Comparison of tooth mesiodistal angulation measurements / AAO heads to Philadelphia / Curriculum is changing for today’s instructors / The mobile-friendly dental practice: Why your website should be optimized for mobile-device users / Debt vs. success / OrthoVOICE gears up for its fourth annual meeting / Industry
Comparison of tooth mesiodistal angulation measurements
01 - 06 viewAAO heads to Philadelphia
01 - 12 viewCurriculum is changing for today’s instructors
02 - 03 viewThe mobile-friendly dental practice: Why your website should be optimized for mobile-device users
08 - 08 viewDebt vs. success
10 - 10 viewOrthoVOICE gears up for its fourth annual meeting
12 - 12 viewIndustry
14 - 18 viewArray
(
[post_data] => WP_Post Object
(
[ID] => 59698
[post_author] => 0
[post_date] => 2013-04-26 11:36:00
[post_date_gmt] => 2013-04-26 11:36:00
[post_content] =>
[post_title] => Ortho Tribune U.S. No. 2, 2013
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
[post_password] =>
[post_name] => ortho-tribune-u-s-no-2-2013-0213
[to_ping] =>
[pinged] =>
[post_modified] => 2024-10-22 02:40:26
[post_modified_gmt] => 2024-10-22 02:40:26
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://e.dental-tribune.com/epaper/otus0213/
[menu_order] => 0
[post_type] => epaper
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[id] => 59698
[id_hash] => 3535734c542703282923c815a93795708a3e7d827212b773824920466cb62f61
[post_type] => epaper
[post_date] => 2013-04-26 11:36:00
[fields] => Array
(
[pdf] => Array
(
[ID] => 59699
[id] => 59699
[title] => OTUS0213.pdf
[filename] => OTUS0213.pdf
[filesize] => 0
[url] => https://e.dental-tribune.com/wp-content/uploads/OTUS0213.pdf
[link] => https://e.dental-tribune.com/epaper/ortho-tribune-u-s-no-2-2013-0213/otus0213-pdf-2/
[alt] =>
[author] => 0
[description] =>
[caption] =>
[name] => otus0213-pdf-2
[status] => inherit
[uploaded_to] => 59698
[date] => 2024-10-22 02:40:20
[modified] => 2024-10-22 02:40:20
[menu_order] => 0
[mime_type] => application/pdf
[type] => application
[subtype] => pdf
[icon] => https://e.dental-tribune.com/wp-includes/images/media/document.png
)
[cf_issue_name] => Ortho Tribune U.S. No. 2, 2013
[contents] => Array
(
[0] => Array
(
[from] => 01
[to] => 06
[title] => Comparison of tooth mesiodistal angulation measurements
[description] => Comparison of tooth mesiodistal angulation measurements
)
[1] => Array
(
[from] => 01
[to] => 12
[title] => AAO heads to Philadelphia
[description] => AAO heads to Philadelphia
)
[2] => Array
(
[from] => 02
[to] => 03
[title] => Curriculum is changing for today’s instructors
[description] => Curriculum is changing for today’s instructors
)
[3] => Array
(
[from] => 08
[to] => 08
[title] => The mobile-friendly dental practice: Why your website should be optimized for mobile-device users
[description] => The mobile-friendly dental practice: Why your website should be optimized for mobile-device users
)
[4] => Array
(
[from] => 10
[to] => 10
[title] => Debt vs. success
[description] => Debt vs. success
)
[5] => Array
(
[from] => 12
[to] => 12
[title] => OrthoVOICE gears up for its fourth annual meeting
[description] => OrthoVOICE gears up for its fourth annual meeting
)
[6] => Array
(
[from] => 14
[to] => 18
[title] => Industry
[description] => Industry
)
)
)
[permalink] => https://e.dental-tribune.com/epaper/ortho-tribune-u-s-no-2-2013-0213/
[post_title] => Ortho Tribune U.S. No. 2, 2013
[client] =>
[client_slug] =>
[pages_generated] =>
[pages] => Array
(
[1] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-0.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-0.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-0.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-0.jpg
[1000] => 59698-791849cd/1000/page-0.jpg
[200] => 59698-791849cd/200/page-0.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[2] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-1.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-1.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-1.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-1.jpg
[1000] => 59698-791849cd/1000/page-1.jpg
[200] => 59698-791849cd/200/page-1.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[3] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-2.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-2.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-2.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-2.jpg
[1000] => 59698-791849cd/1000/page-2.jpg
[200] => 59698-791849cd/200/page-2.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[4] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-3.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-3.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-3.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-3.jpg
[1000] => 59698-791849cd/1000/page-3.jpg
[200] => 59698-791849cd/200/page-3.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[5] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-4.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-4.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-4.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-4.jpg
[1000] => 59698-791849cd/1000/page-4.jpg
[200] => 59698-791849cd/200/page-4.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[6] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-5.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-5.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-5.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-5.jpg
[1000] => 59698-791849cd/1000/page-5.jpg
[200] => 59698-791849cd/200/page-5.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[7] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-6.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-6.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-6.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-6.jpg
[1000] => 59698-791849cd/1000/page-6.jpg
[200] => 59698-791849cd/200/page-6.jpg
)
[ads] => Array
(
[0] => Array
(
[post_data] => WP_Post Object
(
[ID] => 59700
[post_author] => 0
[post_date] => 2024-10-22 02:40:20
[post_date_gmt] => 2024-10-22 02:40:20
[post_content] =>
[post_title] => epaper-59698-page-7-ad-59700
[post_excerpt] =>
[post_status] => publish
[comment_status] => closed
[ping_status] => closed
[post_password] =>
[post_name] => epaper-59698-page-7-ad-59700
[to_ping] =>
[pinged] =>
[post_modified] => 2024-10-22 02:40:20
[post_modified_gmt] => 2024-10-22 02:40:20
[post_content_filtered] =>
[post_parent] => 0
[guid] => https://e.dental-tribune.com/ad/epaper-59698-page-7-ad/
[menu_order] => 0
[post_type] => ad
[post_mime_type] =>
[comment_count] => 0
[filter] => raw
)
[id] => 59700
[id_hash] => dba9584c07b2ec6e18643e34ab8672eaaf7bbaa77c1ddf8752ec0b9077945e4c
[post_type] => ad
[post_date] => 2024-10-22 02:40:20
[fields] => Array
(
[url] => http://www.dental-tribune.com/companies_3550_biolase_technology_inc.html
[link] => URL
)
[permalink] => https://e.dental-tribune.com/ad/epaper-59698-page-7-ad-59700/
[post_title] => epaper-59698-page-7-ad-59700
[post_status] => publish
[position] => 6.2,3.55,89.16,94.81
[belongs_to_epaper] => 59698
[page] => 7
[cached] => false
)
)
[html_content] =>
)
[8] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-7.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-7.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-7.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-7.jpg
[1000] => 59698-791849cd/1000/page-7.jpg
[200] => 59698-791849cd/200/page-7.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[9] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-8.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-8.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-8.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-8.jpg
[1000] => 59698-791849cd/1000/page-8.jpg
[200] => 59698-791849cd/200/page-8.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[10] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-9.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-9.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-9.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-9.jpg
[1000] => 59698-791849cd/1000/page-9.jpg
[200] => 59698-791849cd/200/page-9.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[11] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-10.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-10.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-10.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-10.jpg
[1000] => 59698-791849cd/1000/page-10.jpg
[200] => 59698-791849cd/200/page-10.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[12] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-11.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-11.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-11.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-11.jpg
[1000] => 59698-791849cd/1000/page-11.jpg
[200] => 59698-791849cd/200/page-11.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[13] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-12.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-12.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-12.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-12.jpg
[1000] => 59698-791849cd/1000/page-12.jpg
[200] => 59698-791849cd/200/page-12.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[14] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-13.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-13.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-13.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-13.jpg
[1000] => 59698-791849cd/1000/page-13.jpg
[200] => 59698-791849cd/200/page-13.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[15] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-14.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-14.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-14.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-14.jpg
[1000] => 59698-791849cd/1000/page-14.jpg
[200] => 59698-791849cd/200/page-14.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[16] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-15.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-15.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-15.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-15.jpg
[1000] => 59698-791849cd/1000/page-15.jpg
[200] => 59698-791849cd/200/page-15.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[17] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-16.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-16.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-16.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-16.jpg
[1000] => 59698-791849cd/1000/page-16.jpg
[200] => 59698-791849cd/200/page-16.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[18] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-17.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-17.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-17.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-17.jpg
[1000] => 59698-791849cd/1000/page-17.jpg
[200] => 59698-791849cd/200/page-17.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[19] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-18.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-18.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-18.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-18.jpg
[1000] => 59698-791849cd/1000/page-18.jpg
[200] => 59698-791849cd/200/page-18.jpg
)
[ads] => Array
(
)
[html_content] =>
)
[20] => Array
(
[image_url] => Array
(
[2000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/2000/page-19.jpg
[1000] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/1000/page-19.jpg
[200] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/200/page-19.jpg
)
[key] => Array
(
[2000] => 59698-791849cd/2000/page-19.jpg
[1000] => 59698-791849cd/1000/page-19.jpg
[200] => 59698-791849cd/200/page-19.jpg
)
[ads] => Array
(
)
[html_content] =>
)
)
[pdf_filetime] => 1729564820
[s3_key] => 59698-791849cd
[pdf] => OTUS0213.pdf
[pdf_location_url] => https://e.dental-tribune.com/tmp/dental-tribune-com/59698/OTUS0213.pdf
[pdf_location_local] => /var/www/vhosts/e.dental-tribune.com/httpdocs/tmp/dental-tribune-com/59698/OTUS0213.pdf
[should_regen_pages] => 1
[pdf_url] => https://epaper-dental-tribune.s3.eu-central-1.amazonaws.com/59698-791849cd/epaper.pdf
[pages_text] => Array
(
[1] =>
ORTHO TRIBUNE
The World’s Orthodontic Newspaper · U.S. Edition
AAO Preview 2013 — Vol. 8, No. 2
www.ortho-tribune.com
AAO heads
to Philadelphia
Orthodontists
to meet at 113th
annual session
Comparison
of tooth
mesiodistal
angulation
measurements
Between 3-D CBCT
volumetric images
and 2-D CBCT-derived
panoramic images
By Ammar Siddiqi
and Nicole Sakai, DDS
Advisor: Hongsheng Tong, DDS, PhD
T
he American Association of Orthodontists will host its 113th annual session from May 3-7 at the
Pennsylvania Convention Center
in Philadelphia.
The meeting’s scientific program will
span pivotal orthodontic topics including “New Technology in Tooth Movement: Fact or Fiction,” featuring Drs.
David L. Turpin, Dubravko Pavlin and Anthony M. Puntillo and seven other “Point
& Counterpoint” presentations.
Attendees can interact with lecturers like Dr. William R. Proffit, speaking
on “Evaluating the Chance of Successful
Treatment,” in the “Asking the Experts”
series and learn from internationally recognized lecturers addressing 3-D imaging,
enamel and roots, heredity and orthodontics, TMD, biomechanics, technology, esthetics, early treatment, accelerated tooth
movement, ortho/perio,
Philadelphia is
the site of the
113th annual
session for the
AAO.
Photo/
www.sxc.hu
” See AAO, page 12
One of the major goals orthodontists try to achieve with every patient
is to obtain ideal angulations and positions of all teeth at the end of active
treatment.
In order to accomplish this, twodimensional (2-D) panoramic radiographs have conventionally been
used to visualize both the maxillary
and mandibular arches as well as root
angulations. However, because of inherent flaws in panoramic imaging,
three-dimensional cone-beam computed tomography (CBCT) has been
recommended to provide a more accurate and less distorted image of the
dentition.
Literature review
Orthodontics is a specialty of dentistry that is concerned with the study
and treatment of malocclusions,
” See CBCT, page 4
AD
Dental Tribune America
116 West 23rd Street
Suite #500
New York, N.Y. 10011
PRSRT STD
U.S. Postage
PAID
San Antonio, TX
Permit #1396
[2] =>
From the Editor
2
Ortho Tribune U.S. Edition | AAO Preview 2013
Curriculum is changing
for today’s instructors
By Dennis J. Tartakow,
DMD, MEd, EdD, PhD, Editor in Chief
For each graduating resident, career
decisions come down to determining
which environment is best suited to his
or her personality with regard to orthodontics. Choosing a path that coincides
with one’s beliefs, philosophy, personality and lifestyle is omnipotent. There
are compelling advantages to both
private practice and academics, but in
AD
order to consider teaching as a career,
clinical experience is certainly necessary.
For the most part, postgraduate orthodontic programs have been content
with faculty members teaching in the
same manner as he or she was taught
(show, tell, do). However, the process of
education itself is changing as well.
We are moving toward an age where
new academic skills such as the (a)
” See CURRICULUM, page 3
ORTHO TRIBUNE
Publisher & Chairman
Torsten Oemus t.oemus@dental-tribune.com
Chief Operating Officer
Eric Seid e.seid@dental-tribune.com
Group Editor
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
Sierra Rendon s.rendon@dental-tribune.com
Managing Editor Show Dailies
Kristine Colker k.colker@dental-tribune.com
Managing Editor
Fred Michmershuizen
f.michmershuizen@dental-tribune.com
Managing Editor
Robert Selleck, r.selleck@dental-tribune.com
product/Account Manager
Charles Serra c.serra@dental-tribune.com
product/Account Manager
Humberto Estrada h.estrada@dental-tribune.com
product/Account Manager
Mara Zimmerman m.zimmerman@dental-tribune.com
Marketing director
Anna Wlodarczyk-Kataoka
a.wlodarczyk@dental-tribune.com
Education DIRECTOR
Christiane Ferret c.ferret@dtstudyclub.com
Tribune America, LLC
116 West 23rd Street, Suite 500
New York, NY 10011
Phone (212) 244-7181
Fax (212) 244-7185
Published by Tribune America
© 2013 Tribune America, LLC
All rights reserved.
Tribune America strives to maintain the utmost accuracy in its news and clinical reports. If you find a
factual error or content that requires clarification,
please contact Managing Editor Sierra Rendon at
s.rendon@dental-tribune.com.
Tribune America cannot assume responsibility for
the validity of product claims or for typographical
errors. The publisher also does not assume responsibility for product names or statements made by
advertisers. Opinions expressed by authors are their
own and may not reflect those of Tribune America.
Editorial Board
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
[3] =>
Ortho Tribune U.S. Edition | AAO Preview 2013
“ CURRICULUM, Page 1
methods of teaching, (b) process of
course designing and (c) modality of
learning have become the new standards of the educational process.
There are core areas of knowledge that
teachers will be required to learn and
understand. Without such basic knowledge of education and the learning process, students may remember information by rote but might never possess a
broad and deep understanding of how
to apply or adapt such knowledge in all
situations.
In “Pedagogy of Freedom: Ethics, Democracy and Civic Courage,” Freire
(1998) emphasized that teacher preparation must consider a sense of ethics
inherent in all forms of educational
practice.
As Freire suggested, educators should
consider the best methods for serving
our residents. With this in mind, the efforts of educators would best be focused
on learning modalities, which are not
the same for all individuals. One of the
learning theorists whom educators often look to for guidance is Dr. Howard
Gardner.
Gardner’s work encourages reflection
upon the praxis involved for translating theory into action by considering
the different learning modalities in
new and creative ways. Students utilize
different core methods of learning to
process information, which includes: (a)
visual, (b) spatial, (c) auditory, (d) tactile,
(e) logical, (f) interpersonal and (g) intrapersonal modalities at an unconscious
level, not necessarily in any particular
order.
According to Gardner (1993), most
learners retain a dominant and an auxiliary learning modality throughout
life. Human beings access information
through all senses, but generally favor
one or more processes such as visual
(sight), auditory (sound), kinesthetic
(moving), and tactile (touch).
Recently, new and creative programs
in orthodontic education have been created that address new academic skills
to improve the teaching ability of orthodontic faculty members. These conferences are intended to provide our educators with the tools and methodology
to implement a rigorous, thorough and
broad curriculum on classical clinical
situations.
The preservation of pedagogy in orthodontic education, the potential social
justice implications, and impact on the
public are directly related to: (a) education of well-trained orthodontists, (b)
health-care delivery, (c) outreach programs, (d) welfare agencies and (e) public service communication. Teaching is
all about the fundamentals of education.
Most postgraduate orthodontic faculty members have never had any formal training in the methodology of
teaching or course design. They teach
what they learned from their own clinical experiences. With this in mind, it is
encouraging to see the creation of a few
new and novel educational programs
designed for junior and mid-career
orthodontic faculty members to learn
such academic skills. These conferences
are part of a 2012 AAOF Educational Innovation Grant.
One of the first workshops on faculty career enrichment in orthodon-
from the editor
tics (FACE) occurred in October 2012.
The second FACE workshop was held on
March 7 at the University of Michigan
School of Dentistry. These workshops,
led by recognized orthodontic teaching
experts included an interactive format
with topics such as:
• principles of course design starting
with the end in mind,
• methods to encourage active learning in the classroom and clinic setting,
and
• methods for successfully incorporating technology into the classroom.
Another related program for faculty
members is the James L. Vaden Educational Leadership Conference on May 3.
This conference will emphasize excellence in orthodontic education, concentrating on graduate program standards.
These programs will hopefully improve
the education of our orthodontic faculty members and train our students to
become better clinicians. Incremental
changes for teaching skills is often needed if putting the student at the heart of
the system is to be anything more than
a hyperbole.
Improving the standards of education
can lead to trying times but abhorring
ignorance, I prefer to quote Aristotle
(384–322 B.C.), “Education is an ornament in prosperity and a refuge in adversity.”
References
1)
2)
3)
Aristotle (384–322 BC). Quotations book.
Retrieved March 25, 2013, from: http://
quotationsbook.com/quote/11848/
Freire, P. (1998). “Pedagogy of Freedom:
Ethics, Democracy, and Civic Courage.”
Lanham, MD: Rowman & Littlefield.
Gardner, H. (1993). “Frames of Mind: The
Theory of Multiple Intelligences” (10th
anniversary edition). New York: Basic
Books.
3
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 you would like
to share? Is there a topic you would like to see
articles about in Ortho Tribune? Let us know by
emailing feedback@dentaltribune. com. We look
forward to hearing from you! If you would like
to make any change to your subscription (name,
address or to opt out), send email to database@
dental-tribune.com. Please note that subscription
changes can take up to six weeks to process.
AD
[4] =>
4
clinical study
Ortho Tribune U.S. Edition | AAO Preview 2013
“ CBCT, Page 1
which may be a result of tooth position
irregularity, disproportionate jaw relationships or both. The specialty of orthodontics has continued to evolve since its
advent in the early 20th century. In the
1890s, Dr. Edward H. Angle, regarded as
the “Father of Modern Orthodontics,”
published his classification of malocclusion based on the occlusal relationships
of the first molars (Angle, 1899).
This was a major step toward the development of orthodontics because his
classification defined “normal occlusion.”
He believed that if all of the teeth were
properly aligned, then no deviation from
an ideal occlusion would exist (Angle).
His theories suggested that achieving
the correct tooth position within the
dental arch was critical for ideal angulation, occlusion and esthetics. With the
advent of modern imaging technology
and improved software in the field of orthodontics, Angle’s principles of proper
alignment and positioning have become
easier to apply.
Although there have been constant
changes in diagnosis, treatment philosophy, mechanics and appliances, core
orthodontic treatment principles have
generally remained the same over time.
The main treatment objectives of orthodontics include obtaining (a) proper
esthetics and alignment, (b) ideal functional occlusion and (c) long-term stability. In order to achieve these goals, it is
critical to have ideal angulations of all
teeth in all three planes of space at the
end of active treatment (Andrews, 1972).
Proper mesiodistal angulations (tip) are
necessary for distributing occlusal forces
through tight interproximal contacts
and are an important factor in maintaining a stable treatment result (McKee et
al., 2001; McKee et al., 2002).
For decades, the norm in orthodontic
imaging has been using 2-D panoramic
radiographs to visualize the entire tooth
including the root to judge the angulation of teeth.
Most orthodontists use panoramic radiographs at the start, in the middle and
at the end of treatment in order to judge
root parallelism to reposition brackets if
necessary. This imaging technique produces a single tomographic image of the
facial structures that includes both the
maxillary and mandibular dental arches
as well as their supporting structures.
The principal advantages of panoramic
radiography are the (a) broad anatomic
areas, (b) relatively low patient radiation,
(c) convenience, (d) ease and (e) speed of
the procedure (Sakai, 2011). Additionally,
panoramic radiography is recommended
by the American Board of Orthodontists
to assess root angulation and parallelism
as a part of the objective grading system
for an orthodontist to become board certified.
However, the use of panoramic radiographs to check mesiodistal tooth
angulation is fundamentally flawed primarily due to dimensional and angular
distortions as a result of image layer (focal trough) discrepancy. Investigators
have also attributed the inaccuracy of
panoramic images to projection geometry, variable vertical and horizontal magnification factors and patient positioning
errors (Bouwens, Cevidanes, Ludlow and
Phillips, 2011). Part of the reason why
traditional panoramic radiographs are
inaccurate in capturing the angulations
Fig. 1: Constructing a 2-D panoramic-like image from a 3-D CBCT patient scan. Photos/Provided by Ammar Siddiqi and Nicole Sakai, DDS
Fig. 2: Using the three-point angle to measure the mesiodistal
angulation of the teeth on the 2-D panoramic images.
of teeth may be attributed to the in-orthogonal nature of the X-ray beams as the
X -ray tube and the sensor move around
the target, as well as the large variations
in the size and shape of the dental arches
(Sakai, 2011).
To
overcome
these
problems,
panoramic-like images constructed from
3-D CBCT volumetric images have been
recommended. Three-dimensional CBCT
images have been shown to capture the
target at a 1:1 ratio with very little dimensional and angular distortions and the
trough used to generate the panoramiclike images can be customized to closely
follow the dental arch size and shape
(Sakai, 2011).
Research has also shown that linear and
angular dimensions are more accurate
using a CBCT-derived panoramic radiograph compared to traditional panoramic radiographs (Hutchinson, 2005).
The introduction of CBCT specifically
dedicated to imaging the maxillofacial
region heralds a true paradigm shift
from a 2-D to a 3-D approach in data acquisition and image reconstruction. Utilizing this new technology, orthodontists
can now visualize the dentition in all
Table 1: Comparison between 2-D and 3-D mesiodistal angulation
measurements using the paired t-test. Significance was calculated
at p<0.05/7=0.0071 level (Bonferroni correction). For teeth with
non-normal data, the Wilcoxon Signed-Rank Test was used.
three planes of space. CBCT has opened
up a new horizon for 3-D diagnosis and
treatment planning in dentistry, particularly in orthodontics where shape, form,
structure and position are of critical importance.
Purpose
The short-term goal of this research was
to prove that using CBCT is a valid method in orthodontic treatment planning
and can aid in the visualization and proper alignment of roots within the dental
arch. With these 3-D images, it is finally
possible to see how far root apices have
moved during treatment. Additionally,
placing the root in the right position will
facilitate and maximize tooth stability
and retention resulting in better treatment outcomes.
Although there have been many studies describing the distortions in 2-D
panoramic images, there has not been
a study that has looked at a trend in the
distortions and compared it to an ideal
coordinate system such as a 3-D CBCT.
An orthodontic research study was carried out at the Herman Ostrow School
of Dentistry of University of Southern
California (USC) from February 2012 to
January 2013 to investigate this subject
matter. The objective was to determine if
there are differences in tooth mesiodistal angulation measurements between
2-D panoramic-like images (constructed from CBCT scans) versus measurements obtained directly from 3-D CBCT
volumetric images.
Materials and methods
The study was conducted under chief
investigator Dr. Hongsheng Tong along
with a team of residents and a predoctoral student at the Graduate Orthodontic Department of USC.
The research design aimed at recording
mesiodistal angulation measurements
for both the 2-D panoramic-like images as
well as the 3-D CBCT scans using Dolphin
imaging software. The patients of this
research were a subset (59 patients) from
another related USC orthodontic imaging
study, which was designed to obtain the
standard tip and torque values for each
tooth from 76 patients with near normal
occlusions. Three-dimensional images
” See CBCT, page 6
[5] =>
Ortho Tribune U.S. Edition | WINTER 2012
CLINICAL
5
[6] =>
Industry
clinical
study
6
“ CBCT, Page 4
were generated with a NewTom 3G volumetric scanner at the Redmond Imaging
Center at USC. Images were rendered using Dolphin 3D and tip and torque were
measured with a custom USC Root Vector
Analysis program (Tong et al., 2012). The
3-D measurements data were made available for the current study.
For the construction of 2-D images, the
head orientation was set to the same orientation that was used in the 3-D coordinate system with the sagittal plane equally dividing left and right, coronal plane at
the maxillary molar buccal grooves and
the transverse plane set at the functional occlusal plane bisecting the anterior
overbite and the posterior (maxillary first
molar) overbite. Two different panoramic-like images, one for the maxilla and
one for the mandible were constructed
for each patient (Fig. 1). The long axis was
drawn through each tooth and the angle
was measured against the occlusal plane
using a three-point line angle tool within
the Dolphin software (Fig. 2).
All 59 cases were measured twice (one
week apart) by the same investigator and
an intra-class correlation coefficient (ICC)
was calculated to check for reproducibility of the data.
The averages of the two-time 2-D measurements were compared with the average of the two-time 3-D measurements
available from the previous study (Tong
et al. 2012). All data were entered into a
spreadsheet and analyzed using Microsoft Excel and Statistical Package for Social Sciences (SPSS).
The data were tested for normality using the Kolmogorov-Smirnov-test. To
compare the 2-D and 3-D measurements,
paired t-tests were performed for normal data and Wilcoxon Signed Rank
tests were performed for non-normal
data. Significance was established at p<
0.05/7=0.0071 based on the Bonferroni
adjustment.
Results
For the nine cases used for calibration,
the average ICC for the two-time measurements for all the teeth was 0.939,
indicating reproducibility in measurements obtained in two different trials
by the same investigator. Paired-t test
revealed significant differences in 17 of 28
teeth between measurements from 2-D
constructed panoramic-like images and
3-D images as evidenced by Table 1.
Discussion
Although it was hypothesized that there
would be no differences between constructed 2-D and direct 3-D mesiodistal
measurements for each tooth, statistically significant differences were found
in approximately 60 percent of the teeth.
This indicates that the panoramic X-rays
derived from CBCT scans currently may
not be the optimal choice of imaging for
obtaining precise mesiodistal tooth angulations.
Two-dimensional constructed panoramic images have been shown to have
less distortion compared to 2-D conventional panoramic radiographs (McKee,
2002). However, the accuracy of the constructed images may be compromised
due to one or more of the following reasons: (a) the position of the tooth in the
dental arch (curved or straight), (b) 3-D
torque, (c) 3-D tip, (d) tooth size, (e) center trough location and other variables
(Sakai, 2011). With the increasing body
of evidence showing distortion on 2-D
radiographs with no clear trend in those
differences, more studies are likely to
arise to determine if the distortions can
be quantified.
Measuring mesiodistal angulation
directly from 3-D volumetric images,
although probably the most accurate
method so far, may suffer from a number of limitations: (a) the resolution and
image quality of CBCT scans, (b) subjective nature of identifying the long axes of
teeth and (c) time and effort involved in
digitizing center points for each root and
crown in 3-D images.
An alternative to the method used for
digitizing each tooth would be to define
the tooth long axis mathematically, allowing the software to find the crown and
root centers automatically and objectively. Once the digitizations are made, the
tooth-specific coordinate system for measuring individual tooth tip and torque
would be done mathematically and
the errors kept to a minimum. This would
require very complicated algorithms but
may be a possibility in the future.
In a clinical setting, there are also a
couple of drawbacks to the use of CBCT
imaging, one being the high cost of owning the unit (approximately $100,000$200,000) and the other being the elevated dose of patient radiation exposure.
The effective radiation dosage is 3-11 uSv
for panoramic radiographs and 5-7 uSv
for cephalograms. For a CBCT scan, the
radiation dosage can be 40-135 uSv (Sakai,
2011). Therefore, the selection of CBCT for
dental and maxillofacial imaging should
be based on professional judgment of patient needs for diagnosis and treatment.
This must be in accordance with the
best available scientific evidence, weighing potential patient benefits against the
risks associated with the level of radiation
dose.
Overall, this study on panoramic Xrays and CBCT is still ongoing and will
require further investigation in order to
achieve definitive results. This is in part
due to the need for multiple trials and
sample sizes in order to confirm trends
and discrepancies in the data. The results
of this study should be interpreted with
the knowledge that they may only be relevant to the patients selected in this specific sample group and caution should be
used when applying it to all orthodontic
patients.
The current study used a small sample
size of patients with near-normal occlusion and provided a foundation but continued data collection and interpretation
is necessary to reach conclusive evidence
with regards to panoramic imaging versus CBCT in the field of orthodontics.
Conclusion
This study demonstrated that 2-D mesiodistal angulation measurements from
the constructed panoramic-like images
may not be as accurate as direct measurements from 3-D volumetric images derived from the USC Root Vector Analysis
Program inside Dolphin 3D software.
Presently, the most accurate method
available to orthodontists clinically may
be using direct 3-D CBCT data to find
the appropriate mesiodistal angulations
of the teeth. According to Tong, CBCT
may eventually replace panoramic radiographs in orthodontic diagnosis and
treatment planning because of its ability
to provide detail and precise 3-D informa-
Ortho Tribune U.S. Edition | AAO Preview 2013
tion without distortion (H. Tong, personal
communication, January 11, 2013). Having
different views in one scan, such as frontal, right and left lateral, 45-degree views
and sub-mental, also adds to the many
advantages of CBCT. Coupled with advanced imaging programs that allow for
digital models, CBCT not only can provide
a great diagnostic tool but also can eliminate the need for taking impressions and
fabricating stone models in the near future.
The visualization of all roots and crowns
in ideal occlusion in addition to the maxillofacial complex also has implications
in other areas of dentistry such as implantology, oral surgery and restorative
dentistry. For example, CBCT is largely
used in orthognathic surgery planning,
the assessment of impacted teeth and
visualization of supernumerary teeth.
(Alshehri, Alamri and Alshalhoob, 2010).
With increased demand for replacing
missing teeth with dental implants, accurate measurements are needed to avoid
damage to vital structures. This can be
achieved with conventional CT scans,
but with CBCT providing more accurate
images at lower dosages, it is the preferred option in implant dentistry today
(Alshehri, et al., 2010).
Further studies on this topic will help
to determine if similar results can be
obtained when different variables are introduced into the study such as patients
with non-normal occlusion, patients that
have undergone extraction treatment,
and patients with conventional panoramic radiographs (Sakai, 2011).
Ultimately, the goal of future research
is to use modern imaging technology to
establish norms in measurements of both
mesiodistal angulation (tip) and buccolingual inclination (torque) so that orthodontists have an ideal guide that can
be used for accurate diagnosis and treatment planning.
The accuracy of a CBCT volume is limited only by resolution and/or pixel size
(Sakai, 2011). However, as the resolution
of images are improved by (a) emerging
technology, (b) new data processing software and (c) avoidance of patient movement during scanning, more precise
results will arise. This could lead to improved, exact and realistic visions of virtual three dimensions for records, treatment planning and treatment outcome
evaluation in orthodontics.
6)
7)
8)
positioning in panoramic radiography on
mesiodistal tooth angulations. Angle Orthodontist, 71:442–451.
McKee, I.W., Williamson, P.C., Lam, E.W.,
Heo, G., Glover, K.E., & Major, P.W. (2002).
The accuracy of 4 panoramic units in the
projection of mesiodistal tooth angulations. American Journal of Orthodontics &
Dentofacial Orthopedics, 121:166–675.
Sakai, N. (2011). Comparison between tooth
mesiodistal angulation measurements
from constructed panoramic images and
three dimensional volumetric images. Thesis, University of Southern California. Los
Angeles: Masters Dissertation, ProQuest
Information and Learning Company, Ann
Arbor, MI. (UMI No. 1497016).
Tong, H., Kwon, D., Shi, J., Sakai, N., Enciso,
R., & Sameshima, G.T. (2012). Mesiodistal
angulation and faciolingual inclination of
each whole tooth in 3-dimensional space in
patients with near-normal occlusion.
American Journal of Orthodontics and
Dentofacial Orthopedics, 141(5):604–617.
About the authors
Ammar Siddiqi is a third-year dental student
and pre-doctoral researcher at the Graduate
Orthodontic Department at the Herman Ostrow School of Dentistry of University of
Southern California. He can be reached at
ammarsid@usc.edu.
References
1)
2)
3)
4)
5)
Alshehri, M.A., Alamri, H.M, & Alshalhoob,
M.A. (2010). CBCT applications in dental
practice: A literature review. Dental Tribune. Retrieved from www.dental-tribune.
com/articles/specialities/general_dentistry/3615_cbct_applications_in_dental_
practice_a_literature_review.html
Angle, E. H. (1899). Classification of malocclusion. Dental Cosmos, 41:248–264, 350357.
Bouwens, D., Cevidanes, L., Ludlow, L., &
Phillips, C. (2011). Comparison of mesiodistal root angulation with posttreatment
panoramic radiographs and cone-beam
computed tomography. American Journal
of Orthodontics, 139(1):126–132.
Hutchinson, S.Y. (2005). Cone beam computed tomography panoramic images vs.
traditional panoramic radiographs. American Journal of Orthodontics & Dentofacial
Orthopedics, 28(4):550.
McKee, I.W., Williamson, P.C., Lam, E.W.,
Heo, G., Glover, K.E., & Major, P.W. (2001).
The effect of vertical and horizontal head
Nicole Sakai received her doctorate of DDS
from the University of the Pacific School of
Dentistry. She furthered her education at the
University of Southern California and received her certificate in orthodontics and her
masters degree in craniofacial biology. Her
masters thesis focused on the comparison of
root angulation between two-dimensional
and three-dimensional radiographs. She is
currently a practicing orthodontist in Fort
Worth, Texas.
[7] =>
Ortho Tribune U.S. Edition | WINTER 2012
clinical
7
[8] =>
pr actice matters
8
Ortho Tribune U.S. Edition | AAO Preview 2013
The mobile-friendly dental practice: Why your
website should be optimized for mobile-device users
By Diana P. Friedman
At the AAO
Stop by Sesame booth No. 301 to learn how
Forty-five percent of American adults
owned a smartphone as of December
2012.1 As these powerful devices increasingly make their way into the pockets of
your existing and potential patients, it’s
a business imperative that your website
deliver the experience these users expect.
A strong mobile presence helps you
get in front of prospective patients at
the moment they’re looking for your
business. On the other hand, if your site
AD
your practice can leverage mobile technology.
doesn’t look good or function properly on
a smartphone, it won’t take long for patients to move on to one that does.
Not sure if mobile is important to your
practice? Here are three reasons you
could be missing the boat — and missing
easy opportunities to attract new patients
to your practice.
Mobile is where your patients are
Many of your patients probably use the
mobile web — 87 percent of smartphone
users access the internet using their
phones2. Mobile web usage has exploded
during the past few years, and many industry experts project that mobile internet usage will exceed desktop Internet
usage by 2014.3
For many smartphone users, mobile
has also become their preferred way to
use the web: 31 percent of current mobile
web users mostly go online using their
phones. 4
A Sesame Communications research
case study found that a mobile website
drove an average of 19 calls per month to
the practice.
Mobile is how your patients
research — and make —
buying decisions
More people are using the mobile web
to research and buy goods and services.
Ninety-two percent of smartphone users
seek local information on their device,
and 89 percent have taken action after
looking up local content.5 More significantly for your practice, 52 percent of
smartphone owners have used their
phones to search for health information.6
Without a mobile-optimized site, your
practice will have a harder time driving
new and repeat appointments from the
mobile web. Mobile shoppers are more
likely to buy something if the company’s
site is optimized for mobile, and are more
likely to return to a site in the future if
their mobile experience is good.7
Not mobile? You may be frustrating
current patients … and driving away
potential ones
Mobile users now expect any brand they
engage with to have a mobile-optimized
site. More than half of mobile users say
they won’t recommend a business with a
poorly-designed mobile site.8
If smartphone users reach a site and see
that it’s not optimized for mobile, what
will they do? They might leave — 74 percent of mobile users are only willing to
wait five seconds or less for a single web
page to load before leaving the site.9 Or
worse, they might visit a competitors’
site — 61 percent of customers who visit
a website that isn’t mobile-friendly will
leave to visit a competitor.10
The bottom line is that not having a
mobile-optimized site can hurt your relationships with current patients, and drive
away prospective ones.
The mobile web is where many of your
patients are, and where they go to find
and research your practice. Optimizing
your website for mobile will help you
best capitalize on the mobile web as a tool
for building and strengthening relationships with patients. In selecting a partner
to launch your mobile site, make certain
they understand on-the-go patient online behavior and leverage your existing
online practice brand and social media
channels to optimize the impact of your
new mobile site.
References are available upon request
from the publisher.
About the author
Diana P. Friedman, 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,
she has served as a recognized practice management consultant, author and speaker. She holds an
MA in sociology and an MBA from Arizona State
University.
[9] =>
Ortho Tribune U.S. Edition | AAO Preview 2013
industry
9
[10] =>
pr actice matters
10
Ortho Tribune U.S. Edition | AAO Preview 2013
Debt vs. success
Five steps to keep your career on track
By Robert Graham
Your journey as a dental professional
begins with the hopes of having the best
possible outcome. Yet, once you are out
of school, as many have experienced, you
will encounter some forks in the road.
The forks represents decisions you will
need to make that will chart your course
to either success or failure. They may include questions such as, “Should I go the
route of associate or owner?”, “How long
before I build a practice?”, “How do I build
the best team?”, “What do I do about my
debt?”, “How do I stay out of debt?”, “How
do I organize my practice?” and “Do I
work for a large group or go it alone?”
With all of the above significant and
critical considerations within the life of a
practice, debt stands out as the lynchpin.
In most circumstances, debt is a necessary tool to gain education, purchase or
build a practice and to purchase your
home. However, debt is also the “tool”
that may tether your freedom and limit
your choices when charting your course.
Debt management is essential for a
successful outcome. Here are five simple
steps you can follow to help you identify
the best path to follow or plan to manage
your debt.
Identify your big picture vision and
goals
Identifying your big picture visions and
goals for you and/or your family is the
most critical first step to avoid unnecessary debt.
For example, RG Advisors has a pediatric dentist client who is practicing in
the Northeast. When we met, she had
been out four years as an independent
practice. The practice was still wading
through debt, struggling to make payroll.
However, her practice was experiencing
remarkable growth. This being said, she
still had difficulty paying herself. The
doctor and her husband outlined with
clarity their big picture visions and goals.
One goal that stands out is the goal of
helping their three daughters with their
weddings and a down payment on their
first homes.
You may not think this is a reasonable goal; however, it is their goal. Turn
the clock forward a few months after
building their Financial Freedom Plan™,
which includes their visions and goals,
and their dream property became available for purchase. In order for them to
purchase the property, they would add
an additional $600,000 in debt and
the monthly debt service of $3,000 per
month. When the doctor and her husband called for advice, my first question
back was, “Are you willing to sacrifice
your goal of helping your daughters in
the future?” The answer was a resounding “NO!”
Your vision and goals become sounding boards; they are an objective consideration if their outcome is threatened by
Remember, too
much debt and
not having a
good payback
plan may greatly
reduce your
freedom and
choices.
Photo/www.sxc.hu
When you are considering your debt options, the decisions are mostly economical.
• What is the best rate?
• What is the best term?
• Are there any prepayment penalties
and can I live with them?
• What is the debt being used for?
• Do I need it now?
• What is the monthly require payment? Can I afford the debt service?
that organize all liabilities, required payments and their current interest rates.
For example, we recent worked on a
debt elimination plan for a young general
dentist from Ohio who was out of school
six months. All of his debt was tied to five
student loans, totaling close to $265,000.
After constructing his debt elimination
plan, the dentist’s strategy began with
paying the high-interest balance first and
overpaying required payments by $1,300
each month.
His focused effort and overpayment
will save him $59,254 in interest and the
debts will be forgiven.
Understand the impact of your debt
Implement the plan
Understanding the impact of the debt
will help you make good decisions. In
some cases, the use of debt is needed for
practice growth, purchasing a home or
other large purchases.
However, what is the impact? What
choice should I make? With any choice
you have to budget for the additional
debt service each month. With that being
said, using debt wisely may give you and
or the practice the ability make needed
purchases and more efficiently invest in
your practice and or your future.
When it comes to debt forgiveness or a
plan for debt elimination, implementation or taking action is the only way you
will have the desired outcome. Planning
is like a sports “chalk talk” by the coach.
The coach will draw the best possible
outcome on the board, but if the team or
individual players do not execute their
rolls accordingly, they will NOT have the
desired outcome.
If you build a debt elimination plan,
find the discipline to follow each step. Remember, too much debt and not having
a good payback plan may greatly reduce
your freedom and choices.
more debt. If you have not identified visions and goals, take time and start now.
Identify your choices
Build a debt elimination plan
A good debt elimination plan will give
you a guide, to ensure that you efficiently
pay off all of your debt in a timely manner. Additionally, an efficient plan, will
illustrate the benefits of overpaying the
required payments. When designing our
debt elimination plans for our clients, we
use a proprietary tool named DETool™
In closing
The first five or so years out of school
have always proven to be the most challenging years for dentist. At RG Advisors,
we call this time the “Survival Phase.”
This is the time where you are launching
your careers. You are making choices to
be independent or work for a group. This
is the time most dentist are learning how
to manage a team and/or run the practice. This is also the time when most dentists are concerned with making payroll
or the fear of not having enough money
to cover overhead.
All of the concerns above are stressed
exponentially when you add debt to the
equation. The more debt you have, the
more pressure you will experience. In
most cases, the outcome is either debt or
success.
About RG Capital
RG Capital Investment Advisory Services,
LLC, dba RG Advisor Group; securities offered through Capital Investment Group,
Inc. Member FINRA/SIPC. Investment advisory services offered through RG Capital Investment Advisory Services, LLC, a
registered investment advisor.
About the author
Robert Graham and
RG
Advisors
have
been recognized as
wealth
ment
manageand
tax-
planning specialists
for dental care professionals by many
industry
leaders.
Graham has worked
with and educated
thousands of dental
professionals on topics such as wealth accumulation, tax efficiencies, retirement planning, asset
protection and practice transitions.
[11] =>
Ortho Tribune U.S. Edition | WINTER 2012
Industry
11
[12] =>
events
12
Ortho Tribune U.S. Edition | AAO Preview 2013
OrthoVOICE gears up for
its fourth annual meeting
By Davin Bickford
OrthoVOICE board member
O
Planet Hollywood will be the site of the
fourth annual OrthoVOICE meeting this
September. Photo/www.sxc.hu
rthoVOICE 2013 is all set for its
fourth annual meeting, which
takes place Sept. 19–21.
As our meeting continues
to redefine the orthodontic meeting experience, this year a host of fresh speakers will accompany seasoned lecturers to
bring a variety and dimension not found
at other orthodontic meetings.
This year’s OrthoVOICE meeting will
take place at Planet Hollywood in Las
Vegas.
OrthoVOICE will also highlight its
unique and always popular social
events. These events cultivate practicechanging conversations and idea sharing in a fun and relaxed environment
outside of the lecture hall.
OrthoVOICE has applied for CERP accreditation and will offer C.E. credits for
all lectures at this years meeting with
full registration (only $249 before July
15). Doctors and team may choose to register for the Exhibit Hall Only Pass (only
$49 before July 15), allowing access to the
tradeshow floor and all social activities.
OrthoVOICE is committed to developing a community of orthodontists, team
members and companies who value and
embrace practice-changing experiences
through personals relationships, sharing of ideas and forward-focused techniques.
Orthodontics is a great profession, and
OrthoVOICE has created a platform to
showcase the newest products, marketing trends and treatment techniques.
Because it is not affiliated with an association or a single company, OrthoVOICE
brings together the diversity of ideas and
discussion found at company user meetings and the established broad appeal of
a national meeting.
This year’s speakers include Dr. Katherine Vig, Dr. Neal Kravitz, Dr. Dan Bills, Dr.
John Pobans, Nancy Hyman and Andrea
Cook.
Speaker bios, lecture topics, full speaker lineup and registration information
can be found at www.orthovoice.com.
Call (402) 932-1298 for a code to get $50
off your doctor and team registration.
“ AAO, Page 1
recent treatment advances, sleep apnea and state-of-the-art orthodontics
around the world.
Give back at the AAO
Session attendees have supported
local philanthropic efforts in several past host cities. Attendees at this
year’s annual session are invited to
support the Philadelphia chapter of
Back on My Feet (BoMF). A $4.8 million, national non-profit organization, BoMF builds independence
among homeless people by engaging
them in running as a means of developing confidence, strength and selfesteem. Contributions may be made
at annual session registration.
AAO Society of Educators to hold
first meeting at annual session
The James L. Vaden Educational
Leadership Conference, on Friday,
May 3, from 8 a.m.–5 p.m., will be
the inaugural meeting of the AAO
Society of Educators and will focus on
excellence in orthodontic education
and graduate program standards. All
orthodontic educators in the United
States and Canada may join the society (required for conference registration) as an individual ($30 per year),
or as a department ($250).
For more information on the AAO
annual meeting, visit www.aaoinfo.
org/meetings.
AD
GE T WISE .
O R A L H E A LT H A M E R I C A’ S
WISDOM TOOTH PROJECT
1 9 , 0 0 0 P E O P L E R E T I R E D A I LY.
ONLY 2% HAVE A DENTAL BENEFIT PLAN.
DONATE NOW + DOUBLE YOUR IMPACT.
Help OHA help older adults that are vulnerable! Give a gift today!
Y O U R D O N AT I O N W I L L B E M AT C H E D D O L L A R - F O R - D O L L A R B Y
ORALHEALTHAMERICA.ORG/DONATE |
[13] =>
[14] =>
14
industry
Ortho Tribune U.S. Edition | AAO Preview 2013
AOA offers express aligner
options for every practice’s needs
By Kevin Rattle
AOA sales and marketing manager
At the AAO
Stop by AOA booth No. 1009 to learn more
Every practice is unique and each office provides a different offering of
products or treatments. The decision to
choose certain treatment options is usually based on what best represents both
the practice’s and the patient’s needs.
Allesee Orthodontic Appliances (AOA)
recognizes the luxury that each one of us
enjoys in having choices. That is why we
offer several aligner options for the growing express market uniquely designed
to best fit your individual practice’s
needs, including Clearguide Express and
Simpli5.
Clearguide Express represents the increased desire to have a digital user interface with a complete approver process
to allow both the orthodontist and the
patients the ability to view where the
final teeth positions will be. It also provides the clinician complete control over
movements as they can manipulate the
tooth positioning as they see fit, rather
AD
about its express aligner options. You can also
call (800) 262-5221 or visit www.aoalab.com.
Allesee Orthodontic
Appliances (AOA) offers
several aligner options for
the growing express market.
Photo/Provided by AOA
than relying on a design technician to
make the movements.
Simpli5 is designed for the office that
may not have the time, or want to take
the time, to make corrections or approve
final setups. These offices may recognize
the simplicity of express cases and trust
that a company such as AOA, who has
been doing aligner cases for more than 12
years, can use its knowledge and experience to position teeth according to the
clinician’s prescription, without the need
for a viewer. Simpli5 becomes a very simple solution that can be returned to the
office faster than most express systems
because it does not require the additional
steps of the approver process.
Each option also differs in the number
of aligners available. Clearguide Express
offers up to 10 per each arch, while Simpli5 offers five per arch (for cases needing three or less, we offer “Red, White and
Blue”). Because Clearguide Express offers
up to 10, AOA offers a free mid-course
correction process in which the clinician uses a “Heat & Bite” to capture the
patient’s treatment progress and sends it
to the lab.
This step is designed to aid in the predictability of both the treatment time
and objectives. AOA will evaluate the
“Heat & Bite,” make any adjustments
necessary to the setup and proceed with
the next stage of treatment. While both
Clearguide Express and Simpli5 may be
dual-arch cases, each system also offers
a discounted single-arch option. We have
always felt that if you are only treating
one arch, you should not have to pay as if
you were treating both.
[15] =>
[16] =>
industry
16
Ortho Tribune U.S. Edition | AAO Preview 2013
Results for Nite-Guide preventive
and interceptive procedure
By Earl O. Bergersen, DDS, MDS
The largest of several studies on the
Nite-Guide® technique was done under
the auspices of Turku University in Turku,
Finland, by Keski-Nisula et al (from 2001–
2008). The results of this study were reported in two peer-reviewed articles published in 2008.
Four towns in Finland were selected,
with three of them as the treatment sample of 167 cohorts, and one town served as
the control sample of 104 individuals. Several occlusal dimensions were measured
initially at 5.1 years of age and again at the
termination of the study at 8.4 years.
The most important of these dimensions were crowding of the mandible and
maxilla, overbite, overjet, open-bite, mandibular length (condylion-grathion) and
the need for treatment at the end of the
study (as a percentage).
All of the initial measures had no statistical differences, while both groups at
the termination of treatment exhibited
significant differences at the 0.001 level
of significance.
Mandibular crowding had a 98 percent
correction from 48 percent to a 1 percent incidence. The maxillary crowding
improved 82 percent from 11 percent to
2 percent while the control increased
256 percent (9 to 32 percent incidence).
Both overbite and overjet were treated
optimally to 2.1 mm and 1.9 mm. Two millimeters is the ideal recommended measure at this early age (8.4 years) in order
to accommodate future jaw growth (Bergersen, 1990, 1995).
Open-bite had a 98 percent correction
while the control sample had a 20 percent
increase. The Class II canine relation had
an 87.5 percent improvement while the
control group remained unchanged.
The need for further treatment for
overbite and open-bite at the end of
Nite-Guide use was 2 percent compared
to 74 percent for the control sample. Mandibular crowding was 1 percent (treated)
versus 47 percent (control), and maxillary
crowding was 2 percent (treated) versus 32
percent (control).
The conclusion of these results at the
At the AAO
Dr. Earl O. Bergersen, the inventor of the NiteGuide technique, will be presenting an overview of both Nite-Guide and Occlus-o-Guide®
techniques at AAO booth No. 2301.
For reprints of the complete study or for more
information, please visit Ortho-Tain’s website
at
www.ortho-tain.com,
send
email
to
orthotain@gmail.com, call (800) 541-6612, or
stop by booth No. 2301 at the AAO meeting.
termination of the study were expressed
as “… little treatment need was left in the
treatment group compared with the control group …” (Keski-Nisula et al, 2008).
In a second report from the same study
(Keski-Nisula et al, 2008), the most meaningful conclusion was that the mandibular length (condylion-grathion) grew
54.2 percent greater than the control
sample (11.1 mm vs. 7.2 mm) or 3.9 mm
greater during a three-year period (5.1
to 8.4 years). This represents a very large
orthopedic growth factor in correcting
overjets and proper intercuspation and
also results in little or no overjet relapse
in these cases (Bergersen, unpublished
research).
Ninety-three percent of 5- to 7-year-old
children are candidates for this treatment procedure (Keski-Nisula et al, 2003).
Ninety-three percent of children wore the
appliance as directed while sleeping, while
62 percent kept the appliance in all night
after one week (Methenitou et al, 1990).
It was found that only one hour of passive wear each night was sufficient to obtain a successful result in overbite and
overjet (Methenitou et al, 1990).
Research shows that the mean lower
arch increase as a result of the incisal eruption is 3.21 mm (Lewis & Lehman, 1929;
Korkhaus & Lehmann, 1931; Baume, 1950;
Moorrees, 1959).
The mean maximum lower arch enlargement was 5.1 mm (Lewis & Lehman,
1932, 5.5 mm; Baume, 1950, 4.6 mm). The
mean maximum upper arch increase was
6.8 mm (Lewis & Lehman, 1932, 7.0 mm;
Baume, 1950, 6.5 mm).
The maximum arch increase in a study
of 43 individuals using the Nite-Guide
technique (Methenitou et al, 1990) was 6.9
mm in the lower and 8.9 mm in the upper
arch.
This is a 35.3 percent increase in the
mandible and 30.9 percent increase in the
maxilla over the above maximum in the
literature. This is the approximate mean
widths of an upper lateral and central incisor respectively (G.V. Black, 1902).
PhotoMed G15 digital dental camera
offers ‘frame and focus’ simplicity
The PhotoMed G15 Digital Dental Camera is specifically designed to allow you
take all of the standard clinical views
with “frame and focus” simplicity. The
built-in color monitor allows you to precisely frame your subject. Focus and
shoot.
Proper exposure and balanced even
lighting are assured. By using the camera’s built-in flash, the amount of light
necessary for a proper exposure is guaranteed, and PhotoMed’s custom close-up
At the AAO
To see the PhotoMed G15 in person, stop by
the company’s booth at the AAO, No. 2539.
You may also visit www.photomed.net or call
(800) 998-7765 for more information.
lighting attachment redirects the light
from the camera’s flash to create balanced, even lighting across the field.
The PhotoMed
G15 is specifically
designed to take
clinical views with
‘frame and focus’
simplicity.
Photo/Provided by
PhotoMed
[17] =>
GNYDM
[18] =>
18
industry
Ortho Tribune U.S. Edition | AAO Preview 2013
The outcome is simulated
but the wow is genuine
iTero and Invisalign together can still impress
even your most jaded clients
By Align staff
At the AAO
Those who would like to give the Invisalign
T
echnology is progressing so fast
these days that it can be hard to
still wow people. This is especially true when it comes to younger
patients, who have been born and grown
up knowing nothing but the connected
life.
This is why the new iTero 2.9 intra-oral
scanner is so impressive. Not only does
it offer a set of features that will wow
the most gadget-oriented orthodontist
(you know who you are), but it has some
unique features that will make even the
hardest-to-impress-patients (we’re talking to you, teenagers) offer a begrudging,
“That’s pretty cool.”
The crown jewel of the iTero 2.9 is the
Invisalign Outcome Simulator, which
we’ll get to shortly. But, first things first:
the iTero 2.9 is the latest iteration of the
intraoral scanner from Align Technology.
This next generation iTero has upped
the performance while shrinking the
physical footprint of the entire system,
including the imaging wand. Like its predecessors, the 2.9 is all about accuracy. It
captures a level of detail that simply isn’t
possible using a traditional impression.
If you think this accuracy is overkill,
think again. A recent study suggested
that up to 40 percent of all the PVS impressions taken show some type of physical deformity such as a tear, void or pull.1
Impressions taken with the iTero 2.9
intra-oral scanner have a remake rate of
just .0015 percent.2 A number that small
can seem abstract, so think of it this way,
that means that many practices will go a
year or more without ever having to reimpress a patient.
Still, this kind of accuracy is now expected when it comes to digital processes. It’s once you pair up the iTero 2.9
with Invisalign treatment that the scanner will begin to wow the orthodontist.
That’s because iTero is the only intra-oral
imaging device that offers 100 percent
inter-operability with the Invisalign procedure.
Tim Mack, Align Technology vice president and general manager of iTero says:
“iTero is the only intraoral scanner that
is currently certified with Invisalign. The
process for validating intraoral scanning
with Invisalign production is extensive.
To date, only the iTero system has proven
to consistently meet the requirements
for providing the orthodontic full-arch
scan data required for Invisalign.”
Capturing a scan for Invisalign treat-
Outcome Simulator technology a test drive
and sample the iTero 2.9 intraoral scanner can
do so at AAO booth No. 1601.
Invisalign Outcome Simulator samples. Photos/Provided by Align Technology
ment is easy. But it’s the inclusion of
the Invisalign Outcome Simulator that’s
really captured the imagination of the
orthodontic community.
The Invisalign Outcome Simulator is
a standard part of the latest generation
iTero software. The chairside application
is specifically designed to enhance patient acceptance by helping them visualize how their teeth will look at the end of
treatment.
Simulated outcomes make it easy to
show patients the benefits of Invisalign
treatment, rather than just telling them.
The Invisalign Outcome Simulator’s
dual-view layout shows the patient’s current dentition alongside his or her final
outcome.
Dr. Jonny Feldman is a secondgeneration orthodontist in Feldman Orthodontics (along with his father and
brother) in Cheshire, Conn. He says that
his family’s practice was one of the first
three or four practices in the country to
adopt the iTero technology in 2009. He
believes so strongly in the technology
that his daughter was one of the first Invisalign cases started with an iTero scanner.
“One of the historically difficult things
to do with Invisalign was the PVS impression,” Feldman said. “I love iTero. Quicker
turnaround for us getting the aligners.
I can scan a patient, and it goes directly
to Invisalign. I get my ClinCheck® back
in days as opposed to a week. The turnaround time to just get my patient in
aligners is greatly reduced. Now we don’t
have to rely on the U.S. mail much.”
While the technology is state-of-theart, iTero has followed the lead set forth
by Apple with the revolutionary iPhone
product line and opted to make the process as intuitive as possible. According to
Feldman, the company has succeeded.
“It’s not a hard thing to master at all,”
he said. “The software talks you through
the scan process.” He says that even his
more tenured assistants didn’t have
much trouble integrating the process
into their skill repertoire.
When it comes to the Invisalign Outcome Simulator, it seems that both Feldman and his patients are impressed.
“It helps establish a beginning and an
end,” he said. “Showing them a simulation of the end result is a powerful tool. I
can say ‘I want to close a space here’ but a
picture is worth a thousand words.
“I’ll never go back to not having a scanner in my office. To me, it’s a must-have
for any practice that does Invisalign.
The bottom line is that its stress-free for
your patients, and it’s stress free for your
staff,” Feldman concluded.
References
1)
2)
Review by Arrowhead Dental Lab and published in Aesthetic Dentistry, Summer
2007
Review by Arrowhead Dental Lab and published in Aesthetic Dentistry Summer 2007
reports the average remake rate for their
iTero impressions is less than .0015 percent. “The Remake Debate”, LMT Commu-
[19] =>
Ortho Organizers
[20] =>
Imaging Sciences
)
[page_count] => 20
[pdf_ping_data] => Array
(
[page_count] => 20
[format] => PDF
[width] => 765
[height] => 1080
[colorspace] => COLORSPACE_UNDEFINED
)
[linked_companies] => Array
(
[ids] => Array
(
)
)
[cover_url] =>
[cover_three] =>
[cover] => ![Ortho Tribune U.S. No. 2, 2013]()
[toc] => Array
(
[0] => Array
(
[title] => Comparison of tooth mesiodistal angulation measurements
[page] => 01
)
[1] => Array
(
[title] => AAO heads to Philadelphia
[page] => 01
)
[2] => Array
(
[title] => Curriculum is changing for today’s instructors
[page] => 02
)
[3] => Array
(
[title] => The mobile-friendly dental practice: Why your website should be optimized for mobile-device users
[page] => 08
)
[4] => Array
(
[title] => Debt vs. success
[page] => 10
)
[5] => Array
(
[title] => OrthoVOICE gears up for its fourth annual meeting
[page] => 12
)
[6] => Array
(
[title] => Industry
[page] => 14
)
)
[toc_html] =>
Table of contents
-
Comparison of tooth mesiodistal angulation measurements
01 - 06
view
-
AAO heads to Philadelphia
01 - 12
view
-
Curriculum is changing for today’s instructors
02 - 03
view
-
The mobile-friendly dental practice: Why your website should be optimized for mobile-device users
08 - 08
view
-
Debt vs. success
10 - 10
view
-
OrthoVOICE gears up for its fourth annual meeting
12 - 12
view
-
Industry
14 - 18
view
[toc_titles] => Comparison of tooth mesiodistal angulation measurements
/ AAO heads to Philadelphia
/ Curriculum is changing for today’s instructors
/ The mobile-friendly dental practice: Why your website should be optimized for mobile-device users
/ Debt vs. success
/ OrthoVOICE gears up for its fourth annual meeting
/ Industry
[cached] => true
)