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Credits: None available.
Ever since the development of the skeletal anchorage system (SAS) utilizing titanium miniplates as absolute orthodontic anchorages, we have been offering a non-surgical treatment option for skeletal open-bite adult patients. However, a non-surgical approach is not necessarily easy because most skeletal open-bite cases usually have not only vertical problems but also some anteroposterior and transverse orthodontic problems, including maxillary protrusion, an anterior crossbite, an asymmetric dentition and crowding. The most distinguished feature of SAS is to enable orthodontists to predictably move molars with ease in any of the three dimensions because the miniplates are always placed outside the dental arches with monocortical titanium screws and do not disturb any kind of tooth movement. Therefore, it has become possible to solve complex orthodontic problems of skeletal open-bite cases without the need for jaw surgery or bicuspid extraction. The most important step in open-bite correction with SAS must be to properly establish individualized treatment goals prior to treatment, taking into consideration 1) the level and cant of the occlusal plane, 2) the extent of the interlabial gap, 3) the amount of autorotation of the mandible following intrusion of the molars, and 4) the amount of true arch-length deficiency. In this session, the concept and methods for establishing individualized treatment goals, SAS biomechanics for non-surgical and non-extraction treatment, and the long-term outcomes will be discussed.
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Credits: None available.
Analysis of patients who seek re-treatment has the potential to teach orthodontic specialists important lessons from which they may find methods to reduce various forms of relapse that lead to orthodontic therapy later in life. Through the process of failure analysis, attendees will learn lessons that can be incorporated immediately into their practice. Patients with case types that are at risk for instability and subsequent re-treatment will be identified based on the analysis of 200 adults who sought re-treatment. Similar case types seen in your practice may be guided by treatment plans and retention protocols that provide greater long-term stability. By understanding and properly managing the most common problems for which patients seek re-treatment, orthodontists will be in a position to significantly reduce the time-consuming, costly process of re-treating a large number of orthodontic conditions. This presentation will also describe steps that have been recently integrated into our practice to overcome instability problems associated with the three orthodontic case types that account for 87 percent of re-treatment cases. By incorporating insights gained from this study of orthodontic failure analysis, you will be able to:
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Credits: None available.
The black triangles associated with missing papillae have long been one of the most difficult esthetic dilemmas to manage. The inherent complexities of this problem often lead to misdiagnosis, improper treatment and disappointing results. This session will present interdisciplinary methods to properly diagnose causative factors and more predictably reform missing papillae utilizing periodontal, restorative and orthodontic techniques. These same methods can be used by orthodontists when finishing cases to prevent black triangles. Dr. Roblee will also present advanced examples that illustrate the implementation of the above principles in cases involving severe periodontal defects, implant placement problems, accelerated orthodontic techniques, temporary anchorage devices and dentoalveolar distraction osteogenesis.
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Credits: None available.
The speaker will summarize the current knowledge in growth and development and the techniques in harnessing growth in Class II and Class III patients. Growth prediction can be realized in most patients with the appropriate diagnostic information, and growth modification can be a realistic objective in our treatment-planning process. Successful and unsuccessful cases treated with the Herbst and facemask appliances will be reviewed in an effort to find solutions for growth-modification challenges. For patients with abnormal growth patterns, the speaker will suggest practical ways to forecast excessive or deficient skeletal growth.
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Credits: None available.
To illustrate the effectiveness of the spur appliance, Dr. Justus will present clinical cases and cephalograms of patients with dental and skeletal AOBs treated with spurs. The records of these patients formed part of an AOB sample for a University of Washington thesis that confirmed there is statistically significant increased long-tem stability in corrected AOBs with spur use. This study concluded that stability of AOB correction is apparently related to a modification in tongue posture due to the spurs, both in growing and in non-growing patients.
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Credits: None available.
Dr. Lowe is professor and chair of the Division of Orthodontics in the Faculty of Dentistry at The University of British Columbia and maintains an orthodontic practice in Vancouver, Canada.
Recently, the importance of resting tongue posture in the adult population has received a great deal of attention as it directly affects snoring, upper airway resistance syndrome and obstructive sleep apnea. Orthodontists, with their knowledge and training of functional appliances and established skills to evaluate jaw position, are ideally suited to provide oral appliance therapy in this field. Sleep disordered breathing patients are excellent adherents to therapy after only a few nights of uninterrupted sleep and the subsequent restoration of adequate REM sleep. Oral appliances have a direct effect on tongue posture during sleep and help to stabilize the mandible in a closed vertical position. They also have a direct effect on genioglossus muscle activity. However, a reduction in overbite and/or the development of open bites with long-term wear of oral appliances in adult patients have recently been identified. These long-term occlusal changes are predominantly dental in nature and typically occur after more than two or three years of nightly wear. A better response to appliance therapy is seen in those post titration subjects who exhibit a more anterior velopharyngeal wall, a larger radius of curvature of the airway and an increase in velopharyngeal size. Because sleep apnea is a progressive life-threatening disease and patients tend to be very compliant over time, the long-term occlusal changes may continue each decade.
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Credits: None available.
Pre-restorative Orthodontics in the Anterior Esthetic Case: When to Restore and When to Align
Interdisciplinary dentistry is proving to be the most effective means by which we can deliver the highest level of service to our patients. Whether addressing specific cosmetic concerns or providing advanced rehabilitation and restoration through coordinated efforts at the specialist level, we can engage in more comprehensive treatment and superior outcomes. Through carefully documented clinical cases, the presenters will emphasize communication, decision making, sequencing and execution. Areas in which the various specialists can work in concert to better serve our patients will be illustrated. The forum will provide for a platform upon which we can all begin to communicate and explore some of the latest developments, many of which are very exciting. Participants should come prepared to expand their thinking and horizons.
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Credits: None available.
Although the potential adverse soft-tissue affects of the LeFort I osteotomy have been described and surgical procedures have been developed to minimize the impact of these changes, patients can still end up with unesthetic results following surgery. To minimize the likelihood of these adverse soft-tissue changes, treatment planning decisions should be made jointly between the orthodontist and surgeon. Of primary importance is the position and angulation of the maxillary incisors, as this will contribute greatly to midface esthetics and often lower face esthetics as well. Management of individuals with anterior open bit, occlusal plane deviations or upright maxillary incisors without crowding will be reviewed with special emphasis on patients with previous maxillary premolar extractions and subsequent unesthetic flattening of the upper lip. The orthodontist and surgeon should be aware of the soft-tissue impact of various LeFort I procedures and how to either avoid or utilize these changes to maximize the patients esthetic outcome.
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Credits: None available.
Over the last few decades, doctors have become aware of the special issues associated with interdisciplinary dentistry. All of the speakers at this Interdisciplinary Conference have contributed significantly to this awareness and have provided a vision of what a team can accomplish. The main objective of this presentation will be to provide the strategies that Team Montrose uses to execute the interdisciplinary treatment plans. The strategies include a common language for communication, the mechanics of a team meeting and addressing the most common pitfalls associated with multidisciplinary teams. Treated cases will be shown to demonstrate the results.
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Credits: None available.
This lecture will deal with the advantages and disadvantages of different treatment options for replacement of missing maxillary central and/or lateral incisors in young and adult/elderly patients. The short- and long-term appearance associated with the following treatment options will be covered:
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