Mini-screws is just a tool among others!

With Dr. Kokich at the EOS 2012

Driven from the recent editorial article of Dr. Kokich at the AJODO, I would like to emphasize what this article was all about.


TADs have been around for some time now in the orthodontic field, and have changed the approach we follow at a number of cases.

• This is all wonderful but we should also remember that mini-screws are just a tool among others. 
• What is really important is correct diagnosis, individualized treatment planning and well designed biomechanics applied to the right patient.

PURE intrusion of anterior and/or posterior teeth for example, is a tooth movement that can be achieved ONLY when the reacting force is not applied to the dentition. A clean way of doing that is bone anchorage. 

• However we don't want to intrude the anterior too much especially when treating adolescence, where a gummy smile of 4mm IS very normal for their age!
• Let alone the issue of muscle adaptation when intruding posterior teeth and altering the vertical height of open bite patients...

It feels good to read what I was taught in Aarhus, been repeated by someone like Dr. Kokich and at the AJODO, because unfortunately when you say these things to a group of fellow orthodontists, people tend to look at you a bit strange. Marketing you see...

Thank you ;)

p.s. Here you can find the pdf of the AJODO Editorial

D.G.

Management of unilaterally deep impacted first, second, and third mandibular molars.

This is indeed a difficult and rare case of deeply impacted 1st mandibular molar, treated to a very satisfactory result, by finally uprighting the 2nd mandibular molar and extracting the 1st one. In addition one upper premolar on the same side was extracted in order to move the upper midline on to the facial.

Initial panoramic view

Root resorption and orthodontics

A Swedish prospective clinical trial (Gothenburg), of 152 orthodontic patients, is published at the current issue of The Angle Orthodontist. The study is performed on CBCT data collected at baseline, 6-months in treatment, and treatment finish.

CBCT allows for differentiation of the exact root surface that has been resorbed, such as lingual/palatal, buccal, or mesio-distal. This cannot be differentiated by conventional 2D radiographs.

A case of severe root resorption

Force extension relaxation of medium force orthodontic latex elastics, AngO June 2011, early access

The Angle Orthodontist of June 2011, has a very interesting article concerning the forces of latex elastics, over time.
The elastics is one of the few tools so widely used and so little studied in orthodontics.

The graph on the left shows for three commercial latex elastics, that for the first 3 hours there is a decrease of force.
This force increases for the next 3-6 hours and decreases again up to 12 hours of stretching.

Birte Melsen: How has the spectrum of orthodontics changed over the past decades?

The Journal of Orthodontics of this month has invited Prof. DrOdont, B.Melsen from the university of Aarhus Denmark, to write an article about orthodontics today.


This article is in a form of a lecture. Dr. Melsen talks about almost every aspect of orthodontics today.


From "fast food orthodontics", self-ligating, "intelligent wires and brackets", "no bending orthodontics" to individualized treatments for adults with periodontal and degenerative diseases. TADs and digital orthodontics (digital casts, computerized treatment planing) are a field of interest for the future, and push the limits of orthodontics according to Prof Melsen.


Along the caustic comments about the industry, the marketing of new wires and brackets, it is reminded to everyone, that orthodontics is all about treatment planning and goals orientation. There is no cook book in orthodontics, and this article is certainly worth of your time.

Force and moment monitoring system for fixed orthodontic appliances

The university of Freiburg, Germany, and its Orthodontic Department, are providing public pictures of their research project. It consists of stress sensors that can be embedded at a conventional metal bracket's base. 

The stability of miniscrew placement, Editor's Corner, JCO Jan 2011

The Journal of Clinical Orthodontics published the results of an ongoing survey concerning the failure rate and the factors that are influencing the stability of miniscrew placement.


A wide number of editor contributors of the journal, and some widely known clinicians were given the above question. In other terms what is, in their clinical experience, that matters for the stability of miniscrews.


A number of factors were mentioned:

• Experience of the operator
• Primary stability - Stable insertion
• Self drilling mini-screws
• Loading perpendicular to the long axis of the tooth and avoiding unscrewing moments
• Quality and thickness of cortical bone, along with wise insertion site selection
• Avoidance of root proximity

A wide range of failure rate was suggested, from 5% up to 20% by other clinicians. The whole pdf can be downloaded for free at this link

Loops, A Short View of Some Configurations

This is a very short view on the vast field of loops and the application of them in Orthodontics. Most common are the closing loops, and there have been a lot of loops suggested from different clinicians over time.

Loops, were used more, years ago when the length of the wire was increased by the bend of loops and wires were becoming more flexible and applying more constant forces and moments during deactivation.

Loops are pre-activated or not and apply frictionless mechanics, as there is no sliding of the wire in the bracket slot during deactivation. Some photos of loops on round and rectangular wires follow: