Ortho Tribune U.S. No. 1, 2013

State and regional board examinations of dental students / Teaching residents to act morally in the presence of risk / Impact of automated patient appointment reminders on orthodontic practice no-shows / Imaging Sciences debuts new i-CAT FLX / Industry

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

spring 2013 — Vol. 8, No. 1

www.ortho-tribune.com

State and regional
board examinations
of dental students
Rating
performance,
ethics and
professionalism

By Jaclyn Kostelac and Nicole Ranney,
third-year dental students,
Ostrow School of Dentistry,
University of Southern California

Abstract

By Jonathan Shouhed,
fourth-year dental student,
Ostrow School of Dentistry,
University of Southern California

State and regional board examiners detail the requirements and percentage value for caries
preparation form, restoration anatomy and integrity and the maximum length of time
allowed to complete any procedure in order to achieve a passing grade. Photo/www.sxc.hu

Dental Tribune America
116 West 23rd Street
Suite #500
New York, N.Y. 10011

o dental students treat patients holistically and humanely during dental competency examinations? As
student dentists progress through their
education, clinical skills are learned and
then challenged during competency and
licensure exams to make certain that
the student is prepared to practice dentistry independently.
State and regional board examiners
detail the requirements and percentage value for caries preparation form,
restoration anatomy and integrity and
the maximum length of time allowed
to complete any procedure (including

Studying oral
health in the
United States
vs. foreign
countries

periodontal, endodontic and operative
treatment) in order to achieve a passing
grade. Unfortunately, the emphasis on
ethical and professional behavior during
these exams is far less specific.
Beauchamp and Childress (2001) agree
that dentists fulfill the criteria of professionals because they are specially
trained and licensed, and they are committed to the provision of important
health care services to their patients.
As Tartakow (2010, p. 96) reported “Certosimo cited five principles of ADA codes
that included: non-malfeasance, beneficence, justice, veracity, and patient autonomy, [suggesting] that these were the
obligations for all health-care providers
to make available in order to address the
needs of patients and the profession.”
As defined by Rule and Veatch (2004,
p. 45–46), patient autonomy, or the “pa” See EXAMINATIONS, page 4

The aim of this study was to compare
the oral health status of underserved
individuals in the United States with
underserved individuals in two other
countries, Colombia and Kenya. Each
year, dental students from the Ostrow School of Dentistry of University
of Southern California (USC), Dental
Humanitarian Outreach Program
(DHOP) travel overseas to countries
where residents with untreated dental problems have no access to dental
care. The 2011 and 2012 locations visited were Cartagena, Colombia, and
Nairobi, Kenya; both are considered
third-world countries.
Inhabitants in these locations were
compared to Los Angeles residents
who also had untreated dental problems with no access to dental care.
All patients at each of the three dental clinic locations were treatment
planned by student dentists, obtaining approval for proceeding with dental care from USC dental school volunteer faculty.
Once formal and appropriate data
were collected, specific dental needs
were determined as low, moderate or
severe. Dental treatment was limited
to prophylaxis, restorative treatment
and extractions. Final analysis of dental care from each of the three clinics showed that the individuals from
both third-world communities as well
as Los Angeles had varying degrees of
dental needs. Regardless of whether
patients treated lived in third-world
countries or in the United States, their
needs for dental care were emergent
and crucial to bettering their general
and oral health condition.

Introduction
The DHOP dental students travel overseas each year to countries where residents are underserved with respect to
their dental needs. Dental treatment
and procedures completed included
(a) periodontal cleanings; (b) restorative dentistry, i.e., caries cleanout
followed by amalgam or composite” See FOREIGN, page 4

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From the Editor

Ortho Tribune U.S. Edition | spring 2013

Teaching residents
to act morally in
the presence of risk
By Dennis J. Tartakow,
DMD, MEd, EdD, PhD, Editor in Chief

As Rushworth Kidder (2006) suggested, moral courage bridges talking
ethically and performing ethically. Although Kidder’s book is meant for everyone, it is a must for physicians and
dentists.
Performing ethically is not always
easy and is therefore important to be
stressed during formal educational programs. Dental students must recognize
that moral courage is frequently needed
to address ethical issues in order to take
action for doing the right thing when
questionable issues arise with patients
that place the clinician in an uncomfortable position.
Health-care professionals often face
complex ethical dilemmas in the workplace; some clinicians tackle ethical issues directly while others turn away. Regardless of whether a doctor is involved
with private clinical practice, education,
research or administration, they are not
immune to facing moral dilemmas or
experiencing unethical behavior. Moral
courage takes into account the principles of ethics and the courage to act accordingly. Courage is not the absence of
fear…it is doing what’s right even in the
presence of fear.
Educators and scholars have disputed
the diverse meaning of moral courage
over the centuries. Ancient Greek philosophers Plato and Aristotle repeatedly
used this term in reference to character
on the battlefield, discussing courage
as a trait set aside for situations where
individuals feared death. Aristotle specifically discussed moral courage in the
context of being able to wage war while
being mindful of the possibility of injury or death. To Aristotle, bravery was
a virtue that enabled Greek soldiers to

respond appropriately to the fear of the
battle.
How a doctor responds to ethical dilemmas depends on his or her (a) previous experiences with unethical behavior, (b) individual personality traits, (c)
moral values, and (d) knowledge of social
justice principles, for which moral courage is needed to confront unethical behaviors. As a result of cost control procedures, inadequate staff levels, shortage
of clinicians in some areas delivering
patient care, merging of health-care organizations and ineffective leadership,
there is an increase of ethical dilemmas
in the health-care milieu today and it directly affects all doctors.
The AAO’s Principles of Ethics and
Professional Code of Conduct, Section
VI, states, “Members may exercise discretion in selecting a patient into their
practice, provided they shall not refuse
to accept the patient because of the patient’s race, creed, color, sex, national
origin, disability, HIV seropositive status or other legally recognized protected
class.”
Although dental schools and hospital
clinics often accept fee reimbursement
from federal funding, most private
practitioners do not. It is considered
discriminatory for a dental school or
hospital faculty to reject a patient based
on a disability, even though a “contract”
between the clinic and the patient at a
screening evaluation might not yet have
been established.
It would also be unwise to refuse a patient from your private practice if the
reason is based on discrimination, including any of the reasons listed in the
AAO’s Principles of Ethics and Professional Code of Conduct.
Even though there is no universally
accepted Hippocratic oath for dentists,
it should be stressed to our dental students that they must adhere to affirmations such as:
• I may not always do what’s right, but I
will always try to do what’s right.
• It is sometimes hard to do the right
thing and sometimes hard to know what
the right thing is, but once you know
what that is, do it!
A temperamental tolerance of courage over timidity is needed when facing
risk management issues. The tenets of
decision-making are related to ethics and social justice principles, which
directly begs the clinician’s ability to

‘Even though there is no universally accepted Hippocratic
oath for dentists, it should be stressed to our dental
students that they must adhere to affirmations ...’

serve the (a) individual, and (b) community (educational services, outreach programs, welfare agencies, public service,
etc.), are risk management issues (Walzer, 1983). Such concerns are becoming
increasingly more critical for the profession as well as society.
According to Wren (1995), “Since the
function of leadership is to produce
change, setting the direction of that
change is fundamental to leadership.”
Setting direction and planning are two
separated activities — activities that coincide with teaching and which directly
relate to teaching our dental students
how to ethically and morally cope with
adversity and risk.

References
1)
2)

Kidder, R. (2006). Moral courage. HarlerCollins Publishers, New York, NY.
Walzer, M. (1983). Spheres of justice: A defense of pluralism and equality. New York:
Basic Books.
Wren, J. (Ed.). (1995). The leader’s companion. New York: Free Press.

ORTHO TRIBUNE
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Torsten Oemus t.oemus@dental-tribune.com
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Eric Seid e.seid@dental-tribune.com
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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 ORTHO Tribune
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Phone (212) 244-7181
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Published by Tribune America
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All rights reserved.
Tribune America strives to maintain the utmost accuracy in its news and clinical reports. If you find a
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Tribune America cannot assume responsibility for
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Editorial Board

Image courtesy of Dr. Earl Broker.

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 Sierra Rendon at
s.rendon@dental-tribune .com.

Tell us what you think!
Do you have general comments or criticism you
would like to share? Is there a particular topic
you would like to see articles about in Ortho
Tribune? Let us know by emailing feedback@
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Jay Bowman, DMD, MSD (Journalism & Education)
Robert Boyd, DDS, MEd (Periodontics & Education)
Earl Broker, DDS (T.M.D. & Orofacial Pain)
Tarek El-Bialy, 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

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Ortho Tribune U.S. Edition | WINTER 2012

CLINICAL

3

[4] =>

4
“ EXAMINATIONS, Page 1
tient’s right to make decisions based on
his or her own values, principles or ideals,” can only be upheld if “the healthcare provider respects the patient’s rights
to be adequately informed and acts accordingly.” Rule and Veatch persisted
that the principle of justice delineates
the intrinsic worth and certain rights
that every person possesses and that others are obliged to respect, signifying that
no one patient deserves any more or less
comprehensive treatment than another.
This ideology works in concert with
the principle of veracity, which according to the AMA (Rule and Veatch, 2004)
urges an individual to act honestly and
without concealment regardless of benefit produced or harm encountered.
These principles of social justice create a
unique environment of honesty and respect in which fair treatment of patients
is contextualized.
During dental competency examinations such as state boards, circumstances
arise that can jeopardize these principles
of practice. Through personal experiences and witnessed accounts of misconduct
during practical exams, it is clear that
ethics violations occur when a student is
not mindful of his or her responsibility
as a professional.
For example, the WREB Candidate
Guide outlines the assessment of point
deductions if a student fails to finish the
procedure in the allotted time; completion more than 15 minutes late garners
a score of “0.” As a result, student doctors may use improper isolation, etching time and instrumentation as ways
to complete exams when time becomes
limited. They may also ask patients to
limit questions regarding the treatment
being received during the appointment,
failing to follow proper protocol regarding informed consent in an effort to gain
more “working” time. Under these circumstances substandard care can occur.
This quandary, though, is not the only
ethical gray-area on test day.
During the preparation and restoration evaluations, evaluators must review
students’ work and may lower a score for
any technical errors found during these
checkpoints. This risk of losing valuable points can bring about the fear of
forthright communication, which would
directly result in error detection. For in-

“ FOREIGN, Page 1
resin restorations; and (c) oral surgery for
patients with unrestorable teeth. The 2011
and 2012 abroad clinic locations visited
were Cartagena, Colombia, and Nairobi,
Kenya. Both cities were considered to be
third-world populations and the patients
treated resided in slum areas within these
cities. A review of the literature verified
that dental needs in third-world countries
were more extreme than those found
within the United States (Nunn et al.,
2008). This study was conducted to evaluate and compare the oral health status of
individuals from the following three locations: Cartagena, Colombia; Nairobi, Kenya; and Los Angeles.

Materials and methods
Data were gathered from clinics in three
countries: Colombia, Kenya and the United States. All patients at each of the three

research

stance, a student may be aware of a void
in a composite restoration or an open
margin on a provisional crown, but fail to
present this to an evaluator. A sub-marginal restoration can be “corrected” by
removing sound tooth structure or being
“built-up” with adhesive resin.
Concealment of errors even becomes
a risk as a student can instruct a patient
to “tap lightly” when occlusion is being
checked. These examples encompass
the inherent conflict of interests involving the student’s desire to pass an exam
and his or her obligatory honesty to the
patient and the examination process itself, thus endangering ethical boundaries that are vital to the concept of being
a professional.
While these examples may present
complex scenarios, the response should
not be to eliminate time constraints during exams or the examination process as
a whole. Instead, ethical virtue can be assured on exam day with proper planning
and execution. For example, by explaining the risks and benefits of treatment
to patients during a prior appointment,
with full access to descriptions of the
procedure, a patient’s true informed consent can be gained without pressure to
do so during an exam. A patient’s rights
to autonomy and making informed decisions are unalienable. No amount of time
saved or advantage gained by a student
justifies the failure to deliver a patient
these basic rights.
A student must show preparation and
confidence in clinical skills during an
exam but must not attempt a competency exam for which he or she is unqualified. Proper case selection is vital
to this concept. An example of this is the
attempt of a potential graduate to complete a gold complete veneer crown preparation on a second molar with no distal
contact and a gingival overgrowth in the
area for a test.
Independent of skill and experience, a
satisfactory crown preparation, gingival
reduction, final impression and provisional restoration fabrication would be
an ambitious task for any dental student to complete in a single appointment and brings about the potential for:
(1) excessive patient discomfort, (2) poor
treatment execution and (3) irreversible tissue and pulpal trauma. Had this
patient’s treatment needs been assessed
for clinical exam appropriateness with

city locations were treatment planned by
student dentists, obtaining approval for
proceeding with dental care from USC
dental school volunteer faculty.
After oral examination and radiographic screening, data were collected; the need
and priority for specific dental care was determined. Periodontal health was assessed
from levels of (a) plaque, (b) calculus and
(c) inflammation and measured as low,
moderate or severe. USC student dentists
and faculty assessed inflammation levels
as either localized (< 30 percent) or generalized (> 30 percent). Bone level and gingival attachment were measured to finalize
each patient’s periodontal diagnosis.
The severity of decay and restorability
of teeth were also evaluated. Dental treatment was limited to (a) scaling and root
planing, (b) restorative treatment, and (c)
tooth extractions due to constraints such
as time, financial resources and volume of
patients.

a faculty member prior to test day, the
student may have been advised against
performing a procedure that is not in the
best interest of the patient. In addition to
procedural responsibility, there are also
personal obligations of the student doctor to professional behavior that protect
the patient.
Above all other extrinsic factors, a student must value and protect his or her
integrity as a doctor. He or she should always portray this decorum; that is, to pass
exams based on merit and capability, not
good fortune and concealment. The honesty with which doctors act engenders a
trust between patient and doctor; honesty that has not been corrupted by selfishness and self-interest, the way Allan
Bloom (1987) suggested modern honesty
has, is central to this trust. Bloom’s argument for a review of contemporary “honesty” during a time in which moral code
is being eroded by knowledge of popular
greed, is of particular importance to the
medical field: a doctor’s commitment to
selflessness displays profound strength
of character, and makes him or her worthy of total trust.
Continuing this tradition is pivotal to
the esteemed reputation doctors possess. Dharamsi et al. posited “dental and
postgraduate residency programs must
develop curricula with social justice and
social responsibility as topics for educational training” (Tartakow, 2010, p. 87).
These ethical standards should be applied to the test taking process in order to
prove true proficiency in the principles of
medical and dental practice.
Brown opined that “only through critical reflection, lucid dialogue, and strategic praxis can programs be set into practice for future leaders regarding ethics,
social justice, and the equity to grow in
awareness and action” (Tartakow, 2010,
p. 92). Presently, a disconnect exists between the values of the medical profession and the standards to which students
are held during performance examinations. Standards such as close attentiveness to others and procedural fairness,
for example, have been lost in the student dentist’s overwhelming desire to
pass a competency exam. It is this disconnect that brings about the potential
for patient mistreatment.
If students place personal interests
aside, as contemporary bioethical standards demand, the implementation of

Results
Data analysis from each of the three dental clinics showed that individuals in
underserved, third-world communities
had varying degrees of dental needs, but
greater than did U.S. citizens. Data were
collected from 490 patients in Colombia,
187 patients in Kenya and 110 patients in
the United States.
Periodontal health and restorative
needs were the most impacted variables.
Poor access to care and financial restraints
were two primary restrictions for achieving optimal oral health. Overall dental
care data indicated the following extent of
needs: (a) moderate to severe in Cartagena,
Colombia; (b) severe in Nairobi, Kenya; and
(c) low to moderate in Los Angeles.
Need for dental care was measured
based on the following parameters:
• Low: Prophylaxis treatment and no
carious teeth

Ortho Tribune U.S. Edition | spring 2013

ethical standards during exams can begin; the use of substandard practices during exams could then subsequently end.
In accordance with Brown, critical reflection, lucid dialogue and strategic praxis
is interpreted to mean that patient wellbeing must become a priority to student
doctors during exams and in the future
as a practicing professionals. After all, including morality, humanity and ethics in
a dental student’s education is not an option. It must be highlighted and emphasized throughout the four years, as a professional education cannot be considered
complete without it.

References
1)

Beauchamp, T.L. & Childress, J.F. (2001).
Principles of biomedical ethics (5th ed.).
New York City, N.Y.: Oxford University
Press, 57–103.
Bloom, A. (1987). The closing of the American mind. New York City, N.Y.: Simon and
Schuster Inc, 185–187.
Rule, J.T. & Veatch, R.M. (2004). Ethical
questions in dentistry (2nd ed.). Chicago:
Quintessence Publishing Co, 51–63.
Tartakow, D.J. (2010). An analysis of factors
that align with faculty vacancies in orthodontic education. Doctoral Dissertation,
ProQuest Information and Learning Company, Ann Arbor, Mich. (UMI No. 3438516).
Western Regional Examination Board.
(2012). Dental Exam Candidate Guide.
Phoenix, Ariz.

About the author
Jonathan

Shouhed

was born and raised in
Los Angeles, California as the youngest of
three brothers. After
receiving his bachelor
of arts in political science at the University
of California, Los Angeles (UCLA), he has
continued to pursue
his education at the Ostrow School of Dentistry of
USC as a candidate for doctor of dental surgery.
While remaining engaged as a student and teacher
at both UCLA and USC, Shouhed also enjoys active
hobbies such as golfing and coaching in a young
men’s basketball league. In the future, he hopes to
continue his work as an educator and researcher.
For any additional information regarding this article, contact Shouhed at jshouhed7463@gmail.com.

• Moderate: Prophylaxis treatment and
1-3 carious teeth
• High: Prophylaxis treatment, three or
more carious teeth and/or one or more
unrestorable teeth due to caries or infection

Discussion
Proportionally, more prophylaxes than
restorative treatments were completed
in Cartagena, suggesting that many patients had previous dental treatment and/
or better oral hygiene. In Kenya, dental
prophylaxis and restorative treatments
were found to be equal, with no patient
records of previous dental treatment. The
decreased numbers of patients treated in
Kenya compared to Colombia were affected by (a) limited power supply, (b) supply
arrival delays and (c) time allotted to treating each patient as a result of the severity
” See FOREIGN, page 14

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Ortho Tribune U.S. Edition | WINTER 2012

CLINICAL

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Industry
pr actice
matters

Ortho Tribune U.S. Edition | spring 2013

Impact of automated patient appointment
reminders on orthodontic practice no-shows
By Diana P. Friedman, MA, MBA, and
Tim Williams, BA, MS

The internet age has dramatically altered communication patterns. Face-toface interchanges continue to give way
to digital message exchanges. Channels
for these digital communications have
rapidly morphed and expanded over the
past years toward a faster, more interactive means of exchange.
This is the reality that faces orthodontic
practices — interaction with current and
prospective patients will predominately
take place online. In order to maintain
a productive level of engagement, orthodontic practices have to identify effective ways to leverage these new channels
of communications. Patient engagement
not only drives retention, but new patient
acquisition — two cornerstones of a profitable practice. Research has consistently
shown patients welcome the adoption of
digital interchanges.
A national research study by Sesame
Communications documented that 92
percent of orthodontic patients stated
they find it more convenient to find answers online rather calling the practice.
The same study found that orthodontic
patients prefer SMS text and email reminders over phone reminders four to
one.

Automated appointment reminders
Sesame Communications pioneered the
first automated appointment reminder
system for dentistry in 1999. Automated
patient reminders enable the practice
to confirm scheduled appointments via
email, text messages or automated voice
reminders.
Sophisticated patient portals let patients define their preferred method of
contact. This type of service not only provides a great convenience and benefit to
patients, it can dramatically improve efficiencies for the practice.
Increased production is at the epicenter
of a practice’s financial performance, impacting cost structure, revenue flow, and
ultimately, profitability. Appointment
no-shows have a devastating impact on
practice financial performance. In a 2012
national research study, 20 percent of
orthodontists stated their top need was
to reduce no-shows in the practice. Automated reminders have the potential
to cost effectively and efficiently address
this need.
Research shows that today almost 70
percent of orthodontic practices have
some form of automated appointment
reminder solution. However, until recently there has been very limited research to
document the impact these solutions on
no-show rates and practice production.
With advanced systems costing $300 per
month on average, the Return on Investment (ROI) justification for this investment has, to date, been a challenge.

New practice production study
Sesame Communications recently an-

A national research study by Sesame Communcations found that orthodontic patients prefer text and email reminders over phone reminders
four to one. Photo/www.sxc.hu

Appointment show rate percentages pre- and post-automated
appointment reminder activation

About the authors
Diana P. Friedman,
MA, MBA, is
president and
chief
executive officer
of Sesame
Communications.
She has a 20-year
success track
record in leading
dental innovation
and marketing.
Throughout her
career, Friedman
has served as a recognized practice management consultant, author and speaker. She holds
a master’s in sociology and an MBA from

nounced the results of a breakthrough
study measuring the impact of automated patient appointment reminders
on practice production. The study analyzed five years of performance data and
tracked the detailed confirmation and
patient attendance rates on 19,773,041 appointments across 427 practices.
The study tracked no-show rate changes, both pre and post-implementation, of
automated appointment reminders.
The study found that orthodontic practice no-shows were reduced by 21.83 percent.
The financial implication of schedule
compliance is significant. This research
documented $105,322 in incremental
production for orthodontic practices due
to schedule compliance — revenue that
would otherwise be lost. The benefits of
practice production improvements continued throughout the 36 month postactivation period.

The data clearly demonstrates a positive productivity impact when integrating automated patient appointment reminders into the practice. First-year fees
for this service should be recovered within the first six months post-activation.
Additionally, time previously used by the
administrative team on confirmations
can now leveraged to build relations with
patients, market the practice and activate
patients.

Conclusion
Automated appointment reminders dramatically reduce practice no-shows and
positively impact production. It enables
communication in the patient’s preferred method. It improves efficiency
and profitability. Finally, 90 percent of
dental professionals agree that automating patient reminders gives them peace
of mind that all patients are consistently
contacted prior to appointments.

Arizona State University.

Tim J. Williams,
MS, BA, is vice
president of
product strategy
at Sesame
Communications. As a
former business
owner, he
understands the
challenges
dental and
orthodontic
practice face in
today’s marketplace. He holds a master’s in
applied information management and a
bachelor’s in psychology from Stanford
University.

[7] =>

Ortho Tribune U.S. Edition | WINTER 2012

clinical

7

[8] =>

products

Ortho Tribune U.S. Edition | spring 2013

Imaging Sciences
debuts new i-CAT FLX
Cone-beam 3-D system optimizes clinical control,
ease of use and fast workflow
By Imaging Sciences International staff

Imaging Sciences International is
pleased to announce a new addition to
the award-winning i-CAT® family of conebeam 3-D imaging — the i-CAT FLX — an
innovative 3-D imaging solution that can
help clinicians to quickly diagnose complex problems with less radiation* and develop treatment plans more easily and accurately. This newest system to the i-CAT
brand offers 3-D planning and treatment
tools for implants and restorations, oral
and maxillofacial surgery, orthodontics,
plus TMD and airway disorders.
i-CAT FLX has a range of innovative features that deliver greater clarity, ease-ofuse and control.
• Visual iQuity™ image technology provides i-CAT’s clearest 3-D and 2-D images*.
• QuickScan+ allows for a full-dentition
3-D scan at a lower dose than a panoramic
image*.
• SmartScan STUDIO’s touchscreen interface and integrated acquisition system
yields more control and workflow flexibility by allowing the clinician to easily select
the appropriate scan for each patient at
the lowest acceptable radiation dose.
• Ergonomic Stability System (ESS) offers seated positioning, robust head stability, and adjustable seating controls to
minimize patient movement, thus reducing the need for retakes. ESS also provides
wheelchair accessibility.
• i-Collimator electronically adjusts the
field-of-view to limit radiation only to the
area of scanning interest.
• i-CAT FLX’s small footprint fits easily
into any practice.
• i-PAN for traditional 2-D panoramic
images
Of course, as with all i-CAT products, the
Tx STUDIO™ optimized treatment planning software provides immediate access
to integrated treatment tools for implant
planning, surgical guides, and other applications.
“We are thrilled to debut the i-CAT FLX
— a complete 3-D treatment solution,” said
Kalpana Singh, senior product manager
for Imaging Sciences International. “Given
its high level of control over radiation dose
and easy workflow, we know that the i-CAT
FLX can benefit dental team members and
patients they treat.”

The i-CAT FLX is a new 3-D imaging
solution aimed to help clinicians
quickly diagnose complex
problems with less radiation and
develop treatment plans more
easily and accurately, according
to Imaging Sciences International.
Photo/Provided by Imaging Sciences
International

In 2012, Imaging Sciences International
celebrated two decades of dedication to
dental imaging, developing and manufacturing advanced dental and maxillofacial
radiography products including the i-CAT
Next Generation™ and i-CAT Precise™ and
their exclusive software applications. The
i-CAT brand has become among the most
trusted 3-D radiographic systems in the

dental industry. Now, i-CAT FLX continues
this legacy.

About Imaging Sciences
International
Serving the dental industry since 1992,
Imaging Sciences is at the global forefront
in the development and manufacturing of computer-controlled dental and

maxillofacial radiography products and
internationally recognized by highly regarded dentists and radiologists as one of
the most innovative companies in dental
imaging. The i-CAT system offers clinicians enhanced features for highly effective treatment planning and surgical predictability. For more information, visit
www.i-CAT.com.

‘Given its high level of control over radiation dose and easy workflow, we know that
the i-CAT FLX can benefit dental team members and patients they treat.’

[9] =>

Ortho Tribune U.S. Edition | spring 2013

industry

FORESTADENT Orthodontics,
Dr. Ronald Roncone team up
By Forestadent Orthodontics staff

FORESTADENT Orthodontics recently
gained attention and support from a
high profile leader in the orthodontic
community. Dr. Ronald Roncone kicked
off 2013 with a big announcement that
he is joining forces with Forestadent.
The thriving global orthodontic manufacturer has seen rapid growth in the last
few years and is excited to have attracted
the attention of such a respected leader.
Roncone will contribute on many levels
within the company, both domestically
and internationally, as an advocate, product advisor and lecturer.
Roncone received his dental degree at
Marquette University School of Dental
Medicine while he simultaneously completed his graduate studies in physiology and neuroanatomy. He obtained two
postdoctoral certificates from Harvard
School of Dental Medicine and the Forsythe Dental Center.
In addition to his extensive resume of
worldwide seminars, Roncone has developed an extensive training course called
JSOP (Just Short Of Perfect), covering everything from the business of orthodontics, to in-depth training of the Roncone
philosophy, and marketing and communications.
These year-long courses consist of four
sessions and are held in Southern California where Roncone maintains a private
practice specializing in adult treatment
(esthetics, surgical and TMD) as well as
“early” treatment for children.
Roncone has dedicated his career to
the advancement of the specialty of orthodontics and continued awareness
of a pre-adjusted appliance. As such, he
developed the Roncone prescription.
“There is and never will be a perfect orthodontic prescription due to biological
and anatomical differences between patients,” Roncone said. “However, an orthodontic prescription and treatment sys-

Dr. Ronald Roncone, right, has teamed up with FORESTADENT Orthodontics. Photo/Provided by FORESTADENT Orthodontics

tem should make treatment (especially
finishing) easier. An orthodontist should
not have to undo unwanted effects of a
pre-adjusted appliance or use special
wires to finish cases.”
The Roncone prescription and system
of treatment has been proven during the
last 14 years. Forestadent has agreed to
make some minor changes and additions
to improve even more this J.S.O.P. system.
Roncone added: “I am pleased to join
such a distinguished orthodontic fam-

ily organization. FORESTADENT has a
history of success and dedication to the
orthodontic profession. This remains a
company totally focused on orthodontics and orthodontists. It continues to
understand that orthodontists and the
practice of orthodontics is very unique.
In the current changing corporate environment, it is very refreshing.”
With more than 100 years of experience, FORESTADENT is a leading global
manufacturer of orthodontic prod-

ucts, specializing in brackets, bands,
screws and functional appliances.
FORESTADENT USA is headquartered in
the heart of the United States in St. Louis,
Missouri.
During the past 25 years, the company
has experienced exceptional growth due
to the high quality products and excellent customer service. For more information, about the company or scholarship
opportunities, visit the website at www.
forestadentusa.com.

Complete Clinical Orthodontics Summit:
Connecting individuals, ideas and inspiration
The orthodontists of Complete Clinical
Orthodontics understand that curiosity
can’t be taught, but it can be satisfied. If
you’re an orthodontist of unusually high
standards, then you’re invited to join us
in Philadelphia on the day before the AAO
for the inaugural Complete Clinical Orthodontics symposium. The CCO is a comprehensive system that addresses diagnosis,
treatment planning and treatment delivery in a single, inclusive approach.
This year’s speaker list includes Dr. Antonino Secchi, Dr. Ryan Tamburrino, Dr.

Celestino Nobrega, Dr. Jerry Clark, Dr. Rafaele Spena and Dr. Julia Garcia-Baeza. Don’t
miss this new generation meeting of the
minds on May 3.
By uniting some of the brightest minds
and ideas in orthodontics (Angle, Tweed,
Ricketts, Andrews, Roth, Alexander,
McLaughlin and Damon) the Complete
Clinical Orthodontics can drastically
enhance control, predictability and efficiency for all cases. The CCO represents a
philosophy that — when correctly applied
— enhances the capabilities of applianc-

es, improves treatment mechanics, and
more importantly, produces better results.
Ultimately the goal of CCO is to capitalize on the wealth of knowledge available
to us as orthodontists, and to incorporate
new technology and proven concepts to
achieve a higher level of efficiency.
The CCO Summit is happening May 3 in
Philadelphia. To share in the education, the
ideas and the enthusiasm, please reserve
your spot as soon as possible. You can do
so by calling (800) 645-5530 or visiting
www.mygcare.com.

[10] =>

industry

Ortho Tribune U.S. Edition | spring 2013

Oral-B introduces first of
its kind power toothbrush
to the United States
The New Oral-B Professional Series Deep Sweep is ‘a
breakthrough in brushing’ technique for U.S. consumers
Oral-B®, a worldwide leader in the
brushing market, recently announced
the launch of its newest rechargeable
power (electric) toothbrush to the popular Professional Series line-up: the
Professional™ Series Deep Sweep™
TRIACTION™.
The new Oral-B Deep Sweep TRIACTION toothbrush is a breakthrough in
brushing — the first of its kind in the
United States — to combine the familiar
brushing motion of a manual brush with
the comprehensive power of advanced
triple-zone cleaning action to cover more
surface area and remove up to 100 percent more plaque vs. a regular manual
toothbrush. Furthermore, with up to
48,800 bristle movements per minute
select models of the Oral-B Deep Sweep
TRIACTION remove up to 76 percent
more plaque in hard to reach areas versus
Sonicare™ FlexCare™.
“Taking proper care of one’s teeth and
gums is essential for optimal oral health,”
said Dr. Jonathan B. Levine, a world-renowned dental expert and Oral-B partner. “I recommend Oral-B power toothbrushes to my patients because they are
superior to manual brushing in removing plaque and come with a variety of
features to address every patient’s brushing style.”
With its familiar, manual-shaped brush
head designed to compliment people’s
natural, back-and-forth brushing motion,
Deep Sweep TRIACTION has a unique
combination of sweeping and stationary
bristles, and a dynamic angled power tip
that cleans effectively in hard-to-reach
areas. Inspired by the dentist-recommended Bass technique, Deep Sweep
TRIACTION’s dynamic bristles sweep perpendicular to manual brushing motion
while unique two-level tufting makes
sweeping bristles longer to ensure they
reach deeply between teeth.
“We at Oral-B listen to our customers
and strive to continuously provide them
with the best oral care solutions,” said Rishi Dhingra, marketing director, Procter
and Gamble. “Deep Sweep TRIACTION
provides what many customers have long
been looking for – the familiarity and experience of a manual brush coupled with
the cleaning performance of an Oral-B
power brush — and we’re excited to be
able to meet that need for our customers
nationwide.”

Oral-B has launched its
newest rechargeable
power (electric)
toothbrush to the
Professional Series
lineup. Photo/Provided
by Oral-B

Like other Oral-B power toothbrushes,
all Deep Sweep TRIACTION brushes feature a professional timer that signals at
30-second intervals to encourage thorough brushing in the four quadrants
of the mouth, and at two minutes to
indicate when the dental expert recommended brushing time has been reached.
A pressure sensor in the brush head
stops pulsations when you’re brushing
too hard and Indicator® bristles remind
users to replace their brush head every
three months, or once bristles have faded
halfway.
The Deep Sweep TRIACTION power
toothbrush is available in multiple models including the Professional Series Deep
Sweep TRIACTION 1000 and Professional Series Deep Sweep + Smart Guide™
TRIACTION 5000, offering consumers a
choice of price points and features that

best suit their needs.
Oral-B Professional Series Deep Sweep
TRIACTION brushes will be available at
department, retail and specialty stores
nationwide at suggested retail prices
ranging from $64.99 to $159.99. Deep
Sweep brush head refills will also be
available for purchase and are compatible with all Professional Series brush
handles. For more information about
Deep Sweep TRIACTION, visit www.oralb.
com or Facebook.com/OralB.

About Procter & Gamble
P&G serves approximately 4.6 billion
people around the world with its brands.
The Company has one of the strongest
portfolios of trusted, quality, leadership
brands, including Pampers®, Tide®, Ariel®,
Always®, Whisper®, Pantene®, Mach3®,
Bounty®, Dawn®, Fairy®, Gain®, Char-

min®, Downy®, Lenor®, Iams®, Crest®,
Oral-B®, Duracell®, Olay®, Head & Shoulders®, Wella®, Gillette®, Braun®, Fusion®,
Ace®, Febreze®, Ambi Pur®, SK-II® and
Vicks.® The P&G community includes
operations in approximately 75 countries
worldwide. Please visit www.pg.com for
the latest news and in-depth information
about P&G and its brands.

About Oral-B
Oral-B is the worldwide leader in the
more than $5 billion brushing market.
Part of the Procter & Gamble Company,
the brand includes manual and electric
toothbrushes for children and adults,
oral irrigators and interdental products,
such as dental floss. Oral-B manual toothbrushes are used by more dentists than
any other brand in the U.S. and many international markets.

[11] =>

Ortho Tribune U.S. Edition | WINTER 2012

Industry

11

[12] =>

industry

Ortho Tribune U.S. Edition | SPRING 2013

Ormco Corporation launches
enhanced Damon Doctor Locator
Intuitive web, mobile
and Facebook interfaces
offer increased visibility
and simplified doctor
location for patients
seeking treatment
Ormco Corporation, a leading manufacturer and provider of advanced orthodontic technology and services, recently announced the launch of an enhanced
Damon Doctor Locator — a powerful,
cross-platform tool that now enables
potential patients to quickly and easily
find the nearest Damon System® orthodontists via the web, Facebook and webenabled devices.
The Damon Doctor Locator is a value-added tool from Ormco, created to
help drive new patients to Damon System practices with ease and efficiency
through a streamlined, user-friendly
orthodontic search portal.
While the design of the interface is
rooted in simplicity, the Damon Doctor

Locator is driven by advanced web technologies. With an enlarged map, animated features and a larger pool of displayed
search results, prospective patients can
seamlessly scroll through an increased
number of Damon Doctor options within seconds of the initial search.
The Damon Doctor Locator uses location detection technology to guarantee
precise search results and present users
with a list of Damon Doctors in their
area, without ever requesting an address
or postal zip code. Additionally, newly
added share functionality allows family members and friends searching on
behalf of an individual in need of treatment to send search results via email,
Facebook and Twitter.
“In addition to multi-platform accessibility, the Damon Doctor Locator’s ability to allow family members and friends
to easily share search results and doctor
contact information with those in need
of treatment further extends our practice reach and likelihood of attracting
new patients,” said John Graham, DDS,
MD. “Ormco’s work to better an already
effective tool is helping to increase my
practice visibility among today’s busy,
mobile driven and social media savvy
adults and teens.”

Photo/Provided by ClearCorrect

ClearCorrect announces $395
Limited 6 treatment option

By ClearCorrect staff

ClearCorrect has announced a new
Limited 6 clear aligner treatment option, available for just $395. This option is ideal for simple anterior adjustments.
The low lab fee includes up to six
steps of clear aligners (single or dual
arch) along with a treatment setup.
Unlike the other guys, Phase Zero and

retainers are also included at no extra
cost. It’s the same great ClearCorrect
product, now even more affordable
and doctor-friendly.
ClearCorrect’s new treatment options (including Limited 6 and a new
Unlimited option) is now available.
ClearCorrect is a leading manufacturer of clear aligners located in Houston,
Texas. For more information, please
call (888) 331-3323.

The continued innovation of the Damon Doctor Locator is a result of Ormco’s
dedication to leveraging today’s mobile
commerce and social media trends to
create more opportunity for orthodontists within the online space. It’s with
this in mind that the company has optimized the Damon Doctor Locator for use
with connected devices, such as smart
phones and web-enabled tablets.
Similarly, Damon Doctors also have
the opportunity to capitalize on expanding social media popularity among consumers with the Damon Doctor Locator
Facebook application. Patients seeking
orthodontic treatment can easily access
the Damon Doctor Locator without leaving Ormco’s Damon System Braces Facebook page.
The same user-friendly features and
share capabilities are accessible via the
Damon Doctor Locator mobile site and
Facebook application.
“We are committed to supporting Damon System Doctors in their efforts to
increase practice visibility and generate
new patient traffic,” said Vicente Reynal, president of Ormco. “We firmly believe that the most successful practices
are those that use multiple channels of
communication to interact directly with

consumers. With the redesigned Damon
Doctor Locator, we’ve harnessed the
power of the ever-changing digital landscape to create a fluid user experience —
on web, mobile and Facebook — that will
help Damon Doctors elevate their online
footprint.”

About Ormco
Ormco is dedicated to manufacturing innovative products that improve the clinician’s opportunity to achieve excellent
results in the least amount of time, in
the fewest number of appointments, and
with the greatest patient comfort.
Distinguished products range from
legacy twins Titanium Orthos™ and
Mini-Twin™ to self-ligation with the Damon System and new active Prodigy™
SL as well as Insignia™ Advanced Smile
Design, a combination of 3-D software
and an expansive menu of customized
treatment options ranging from aligners,
such as Insignia Clearguide™ Express, to
fixed appliances. From personalized service to worldwide continuing education
programs and marketing support, Ormco is committed to helping orthodontists
achieve their clinical and practice management objectives. For more information, visit www.ormco.com.

ABC News features
PROPEL Orthodontics
PROPEL® Orthodontics, the developer
of innovative orthodontic devices and
techniques that dramatically accelerates
the rate at which teeth are moved during
orthodontic treatment, was featured on a
special segment of ABC Health News that
aired on Feb. 7.
The segment featured New York University College of Dentistry researcher
and chair of the orthodontic department,
Dr. Cristina Teixeira, who explained how
PROPEL is revolutionizing the field of
orthodontics. During the broadcast she
was quoted as saying: “I think this is the
future of orthodontics. The challenge is
to move teeth safer and faster and this
technique addresses all of these issues.”
The PROPEL System is a simple threestep, in-office procedure that is performed in minutes. The PROPEL System is a patented treatment which uses
Alveocentesis™ to stimulate alveolar
bone in patients undergoing orthodontic treatment. This stimulation increases
cytokine activity leading to faster bone
remodeling and translates into reduced
treatment time by 60 percent or more.
In addition, doctors can use PROPEL to
increase predictability of tooth movements, improve finishes in braces and
eliminate the need for refinement.
Two of NYU’s patients who are receiving the PROPEL treatment were featured

during the program; a high school student and a 34-year-old mother who are
excited to complete their treatment in
half the time. The mother also shared her
excitement that her daughter will be going into braces soon, and she will receive
the PROPEL treatment as well.
Patients and doctors seeking additional
information on the PROPEL accelerated
orthodontic treatment are encouraged
to visit www.propelorthodontics.com.
To watch a recording log onto http://abc
local.go.com/wabc/story?section=news/
health&id=8982761

About PROPEL Orthodontics
PROPEL Orthodontics is a developer of
innovative orthodontic procedures and
devices which accelerate orthodontic
treatment. In 2010, PROPEL Orthodontics
developed the PROPEL System, a novel
micro-invasive procedure that is relatively painless for the patient. This technique
stimulates alveolar bone remodeling for
faster tooth movement under any modality of orthodontic force. Universityproven scientific research has shown the
PROPEL System to reduce the amount of
time spent in orthodontic treatment by
greater than 50 percent. PROPEL Orthodontics is rapidly expanding its position
within the dental market with many
more products and treatment options.

[13] =>

[14] =>

FROM PAGE 1

About the authors

“ FOREIGN, Page 4
of dental needs.
To improve the oral health status of
individuals in these countries, USC dental students (a) delivered 15,000 toothbrushes to patients and their families;
(b) provided oral hygiene instructions
to each patient, emphasizing the importance of proper brushing and flossing;
and (c) reviewed nutritional counseling
to all patients with poor eating habits.

Jaclyn S. Kostelac graduated from
the University of Illinois in 2008 with
a bachelor of science degree in biology and a minor in chemistry. She
continued her education at Southern
Illinois University and, in 2010, graduated with a master of science degree in neurobiology. She is now a
third-year dental student at the Ostrow School of Dentistry at the University of Southern California (USC),

Conclusion
Regardless of whether individuals live
in third-world countries or the United
States, the need for dental care and
maintenance is imperative. Alarmingly,
one does not have to visit a foreign country to see conditions of third-world oral
health. As dental professionals, it is our
ethical responsibility and moral obligation to society, adhering to the principles
of social justice, to provide dental care
to less fortunate individuals in our communities.
While this study concentrated on oral
health status comparisons from the
three countries, no formal oral health
surveys have been conducted in specific
areas of Kenya, Colombia and the United
States (Kaimenyi, 2004).
Although the results of this study are

Ortho Tribune U.S. Edition | SPRING 2013

where she serves as co-president of
the Orthodontic Study Club. She currently resides in Manhattan Beach,
Calif., and can be reached through
email at kostelac@usc.edu.
Nicole E. Ranney graduated from the
University of San Diego in 2010 with
a bachelor of arts degree in biology
and minors in chemistry and business administration. She is now a
third-year dental student at the Os-

not representative for each of these populations as a whole, they did provide a
general understanding and appreciation
for the oral health status of the Kenyan,
Colombian and American populaces.

trow School of Dentistry at the University of Southern California (USC)
where she serves as class president
and Orthodontic Study Club co-president. She currently resides in Manhattan Beach, Calif., and can be

References available upon request from
the publisher.

reached through email at nranney@
usc.edu.

‘Alarmingly, one does not have to visit a foreign country to see
conditions of third-world oral health.’
AD

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[cover] => Ortho Tribune U.S. No. 1, 2013

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