally for the subsequent prosthesis. This can include intrusion,
uprighting and the opening or closing of gaps amongst other techniques.
Send
us your
case
study!
Ortho Tribune | August Supplement
As this series and many other
publications have already shown,
miniscrews are particularly useful
in this context. Miniscrews can also
be used as anchoring elements for
a provisional prosthesis.
Where teeth are missing (particularly the second canines, Fig. 10a)
and the growth phase is not yet
completed, the fitting of an intermediate prosthesis is problematic.
As an alternative, particularly where additional anchorage is
required, miniscrews can be used.
A longer screw (8 or 10 mm) can be
inserted in the center of the dental
ridge (Fig. 10b).
There should be at least 1 mm of
bone to the mesial and distal sides
of the miniscrew.
The hole for the insertion of a
miniscrew (1.6 mm) should thus
be at least 2.6 mm. A provisional
crown can then be mounted onto
the head of the miniscrew. If necessary, a bracket can be fixed to this
crown (Fig. 10c).
Outlook
The clinical use of miniscrews supports a wide range of tasks. Dental repositioning that was previously deemed impossible becomes
achievable, whilst possible repositioning techniques are improved
and supported.
In order to achieve this, miniscrews alone are not sufficient; an
appropriate range of equipment is
also necessary.
Several suppliers of miniscrews
offer, in addition to screws and
insertion tools, a number of devices
that facilitate the use of miniscrews.
The fifth part of this series will
focus on the wide range of useful
auxiliaries that are available. OT
Fig. 9: The use of miniscrews to attach intermaxillary rubber traction bands
means that no other attachments to the teeth are necessary.
Fig. 10a
(Editorial note: A complete list
of references is available from the
publisher. This article first appeared
in Dental Tribune Asia Pacific, Vol.
7, No. 5, 2009. The next edition of
Ortho Tribune will feature “Part V
— Therapeutic auxiliary elements.”
All photos were provided by the
authors.)
OT Contact
Dr. Björn Ludwig
Am Bahnhof 54
56841 Traben-Trarbach
Germany
Phone: +49 (654) 181-8381
Fax: +49 (654) 181-8394
E-mail:
bludwig@kieferorthopaedie-mosel.de
Have an interesting ortho case you would like to
share with your peers? To have your case study
considered for publication in Ortho Tribune, send
your 800- to 1,200-word case study and up to 12
high-resolution photos to Managing Editor Kristine
Colker at k.colker@dental-tribune.com. Authors will
be notified of publication and have an opportunity
to review the designed case study prior to final
publication. Cases will be published pending editor
approval and space availablility.
Fig. 10b
Fig. 10c
Fig. 10d
Figs. 10a–d: Missing tooth #12 is to be replaced by an implantbased crown. The initial phase of treatment involves widening the
gap (a). The head of the vertically inserted OrthoEasy screw (b,c)
is used to anchor a provisional crown (including bracket), which
serves to widen the gap further (d).
[9] =>
Practice Matters
Ortho Tribune | August Supplement
9
Proven strategies for ortho growth
By Roger P. Levin, DDS
D
eclines in ortho production are
still a reality for many orthodontists across the country.
Research from a first quarter ADA
2010 survey shows 44 percent of
orthodontists reporting lower net
income, 37 percent reporting lower
gross billings and 41 percent with
lower numbers of new patients.
These results should come as no
surprise to orthodontists.
From the patients’ perspective, orthodontics is increasingly
viewed as a commodity. Competition increases every day. Recent
advances, such as Invisalign®, have
increased competition even more.
There is no evidence to suggest this
scenario will change anytime soon.
Yet, despite all of these potential
obstacles, Levin Group ortho practices continue to grow by:
• Encouraging patient referrals
through superior customer service,
• Turning occasional referring
dentists into frequent referring
dentists.
What is superior customer
service?
The ortho practice needs to make
certain it provides truly excellent
customer service to ensure patients
or parents would find it odd to even
consider going elsewhere when
another family member needs ortho
treatment.
“WOWing” your patients requires
having the right systems in place.
To do so, you should follow these
steps:
• Establish operating procedures
for customer service that every
patient will experience.
• Survey your patients regularly to
determine their satisfaction levels.
• Ask your referring dentists how
they view customer service in
your practice.
• Develop a system to handle any
patient/parent concerns or complaints quickly and in a manner
that achieves total patient satisfaction.
How do occasional referrers
become frequent referrers?
Every ortho practice has one or two
top referrers who contribute the
bulk of referrals. However, if you
lose one of these referring dentists,
an extraordinary amount of revenue
— possibly hundreds of thousands
of dollars over time — could be lost.
Diversifying your referral sources begins by:
• Determining who refers
• Analyzing how many patients
each of them refers
• Customizing marketing strategies to effectively get GPs to refer
more patients
• Subsequently tracking each strategy for effectiveness and then
making adjustments as needed
OT About the author
An effective referral marketing
program will foster better relationships, generate more referrals and
subsequently reduce or reverse the
noticeable declines many orthodontists have experienced.
Conclusion
Now is not the time to adopt diminished expectations. Remember that
ortho practices have incredible
potential. By upgrading your customer service and referral marketing systems, ortho practices can
grow exponentially.
To jumpstart practice growth,
experience Dr. Roger Levin’s next
Total Ortho Success™ Seminar from
Oct. 28–29 in Orlando. Ortho Tribune
readers are entitled to receive a 20
percent courtesy. To receive this, call
Dr. Roger P. Levin is chairman
and chief executive officer of Levin
Group, the leading orthodontic practice management firm. Levin Group
provides Total Ortho Success™, the
premier comprehensive consulting
solution for lifetime success to orthodontists in the United States and
around the world. Levin Group may
be reached at (888) 973-0000 and
customerservice@levingroup.com.
(888) 973-0000 and mention “Ortho
Tribune” or e-mail customerservice@
levingroup.com with “Ortho Tribune
Courtesy” in the subject line. OT
AD
[10] =>
10
Practice Matters
Ortho Tribune | August Supplement
Defining a profitable office
By Scarlett Thomas, President of Orthodontic
Management Solutions
T
he most profitable way to run
the business side of your orthodontic practice is to understand, define and know what your
break-even number is for your
business. Many orthodontists try to
operate the business side of their
practice on intuition: “I think we did
really well this month,” “It feels like
we started a ton of patients,” “The
checking account looks good, our
starts must be great.”
Intuition does not provide
feedback of real data for making
knowledgeable decisions. Profits
AD
in a practice can greatly increase
when the clinician has the ability to
understand the business numbers,
particularly the practice’s breakeven point, and can monitor these
numbers with a system to keep the
team and practice on course.
• Salary expenses
• Loan payments
• Increase in staff labor costs such
as raises, benefits and skill levels
• Capital improvements such as
equipment and office remodeling
The break-even number
Profits in an orthodontic practice
depend directly on four numbers:
the break-even point, production,
collection and overhead expenses.
From the break-even point number, production and collection goal
numbers and a budget for the practice can be calculated.
Defining, monitoring and controlling all of these numbers each
The break-even number is the first
and most important number an
orthodontist and his staff should
know. The break-even point number should provide enough revenue
to meet the following goals:
• Clinician income
• Retirement contributions
• Overhead expenses
The four keys to success
month will more likely result in the
desired profits for the practice.
The game plan
1. The break-even point must be
calculated and defined.
2. The orthodontist must determine
what the practice will need to produce and collect each month to
meet the break-even point number. The production goal must be
defined and divided among the
producers in the office. This is
generally by the number of new
patient exams, records and starts.
3. The scheduling coordinator must
schedule all producers’ days to
meet their individual production
goals. It is important to remember
that cancellations and changes in
the schedule affect how much the
orthodontist, the treatment coordinator and other staff members
may be able to produce each day.
4. Have excellent financial arrangements and/or collection policies
in the practice. Delinquencies
should be no more than 3 percent
of your total collections.
5. The orthodontist must have a
defined budget for the overhead
expenses of a practice. The budget should be divided among
many areas: salary expenses,
clinical supplies, lab costs, marketing, etc. These budgets should
be monitored on a monthly basis.
The clinician’s profit-and-loss
statement will have the necessary
information to monitor expenses.
The entire team can help the
orthodontist control and monitor production, collection and the
expenses. Each member should
know what these numbers are, how
accountable he or she is for meeting
these numbers and how to monitor
the numbers throughout the month.
Summary
It is well worth the time and effort to
define and monitor the business
numbers discussed: break-even
point, production and collection
goals and overhead expense budgets. This maximizes profits, gives
the orthodontist and team more
control and ends the guessing game
of where you really are financially
as a business. OT
OT About the author
Scarlett Thomas
is an orthodontic
practice consultant
who has been in
the field for more
than 23 years, specializing in case
acceptance, team
building,
office
management and
marketing. Contact her at (858) 4352149, e-mail scarlett@orthoconsulting.
com or visit www.orthoconsulting.com.
[11] =>
[12] =>
12
Industry
Ortho Tribune | August Supplement
New version of imaging software allows
clinicians to capture, diagnose and plan
i-CATVision 1.9, featuring Quantum IQ image enhancement, now available
I
maging Sciences International
and Gendex Dental Systems have
introduced the next version of
software for the i-CAT™, GXCB-500™
and GXCB-500 HD™ cone-beam systems: the i-CATVision™ 1.9.
Not only has i-CATVision 1.9
retained its comprehensive yet
easy-to-use capabilities with multiple views and 3-D rendering, it
now delivers a new, owner-driven
image enhancement tool: the Quantum IQ™.
AD
Quantum IQ: image
enhancement
Exclusive to i-CATVision 1.9, the
Quantum IQ, a new, proprietary
image enhancement feature, allows
clinicians the flexibility to choose
how they want to view image detail.
Applied during the reconstruction
process, Quantum IQ delivers an
improved smoothness to overall
image clarity by yielding a more
pleasing diagnostic view of soft tissue while retaining crisp definition
around anatomical landmarks and
hard tissues. The selection of Quantum IQ or standard view allows
clinicians to focus on the details that
matter most to them.
“We are pleased to provide our
owners with features that enhance
their daily 3-D workflow and yield
the types of images that they prefer — especially when it relates to
something as important as diagnosis,” Mark Hillebrandt, director of
product management for Imaging
OT Contact
For more information on the
i-CATVision 1.9 and Quantum IQ,
call (800) 205-3570.
Sciences and Gendex, said.
Enhanced data transfer
The ability of i-CATVision 1.9 to
save and export scan data in DICOM
allows clinicians to work within
their 3-D planning software of
choice. With improvements made
to the DICOM component of this
version, corporate practices, hospitals and universities will be better
equipped to efficiently share large
amounts of information.
Time-saving quick launch
Another feature available in i-CATVision 1.9 is time-saving quick
launch integration with 3-D planning software, including Dolphin®
3D for Orthodontists, Anatomage®
Invivo5, one of the most popular
planning software programs, and
3DVR. This new tool provides faster
workflow when treatment planning
— especially important in busy
practices. OT
New products
arouse interest
during AAO
FORESTADENT presented
several products at this year’s
annual session of the American
Association of Orthodontists,
held in May in Washington, D.C.
One product on display was
BioQuick®, the third generation
of the self-ligating Quick bracket system. The most significant
feature of BioQuick is a new
base, which has been adapted to
the anatomical contour of tooth
crowns.
Another product on display
was MiniAnts, a type of bracket with a reduced width, which
complements the 2D® lingual
bracket system. Until now, twinwing brackets in the lower anterior region have had to be placed
close together because of their
width, but there is much more
space available with the mini
anteriors. This facilitates compensation bends required mainly
during the finishing phase.
[13] =>
[14] =>
14
Products
doctorseyes Ultrabright
Dental Mirror
New from Great Lakes, the doctorseyes Ultrabright Dental Mirror is
the best possible combination of reflection surface, safe handling and
comfort.
With optimum reflectivity,
doctorseyes provides highly
defined intraoral images with
true color representation.
The vaporized glass surface coating prevents ghost
image reflections and is
resistant to most acids, alkalines and chemicals.
It features rounded edges
for patient comfort and
removable silicone grip handles. Both the grip handles
and glass are autoclavable up
to 390 degrees Fahrenheit.
The doctorseyes Ultrabright Dental Mirror is available in lingual, buccal and
various occlusal sizes.
Great Lakes Ortho
product customer service
(800) 828-7626
www.greatlakesortho.com
(Photo/Provided by
Great Lakes Ortho)
AD
Ortho Tribune | August Supplement
Maestro Buccal Tube
(Photo/Provided by
Ortho Organizers)
Ortho Organizers offers classic orthodontic design with a smooth modern flare with its latest development, the Maestro™ Buccal Tube.
The Maestro Buccal Tube is a non-convertible, single tube that harmonizes traditional orthodontic designs with the needs of today’s practitioners and patients.
This design provides the precise control needed throughout all phases
of treatment for a predictable finish.
The Maestro Buccal Tube’s large funneled entrance, side grip areas
and color-coding help simplify treatment by allowing for easier identification, placement, positioning and wire insertion.
Because it has the lowest possible profile, the Maestro is able to optimize patient comfort without hindering the precision and control needed
for case completion. In addition, the 80-gauge mesh bondable pad offers
consistent and proven bond adhesion.
The ease of use associated with this product also reduces chair time,
which makes the Maestro Buccal Tube a cost-effective choice for your
practice.
Ortho Organizers, a U.S. manufacturer, is an international company in
the orthodontic market, providing a wide range of products, educational
courses and practice-building programs. The company combines experience with the most current technological advancements, including stateof-the-art metal-injection molding (MIM) technology to manufacture a
full line of orthodontic products.
Ortho Organizers
(800) 547-2000
www.orthoorganizers.com
Boyd gaming bar
Boyd Industries, the leading
manufacturer of dental specialty equipment, has recently introduced a new gaming
option for orthodontists to
entertain their patients.
Boyd has introduced a gaming bar concept that features
the Sony PSP or Apple iTouch
gaming platforms.
The gaming bar/counter
has been designed to offer a
maximum number of gaming
stations in a space-efficient
manner. There are a variety of
laminates, shapes and lengths
available.
(Photo/Provided by Boyd Industries)
Boyd E2 (Entertaining
Environments) gaming options
Phone: (800) 255-2693
www.boydindustries.com
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Table of contents
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Miniscrews: a focal point in practice (Continued on page 3)
01 - 01
view
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What does it mean to be scholarly?
02 - 02
view
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Miniscrews: a focal point in practice
03 - 08
view
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Proven strategies for ortho growth
09 - 09
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Defining a profitable office
10 - 10
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New version of imaging software allows clinicians to capture - diagnose and plan
12 - 12
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Products
14 - 14
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[toc_titles] => Miniscrews: a focal point in practice (Continued on page 3)
/ What does it mean to be scholarly?
/ Miniscrews: a focal point in practice
/ Proven strategies for ortho growth
/ Defining a profitable office
/ New version of imaging software allows clinicians to capture - diagnose and plan
/ Products
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