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October's Tip: The Effects of Mandibular Position on Airway and TMD: A Case Report

October's Tip: The Effects of Mandibular Position on Airway and TMD: A Case Report

By Dr. Keri Do:

Comprehensive orthodontics is a treatment that needs to target and correct issues beyond malocclusions, such as teeth alignment or damaging overbites. It can affect comprehensive factors that require a multidisciplinary approach such as alignment of the TMJ, opening of the respiratory passage or airway, leveling of the occlusal plane, and stabilization of the occlusion, subsequently creating beautiful smiles and faces. In addition, an important development of treatment that should not be overlooked is the patency of an airway. The position of the mandible can contribute to how much an airway is open or closed. For example, when the mandible is more retruded, which can occur when changing from an upright to a supine position, the airway passage will narrow. (1) A retruded mandible position can also negatively affect the TMJ. Joint derangement has been shown to have a direct correlation with the amount of mandibular retrusion. (2) Treatment goals should include positioning the mandible in the correct condylar position and functional airway position and subsequently moving the teeth to support that position. (3-5) This clinical report illustrates cases where the patient was treated for TMD and obstructive sleep apnea with functional appliances and orthodontics.

September's Tip: Treatment of Impacted Lower Permanent Cuspid: Clinical and Mechanical Considerations

September's Tip:  Treatment of Impacted Lower Permanent Cuspid: Clinical and Mechanical Considerations

By: Dr. Pierre Pellan

Mandibular canine impaction is way less frequent than is maxillary canine impaction.  (1, 2, 3). The best way to treat impaction of lower permanent cuspids is simply to prevent its occurrence. Each year, our office welcomes 15-year-old patients who are referred because their family dentist wondered why the permanent cuspids had not erupted still.

August's Tip: The Sling Shot Appliance

By: Dr. Rick Grant

A couple of years ago I had the opportunity to speak at the Pittsburgh Study Club.  The following day Dr. Jack Pechersky, a practicing Pediatric Dentist and an associate Professor at the University of Pittsburgh, spoke on an appliance that I thought would be excellent to share with his permission.  He calls it the "Sling Shot Appliance."  This is another "tool" that you can use to help align ectopically erupting teeth.

July's Tip: How to Run a Successful Orthodontic Practice- Part IV

By: Dr. Mark Paschen

Marketing starts with the first phone call to your office. Your receptionist should be answering the phone as follows: "Dr. Johnson's Office, General Dentistry and Orthodontics, this is Lisa, how may I help you?" Notice you add, and Orthodontics when the phone is answered. Don't take it for granted that your current patients know you do orthodontics. The fact you do orthodontics should also be apparent from signage on your building and from signage and pictures or posters within your building. Use photos of your actual patients (with their signed consent) and keep all signage simple, fun, and eye-catching. Our reception area has a large mural-type display with beautiful canvas-wrapped photos of my patients' smiles. These were professionally done and are much more effective than typical stock images that you purchase from a catalogue. You need to be cognizant of what the ethics rules are in your state concerning what a general dentist can display or advertise concerning orthodontics. I contacted my state's ethics committee before I spent any money on a logo or advertising pieces. Also, put up any continuing education class certificates that you have earned in orthodontic studies. Make sure these certificates are in a central location that can be seen by your general dentistry patients. Too many times, dentists only put the certificates in their consultation room, so they are only seen by patients going through the orthodontic evaluation process, not by all of their general dentistry patients. Your patients look at these and want to know your credentials.

June's Tip: Common Areas For Case Disruption

June's Tip: Common Areas For Case Disruption

By: Dr. William Buckley

After practicing for 39 years and providing orthodontics for thirty years, the best Information I can pass on is: when the intra-case results are not what you expected go back to basics.  For any mechanical technique there are common basics which we all share: Diagnosis, Tooth Movement Progression, Functional Occlusion, and Retention.

April's Tip: How to Run a Successful Orthodontic Practice - Part III

April's Tip: How to Run a Successful Orthodontic Practice - Part III

By: Dr. Mark Paschen:

Introduction:
Treatment Coordinator: (I will refer to the TC as "she" even though there may be many very qualified and talented men out there serving in that role). There are five main responsibilities of the TC. They range from meeting the new patient to getting the new patient to accept treatment.

March's Tip: Evidence of Pineal Gland Calcification on CBCT is Not Insignificant: What Else You Might Discover about Your Patient

March's Tip: Evidence of Pineal Gland Calcification on CBCT is Not Insignificant: What Else You Might Discover about Your Patient

By: Dr. Stacy Fore

Many dental practices utilize a CBCT to examine and evaluate patients. These scans are then evaluated by a radiologist. A review of these reports often reveal that a radiopacity is noted in the midsagittal plane posterior and superior to the sella tursica compatible with calcification of the pineal gland. It is often reported that these findings have no clinical significance and follow —up/clinical correlation is not required. The following paper offers a review of anatomy and purpose of the pineal gland. It is intriguing that this tiny rice-sized gland has such a broad range of functions and influence. Of particular interest with the increase in research and treatment of sleep disorders is the pineal gland and melatonin production. A further review of the literature may encourage practitioners that these calcifications may be of clinical significance and warrant further follow-up.

February's Tip: Understanding and Treating Macroglossia

By: Maria-Cristina Iova

According to the Guinness World Records 2015, the largest tongue recorded in history belongs to Nick Stoeberl measuring 10.1 cm.  Although this seems like an interesting trait, dentists confirm that having a large tongue is disadvantageous. The tongue is a specialized, muscular, and multifunctional organ that is part of the oral cavity, pharynx, and larynx.' It is essential in speaking, tasting, chewing, swallowing, and facial growth' and has tremendous importance in the airway path. It is particularly important to consider it when doing an orthodontic treatment or in obstructive sleep apnea (OSA). To understand the complications of a large tongue, the tongue will be first looked at the anatomical level so that the meaning of an oversized tongue and the different types of treatment solutions available to patients with specifically larger tongues can be discussed. In order to help the medical field, dentists need to pay more attention to the tongue by participating in and with clinical studies and publishing observations and information about the tongue, its size, and role in oral health.

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