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Obstructive Sleep Apnea is a health and life threatening condition affecting adults and children. Current evidence suggests that certain types of craniofacial morphology such as maxillary and mandibular deficiencies predispose to OSA. Therefore, early orthopedic dento-skeletal maxillary and mandibular development may be critical treatment modality in resolving and preventing OSA. This lecture will discuss current evidence and future vision for orthodontic profession taking the lead in management of this serious medical condition.
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The lecture will emphasize the importance of having a proper diagnosis to define the correct treatment planning. The proposed planning will be guided by the cause of the Class II malocclusion whether dental, skeletal, functional, or a combination of factors.
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Overnight polysomnolgaphy in a sleep laboratory remains the gold standard for diagnosis of sleep disordered breathing (SDB). However, the high cost and inconvenience of this test makes home monitoring an attractive alternative. This lecture will discuss the merits of home monitoring as well as the use of the Pediatric Sleep Questionaire to identify patients at risk for SDB in the orthodontic practice. And, importantly, what to do when you find them.
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Mini-implants are one of the latest successful technologies introduced and widely used in orthodontic treatment, as a reinforcement of anchorage. Same concepts adopted to treat different types of malocclusions in the past are still used, but with the raise of mini-implants era, the mechanical considerations of these traditional strategies need to be revisited. Nevertheless, ignorance of the entire mechanical effects that result from usage of mini-implants might cause undesirable outcomes which can complicate the orthodontic treatment. In this lecture, we will show how mini-implants can facilitate our orthodontic treatment, highlighting at the same time the failure of these techniques in some circumstances.
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Sleep apnea has been part of the human experience centuries before Charles Dickens’ ‘Pickwick Papers’ actually made it part of our culture in the 19th century. At that time, however, most of the focus was on one of the character’s obesity rather than the sleeping disorder associated with it. It wasn’t till the early ‘60s that the complexity and variability of expression associated with sleep disorders was more fully appreciated as the use of polysomnography made it possible to fully document apneas during sleep. Soon we were able to begin to effectively address the disorder’s etiologies thanks to the proliferation of Sleep Centers around the globe. As a result, all sorts of therapeutic approaches evolved ranging from drug & inhalation therapies, to various surgical and appliance methodologies/gizmologies. But how far have we progressed in effectively managing or eliminating this condition as now more reports document its worldwide impact. Its prevalence persists at ever-higher rates across a wider variety of ethnic groups, and even increasing in the pediatric population as well. What have we accomplished to date in sleep medicine? Why are matters apparently getting worse in this field? What is it that we are missing? Where should we better focus our efforts? This presentation will attempt to address these concerns by: reviewing the history of sleep-disorders and our accomplishments in managing them. It will focus on how we as healthcare providers can help our patients better manage their conditions beyond the mere use of intraoral appliances.
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Structural differences between various classes of malocclusion dictate variation in response to treatment. Research indicates the limitation of common treatment approaches to transform a Class II, division 1 phenotype to a facial pattern with normal skeletal relationships expected with a Class I phenotype. Available data from untreated Class II further support these observations, leading to the consideration of treatment outcome as the cumulative effect of small to moderate changes in skeletal and dentoalveolar components of the malocclusion, rather than a major change in one of these components.
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Improve Facial Esthetics is often a goal of orthodontic treatment. Proper diagnosis and mechanics of treatment can lead to excellent facial changes in non-growing individuals without surgery. This lecture will review orthodontic treatment that is not overly complex to effect facial changes in typical patients we all see in our practices.
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Wires and pliers, plastic and punches, scars and solutions, IIs and IIIs, fore and aft, faster and friction, chewies and positioners, quick fixes, horseshoes, monkey hooks, cold steel and sunshine, enhanced anchorage and anchors. Everything from soup-to-nuts: an orthodontic travelogue through daily problem solving as the mother of invention.
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The purpose of this lecture is to discuss medical procedure of reconstraction of multiple agenesis. The solution could be rather difficult – including setting up an ideal treatment plan and coordinating the whole treatment process – since several dental disciplines take part in the process of the treatment. Therefore, orthodontic therapy often consists of only adjusting the position of pillars and gaps in the place of agenesis, then the prosthetic reconstruction takes place. The age of the patient and other factors are important when planning the final prosthetic reconstruction. The author analyze the process of treatment plan formation on several cases, then possible complications, which can occur during the treatment, together with consequential modifications. Resolving multiple agenesis is thus based on interdisciplinary co-operation of an orthodontist, prosthodontist and implantologist; in some cases an maxillofacial surgeon can be involved. The authors stress the importance of the therapy coordinator who manages individual phases of the treatment, who bears the responsibility for forming the team, as well as for the treatment results.
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Dr. Jim McNamara has used a wide variety of appliances, both fixed and removable, in the management of patients with Class II occlusal relationships. His current focus is a prospective clinical study of the Carriere Motion appliance carried out in conjunction with developer of this treatment approach, Dr. Luis Carriere. The results of this study as well as the specific protocol used will be described in detail.
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