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February's Tip: Diagnosing Patients Dynamically

February's Tip: Diagnosing Patients Dynamically

By: Dr. Michel Champagne

Commented On By: Dr. Allan Macdonald

Many clinicians only evaluate malocclusions in a static position which means in maximum intercuspation. This is not the best way to make a diagnosis and this will probably increase the number of  mistakes. Omitting to diagnose a patient dynamically by looking at the path of closure of the lower jaw from the position of first contact to maximum intercuspation opens the door to misdiagnosis.

December's Tip: Class III Treatment

December's Tip: Class III Treatment

By: Dr. Mike Lowry

There are 2 possibilities when presented with a class III patient. Either they have a normally positioned maxilla and a prognathic mandible or a retrognathic maxilla and a normal mandible. About 80% of the class III patients present with the latter. The formal requires surgery to correct. We will address the retrognathic maxilla. This tip is going to demonstrate the tandem appliance. The appliance consists of a 3-way sagittal on the upper with NiTi springs in the sagittal portion and a holding arch on the lower. Hooks are added to the appliances so as to be over the middle of the buccal surface of the cuspids. A labial bow is added to headgear tubes on the lower appliance and worn 1+ hours before bedtime and all night. Class III elastics are worn during the day without the labial bow. See figures 1-4.

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.

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