Ortho Tribune U.S. No. 4, 2012

MASO can help you ‘Chart a Course’ / What does it mean to ‘do research’? Part One / How to avoid extractions when treating malocclusions using MRC’s Bent Wire System and Trainer System for arch development / Events / Industry

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

MASO 2012 — Vol. 7, No. 4

www.ortho-tribune.com

MASO can help you
‘Chart a Course’
Middle Atlantic
Society of
Orthodontists to
host annual session
By Sierra Rendon, Managing Editor

T

he Middle Atlantic Society of
Orthodontists (MASO) will host
its annual session from Sept.
20–23 at the Hilton Baltimore
on Baltimore’s inner harbor. During this
time, you and your colleagues will be
“Charting a Course for the Future.”
Annual session speakers include: Drs.
David Sarver, Roger Levin, Neal Kravitz,
Jeffrey Posnick, Normand Boucher, Jeff
Behan and Chris Bentson. MASO’s staff
program will include Char Eash and
Tina Byrne.
At this annual session, MASO will
present its Lifetime Achievement
Award to Dr. David Paolini. Paolini
graduated from La Salle College in
Philadelphia and the University of
Pittsburgh School of Dental Medicine
in 1964. He received a three-year fellowship in orthodontics at the start

” See MASO, page 7

The HIlton Baltimore on Baltimore’s inner harbor will be the site of the Middle Atlantic Society of Orthodontists annual session from Sept. 20–23.
(Photo/Provided by MASO)

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From the Editor

Ortho Tribune U.S. Edition | MASO 2012

What does it mean
to ‘do research’?

When students and residents talk
about “doing research,” many are not
thinking in the realm of classic research
approaches, but rather writing an article on a specific topic or exploring a
limited clinical project.
Most medical and dental students
think about the quantitative approach
because it has been used as the method of choice for many years, whereas
the social science students are more
familiar with qualitative methodologies. Inquiry into a variety of clinical or
theoretical medical and dental topics
can employ quantitative, qualitative or
both methodologies in the same study.
It is time to expand the erudition of research, and it is at the medical and dental student level that such new points of
interest must be established.
Until recently, the medical and dental sciences have been more concerned
with treating the down stream problems, rather than up the stream etiology of disease. It is essential to focus on
treating the systems and not just the
symptoms. In order to appreciate that
spectrum, it is necessary to acknowledge that research is at the forefront of
such knowledge. To facilitate better understanding, diagnosis and treatment
of our patients, doctors must appreciate
and value research with an open mind
and a quest for visualizing medical and
dental research.
Basically, research is story telling; it
is a methodical and organized inquiry
into a theoretical subject or practical
understanding of a subject. Research is
used to (a) establish or confirm facts, (b)
reaffirm results of previous studies, (c)
solve new or existing problems, (d) support statements, and/ or (e) develop new
theories regarding the hypothetical or
practical milieu. A research project may
also be an expansion on past work in order to test the validity of instruments,

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

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

ORTHO TRIBUNE

Managing Editor ORTHO Tribune
Sierra Rendon s.rendon@dental-tribune.com

procedures, or experiments, including
replication of prior projects or development of new areas.
A classic explanation of the differences between the “theoretical” and “practical” disciplines of medical, dental and
scientific research is the: (a) theoretical
attempts to understand the causes and
nature of health and sickness, while
(b) practical struggles to make people
healthy. These two areas are related but
can also be independent from each other. It is possible to research sickness and
health without curing a specific patient,
and it is possible to cure a patient without knowing how the cure works.
The primary purpose of “basic” research as opposed to “applied” research
is established in the documentation,
discovery, development and interpretation of methods, systems or approaches.
These research approaches depend on
epistemology and vary considerably between the humanities and the sciences.
A primary distinction in scientific
research is between a theory and the
hypothesis: A theory is a collection of
hypotheses that are logically linked together into a coherent explanation of
some aspect of reality, which individually or jointly receives some empirical
support. Hypotheses are individual and
empirically testable conjectures. As a
basic review, the three most common
research approaches are outlined as follows:
I Quantitative research
II Qualitative research
• Phenomenology
• Ethnography
• Case Study
• Grounded theory
• Historical
III Mixed research

Rationale for research method
appropriateness
For a very simple understanding, these
three research methodologies (qualitative, quantitative and mixed) have been
used to investigate a variety of issues,
focusing on different aspects.
A quantitative approach is helpful
to develop and employ mathematics,
statistics and hypotheses pertaining
to a problem. It uses measurements to
provide the primary connection and
expression of the quantitative relationships. A qualitative research approach
is appropriate when gathering in-depth
understanding of human and social
behavior and the reasons for such behavior. It investigates the how and why
rather than the when, what, or where of
decision-making, as well as various re-

actions to, or perceptions of a particular
phenomenon.
This approach might assume some
commonality to the perceptions of human beings and how they interpret
similar experiences seeking to identify,
understand and describe these commonalities. The mixed approach has
evolved as a pragmatic way of using
the strengths of both qualitative and
quantitative research methodologies. It
is still in its infancy and is expected to
become more popular in the next few
years.
As a pragmatist and realist, I see the
worldview of a research question for allowing the researcher to be open to (a)
multiple methods of data collection,
such as qualitative and quantitative
sources; (b) focus on practical implications of research; and (c) emphasize the
importance of conducting research that
best addresses the research problem.
Please look for Part Two in the next edition of Ortho Tribune.

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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.

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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)
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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)
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Gregg Tartakow, DMD (Orthodontics) & Ortho
Tribune Associate Editor

[3] =>

Ortho Tribune U.S. Edition | MASO 2012

industry clinical

How to avoid extractions when treating
malocclusions using MRC’s Bent Wire System
and Trainer System for arch development
By German O. Ramirez-Yañez, DDS,
PhD, and Chris Farrell, BDS

Abstract
Maxillary and mandibular expansion
has been proposed to increase the arch
perimeter and to avoid extractions during orthodontic treatment. Although
controversy has persisted over the stability of expansion techniques, there
is an increasing trend toward “nonextraction.”
This paper describes a novel method to
produce expansion of the dental arches,
and at the same time, to treat muscular
dysfunctions that may be the etiological
factor of the malocclusion. The system
has been developed by Myofunctional
Research Co. (MRC), Queensland, Australia, as a simpler method of phase one expansion, which may produce improved
stability because of simultaneous habit
correction in selected cases. Two cases
treated with the Farrell Bent Wire System™ (BWS™) are described and the advantage of this method of treatment is
discussed.

Introduction
Expansion of the jaws has been increasingly performed in orthodontics to
achieve better occlusal and maxillary
relationship and, in doing so, improving oral functions. Maxillary and mandibular expansion has been proposed
since Edward Angle to avoid extractions
(Dewel, 1964). This paper presents a novel
method to produce dental arch development in the maxilla and the mandible,
while at the same time correcting or
maintaining the inter-maxillary relationship either if a sagittal and/or vertical problem exists or a Class I malocclusion with normal overjet and overbite is
present at the beginning of treatment.
There is a controversy regarding the
ideal time for performing the expansion.
Sari and co-workers reported that rapid
maxillary expansion by means of a fixed
screw (eg. Hyrax) produces better results
when it is performed in the early permanent dentition (Sari, 2003). Although
this statement appears to be supported
by other studies (Chung; Housley, 2003;
Spillane, 1995), maxillary expansion may
also be successfully done in older adolescents and adults (Stuart, 2003; Iseri,
2004; Lima, 2000). In the maxilla, rapid
and semi-rapid expansion produce an increase of the lower nasal and maxillary
base widths, with the maxilla moving
forward and downward (Chung, 2004;
Sari, 2003; Iseri, 2004).
These changes in the maxilla produced
by the expansion are accompanied by
a spontaneous mandibular response,
which increases the dental arch perimeter (Lima, 2004; McNamara, 2003) and
rotates the mandible posteriorly (Sari,
2003; Chung, 2004). Mandibular displacement is associated with an increase
in facial height (Sari, 2003, Chung, 2004).
Net gain in the arch perimeter may
be calculated accordingly with the ex-

pansion performed. Motoyoshi and coworkers reported that 1 mm increase in
arch width results in an increase in arch
perimeter of 0.37 mm (Motoyoshi, 2002).
Akkaya and collaborators determined
that arch perimeter gain through expansion could be predicted as 0.65 times
the amount of the posterior expansion
when treatment is performed with rapid
maxillary expansion, and 0.60 times the
amount of posterior expansion when
treatment is performed with semi-rapid
maxillary expansion (Akkaya, 1998). This

is also supported by Adkins and co-workers, who determined that arch perimeter
may increase 0.7 times the expansion
produced at the premolars.
An expected relapse in the amount of
expansion has been reported by some authors (Hime, 1990; Housley, 2003), which
appears to be the result of that pressure
delivered by the cheeks on the maxillary
arch and the resistance to deformation of
maxillary sutures and surrounding tissues to maxillary expansion.
Nevertheless, maxillary and mandibu-

lar expansion rises up as one of the important phases of orthodontic treatment,
producing arch perimeter increase,
and thus, avoiding extraction of teeth.
Increasing numbers of multi-banded
techniques using passive self-ligating
brackets have become popular, but few
address the challenges of adapting the
soft tissues to this new dental position.
Long-term retention is the recommended solution to stability. Thus, the aim
” See MRC, page 4
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industry clinical

Ortho Tribune U.S. Edition | MASO 2012

“ MRC, Page 3
of the current paper is to present a new
method to produce maxillary and mandibular expansion and, at the same time,
to treat the soft-tissue dysfunction that
may be responsible for treatment relapse
(Ramirez-Yañez, 2005). Two example
cases treated with the BWS Orthodontic
System developed by Myofunctional Research Co (MRC) in Australia are presented to explain the proposed treatment.

Fig. 1: Photos/Provided by Drs. German O.
Ramirez-Yañez and Chris Farrell.

Fig. 2

The BWS Orthodontic System
The BWS Orthodontic System discussed
in this article is composed of two different appliances: the Trainer™ and the
BWS. These two appliances combined
may simultaneously produce arch development and treat poor myofunctional habits. The Trainer, a pre-fabricated
functional appliance, has amply demonstrated an ability to relocate the mandible (Usumez, 2004) to correct improper
forces produced by the muscles of the
cheek and lips (Quatrelli, Ramirez-Yañez,
2005a) and to change the dimensions of
the dental arches (Ramirez-Yañez, 2005b).
Further research (Yagci 2011) showed that
treatment using the Trainer produced a
positive influence on the masticatory
and peri-oral musculature.
However, in those cases where more
maxillary and mandibular expansion is
required to avoid teeth extractions, the
Trainer combined with the BWS produces
higher amounts of expansion and, therefore, a higher increase in arch perimeter.
It is also proposed that by utilizing the
Trainer in conjunction with the arch expansion, the force of the tongue activates
further alveolar changes that other techniques may not achieve because of the
bulk of the appliance being located in the
palate where the tongue should naturally position.
The BWS is typically composed of a
lingual arch, which follows the lingual
surfaces of the teeth crowns at the gingival third and ends in a loop at the interproximal space between the second premolar and the first molar at both sides.
The distal end engages a tube (0.7 Farrell
tube by MRC) welded to a cemented band
on the first molars (Fig. 1). Additionally,
the BWS is maintained in place, facing
the gingival third of teeth’s crown, by
two begg premolar brackets cemented on
the first premolars with the slot directed
toward gingival or alternately composite
stops bonded to the premolar or anterior
dentition (Fig. 2). The wire component is
0.7 mm spring wire and is fabricated to
the arch form of the starting models either by the laboratory or the orthodontist. The simple nature of the BWS makes
it possible to assemble in-house, avoiding the fees that accompany laboratoryconstructed appliances.
An advantage of this system is that it
does not involve using acrylic in the palatal vault. A functional appliance designed
with acrylic on the palate and that is not
properly built may lower the tongue, encouraging tongue thrusting, and, thus,
either worsening the malocclusion or
producing a relapse (Fig. 3). The Trainer
is a prefabricated functional appliance,
which means no laboratory involvement,
and the BWS can be entirely constructed
“in office.” The BWS is not made of acrylic, nor does it occupy the palate. It allows
the tongue to position correctly and the
patient to speak normally.
The BWS is also suitable for use in the

Fig. 3

Fig. 4a

Fig. 4b

Fig. 5

lower arch. Typical treatment tends to
use only upper expansion for three to
four months, after which time the wire
component of the BWS is removed (the
bands are kept for later use of the BWS).
The i-2 Trainer (with the inner-cage that
produces arch expansion) is then used
to maintain the initial arch expansion
gained using the BWS. Lower alignment is
re-evaluated throughout this stage of i-2
Trainer use. Often, as can be demonstrated in the cases selected, lower alignment
and arch form improves because of the
maxillary expansion and peri-oral musculature functional improvement (Fig. 4).
The BWS is held in place using standard
ligatures placed around the BWS tube as
pictured (Fig. 5).
The following two cases show the effect
of the BWS Orthodontic System on arch
development.

Case No. 1
This 10-year-old female patient consulted because of a crowded dentition
involving unusually misaligned upper
central incisors with a midline shift of 10
mm and with lost “c” space on the lower
left side. The parents requested that the
treatment be non-extraction, although
they had previously been advised that
future orthodontic treatment might require this option (Fig. 6).
The occlusion was classified as Class I
with normal slight overjet and with normal overbite. No skeletal alteration was
found on cephalometric measurements
and analysis of cast models reported a
lack of arch development. This case was
diagnosed as a Class I malocclusion with
underdevelopment of both dental arches.
Midline shift was primarily as a result of
the lost lower “c” space. Soft-tissue analy-

sis showed a mouth-open posture and
hyperactive peri-oral musculature. It
was considered the myofunctional habits were a contributing factor to the malocclusion and, thus, a suitable case for
the BWS and Trainer combination prior
to fixed appliances once the permanent
dentition was fully erupted.
The plan of treatment involved a first
phase with a BWS for the upper arch combined with an I-2n Trainer — “n” for no
core or cage for increased flexibility and
use with the BWS. The i-2n Trainer was
used one hour daily plus overnight while
sleeping. Monthly adjustment to the activating loops of the BWS were made in
increments of 1-2 mm per month.
This treatment was continued for four
months, after which time the upper BWS
was removed and i-2 Trainer was used to
maintain the expansion achieved by the
BWS. The i-2 Trainer also encouraged the
tongue to assist in maintaining the maxillary expansion without retainers. At
this stage, the lower arch form and dental
alignment was assessed and showed considerable improvement. It was noted the
space for the lower left permanent canine had increased — an effect thought
to be produced by the combination of
maxillary arch expansion and correction
of myofunctional habits. The midlines
were also self-correcting.
Space for the lower canines was ultimately achieved without a lower BWS.
The case is further improved by continued use of the i-2 Trainer and the Myobrace Regular™ to exploit the eruption
stage prior to treatment finalization with
fixed appliances as required.
The observation of the effects and benefits of the BWS Orthodontic System are
evident from this case, and the concepts
are not new to orthodontics. Maxillary
expansion tends to also improve the
lower arch length and assists the orthodontist in achieving non-extraction outcomes with more stable results because
of simultaneous correction of tongue
position and retraining of the peri-oral
musculature. The second phase of treatment did not require the BWS on the lower arch as arch development during the
treatment period sufficiently opened the
space for the lower permanent canine.
The lower anterior dentition did not require the use of fixed appliances (Fig. 7).
Thus, this case was treated in a 2-year
period, required minimal chair side time
and a difficult extraction case was converted to a simple, non-extraction case.

Case No. 2
This 12-year-old female patient consulted
because of very underdeveloped maxillary arch form and ectopic erupting
canines (Fig. 8). This is far from an ideal
stage to be considering non-extraction
treatment; however, the parent insisted that the case was attempted nonextraction. The lower anterior teeth were
also considerably crowded, and it would
regularly be justified in extracting the
first four premolar teeth and going into
upper and lower straight wire fixed appliances.
It could be argued that treating nonextraction will prolong the treatment
and certainly incur greater expense on
the parent. However, there is a growing
demand from parents who have had
extraction orthodontics in the past to
” See MRC, page 5

[5] =>

industry clinical

Ortho Tribune U.S. Edition | MASO 2012

Fig. 6a

Fig. 6b

Fig. 6c

Fig. 6d

Fig. 7a

Fig. 7b

Fig. 7c

Fig. 7d

“ MRC, Page 4
avoid this approach for their children.
Therefore, the BWS Orthodontic System
can be a beneficial technique that the orthodontist can use in these exceptional
cases.
Treatment was similar to case 1. An upper BWS was fitted and combined with
the use of the i-2n Trainer initially for
four months, after which time the BWS
wire was removed, leaving the molar
bands in place. The i-2 Trainer was introduced at this stage for a further three
months to maintain the expansion prior
to a second phase of treatment using the
BWS and i2n Trainer for three months (as
mentioned earlier in this article).
This allows the dentition to “catch up”
and prevents excessive tooth mobility.
It is thought that much of the expansion achieved by this system is dentoalveolar rather than sutural, as with a
rapid maxillary expander and other
acrylic expanders. Also, there is more
development in the anterior arch form,
which is an effect previously found in
the research on the Trainer (RamirezYañez, 2005b).
The difficulty in cases like this, requiring large amounts of expansion
to achieve a non-extraction result, is
a tendency to create an open bite. Although this occurs to some extent, the
BWS Orthodontic System does not open
the bite as much as more conventional
techniques because the tongue position
is favorably altered by use of the Trainer.
This conjecture may require further investigation to ratify.
Once again, spontaneous alignment
of the lower anterior dentition has occurred without the requirement for an
additional BWS for the lower arch. This
effect is not just restricted to these two
cases but is a routine observation of the
BWS Orthodontic System. This case also
illustrates the stability achieved in the
lower dentition as no retainers were used
apart from night use of the Trainer.
Although this patient is not at the ideal
age, the pictures show that it was possible to obtain space for all permanent
canines, without extractions and with
good stability.
The bite opening is minimal and tends
to decrease with further dental development. Although this case was finalized
” See MRC, page 6

[6] =>

Industry
industry
clinical

Ortho Tribune U.S. Edition | MASO 2012

Fig. 8a

Fig. 8b

Fig. 8c

Fig. 8d

Fig. 9a

Fig. 9b

Fig. 9c

Fig. 9d

duces arch development and, at the same
time, the mandibular relocation effect is
produced by the Trainer (Usumez, 2004;
Ramirez-Yañez, 2005a; Quadrelli, 2002),
which treats the distal position of the
mandible.
Additionally, the BWS Orthodontic
System has shown to improve the overjet and overbite but to maintain them
when they are correct at the beginning
of treatment. This system treats muscular dysfunctions that may be the cause
of crowding and malocclusion and may
cause relapse after treatment is finished.
Thus, the BWS Orthodontic System
may be proposed as an excellent alternative form of treatment in those cases
where arch development is required to
align teeth, patients want to minimize or
even avoid brackets and extractions, the
mandible needs to be relocated, soft tissue dysfunction is present and treatment
needs to be performed in a reasonable
period of time.

About the authors

“ MRC, Page 5
with the Myobrace Regular™ from MRC,
fixed appliances on the upper arch would
possibly have delivered quicker results
following the BWS Orthodontic System.
The assistance of correcting the forces
delivered by the muscles of the cheek
(buccinator) and lips (orbicularis oris) at
swallowing cannot be ignored and is a
key part of the modus operandi of this
expansion system.
After two years of treatment and observation, along with night-time retention
using the i-2 Trainer for 12 months after
treatment, the BWS produced enough
upper arch development to not only accommodate the erupting canines, but
also achieve lower anterior alignment
with minimal intervention and minimal
retention (Fig. 9). This case was a more
extreme example that orthodontists
will face in the future as more parents
demand the non-extraction option with
minimal use of multi-bracket systems.

Conclusions
Maxillary and mandibular expansion
has been shown to be an excellent alternative to increase the arch perimeter
and, thus, to avoid the need for extractions to properly align teeth. This paper
has presented two cases treated using the
BWS Orthodontic System, which involves
the combination of two appliance systems: the Trainer, a pre-fabricated functional appliance, and the BWS.
Both appliances, Trainer and BWS, have
to be used in order to get the results reported in this paper. The BWS Orthodontic System showed in these two cases and
in many cases treated by the authors is an
excellent means to produce arch development in both upper and lower dental
arches in a short time.
The effect of the BWS Orthodontic
System on arch development does not
change the inter-maxillary relationship
when a Class I occlusion exists at the beginning of treatment.
However, when a Class II malocclusion
associated to a crowded dentition is present the BWS Orthodontic System pro-

10.

11.

12.

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Motoyoshi M, Hirabayashi M, Shimazaki T,
Nawra S. An experimental study on mandibular expansion: increases in arch width
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2:109–122.
Ramírez-Yáñez GO, Farrell C. Soft tissue
dysfunction: A missing clue when treating
malocclusions. Int J Jaw Func Orthop 2005;
5.
Ramírez-Yáñez GO, Junior E, Sidlauskas A,
Flutter J, Farrell C. The effect of a pre-fabricated functional appliance on arch development. 2005 (in preparation).
Sari Z, Uysal T, Usumez S, Basciftci FA. Rapid maxillary expansion. Is it better in the
mixed or in the permanent dentition? Angle Orthod 2003; 73:654–661.
Spillane LM, McNamara JA Jr. Maxillary adaptation to expansion in the mixed dentition. Semin Orthod 1995; 1:176–187.
Stuart DA, Wilkshire WA. Rapid palatal expansion in the young adult: Time for a paradigm shift? J Can Dent Assoc 2003;
69:374–377.
Usumez S, Uysal T, Sari Z, Basciftci FA, Karaman AI, Guray E. The effects of early preorthodontic Trainer treatment on Class II,
division 1 patients. Angle Orthod 2004;
74:605–609.

Chris Farrell, BDS, graduated from Sydney University in 1971 with a comprehensive knowledge of
traditional orthodontics using the BEGG technique.
Through clinical experience, he took an interest in
TMJ/TMD disorder and, after further research, Farrell discovered that the etiology of malocclusion
and TMJ disorder was myofunctional, contradicting the current views of his profession. Farrell
founded Myofunctional Research Co. (MRC) in 1989
and has become the leading designer of intra-oral
appliances for orthodontics, TMJ and sports
mouthguards.

German O. Ramirez-Yañez, DDS, PhD, is a dentist
from Colombia (South America) with more than 20
years of experience in guiding craniofacial growth
and development. He is a specialist in pediatric
dentistry (Mexico) and functional maxillofacial orthopedics (Mexico and Brazil), and is trained in orthodontics (Mexico). Ramirez has a master’s in oral

‘The simple nature of the BWS makes it possible to assemble in-house,
avoiding the fees that accompany laboratory-constructed appliances.’

biology and a PhD in dental sciences (Australia). He
has published more than 20 articles about early
orthodontic treatment and about craniofacial biology in peer- reviewed international journals.

[7] =>

events

Ortho Tribune U.S. Edition | MASO 2012

OrthoVOICE 2012 on slate for October
Enhanced social events and a focus
on presenting outstanding clinical and
entrepreneurial ideas in a fresh environment have attendees and the event
organizers preparing for another dynamic “social meeting” experience at
the OrthoVOICE 2012, which takes place
Oct. 11–13 at Paris & Bally’s Resort in Las
Vegas.
Leading off with an entertaining and
educational talk with Dr. Lysle Johnston,
OrthoVOICE attendees are in for a wild
ride of mind-stretching ideas for practice growth, according to organizers.
With a unique take on building the
speaker lineup and creative social
events, OrthoVOICE is set to be orthodontics’ most innovative and socially

interactive meeting of the year, its organizers say.
“For OrthoVOICE, it’s about education,
fun and giving back,” according to the
event organizers.
Plan to attend the meeting’s second
charity golf event on Thursday morning, Oct. 11. This year’s event will be
held at Desert Pines Golf Club to benefit
Smile for a Lifetime Foundation (S4L).
The $229 registration is open online
at www.orthovoice.com and includes a
donation to S4L, breakfast and lunch,
round-trip transportation, green fees,
carts and range balls.
To learn more about the full range of
events and lectures at OrthoVOICE 2012,
visit www.orthovoice.com.

The OrthoVOICE
2012 will take
place Oct. 11-13 at
Paris & Bally’s
Resort in Las
Vegas.

Twelve C.E. credits are offered and doctor/team registration is only $399 per

person, through Sept. 30. Registration is
open now at www.orthovoice.com.

“ MASO, Page 1
of his sophomore year in dental school,
which started him on the career path of
this specialty. After completing dental
school, Paolini married his wife, Caroline, and began his orthodontic training at Pitt. He received his certificate in
orthodontics and his master’s in dentistry, and then entered military service,
spending two years at Fort Benning, Ga.
In 1972, he established his first office
in Gettysburg, Pa., and opened a satellite
office in Waynesboro a year later. He retired in 2010. During his 38 years of practice, Paolini has served as president of
both the Pennsylvania State and Middle
Atlantic Society of Orthodontists. During his service on, and chairmanship
of, the AAO’s Council on Insurance, he
achieved the highlight of his AAO career
when he was instrumental in establishing the current malpractice program. He
served on the council for an additional
five years. He has served two eight-year
terms in the AAO House of Delegates
and eight years on the Council on Orthodontic Practice.

Session schedule
Thursday, Sept. 20
• 7–11 a.m.: MASO Board Meeting (invitation only)
• 1–5:30 p.m.: Golf outing at the Country Club of Maryland
• 1–6 p.m.: Registration/exhibitor setup
Friday, Sept. 21
• 7:30–8:30 a.m.: Continental breakfast
in exhibit hall (complimentary)
• 7:30 a.m.–4 p.m.: Registration/exhibit
hall open
• 7:30 a.m.–4 p.m.: ABO case displays
• 8–9:30 a.m.: Staff session, Dr. Neal
Kravitz, “Developing the ‘Dream Team’:
10 Characteristics of an Elite and Irreplaceable Orthodontic Team Member”
• 8:30–10 a.m.: Doctor session, Dr. Roger
Levin, “Create the Ideal Ortho Practice,
Part One” (co-sponsored by Levin Group)
• 9:30– 10:30 a.m.: Beverage break in
exhibit hall (complimentary)
• 10 a.m.–noon: Staff session, Tina
Byrne, “Navigating as Part of the Ortho
Crew: Winning May Be As Simple As
Adjusting Your Sails, Part One” (co-spon” See MASO, page 8

Technolog y designed the way you work

Closing the digital loop
The first open CAD/CAM system for orthodontics
3Shape TRIOS® is the new ultra-fast and easy to use
chairside scanner to create accurate digital impressions in open format.
3Shape Ortho System
3rd party
Production

•

R700

format STL

3Shape
Ortho System
2012

Appliance Designer™

Intraoral scans, impression/model scanning, open

TRIOS

Ortho Analyzer ™

•

Customizable analysis workflows

•

Full treatment simulation, including virtual setups

•

Virtual articulators for easy validation

•

CAD design of any orthodontic appliance

•

Free choice of manufacturing equipment and
materials

See the full digital loop at an exhibition near you

Note: TRIOS® will be available in North America in 2012

Scan the QR code

& sign up for our newsletter

[8] =>

charit y/events

8

Ortho Tribune U.S. Edition | MASO 2012

ClearCorrect reaches new milestone
with charitable clean water project
ClearCorrect, a leading manufacturer
of clear aligners, recently reached a milestone in its charitable project, Phase Out.
Since the launch of its first initiative with
“charity: water” (phase out unsafe drinking water) on Jan. 1, ClearCorrect has
raised more than $60,000, which will
help about 3,000 people gain access to
clean and safe drinking water.
Of the $60,000 raised so far, $36,555
has been allocated to funding the first
five projects with charity water in the
Democratic Republic of the Congo. The
funding will help create spring protections, rainwater catchments and largescale gravity-fed water systems that will
have dozens of distribution points to
serve a large population. These projects
are planned for a mix of villages, schools
and clinics with a strong focus on hygiene, sanitation training and community buy-in to ensure sustainability and
prevention of water-borne diseases.
“It is hard to believe that there are still
people out there that don’t have safe
drinking water. Phase Out is an amazing
effort and an amazing project, and I’m
proud to be a part of it,” said Dr. Annette
Murphy, ClearCorrect provider.
When asked how long the company intends to run the Phase Out project, Jarrett
Pumphrey, ClearCorrect CEO, responded,
“For as long as we can make a difference.”
To see the video, please visit www.
clearcorrect.com/phaseout.

About ClearCorrect

phase out unsafe drinking

ClearCorrect works with more than
11,000 clinicians, making it a leading
manufacturer of clear aligners. The com-

“ MASO, Page 7
sored by Byrne Consulting Group)
• 10:30 a.m.–noon: Doctor session, Dr.
Roger Levin, “Create the Ideal Ortho Practice, Part Two” (co-sponsored by Levin
Group)
• Noon–1:30 p.m.: Box lunch in exhibit
hall (complimentary)
• Noon–1 p.m: MASO delegates meeting
with MASO Board (invitation only)
• 12:15–1:30 p.m.: ABO certification
information meeting
• 1–2 p.m.: Doctor session, Dr. Neal
Kravitz, “Creating an Elite Orthodontics
Office: A comprehensive review on how
to increase case-starts, brand your office
and develop a reputation within your
community”
• 1:30–3 p.m.: Staff session, Tina Byrne,
“Navigating as Part of the Ortho Crew:
Winning May Be As Simple As Adjusting
Your Sails, Part Two” (co-sponsored by
Byrne Consulting Group)
• 2–3 p.m.: Doctor session, Dr. Normand
Boucher, “Diagnosis and Management of
Joint Related Malocclusion”
• 3–4 p.m.: Beverage break in exhibit
hall (complimentary)
• 4–5 p.m.: MASO member/business
meeting (all members welcome)

Photo/Provided by ClearCorrect

pany offers an affordable and doctorfriendly approach, including a phase-

based system to enhance flexibility and
control for clinicians. For more informa-

tion, visit www.clearcorrect.com or call
(888) 331-3323.

• 6–7 p.m.: Welcome reception in exhibit hall (complimentary; co-sponsored by
Maryland State Society of Orthodontists)

ments, Part Two”
• Noon–1:30 p.m.: Box lunch in exhibit
hall (complimentary)
• Noon–1:30 p.m.: Component roundtable discussions
• Noon–1:30 p.m.: Educators luncheon
(invitation only)
• 1:30–3 p.m.: Staff session, Char Eash,
“Marketing — No Gimmicks, Just a Lesson in Building the Network from Within,
Part One” (co-sponsored by Profit Marketing Systems)
• 1:30–3 p.m.: Doctor session, Dr. David
Sarver, “Goal-Oriented Treatment Planning and Technological Advancements,
Part Three”
• 3–3:30 p.m.: Beverage break in exhibit
hall (complimentary)
• 3:30–4:30 p.m.: Staff session, Char
Eash, “Marketing — No Gimmicks, Just
a Lesson in Building the Network from
Within, Part Two” (co-sponsored by Profit
Marketing Systems)
• 3:30 p.m.–4:30 p.m.: Doctor session,
Dr. Jeffrey Posnick, “Contemporary
Management of Chronic Upper Airway
Obstruction in a Dentofacial Deformity”
• 4:30–5:30 p.m.: Resident session,
(mandatory to receive grant), Chris Bentson, “The Process of Locating a Practice
to Build, Join, Partner or Purchase” (co-

sponsored by Bentson, Clark & Copple,
LLC)
• 4:30–5:30 p.m.: Component business
meetings/Delaware, District of Columbia,
Maryland
• 6–10 p.m.: President’s party — Geppi’s
Museum of Pop Culture (Sponsored by
3M Unitek)

Saturday, Sept. 22
• 6:30–7:30 a.m.: Fun run and historical
walking tour of Baltimore Harbor
• 7:30–8:30 a.m.: Continental breakfast
in exhibit hall (complimentary; sponsored by Invisalign/OrthoCAD)
• 7:30 a.m.–4 p.m.: Registration/exhibit
hall open
• 7:30 a.m.– 4 p.m.: ABO case displays
• 8–9:30 a.m.: Staff session, Char Eash,
“Taking Back the Specialty — Game On!
Part One” (co-sponsored by Profit Marketing Systems)
• 8:15–8:30 a.m: AAOF presentation
• 8:30–10 a.m.: Doctor session, Dr.
David Sarver, “Goal-Oriented Treatment
Planning and Technological Advancements, Part One”
• 9:30–10:30 a.m.: Beverage break in
exhibit hall (complimentary)
• 10 a.m.–noon: Staff session, Char Eash,
“Taking Back the Specialty — Game On!
Part Two” (co-sponsored by Profit Marketing Systems)
• 10:30 a.m.–noon: Doctor session, Dr.
David Sarver, “Goal-Oriented Treatment
Planning and Technological Advance-

Sunday, Sept. 23
• 7–8 a.m.: MASO board meeting (invitation only)
• 7:30–8:30 a.m.: Continental breakfast
in exhibit hall (complimentary)
• 7:30 a.m.–noon: Registration/exhibit
hall open
• 7:30 a.m.–noon: ABO case displays
• 8:30–9:45 a.m.: Doctor session, Chris
Bentson, “Benchmarking the Orthodontic Practice” (co-sponsored by Bentson,
Clark & Copple)
• 9:45–10:30 a.m.: Beverage break in
exhibit hall (complimentary)
• 10:30 a.m.–12:30 p.m.: Doctor/staff
session, Jeff Behan, “Using the Power of
Story to Grow Your Members” (co-sponsored by VisualTrust Communications)

Information/registration
Go to www.MASO.org to register or to
seek out additional information.

[9] =>

Ortho Tribune U.S. Edition | MASO 2012

industry

Creating a win-win in the changing
landscape of orthodontic treatment
By Davin Bickford, VP for practice
development, WildSmiles Braces

Today, braces are a must-have for tweens
and teens. The fact that getting braces is a
big step, and often daunting for most kids,
can easily get lost in the conversation.
Statistics from many of the industry’s
leading organizations show that providing treatment focused on patient participation and “buy in” leads to happier and
more compliant patients throughout
treatment.
Take, for example, your expectation for
personal life outside of orthodontics. Society demands a choice in the cars we drive,
clothes we wear and shoes we sport. Everyone desires to be different and unique.
Body art and piercing have become more
and more popular in the past decade and
are prime examples of societal beliefs to
be different and unique.
In orthodontics, it is important to create a win-win experience for the patient
and the practice. Popular choices of mini
twins, clear brackets, WildSmiles Braces
and clear aligners are an expression of
these societal beliefs taking hold in orth-

WildSmiles offers unique options for children and adults. (Photo/Provided by WildSmiles Braces)

odontic treatment.
Just like Nike, Lexus, Louis Vuitton, Walt
Disney or Titleist, you are an orthodontic
brand in your community. These brands
have learned how to create a win-win
experience for their customers, offering
options that create customer loyalty and
brand ambassadors. The company wins
through brand loyalty and referrals. The
customers win because they have choice
to build a customized user experience
with a quality brand. Simply, they get what
they want!
You are a service provider, and you
should be exploring every opportunity to
build your brand as the go-to practice. This
is only achieved though offering options
that create win-win experiences, thus cre-

ating positive brand ambassadors. Patients
seek out the opportunity to customize and
participate in their treatment in a caring,
full-service environment.
Imagine going to a high-end car dealer
and being told the features you desire
(leather seats, CD or DVD player, etc.) were
not available. Additionally, the salesperson
suggests the base model offered on the lot
should sufficiently meet your needs. While
it might meet your need, getting you from
point A to point B, choosing the base model is not what you desired. This experience
almost definitely would encourage you to
continue your search for your next new
car, right?
Well, the patient expectation for his or
her orthodontic experience is no differ-

ent from this scenario.
In the new economy, consumers demand options, such as clear braces, WildSmiles Braces and clear aligners. As a
service provider, you must be willing to
create these win-win situations. Offering
these options in your practice does not
cost you anything but gives you the ability
to meet customer expectations and create
brand loyalty. It’s a win-win.
Brands offering great customer experiences and a wide variety of choice seldom
worry about cost on the front end, often
sparing little expense to enhance the customer experience. These investments allow the brand to charge higher prices for
products, retain a higher percentage of
customers and facilitate greater customer
loyalty and referrals.
Orthodontic customer expectations and
demands are changing with the new economy. What kind of brand are you building
in your community? Are you cultivating
a win-win experience by offering your
patients a variety of choices with a fullservice experience?
To learn more, visit wildsmilesbraces.
com or call (402) 334-7171.
AD

[10] =>

industry

Ortho Tribune U.S. Edition | MASO 2012

Edge management, imaging and communication
system from Ortho2 — it’s all you really need
Edge from Ortho2 delivers the ideal
all-encompassing practice management,
imaging and communication system
with robust features, unmatched capabilities and integrated programs — all
supported by the industry-leading Ortho2 customer service team, the company said.
Ortho2 Edge provides secure cloud
computing technology, an offsite data
hosting system that replaces your onsite
network servers. This feature allows you
to fully access your secure web-based
data infrastructure from anywhere,
even tablets and smart phones. Now
used by more than 100 orthodontists,
AD

Edge portal
shown on an
iPad.
Photo/Provided
by Ortho2

Edge features innovative imaging, reminders, patient education animations
and more.

Edge Imaging is one of the most robust
imaging technologies available today,
the company said With an intuitive interface, comprehensive features and
easy functionality, Edge Imaging can
help efficiently manage all of your patient image files.
It includes features such as card flow
presentation, drag-and-drop layout customization, unlimited undo and redo,
silhouette image alignment and much
more. Edge Imaging can be used with
all Ortho2 management systems, with
other management systems or by itself.
Premier Imaging is an optional upgrade
for Edge Imaging and includes compre-

hensive image morphing, cephalometric
analysis and Bolton Standards.
Edge Animations is a set of powerful
patient education animations for improved compliance and case presentation. Edge includes a set of patient compliance animations at no charge and
an optional extended set of treatmentbased animations.
With Edge Animations, you have the
ability to easily edit and customize videos, including surgical and 3-D animations, using annotation and audio controls. Virtually any image or movie can
be included with drag-and-drop capabilities. Give patients, responsible parties
and referrers access to your videos with
ease through disc, e-mail or YouTube.
Edge Animations is available for Edge,
ViewPoint and as a standalone product.
Edge Reminders is an easy-to-use, efficient system for automating your patient reminders via phone, text and/or email. Phone messages are delivered with
a human voice. Patient responses automatically appear as icons in the scheduler. Edge Reminders is cost effective with
a low, flat fee and no minimum monthly
charge. Edge Reminders is available for
Edge and ViewPoint users.
Edge Portal adds online account access
to appropriate information for you, your
patients, responsible parties and consulting professionals from any computer, tablet or smartphone. You can view
or schedule appointments, view patient
information or quickly and easily access
treatment chart data and much more,
all from Edge Portal. Optionally, accept
credit card payments that are automatically posted for you.
The Edge system also includes comprehensive features such as dynamic dashboard and widget library, smart scheduler, workflows, online forms, edge reports,
electronic insurance and much more.
Edge is compatible with PCs, Macs or a
mixed environment and can even support multiple monitors for a power user.
One Edge user, Dr. Andy Trosien (Tracy,
Calif.), says: “The Edge software system is
a true revelation in orthodontic practice
management software. The system features all of the imaging and communication features, financial applications and
practice tools that can help any practice
thrive. It’s simple to install and easy for
the staff to learn, and Ortho2’s customer
support is absolutely amazing. Switching to Edge was an easy decision — it’s
everything I need to take my practice to
the next level.”

About Ortho2
For more than 30 years, Ortho2 has
designed, developed and provided all
software and services exclusively to
the orthodontic market. Nearly 1,700
orthodontists have discovered Ortho2’s
software, effective conversion process,
quality training, industry-leading support and optional equipment services.
Discover the Ortho2 different for yourself. Discover Edge.
For more information, contact Ortho2
at (800) 678-4644, sales@ortho2.com, or
www.ortho2.com.

[11] =>

Ortho Tribune U.S. Edition | MASO 2012

Industry

Age of digital orthodontics is here
After having radically transformed
dental restorations, the CAD/CAM revolution is finally reaching the orthodontic
market. 3Shape, a world leader in digital
dentistry, is bringing its technology and
development power to the orthodontic
market with a digital-age solution for
orthodontic labs and clinics.
Ortho System™ brings together accurate 3-D scanning, archiving, intuitive
treatment planning and analysis, efficient patient management, communication tools and appliance design — all
providing streamlined workflows that
increase efficiency and productivity for
labs and practices, the company said.
The introduction of 3Shape’s TRIOS
intra-oral scanner marks a new era
for digital orthodontics. This groundbreaking technology offers a more productive, accurate and comfortable way to
capture the patient’s impressions at the
start of or during the orthodontic treatment, while reducing chair time compared to traditional impression taking.
Digital study models captured with the
TRIOS, or with 3Shape’s R700 desktop 3D
scanner, become ready for further processing and manufacturing in 3Shape’s
Ortho System thanks to tight scanner
and software integration. With OrthoAnalyzer, orthodontists can perform full
treatment planning and fully customized analysis protocols, using advanced
2-D and 3-D tools.
Simulation of extractions, interproximal reductions, full treatment planning
with detailed movement overview and
realistic virtual articulators are all possible in a very user-friendly environment, the company said. Full analysis or
validation protocols, such as PAR or ABO,
can also be implemented, allowing consistent and more efficient workflows. The
unique insight provided by 3-D study
models make the assessment of treatment results both easy and accurate.
Appliance Designer is the first complete digital toolbox dedicated to all
types of orthodontic appliances. A host
of intuitive and accurate tools enables
users to create even the most demanding
designs. Appliances such as nightguards,
retainers, customized bands, splints, surgical bites, palatal expanders, bionators,
Twin blocks, Herbst appliances, Planas
tracks and much more, can easily be
created on screen and made ready for
computer-driven manufacturing.
Appliance Designer’s open STL format
guarantees complete freedom of choice
in relation to materials and 3-D-driven
equipment, such as 3-D printers or milling machines. 3Shape’s solutions also allow full integration and file preparation
for the equipment chosen. All tools and
design parameters can be combined in
any way, and these can be stored as reusable and unique workflows to ensure
consistency and efficiency. A tight integration between the treatment planning
tools in OrthoAnalyzer and the use of realistic virtual articulators allows optimal
CAD design and maximum efficiency of
the orthodontic treatment, the company
said.
3Shape Ortho System is the only fully
integrated CAD/CAM system dedicated
to orthodontics, which allows full free-

dom of choice in terms of equipment,
material and manufacturing partners —
thanks to its open format. It is easy and
fast to transfer digital files, and the communication tools offered by 3-D study
models enable tighter cooperation be-

tween orthodontic professionals.
The applications of CAD/CAM in orthodontics offer a host of new opportunities for more efficient treatments and
follow-up. The technology also enables
improved communication between orthodontists, technicians and patients,
higher accuracy and repeatability, better control of costs and material consumption, and increased patient comfort. Through improved consistency
and efficiency in manufacturing, CAD/
CAM technologies allow the orthodontic professional to concentrate his or her
resources on value-adding activities.
For
more
information,
visit
www.3shape.com.

3Shape is
bringing
digital
options to
orthodontics.
Photos/Provided
by 3Shape

[12] =>

12

industry

Ortho Tribune U.S. Edition | MASO 2012

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[cover] => Ortho Tribune U.S. No. 4, 2012

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