Documenti di Didattica
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TABLE OF CONTENTS
32
14
26
10
FEATURES
DEPARTMENTS
8
EDITORS WELCOME
ASSOCIATION STAFF
ADVERTISER INDEX
Academy of Gp Orthodontics ........4
OrthoArch....................................25
Adam Griswold
AGpO Executive Director
Academy of Gp Orthodontics
509 E. Boydston St.
Rockwall, TX 75087-3956
(800) 634-2027
E-mail:
agriswold@academygportho.com
Thomas N. Chapman, CAE
AOS Executive Director
American Orthodontic Society
11884 Greenville Avenue, Suite 112
Dallas, TX 75243
(800) 448-1601
E-mail: tchapman@orthodontics.com
EDITORIAL STAFF
Greg Cannizzo, DDS ...............AGpO
Editor
Jordan Balvich, DMD ................AOS
Co-Editor
Jim Mcllwain, DDS, MSD ..........AOS
Co-Editor
Lisa A. Wright ..................AOS/AGpO
Managing Editor
Email: lisa@wrightgrp.com
EDITORIAL REVIEW BOARD
Ron Austin, DDS............................AGpO
Chris Baker, RN, DMD......................AOS
Ernest Barbosa, DDS ......................AGpO
Eugene Boone, DDS.......................AGpO
Steve Bradley, DDS ........................AGpO
Felecia Burridge, DDS ....................AGpO
Fred Der, DDS ................................AGpO
Joe Drinkwater, DDS......................AGpO
Twana Farley-Duncan, DDS..............AOS
Debra Ettle-Resnick, DDS .................AOS
Joe Fallin, DDS...............................AGpO
Edward Gonzalez, Jr., DMD..............AOS
Joe Haack, DDS .................................AOS
Kevin J. Hester, DDS .........................AOS
Roy Holexa, DDS ...........................AGpO
Thomas Jacobsen, DDS..................AGpO
Giancarlo Maldonado, DDS ..........AGpO
Kyle McCrea, DDS .........................AGpO
Sherman Menser, DDS...................AGpO
Brian Olsen, DDS...........................AGpO
Ann Mary Orr, DDS ..........................AOS
James Orrington, DMD ....................AOS
Leslie R. Penley, DDS .....................AGpO
Joseph R. Schmidbauer, DDS............AOS
Robert Shirley, DDS .......................AGpO
Jill Snyder, DDS .............................AGpO
Juan J. Solano, DDS ..........................AOS
Kurt Stodola, DDS..........................AGpO
David Thorfinnson, DDS..................AOS
Walter Tippen, DDS.......................AGpO
John Wells, DDS ............................AGpO
Bradford R. Williams, DDS ...............AOS
Paul L. Winborn, DDS ......................AOS
William Wyatt, Sr., DDS ...................AOS
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CONTRIBUTOR BIOGRAPHIES
Josh Brower DDS, MIAMDI, FAASDI, is a
general practitioner who practices using both
orthodontics and dental implants of all sizes. He is
Master of the International Academy of Mini Dental
Implants (IAMDI), a Founder/Fellow of the American
Academy of Small Diameter Implants (AASDI) and
founding member. He does not practice exclusively
with small diameter implants. The author would like to
extend special thanks to Dr. Larry White, a Board
Certified Orthodontist, teacher at Baylor College of
Dentistry and instructor of the AOS.
COPYRIGHT
2014. Journal of the American
Orthodontic Society. The material in each
issue of the JAOS is protected by copyright.
None of it may be duplicated, reprinted or
reproduced in any manner without express
written consent from the publisher. All
inquiries and/or requests should be
submitted in writing to The Thornton Group
via e-mail to jennifer@thorntongrp.com.
SUBSCRIPTIONS
The Journal of the American Orthodontic
Society is a benefit of membership for
current American Orthodontic Society and
Academy of Gp Orthodontics members.
Annual subscriptions to the quarterly journal (4 issues per year) are available at a rate
of $50/year for US residents, $100
USD/year for Canada and $120 USD/year
internationally. Back issues are available at
a rate of $10 per copy until supplies run
out. To subscribe to the JAOS, please visit
www.orthodontics.com.
David W. Jackson, DDS, FAGD, IBO, graduated from Baylor College of Dentistry in 1978. Dr.
Jackson, was a member of the AOS and AGpO, as well
as other professional organizations. He lectured extensively for the American Orthodontic Society as well as
the International Association of Orthodontics. His
insight to the real world of orthodontics in the
general practice was honest and informative. We are
saddened by Dr. Jackson's recent passing. He was a
constant contributor to this Journal and a great friend.
Space Maintainers
Laboratories Launches
Global Website
SML (Space Maintainers Laboratories) has announced the debut of
its new website, SMLGlobal.com.
The move is part of an in-house
rebranding effort initiated with
the new SML logo and the handson manifestation of the companys
drive toward increased message
clarity, client connection and
service satisfaction.
As VP of Marketing Scott Veis
explains, SMLGlobal.com is a
fresher, faster, far more satisfying
online experience. Its our virtual
storeand perhaps more significantly, a vast repository of quickaccess information on all things
dental and orthodontic. The
website serves the fourfold purpose
of 1) educating the dental professional as to the function, clinical
application, and treatment modalities of more than 500 available
made-to-order dental appliances
2) providing digital solutions and
expert diagnostic recommendations for dental professionals at all
levels of expertise and 3) facilitating the order, delivery and tracking of the product or appliance
that gets the job done.
Founded in 1957, SML is a labbased consortium of core-supporting dental/orthodontic specialties,
e.g. appliance manufacture; ADA
CERP-recognized continuing
education; digital services; diagnostic consultation; and supplies.
The companys worldwide network
of labs is renowned for providing
dental practitioners with the
opportunity to receive the service
and caring of a mom-and-pop lab
and the technological assets and
resources of a large, globally realized company.
Practitioners interested in learning more about the SML laboratory franchise may request an
introductory orientation by calling
1-800-423-3270. For more detailed
information on the offerings and
advantages of SML, visit us online.
eXceed Computerized
Bracket Placement Service
New from Great Lakes, the
eXceed Computerized Bracket
Placement Service is
a patented suite of
computer-aided,
bracket placement
services that scientifically calculates the
ideal digital placement coordinates for
each bracket on the
teeth. Then, through
cutting-edge 3D
model printing technology, bonding
trays are manufactured with unrivaled fit and bracket
position accuracy. Outcomes are
more predictable and consistent,
and adjustments to brackets and
archwire are minimized or eliminated. eXceed significantly reduces
time spent placing brackets, minimizes chair time, and increases
patient comfort.
eXceed offers two different
methods to calculate ideal bracket
Fig. 1
Fig. 2
Fig. 3
100mm. Usually the 60mm is not the recommended lens as the subject to camera distance for
both close-up and facial views is too close. The
90mm or 100mm macro lens yields a comfortable
working distance when taking intraoral views and
eliminates distortion when taking portraits. While
lenses can be used in the autofocus mode, we
suggest that the manual mode be selected, and with
this in mind, our lenses are imprinted with the
preferred Orthodontic views for accurate, consistent
before & after images .
The complete SLR system should include a camera
body, macro lens and the proper lighting. There are
currently two choices that are suggested, the traditional Ring-light and the latest advancement, the
Wire-less Ring-flash which eliminates the power pack
and offers a lighter weight system. (Figs. 2 and 3)
Choose the camera that enables you and/or your
staff to provide the best possible images to satisfy
your particular requirements. Let your patients see
the work your practice can accomplish and how it
will improve their looks and their self- esteem. In
addition, photography is the ideal way to communicate with a laboratory when necessary. Remember the old saying, one picture is worth a thousand words. This is especially true when marketing your practice.
And as a final thought to leave you with, support
is critical for folks who so not have a great knowledge of photography. Due to the different lighting in
various offices, sometimes the preset settings that
come on the camera need to be changed quickly.
That is again the advantage and importance of working with a company like CLINIPIX. If I have issues
with a camera, I simply pick up the phone and
scream, Hey Fred!! Help!!!
EXPLORING
the First Two Keys of
Class II Correction:
Fig. 1
Big Daddy
The .032 stainless steel overlay arch was aptly
named the Big Daddy by William Wyatt, DDS, FACD,
14 Fall 2014 JAOS
Fig. 2
Fig. 3
Fig. 5
Fig. 4
Fig. 6A
Fig. 6B
Fig. 6D
Fig. 6C
Fig. 7
Fig. 8
Fig. 9
of the bends described. It should be used in adults
where higher force magnitudes may be desirable.
If 6|6 distal rotation only is needed, utilize Toe-in
Bends mesial of 6|6 and In-Bends distal of 3|3
(Fig. 6D)
Make these bends in the mouth after the archwire
has already been placed. Use a Tweed loop plier (Fig. 7A)
that will produce a 45 bend. Hold the plier vertically
and at a right angle to the archwire and squeeze the
plier fully. You need to create consistent 45 bends. I
lace 3,2,1 | 1,2,3 for control when making these bends
so that the anterior teeth maintain their position.
Figs. 7B, 8, and 9 demonstrate a clinical case in the
late mixed dentition. The maxillary arch is narrow
and V-shaped. 3,2,1 | 1,2,3 were bracketed and 6|6
were banded. Toe-in bends were placed mesial of 6|6
and out-bends were placed distal of 3|3. The result
will be expansion and distal rotation of the maxillary
first molars.
The formed archwire configurations outside of the
mouth might appear very strange looking. However,
these configurations are correct and will provide great
results (Fig. 10)8 Mulligan mechanics may seem abstract
and difficult to grasp at first. Dr. Mulligans text is a
great resource for understanding the concepts. I have
found Mulligan mechanics principles to be effective
and easy to implement.
Nitanium Palatal Expander 2 (NPE)
The following is a brief overview of how to size, use,
and reactivate the Nitanium Palatal Expander 2 (NPE).
For a technique guide about the NPE refer to the Ortho
Organizers Instructions for Use Sheet REF 1010760/101-770.10 Another excellent source is the Gerety
Orthodontic Seminars titled: Palatal Expansion With
the Nitanium Palatal Expander (NPE) pages 277-285.3
Figure 11 shows the NPE in a patients mouth with the
components labeled.
NPE features:
Rotates 6|6 distally
16 Fall 2014 JAOS
Fig. 10
Fig. 13
Fig. 11
Fig. 12
Fig. 14
Fig. 15
Fig. 17
Fig. 16
The TPB has many capabilities:4
Torque
Intrusion or extrusion
Expansion
Rotation
Distalization
Molar uprighting
Reinforcement of anchorage
How do I prepare the mesial loop (Palatal Arch
Bar) to be added prior to activation and
determine which size to use?
The mesial loop PABs come in eleven sizes starting
with 35mm and increasing in 2mm increments up to
55mm. Measure in the mouth or on a stone model
from the lingual tissue to tooth junction of one maxillary first molar adapting the plastic measuring device to
the curvature of the palate to the lingual tissue tooth
junction of the other maxillary first molar (Fig. 13B).
In this example a 47mm mesial loop PAB was selected.
With the Adams plier bend one terminal loop 30 (Fig.
18 Fall 2014 JAOS
Fig. 18
14A.) Repeat on the other side and view laterally to
make sure that the bends are symmetrical. In the
middle of one straight wire portion of the PAB place a
30 bend (Fig 14B). Repeat on the other side and view
laterally to make sure that the bends are symmetrical.
Making the bends in the middle of the straight wire
portion of the PAB allows for proper adaptation to the
curvature of the palate. At the junction of the straight
wire portion and central loop place a 30 bend (Fig.
14C). Repeat on the other side and view laterally to
make sure that the bends are symmetrical. Figs. 14D
and 14E demonstrate a passive PAB prior to activation.
A multitude of actions may be programmed into the
TPB, far too many to cover in this article. I will focus
on bilateral expansion, buccal root torque, distobuccal
rotation, and distalization of maxillary first molars - the
main issues encountered in constricted Class II cases.
Only two activations should be performed at the same
time. Excessive multi-directional activations can
compromise results and lengthen treatment time.
I link bilateral expansion and bilateral buccal root
torque of 6|6 and perform these activations first. To
program bilateral buccal root torque into the appliance
bend the terminal loop on one side several degrees to
Fig. 19
Fig. 20
Fig. 20B demonstrates a clinical case with the TFT
placed in the mandibular arch. Small composite beads
on the lingual of the cuspids help to lock the TFT
down so that the appliance does not rise up occlusally
as it expands.
TFT Features:
Expands the maxillary and mandibular arches
On the palate but with a tight lingual profile,
therefore not as obtrusive as some palatal appliances
Nitanium coil springs enclosed in the expansion
modules provide a slow continuous force11
Allows for up to 2 mm expansion every 6-8
weeks11
Hyrax
The Hyrax is a fixed laboratory fabricated maxillary
arch widening appliance. Molar bands are used on the
first molars and are optional on the first bicuspids.
Hyrax Features:
The midline screw assembly is closer to the COR
(Center of Resistance) in the transverse plane
allowing for close to bodily buccal movement of
the maxillary molars
Bayonet ends (blades) fit into .036 x .072 horizontal sheaths on the lingual of the first molar bands
Fig. 21
Fig. 23
Fig. 22
Fig. 24
indications for use, advantages, disadvantages, vendors,
and cost.
An excellent appliance in Class III cases where the
maxilla is deficient horizontally; Class III elastics
are worn from extended buccal arms on the appliance to a removable mandibular bow that is worn
during sleep to protract the maxilla (Fig. 21
demonstrates such a case)
Fig. 21A demonstrates that the midline screw assembly
is close to the COR in the transverse plane, allowing for
translation of the maxillary first molars when expanding.
This case has both maxillary expansion and protraction
components. Figs. 21B and C demonstrate 5mm of maxillary expansion.
Figures 21D and E demonstrate the removable
mandibular bow. Class III protraction elastics connect
from the extended buccal arms of the Hyrax to hooks
on the bow.
Archwire Sequence
It is generally accepted that if an archwire sequence
has a broader arch form than the dentition, then approximately 2 mm per side of lateral expansion may be
achieved without significant buccal tipping of the posterior teeth.
Table 1 summarizes the appliances used, actions,
BIOMECHANICS DISCUSSION
A review of some fundamental biomechanical definitions and principles is necessary to understand clinically what happens when a force(s) is/are applied to a
tooth/teeth.
Force a push or a pull that acts in a straight line7
(Fig. 22A)
Center of Resistance (COR)the point through
which a force will result in translation of a/the
tooth/teeth without rotation12; the COR of a tooth
depends on the root length, morphology, number of
roots, and the level of bone support 9 (Fig. 22B)
Translationall points on a tooth move in a parallel
straight line (bodily movement) when a force is
applied12 (Fig. 22C)
When a force acts away from the COR, there is a
perpendicular distance established between the
applied force and the center of the object8 and a
moment is produced (Fig. 22D). A moment is the
product of force times distance.7 Half of the force
times twice the distance produces the same moment
as half the distance times twice the force8 (Fig. 22E).
When the line of force does not pass through the COR
Table 1
Fig. 25
Fig. 26
Fig. 27
Fig. 29
Fig. 28
Is the buccal tipping of the maxillary molars clinically significant? The younger a patient is (mixed
dentition) and the lesser the amount of expansion
required, can tilt the scales toward the tipping issue
not being clinically significant. The older a patient is
(adult dentition) and the greater the amount of expansion required results in a higher degree of buccal
tipping that is clinically significant. In his book Dr.
Mulligan shows that the long axis of the maxillary and
mandibular posterior teeth should be parallel with the
muscles of mastication for ideal function8 (Fig. 26A).
He describes two curves: Monson and Wilson (Fig
26B). The curve of Monson refers to the ideal curve
where the buccal and lingual cusp tips of the maxillary
first molars contact. The curve of Wilson refers to the
ideal curve where the buccal and lingual cusp tips of
the mandibular molars contact.6
When these curves are coincident, excellent axial
loading occurs. However when the crowns of the maxillary molars are tipped buccally there is an excessive
curve of Monson with a loss of axial loading3 (Fig.
26C). Furthermore, the molar crowns are not uprighted
over their roots and will not be stable. Fig. 27 demonstrates an expansion case using the NPE. Despite
programming buccal root torque into the appliance,
the maxillary molar crowns tipped excessively to the
buccal as they were expanded. Upon removal of the
appliance the crowns will upright over their respective
roots and the amount of actual expansion gained will
be less than what was originally thought to be.
I am currently working on developing a prototype
first molar band with Jerry Anderson of Anderson
Orthodontics1 that will place a second buccal tube
level with the COR in the transverse plane (Fig. 28).
Using the Big Daddy, the pulling force would be
applied at the level of the COR and bodily buccal
movement of the molars without tipping would
theoretically take place (Fig. 29).
CONCLUSION
Several of the appliances that I use satisfy the
requirements of Key One: Maxillary Arch Development
so that the the shoe (maxilla), and the foot (mandible)
Fig. 30
will fit.2 Some of the appliances (Mulligan mechanics
in the horizontal plane, Nitanium Palatal Expander 2,
the transpalatal bar, and to a lesser extent the Big
Daddy) satisfy the requirements of Key Two: Maxillary
Molar Position. These appliances have the capability of
distobuccally rotating maxillary first molars. From a
biomechanical standpoint it was demonstrated that
when a maxillary arch is developed transversely with
forces occlusal to the COR, tipping of the maxillary first
molars occurs and may be problematic in some cases.
Fig. 30A shows a common problem when expanding
the maxillary arch transversely. In those cases I would
recommend using a Hyrax for expansion as the midline
screw assembly approximates the level of the COR.
Another option if utilizing the Big Daddy pulling technique would be to use a molar band that has a double
buccal tube and use the more gingivally positioned
tube (closest to the COR). A final option would be to
utilize a custom made molar band that has a second
buccal tube placed at the level of the COR. This would
allow for the potential of the maxillary first molars to
expand buccally in a bodily fashion (translate with no
tipping) when using the Big Daddy pulling technique.
Figure 30-B shows the ideal goal of maxillary arch
expansion TRANSLATION of the maxillary molars!
References
1. Anderson, Jerry. Anderson Orthodontics, Inc. Laboratory. 4318 W. Central, Wichita, KS 67212, Box 48745,
Wichita, KS 67201. 316-942-8703/Fax 316-942-6315/800456-1954
2. Carapezza, Leonard J., DMD. Six Keys to Early Mixed
Dentition Class II Correction: A Quantified Approach to
Diagnosis and Treatment. Journal of American Orthodontic Society; Spring 2014.
3. Gerety, Robert G. Gerety Orthodontic Seminars. Palatal
Expansion with the Nitanium Palatal Expander 2 (NPE).
Straight Wire Concepts: Diagnosis and Technique.
Produced by Kay C. Gerety, CDA
4. Greenfield, Raphael L. DDS, MSCD. Non Ex Factors.
98.5% Nonextraction Therapy using Coordinated Arch
Development. DaehancNarae Publishing, Inc. Seoul,
South Korea; 2010.
5. http://medical-dictionary. the freedictionary.com/application.
6. http://www.ptcdental.com/dentaldictionary/c/curve-ofmonson/curve-of-wilson/
Fig. 1A
26 Fall 2014 JAOS
Fig. 1B
www.orthodontics.com Fall 2014 27
Fig. 2
Fig. 3
Fig. 4
habits, home care and even
frequency of hygiene to help reduce
the chance of getting periodontal
disease that has the potential of
being more aggressive compared to
other patients. I use the MyPerioPath to help educate the patient to
the level of periodontal pathogens
in their mouth. I use the report to
help with antibiotic therapy and
can do the test at a follow up to see
if the patient has effectively lowered
their bacterial load.
All new patients are given the
CRA form developed by CariFree so
that they can start some self-assessment as to their own individual
risk of getting cavities in the future.
If the patient elects to move
forward, they are given the
CariScreen test and after the exam,
I review all the findings with the
patient. They are then given
options (including CariFree products) as to how they want to
handle their individual risk factors.
In conclusion, there are new
tools that dentist can use to help
predict who might be at risk for
dental disease, what bacteria are
present in the biofilm and who
might be genetically predisposed to
more aggressive reactions to periodontal disease. It is very exciting
that as clinicians we can be more
progressive in actually preventing
disease as opposed to the standard
of treating dental disease.
30 Fall 2014 JAOS
References
1. Kaufman, Lamster The Diagnostic
applications of Saliva A Review.
Critical Reviews in Oral Biology &
Medicine, March 2002 vol 13 no 2
187-212
2. Loo, Yan, Ramahcandran, Wong.
Comparative human salivary and
plasma proteomes. JDR October
2010. 89 (10):1016-1023
3. Gau, Wong. Oral fluid nonosensor
test (OFNASET) with advanced electrochemical-based molecular analysis
platform. Amm N Y Acac Sci 2007
march, 1098:401-410
4. Kaufman, Lamster The Diagnostic
applications of Saliva A Review.
Critical Reviews in Oral Biology &
Medicine, March 2002 vol 13 no 2
187-212
5. Ellias,Ariffin et all Proteiomic analysis of Saliva Identifies Potential
Biomarkers for Orthodontic Tooth
Movement,The Scientific World Journal, Volume 2012, article id 647240
6. Website of National Human Genone
research Institute (National Institutes
of Health) www.genome.gov/
10000207
7. Nabors, McGlennen, Thompson,
Salivary Testing for Periodontal
Disease Diagnosis and Treatment,
Dent Today. 2010 Jun;29(6):53-4, 56,
58-60
dental
implants
& orthodontics:
Mini Dental Implant
Placement, Use
and Protocols
PART 2
By Josh Brower DDS, MIAMDI, FAASDI
Fig. 1
expect faster less invasive treatment with less recuperation time. The same is true with dentistry, as it continues to modernize patients will also expect less invasive
treatment with shorter recuperation time. Sizing an
implant to the available bone so grafting is not necessary, using immediate load implants so that the crown
can be fabricated and used during osseointegration ,
using bone mapping or 3D radiographic techniques to
evaluate the bone without creating a flap for implant
placement are all important improvements and
enhancements of old techniques that makes the treatment faster, cheaper, and better which meets the
patients criteria and expectations.
Fig. 3
Creating a pilot hole with a 1.8mm bur for a 3.0 mm
implant (at this stage a paralleling pin can be used to
check the angle and placement of the implant placement) Radiographs are sometimes necessary at this stage
when minimal bone is available between adjacent tooth
roots.(Fig.4)
Fig. 2
Fig. 4
Using the final drill designed for a 3.0mm implant
after the tissue punch and countersink have been used
to prep the implant for placement.(Fig.5)
Begin by using the manufacturers carrier to thread in
www.orthodontics.com Fall 2014 33
Fig. 5
pressure...about
the implant as far as possible with fi
ffinger
nger pressure
about
35ncm. Once you have achieved this tightness you know
the implant will have good primary initial stability.
Mini dental implants have an osseoapposition phase
where they are mechanically locked into the bone while
waiting for osseointegration. Osseointegration begins
occurring with bone growth very rapidly, but final
growth of bone onto the implant is dependent on many
factors and can take more than 9 months10,11,12 With
this in mind loading of the implant is of paramount
importance. There must be no working or nonworking
interferences and a flat narrow occlusal table works best
to avoid horizontal overloading forces. (Fig.6)
Fig. 8
Immediate temporary in place created from composite directly placed on implant #20 and then carved to
shape with a dental bur. Pt previously completed mini
implants and crowns in two other locations.(Fig.9)
Fig. 9
Fig. 6
Fig. 7
An impression has been taken after checking
occlusal clearance in the picture on the right and
34 Fall 2014 JAOS
Fig. 12
Fig. 10
Fig. 11
2 5mm implants.
2.5mm
implants The 1.25mm
1 25mm drill does come with
every case planned, but not the implants unless you
request them. Since you don't know which sizes he will
pick and scheduling is always tricky I recommend you
have him also send the implants he recommends with
the case. The second photo shows the maxillary bone
on the pilot drill after use. This must be cleaned off
prior to use again or drilling will become difficult.
(Fig.12)
Placing the implant using the handpiece and driver
through the surgical guide. The implant driver will
Fig. 13
not place the implant to full
f ll depth,
fu
depth so the guide must
be removed and the implant driver used to get the
final depth. Be careful when placing multiple implants
on the same guide that you put each one to depth
prior to proceeding to the next implant, or the various
angles you produce may make removing the surgical
guide impossible. (Fig. 13)
Implant at full depth with guide removed. The
implant should be left out as far as possible so that
www.orthodontics.com Fall 2014 35
Fig. 17
Fig. 14
Fig. 18
Fig. 15
The
is d
driven just ffar enough
h implant
l
h in ffor the
h
crown to seat and blanch the tissue. There is a slight
white blanching of the tissue shown in this photo. The
crown is cleaned with a waterpik, or by flossing down
and then under the crown right up to the implant.
Since the crown is a full ridge lap like some bridge
pontics you will find that very little if any debris are
able to get under it.(Fig.15)
Typical mini implant molar also done with immediate placement and cementation of crown by Shatkin
labs (Courtesy of Melinda Marino DDS, San Diego CA)
(Fig.18)
Fig. 16
Crowns cemented on the implants immediately after
placement. Note the lingual emergence profile also
going directly to the tissue. (Fig .16)
36 Fall 2014 JAOS
Mi i iimplant
Mini
l
crowns
PFM on mini implant for lateral incisor next to natural teeth (For some cases you can avoid lateral forces-- I
Fig. 24
Full Mouth
Restorations
Lifetime denture wearer
initially wanted denture
stabilization on the upper.
Was so happy with stability of denture that she
immediately changed her
ion she did not have to
mind and wanted a restoration
remove. Zirconium roundhouse completed compared to
stabilized denture with patients new smile.(Fig. 25)
Fig. 25
Fig. 21
PFZ (Porcelain fused to Zirconium) bridge all
implants with splinted implants (cemented with
retrievable cement) (Fig.22)
Fig. 22
Fig. 26
Fig. 27
Fig. 31
Fig. 28
Fig. 32
Fig. 29
Fixed final PFM restoration combining mini dental
implants and natural teeth by Dr. Victor Sendax1 (Fig. 29)
Salvage cases
Conventional implant
failed and pt didn't want
sinus augmentation so
implants were placed into
buccal and palatal bone as
shown in the previous
article for bicortical stabilization. PFZ restoration.
(Fig. 30)
38 Fall 2014 JAOS
Fig. 30
Cementation
There is a dirth of literature on cementation of
dental implants. Failure of the implant and prosthesis
due to leaving excess cement is a common concern
(3,4,5). I would highly recommend modern retrievable
cements. Numerous studies support retrievable cements
(6) Being able to remove the crown or crowns in the
future as an adjunct to treat peri-implantitis, occlusal
loads, or to change the use of the implant should their
natural dentition change in a way that makes it a logical choice is crucial. I cement most of my prosthesis
with a zinc oxide eugenol cement for the additional
benefit of having the antibacterial effect from eugenol.
If you would like to see additional information or cases involving
mini implants in the journal please email Dr Greg Cannizzo at
drgrc@joltmail.com and put in the subject line mini implants.
Sources
1. Dr. Victor Sendax (Mini Dental Implants textbook 2012)
2. Shatkin TE, Shatkin S, Oppenheimer BD, et al. Mini dental
implants for long-term fixed and removable prosthetics: a retrospective analysis of 2514 implants placed over a five-year period.
Compend Contin Educ Dent. 2007;28:92-99.
3. Pauletto N, Lahiffe BJ, Walton JN. Complications associated with
excess cement around crowns or osseointegrated implants; a clinical report. Int J Oral Maxillofac Implants. 1999;14:865-868
4. Gapski R. Neugeboren N. Pomeranz AZ, et al. Endosseous
Implant failure influence by crown cementation: a clinical case
report. Int J Oral Maxillofac Implants. 2008;23:943-946
he AOS membership
came together for our
Annual Meeting in
Denver, CO this past August. If
you were not there, you
missed out on beautiful
weather and gorgeous scenery
that allowed for golfing,
hiking, zip-lining and dancing
to the sounds of the All in
the Family Band, all
combined with a stellar educational program. An exhibit
hall full of industry partners
were able to show their newest
products to an interested audience when classes were not in
AGpO On Top
www.academygportho.com
Academy of
Gp Orthodontics
2014 Officers
President
Kyle McCrea, DDS
President Elect
Eugene Boone, DDS
Vice President
Steven Bradley, DDS
Secretary - Treasurer
Sherman Menser, DDS
Immediate Past-President
Fred Der, DDS
Board of Directors
Budda said, "To keep the body in good health is a duty... otherwise we
shall not be able to keep our mind strong and clear. With that in mind,
three AGpO members and a non-dentist wife, tackled one of the most
scenic segments of the John Muir Trail this summer. Months of conditioning preceded the three day backpack trip, ensuring our ability to handle
the altitude and the mileage. The question came up during our trip. "Why
do people do this?" Several answers came to mind: the serenity of wilderness, enjoying the scenic beauty, the spirituality of the experience and the
physical challenge. Without question, the practice of orthodontics
demands a "mind strong and clear". I think Buddha would have approved.
--Tom Jacobsen, Ron Austin, Fred Der, Margaret Leighton
plishes when I was appointed to my first Board position. As I moved up the slate of officers in the
Academy, I learned more about the nuts and bolts of
making the Academy work from first Cynthia Boreleon
and then Adam Griswold, the Academy Executive
Director. Every one of these valued members struggles
to find the formats, topics, and meeting locations that
will excite and motivate the Academy members.
Being a part of the Academy for the past nine years
has been great! It has been an honor to serve as your
President this last year. I have found that the best way
to get the most out of membership in the Academy is
to participate. Attend the annual meetings, take one of
the advanced or specialized courses offered, join a
message board, or even just keep in touch with your
fellow classmates from your 12-Session Class. Be a part
of the Tip Edge Community and you will grow.
Kyle McCrea
Front row, left to right: Jamie DA, Robin DA, Lourdes DA, Dr. Wendy Winarick, Tamara DA, Abby DA.
Back row, left to right: Dr Amy Laymon, Dr. Ron Austin, Dr Brad Donabauer, Dr. Harold Reel, Dr. Olan Rotowa,
Dr. Adam Beers, Dr. Oscar Luna
The American
Orthodontic Society
2014-15 Officers
& Directors
President
David M. Thorfinnson, DDS
President-Elect
Juan C. Echeverri, DDS
Secretary-Treasurer
W. Edward Gonzalez, Jr., DMD
Immediate Past President
Michael J. Newman, DDS
Board of Directors
Twana Farley-Duncan, DDS
Robert G. Gerety, DDS
Emeritus
Kevin J. Hester, DDS
James E. McIlwain, DDS, MSD
Anne Mary Orr, DDS
James L. Orrington, DMD
Allan Rotberg, DDS
Kimberly Suter, DDS
Bradford R. Williams, DDS
Paul L. Winborn, II, DDS
William E. Wyatt, Sr., DDS
Emeritus
Board of Examiners
Jeffrey H. Ahlin, DDS
Azita Anissi, DDS
Leonard J. Carapezza, DMD
Kenneth Ellis, DDS
Joseph M. Haack, DDS
Debra Ettle-Resnick, DDS
Executive Director
Thomas N. Chapman, CAE
JAOS Editor
Greg Cannizzo, DDS
44 Fall 2014 JAOS
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Which Road?
by Snorri M. Thorfinnson
(grandfather of David M. Thorfinnson)
Two old men sat at the end of the trail,
Life's gains in their toil-worn hands.
Besides them a Youth stood, tall and strong,
His eyes on Life's distant lands.
"Which road shall I take?" the young man cried,
And he turned to the tired old men.
"Shall I spend my life in the quest of gold
Or the love of my fellowmen?"