tag:blogger.com,1999:blog-64287784111334317852024-03-20T05:04:05.341-07:00Avery Orthodontics: The Art, Science and Excitement of Orthodontic TreatmentBlair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.comBlogger13125tag:blogger.com,1999:blog-6428778411133431785.post-43589423442182808242015-04-27T12:15:00.001-07:002015-04-28T06:16:42.981-07:00Correction of an Impacted and Severely Displaced Central Incisor in an 8 Year Old PatientThis patient (8 years old) presented to our practice after referral from their dentist after it was discovered that his upper left central incisor was displaced severely and would not erupt due to the presence of two supernumerary teeth (extra teeth) in the same region.<br />
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The initial panoramic radiograph shows the central incisor crown tipped up toward the nose and one of the developing supernumerary teeth is circled. The other had already been removed previously. Supernumerary incisors in the maxilla (upper jaw) are actually fairly common and are called mesiodens if in the region of the central incisors.<br />
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The initial cephalometric radiograph cleary shows just how far the extra tooth's development pushed the central incisor out of position.<br />
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To correct this problem and bring the impacted central incisor into position, we placed limited braces along with a transpalatal arch bar and referred him to an oral surgeon to attach a button and gold chain to the impacted incisor. The button and chain allow the orthodontist to gradually guide the tooth in by applying orthodontic traction in desired directions periodically. The surgeon determined that the extra tooth was too close to the incisor needing to be moved so he wanted to perform a second surgery later to remove the extra tooth once there would be minimal risk of damage to adjacent teeth. <br />
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The following photo is following the surgery with our orthodontic appliances in place:<br />
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We started seeing him once per month to apply orthodontic traction with an elastic thread usually and gradually bring the tooth in. The discomfort associated with activation is usually minimal and lasts for just a few minutes. The patient did great at every appointment.<br />
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This panoramic radiograph shows the attachment of the gold chain to the lingual (backside of the tooth):<br />
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The next progress panoramic radiograph shows the position of the central incisor after 6 months of activation. The supernumerary tooth is much more visible also, so it was decided that it was time for a second visit to the oral surgeon to now remove the extra tooth safely now that the central was not so close and move the button from the underside of the tooth to the more ideal position on the front side of the tooth:<br />
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Here is the tooth 10 months after starting traction with the button now on the facial but still a lot of root movement needed to get the tooth into the right angulation:<br />
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And finally here is the final photo and panoramic radiograph. The central incisor has good root form and is fully vital making the case a great success. We are currently giving him a little break and will start his comprehensive orthodontic treatment with full braces once the rest of his permanent teeth finish erupting to ideally align all teeth, even the vertical position of the central incisors a little better and perfect his bite. Needless to say he was very excited to have that front tooth finally!<br />
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<br />Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com3tag:blogger.com,1999:blog-6428778411133431785.post-72963139090599676802014-04-22T05:26:00.000-07:002014-04-22T05:26:55.486-07:00Impressive Orthognathic Surgery Correction of a Patient With a Pituitary Tumor<div class="separator" style="clear: both; text-align: center;">
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Pituitary tumors can cause widespread effects on our bodies because the pituitary gland secretes a total of nine hormones and is vital for homeostasis. Human growth hormone (HGH) is often one of the hormones that starts to increase when a tumor of the pituitary gland is present and the increased production of HGH can lead to dramatic changes in the body, even in adults.<br />
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When excess HGH is being produced in the body, a condition known as acromegaly results. Acromegaly causes soft tissue swelling, pronounced brow protrusion, pronounced lower jaw protrusion (prognathism), macroglossia (enlargement of the tongue), and related shifting of teeth.<br />
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The following patient presented to Avery Orthodontics after referral from the Oral Surgery Department at the University of Texas Health Science Center San Antonio. She was 28 years old and had a benign pituitary tumor removed about 6 months earlier. The goal of the surgery department was to repair the effects that the acromegaly had, namely macroglossia and prognathism (protrusion of the lower jaw). As you can see in the initial photos below, the effects of the tumor on the bite and jaw structures was dramatic:<br />
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My job as the orthodontist was to align the teeth, close excess spacing and level the arches so that the surgical team could then have an upper arch and a lower arch that matched nicely when they move the underlying jaw bones during the surgery. Full upper and lower braces were placed and in a little over a year, she was ready for her surgery. Her hormone levels were continuously checked after the removal of the tumor as we would not have wanted to perform the jaw surgery until we were certain that hormone levels were normal and stable again.<br />
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The following photo shows our progress prior to surgery:<br />
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Dr. Daniel Perez (Department of Oral Surgery, University of Texas Health Science Center San Antonio) and his surgical team were tasked with quite a challenge as the distance of the surgical moves in this case were larger than usual. The summarized surgical plan was to set the mandible (lower jaw) back while also attempting to correct the asymmetry present with a little more of a set back on the right than the left sides. The maxilla (upper jaw) meanwhile would need to be widened and brought forward the necessary distance to end up with the teeth in the proper bite position while trying to improve facial balance and esthetics as much as possible. Finally, the tongue would need to be reduced (glossectomy) due to the macroglossia that had occurred.<br />
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The resulting surgery was one of the finest orthognathic surgeries I have ever seen performed. When the patient returned to us, it was a simple matter to finish out the detailing of her bite and putting the teeth into their final positions. The post-surgical phase of orthodontics usually takes from 6-12 months and is shorter if the bite is already in great position following surgery, requiring less detailing on the orthodontist's part. It is with great admiration for Dr. Perez and his team in San Antonio that I present the final photos. As you can see, we have an almost ideal bite at the finish. I did not include facial photos for patient privacy, but needless to say the improvement in facial symmetry and balance were also dramatic. The missing lower molars are planned to be replaced with either bridges or dental implants in the future. She will always be one of my favorite patients due to the way she bravely handled all the difficult medical challenges she faced and I cannot be prouder that we were able to erase the effects of the pituitary tumor and get her confident and smiling once again.<br />
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<br />Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com2tag:blogger.com,1999:blog-6428778411133431785.post-82864028023911219972013-04-23T11:41:00.000-07:002013-04-23T11:47:36.786-07:00Case of the Month: April 2013 (Orthognathic Surgical Correction)This month's case illustrates the sometimes life changing transformation that orthodontics combined with orthognathic (jaw) surgery can make. This particular patient presented to our office at age 15 wanting straighter teeth, an improved bite and an increase in the prominence of her lower jaw.<br />
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She was diagnosed as having a constricted maxilla (upper jaw), retrusive mandible (lower jaw) in part to a high jaw angle, proclined and protrusive upper incisors (front teeth), and an excessive overjet (front to back distance between the upper and lower incisors). Her facial balance needed improvement due to the lower jaw being so retrusive, which also causes the lip balance to appear strained when trying to keep the lips closed.<br />
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The initial cephalometric radiograph below illustrates the jaw and bite discrepancies from a lateral view (patients facial photos are not shown for privacy purposes):<br />
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During our orthodontic consult, we explained that jaw surgery would be required to meet all of the patient's goals and expectations due to the severity of the skeletal discrepancies. Many cases with more mild skeletal problems can be fixed with orthodontics alone, but some cases require the jaw bones themselves be moved to create the proper balance. A referral was made to Dr. Steve Widner, an oral surgeon in central Austin. After discussing the patient's case, Dr. Widner and I agreed that two-jaw surgery involving expanding the upper jaw along with tipping the back part of the upper jaw up and an advancement of the lower jaw would meet everyone's expectations. The upper front teeth would also have space to tip back once the upper jaw was widened surgically.<br />
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Orthodontic treatment was initiated with the expected 12 months of pre-surgical tooth movements needed. Essentially it is the orthodontist's job to align and level each arch individually so that when the jaws themselves are moved, the dental arches and bite will fit together nicely. Once we were ready and all preparations were made, the jaw surgery was completed and about 9 months of post-surgery orthodontic finishing was done. Jaw surgery usually requires 2 weeks of rest (usually no school or work) post-surgery and patients start feeling 100% about a month after the surgery. A month of rest and healing is worth the dramatic quality of life improvement in my opinion.<br />
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The following before and after photos impressively illustrate the powerful changes that jaw surgery combined with orthodontics can make for those who can benefit from it:<br />
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Believe it or not that is the same patient in the before and after photos and needless to say she is thrilled and can't wait to start college.<br />
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<br />Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com2tag:blogger.com,1999:blog-6428778411133431785.post-148285580944897292013-01-06T16:07:00.000-08:002013-01-06T16:07:32.700-08:00Case of the Month: January 2013The following case will demonstrate the effectiveness of early orthodontic intervention to address an ectopically erupting tooth (a tooth erupting in the wrong direction or location) followed by the use of pre-molar extractions during comprehensive treatment to alleviate severe crowding.<br />
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The patient presented to the office at the age of 9 having been sent by her pediatric dentist due to a mandibular incisor erupting ectopically.<br />
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As you can see above, the lower right lateral incisor erupted backwards in the dental arch, while the primary (baby) incisor (yellow X) that should have been lost was not. This is obviously a problem because the canine and first pre-molar on that side would be blocked from erupting in the future. She was sent back to her pediatric dentist to remove the retained primary incisor and limited braces on the front four incisors was initiated to tip the ectopic tooth into the correct position. Because the patient was in the mixed dentition stage (half primary teeth/half permanent teeth), we call any orthodontic treatment at this time early or interceptive because we are essentially ensuring that a normal eruption process can occur. Other common early or interceptive treatments include maxillary expansion and various types of headgear if a patient has a large enough jaw growth discrepancy. <br />
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The total treatment time for the interceptive treatment was 7 months and the picture below shows the lower incisors in better position.<br />
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We continued to monitor the patient's tooth eruption pattern periodically over the next two years and comprehensive orthodontic treatment (full braces once all permanent teeth are in) was initiated at age 12. When the patient returned almost ready for her comprehensive treatment, she had severe crowding due to a large tooth size/jaw size discrepancy and the decision was made to extract all of the permanent first pre-molars. Orthodontists try to not have to extract permanent teeth, but the lower jaw limits our ability to expand because the jaw itself does not expand like the upper jaw because it does not have a growth suture in the midline and we also have to be careful not to push the teeth too far forward when aligning them and cause gingival recession. <br />
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The panoramic radiograph above shows the crowding issues, especially in the lower jaw where some of the canines and pre-molars don't have enough space to erupt. A referral to her dentist was made to extract the first pre-molars and she returned in 6 months after the remaining teeth erupted to begin her comprehensive treatment. The pictures below show how she presented at that time.<br />
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We then proceeded to place full braces on both arches. After aligning and leveling each arch, the remaining extraction space needed to be closed. The patient did a great job wearing rubber bands for us and otherwise did not need any other kinds of appliances. The pictures below show the nice finish with excellent alignment, great esthetics and all teeth positioned well within their bony housing for long-term good periodontal health.<br />
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The total treatment time for phase II or her comprehensive treatment was 20 months, which is pretty typical for extraction cases. If you look carefully, you can see that we are missing all of the first pre-molars, but no one would ever be able to tell. Many people you know may have been effectively treated with extractions by their orthodontist. As I stated earlier, we only extract when we absolutely have to (about 10% of cases in my practice), but extraction cases can work out very nicely when the proper diagnosis and treatment plan is followed.<br />
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Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com1tag:blogger.com,1999:blog-6428778411133431785.post-39286195061425439612012-12-02T11:03:00.001-08:002012-12-02T11:03:37.214-08:00Invisalign Summit 2012 Review: Invisalign G4I recently had the pleasure of attending the Invisalign Summit, which is held every other year and offers orthodontists and their team members an opportunity for continuing education time along with updating all of us on the current changes and innovations that Invisalign is making to improve their product. I saw a variety of case presentations where Invisalign was effectively used to treat cases that were complex, and in many cases most orthodontists would not have considered Invisalign as an option. In addition, I am becoming more and more comfortable with Invisalign as an option for teenagers instead of braces with the Invisalign Teen product. The biggest news out of the conference was the future implementation of Invisalign G4. Whenever Invisalign makes an innovation that is big enough to warrant calling it a new generation for the product, they give it a "G" tag and thus this is considered the 4th generation of the product.<br />
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Here is a video explaining the new approaches to some of the tooth movements that have been more difficult to achieve with Invisalign versus braces.<br />
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http://www.youtube.com/watch?v=VCm7irT2XQI<br />
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Invisalign G4 should thus allow:<br />
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1. Greater root tip control for upper central incisors and canines<br />
2. Improved predictability for upper lateral incisors<br />
3. Better clinical outcomes for anterior open bite treatment<br />
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All three of those categories of tooth movement were by far the most unpredictable with Invisalign treatment in the past, so I am looking forward to being able to offer the Invisalign option to patients who have those tooth movement needs to achieve a nice result.<br />
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Finally, the news I was most excited about was to hear that Invisalign has been very active in researching ways to improve the properties of the plastic used for the aligners. Invisalign suffers in comparison to braces in that the force levels are fairly high with the initial placement of the new trays and they then decay over the typical two week period a set of trays is worn. Not to get too technical, but this is the opposite of the properties of the initial wires we place to start the alignment and leveling process in a braces patient. The initial wires are made of nitinol and deliver a low, almost constant force throughout the period that they are in the mouth. These wires were obviously a huge advancement a few decades ago for the profession. As this chart shows, the plastic they are working on should allow force levels more in line with the most ideal for efficient tooth movement and I feel it could be a major game changer for clear aligner treatment versus braces.<br />
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<img height="285" id="il_fi" src="http://www.ortodonciamalaga.com/wp-content/blogs.dir/7/files/smarttrack.jpg" style="padding-bottom: 8px; padding-right: 8px; padding-top: 8px;" width="434" /><br />
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<img height="272" id="il_fi" src="http://www.michaelyungdds.com/images/invisalign-pic_logo.jpg" style="padding-bottom: 8px; padding-right: 8px; padding-top: 8px;" width="300" /><br />
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Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com4tag:blogger.com,1999:blog-6428778411133431785.post-58309251062518812222012-09-28T09:29:00.000-07:002012-09-28T09:29:19.038-07:00Case of the Month, September 2012This month's case will illustrate an impressive improvement of a patient's overbite due to the lower jaw being positioned too far back or posterior to the upper jaw. This is a common problem that orthodontists have to correct and not only does it result in a more functional bite, it can greatly improve lip and facial balance. There are many methods of correction of these types of bites and this case will demonstrate a non-surgical correction that avoids the use of headgear.<br />
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The patient was 12 years old at the start of treatment and the initial photos below illustrate the large overbite (vertical), overjet (front-back discrepancy of the front teeth) and class II occlusion (lower back teeth a full tooth behind where they should be versus the upper teeth).<br />
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The cephalometric radiograph shows the poor soft tissue profile and proclined incisor positions.</div>
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The method of bite correction used in this case was an appliance called Forsus Springs. Once the teeth were well aligned and leveled (about 6 months), the Forsus springs were placed and worn for 6 months. This is a great appliance when methods such as rubber band wear alone would not be expected to achieve desired treatment results and the patient does not desire to wear headgear or other less patient friendly appliances. Patients actually do quite well with the springs, as they are flexible and allow a wide range of jaw movements, making eating almost normal. They are also not too large and sit on the sides of the mouth and thus are not highly noticeable. The force the springs apply is also at at low, constant level, so the discomfort is not a bad as one might think. </div>
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Illustration of the Forsus Springs appliance. We placed springs on both sides, but they can also be very effective placed on one side when the bite is asymmetrical and off on one side only. The springs are not removable (probably another reason for their high effectiveness).</div>
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The results of our treatment are shown below. The bite was fully corrected to an ideal overbite and overjet and a marked improvement in lip and facial balance can be seen on the lateral radiograph (actual facial photos of the patient are not shown for patient privacy). The total treatment time was right at 2 years with a few months added on because we had to wait on a few teeth to finish erupting near the beginning of treatment. Our young patient did a wonderful job and all in all we are very proud of the finished product.</div>
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Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com4tag:blogger.com,1999:blog-6428778411133431785.post-74428575864884942412012-08-17T09:55:00.000-07:002012-08-17T09:55:11.481-07:00Case of the MonthThis 11 year old patient presented with the following main orthodontic problems:<br />
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1. Insufficient space for the upper canines to erupt fully<br />
2. Class II bite (posterior teeth not interdigitating well)<br />
3. Moderate crowding in the upper arch, mild in the lower<br />
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The summarized orthodontic treatment plan was to shift the upper posterior teeth back into proper bite position while creating room for the canines to erupt fully and align. We utilized a very patient friendly appliance called a Carrier Distalizer as shown in the next photos. More traditional methods might have included the wear of a headgear. The patient wore rubber bands from the lower molar (back tooth) up to the upper first premolars where you see the little hook to accomplish the shift of the back teeth and the space creation. Below are pictures of the appliance showing treatment progress.<br />
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The patient did an excellent job with rubber band wear and the final pictures showing the treatment results are below. The alignment of the teeth and the bite both look excellent and we were able to achieve our goals without extracting teeth. The total treatment time was 16 months.<br />
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Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com1tag:blogger.com,1999:blog-6428778411133431785.post-3073651705217614422012-08-04T09:27:00.001-07:002012-08-04T09:27:25.443-07:00Common Bite Problems Seen in ChildrenThe following is a video from the American Association of Orthodontists that discusses the common bite problems we see in children in the mixed dentition (children between the ages of 7 and 11 that have a combination of permanent and primary (baby) teeth present). <br />
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<a href="http://www.youtube.com/watch?v=MvB7ga6lNsc&feature=relmfu">http://www.youtube.com/watch?v=MvB7ga6lNsc&feature=relmfu</a><br />
<br />Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com0tag:blogger.com,1999:blog-6428778411133431785.post-24124692787587589932012-07-07T11:54:00.000-07:002012-07-07T11:58:47.614-07:00What in the world is the orthodontist looking at when he or she evaluates my teeth?!?!Orthodontists usually have the basic goal of achieving Angle's Six Keys of Occlusion in any of our comprehensive orthodontic cases. Dr. Edward Angle is considered the "father" of modern orthodontics and essentially created the orthodontic specialty by opening the first school focused on orthodontics only in 1900. He noted that function (the way the bite works) and form (the way the teeth and bite look) go hand in hand and wrote a paper on the aspects of tooth positioning that resulted in the most ideal form and function. While there have been a few modifications to the original Six Keys since, Dr. Angle was remarkably accurate in his descriptions.<br />
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So, when an orthodontist evaluates a person's bite and tooth positions, he or she is comparing the current positioning versus the Six Keys of Occlusion. Occlusion basically means the way the teeth fit together. <br />
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<b>Angle's Six Keys to Occlusion</b><br />
<table border="0" cellpadding="0" cellspacing="0" role="presentation"><tbody>
<tr><td align="left" valign="baseline" width="42"><img alt="bullet" height="10" hspace="16" src="http://www.dentalcare.com/images/en-US/education/common/smbox_tl.gif" width="10" /></td><td align="left" valign="top" width="100%"><b>Key I – Molar Relationship</b></td></tr>
<tr><td valign="baseline" width="42"><img alt="bullet" height="10" hspace="16" src="http://www.dentalcare.com/images/en-US/education/common/smbox_tl.gif" width="10" /></td><td align="left" valign="top" width="100%"><b>Key II – Crown Angulation (tip)</b></td></tr>
<tr><td valign="baseline" width="42"><img alt="bullet" height="10" hspace="16" src="http://www.dentalcare.com/images/en-US/education/common/smbox_tl.gif" width="10" /></td><td align="left" valign="top" width="100%"><b>Key III – Crown Inclination (torque)</b></td></tr>
<tr><td valign="baseline" width="42"><img alt="bullet" height="10" hspace="16" src="http://www.dentalcare.com/images/en-US/education/common/smbox_tl.gif" width="10" /></td><td align="left" valign="top" width="100%"><b>Key IV – Rotation</b></td></tr>
<tr><td align="left" valign="baseline" width="42"><img alt="bullet" height="10" hspace="16" src="http://www.dentalcare.com/images/en-US/education/common/smbox_tl.gif" width="10" /></td><td valign="top" width="100%"><b>Key V – Spacing</b></td></tr>
<tr><td align="left" valign="baseline" width="42"><img alt="bullet" height="10" hspace="16" src="http://www.dentalcare.com/images/en-US/education/common/smbox_tl.gif" width="10" /></td><td valign="top" width="100%"><b>Key VI – Curve of Spee</b></td><td valign="top" width="100%"></td><td valign="top" width="100%"></td><td valign="top" width="100%"></td><td valign="top" width="100%"></td><td valign="top" width="100%"></td></tr>
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The photo above illustrates dental casts with ideal occlusion (inter-digitation of teeth) and ideal overbite/overjet. <br />
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The following link provides a great explanation and pictures for each of the Six Keys:<br />
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http://www.dentalcare.com/en-US/dental-education/continuing-education/ce326/ce326.aspx?ModuleName=coursecontent&PartID=2&SectionID=-1<br />
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So, when many patients think they should be finished with treatment when their teeth are straight, just remember that orthodontists are specially trained to go the distance and achieve both a great looking smile and a bite that fits together and functions in the most ideal way. Orthodontists also evaluate jaw relationships, anterior/posterior and vertical positioning of the teeth relative to the face, and soft tissue form (lips especially), but the Six Keys truly are the key to the best orthodontic treatment in most cases.Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com0tag:blogger.com,1999:blog-6428778411133431785.post-90832120885291781832012-06-23T10:04:00.000-07:002012-06-23T10:04:22.304-07:00AcceleDent: The Future for Faster Tooth Movement?The FDA has recently approved a device that has been tested for the last few years at my residency program in San Antonio called AcceleDent. AcceleDent works through the
application of pulsating, low magnitude forces (cyclic forces) to the
dentition and surrounding bone as a means of accelerating orthodontic
tooth movement through enhanced bone remodeling. Teeth move as bone is resorbed in the direction the roots are moving and built behind the roots after the movement. The forces the AcceleDent device apply to the teeth are very low in magnitude and do not cause any discomfort. We have known for years that teeth move faster in younger patients because their bone biology adapts more quickly to the forces being placed on the teeth, so this system is just a new way to cause any patient's response to orthodontic forces quicken.<br />
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Here is a picture of the device:<br />
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The current recommendations are to bite into the mouthpiece 20 minutes per day while in orthodontic treatment. This can be easily accomplished while doing normal daily activities like watching TV, reading, or surfing the internet. <br />
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I fully believe in the strong scientific evidence supporting the device's effectiveness coming out because fields such as orthopedic medicine have been using similar methods for decades to heal bone fractures faster, for example. I plan to offer it to patients at Avery Orthodontics but the current price point may result in it being used by adult patients for the most part until the pricing may drop (it costs about $900 to order each unit from the manufacturer and this amount would just be applied to the overall orthodontic fee). I believe most orthodontists who will offer it would essentially sell it to the patients at cost because faster treatment times is a bonus for both the patients and doctors. The group of patients I am especially excited about AcceleDent would be Invisalign patients. Invisalign is a series of clear trays that move the teeth in little increments. The current protocol is to change the Invisalign trays once every 14 days, but the use of AcceleDent would certainly allow us to change trays every 10 days and possibly just every 7 days, thus having the potential to reduce the Invisalign treatment time in half. The situation with patients in braces is a little different because many of our wires need plenty of time to work and express themselves, but braces patients who elect to use AcceleDent in my practice would be seen at quicker appointment intervals to change the wires a little faster than we would in traditional treatment. I would expect treatment time in braces patients to be reduced about 30%, but that is definitely dependent on the type of case.<br />
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Here is a nice video on the AcceleDent system and if you would like to consider its use, be sure to ask us at our consultation appointment.<br />
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http://www.youtube.com/watch?v=du3KSifHCg8&feature=context-vrecBlair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com1tag:blogger.com,1999:blog-6428778411133431785.post-23234249597904994992012-05-21T06:44:00.000-07:002012-05-21T06:44:15.147-07:00<div class="separator" style="clear: both; text-align: center;">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhFx0HOPDo4C1FAsMTkskgMixrDNYyqvvQsNLnReBAXT_Tp6bqVEgTlU7TCoGC9ssVNotq3AysE4pHE31vP-liP2aD45Yvsjmpv0CUaRJ7qr961KBXAx5dC8XjekKp82d0oPWp-qDbTQN8/s1600/Problems_Growing_Children-12-l_Page_1.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="640" kba="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhFx0HOPDo4C1FAsMTkskgMixrDNYyqvvQsNLnReBAXT_Tp6bqVEgTlU7TCoGC9ssVNotq3AysE4pHE31vP-liP2aD45Yvsjmpv0CUaRJ7qr961KBXAx5dC8XjekKp82d0oPWp-qDbTQN8/s640/Problems_Growing_Children-12-l_Page_1.png" width="474" /></a></div>Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com0tag:blogger.com,1999:blog-6428778411133431785.post-48710703541056949672012-05-09T09:37:00.001-07:002012-05-09T09:46:13.623-07:00<div class="CS_Textblock_Caption" style="background-color: white; color: black;">
<b>Seven Common Questions Parents Have About Orthodontic Treatment</b></div>
<br />
Today,
nearly four millio<span style="background-color: white;"></span>n children in the United States and Canada are
receiving treatment from members of the American Association of
Orthodontists (AAO). And while parents know that orthodontic treatment
results in a healthy, beautiful smile, many don’t realize the important
long-term health benefits.<br />
<br />
As part of its commitment to education, the AAO provides parents with
this list of answers to commonly asked questions about orthodontic care.<br />
<br />
1. Why is orthodontic treatment important?<br />
A: Straight teeth and properly aligned jaws contribute to good dental
health as well as overall physical health. Orthodontic treatment can
boost a person’s self-image as teeth, lips and jaws move into position
and improve appearance.<br />
<br />
2. How do parents know if their child needs orthodontic treatment?<br />
A: The best way is to visit an orthodontist. The AAO recommends that all
children get a check-up with an orthodontist no later than age seven.<br />
<br />
3. What if my child still has baby teeth at age seven? Should they still see an orthodontist?<br />
A: Yes. By age 7, enough permanent teeth have arrived for
orthodontists to evaluate how the teeth and jaws meet, and to identify
current or developing problems. If a problem is detected, the
orthodontist and parents can discuss when treatment may be necessary.<br />
<br />
4. How does a child’s growth affect orthodontic treatment?<br />
A: Treatment and growth often compliment each other. In some cases, the
orthodontist takes advantage of a child’s growth to guide jaws and teeth
into their ideal positions.<br />
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5. How often do you visit your orthodontist while in orthodontic treatment?<br />
A: Typically a child will see the orthodontist every 6-12 weeks throughout the course of treatment.<br />
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6. If you currently don’t have an orthodontist, what is the best way to find someone to treat orthodontic problems?<br />
A: To find an orthodontist near you, ask for a referral from your family
dentist, your pediatrician or your child’s school nurse. Or you can
visit www.braces.org and click on the Find an Orthodontist service. It
is important to choose an orthodontist who is a member of the AAO.
Orthodontists receive an additional two to three years of specialized
education beyond dental school to learn the proper way to align and
straighten teeth. Only those with this formal education may call
themselves “orthodontists,” and only orthodontists may be members of the
AAO.<br />
<br />
7. What is the average cost of orthodontic treatment?<br />
A: Fees will vary, depending on the treatment needed. Most
orthodontists offer convenient payment plans, making treatment more
affordable than ever. Most orthodontists will work with you to find a
plan that fits your family budget. In addition, many patients have
dental insurance that includes orthodontic benefits. Check with your
employer’s human resources department to learn about your coverage.Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com2tag:blogger.com,1999:blog-6428778411133431785.post-42968065851727922022012-04-24T08:32:00.000-07:002012-04-24T08:32:23.292-07:00Invisalign is Continuing to Improve and Evolve with G4The Invisalign method of moving teeth has actually been around for much longer than many people realize. Clear plastic trays or aligners used to be fabricated by making a series of stone models and resetting the teeth in the lab in small increments. Invisalign redefined the clear plastic tray method of tooth movement about 20 years by incorporating computer scanning technology to create a virtual model of the patient's teeth and then perform the movements on a computer prior to tray fabrication, thus greatly improving accuracy.<br />
<br />
While the product was a great advancement 20 years ago, Invisalign continues to evolve and improve as much more experience and data is gathered and analyzed regarding this type of tooth movement. The product of today is far more predictable in achieving a wider range of tooth movements that orthodontists thought were nearly impossible with plastic trays a couple decades previously.<br />
<br />
I do not like the tagline "clear braces" because simply put, nothing is more precise in achieving desired tooth movement than the use of braces and wires in the hands of an experienced orthodontist and thus equating Invisalign to that is a bit misleading. That said, I have never felt more confident in the Invisalign product and I am starting to change my mind about the tagline because nearly any type of orthodontic case can be effectively treated with the system now. Invisalign recently made a series of scientifically based treatment protocol changes (called Invisalign G4), which should continue to increase the types of cases with which orthodontists will feel comfortable treating. The protocols have changed the default rates of different types of tooth movement and also the shape and position of attachments that are placed on the teeth to allow better force application.<br />
<br />
In addition to the clinical Invisalign G4 changes, Invisalign now offers orthodontists more options to be able to present their patients. The new options are as follows:<br />
<br />
<strong>Invisalign 5: </strong>This low-cost option is for simple cases involving minor crowding (often the result of relapse of previous orthdontic treatment due to not wearing retainers). This is great for people who would like to see their teeth as perfectly straight as they once were but want to avoid a large treatment fee associated with longer, more comprehensive treatment needs. Patients who qualify for Invisalign 5 could be treated with 5 or fewer total aligners (about 3-4 months total treatment time).<br />
<br />
<strong>Invisalign 10:</strong> This is another low-cost option for patients with mild to moderate crowding and whom can be treated with 10 or fewer aligners. This option results in treatment times of about 6 months typically.<br />
<br />
<strong>Invisalign Full</strong>: This is the comprehensive treatment option for any case requiring more than 10 trays and includes a broad range of treatment types. The fee is usually similar to the fee for comprehensive orthodontic treatment with braces and the treatment times vary from about 9 months to up to 2 years. Treatment times depend on the specific case and typical case types Invisalign Full is used for include crowding, deep bite, excess overbite or overjet, class II, class III and even open bites. Essentially patients whose treatment needs are more than just anterior crowding will fall under this category and I would determine the expected length of treatment and if Invisalign is truly an option at the consulatation.<br />
<br />
<strong>Invisalign Teen:</strong> Invisalign Teen is a new category of Invisalign treatment designed with the unique needs of teenagers in mind. It is essentially the same as Invisalign Full or comprehensive Invisalign, yet has a few special features. The special features include compliance indicators (color tabs that tell the orthodontist and parents if the trays are truly being worn for the prescribed period of time), eruption tabs for second molars (a tab that extends at the end of a tray if the second molars are not fully erupted yet), and the ability to replace trays at no extra charge if they are lost. More and more teenagers are desiring the Invisalign method of orthodontic treatment and I always discuss if it is a realistic option during the consultation.Blair R. Barnett, DDS, MShttp://www.blogger.com/profile/08147867326294811985noreply@blogger.com0