Doctors Program - 2018 Annual Session Conference

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Scientific Treatment Goals for Teeth and Jaws

May 6, 2018 2:05pm ‐ May 6, 2018 2:50pm

The quality of an orthodontist’s treatment results is determined by the quality of the landmarks and referents used for diagnosing far more than the appliance. The Six Elements Orthodontic Philosophy begins by learning the landmarks and referents for each of the six areas for which orthodontists have diagnostic responsibility. It was the discovery of those landmarks and referents that allow treatment results to be uniquely correct for each person regardless of race or gender. Six Elements™ landmarks and referents are also essential for orthodontics to have a positionally-accurate classification system.

Learning Objectives:

• Assess treatment goals that are uniquely correct for each person regardless of race or gender.
• Recognize the positionally-accurate classification system for all six areas for which orthodontists have diagnostic responsibility.
• Realize that with the Six Elements Orthodontic Philosophy™ it is possible to routinely attain gnathological occlusions on compliant patients.

• Lawrence F. Andrews, DDS, CertOrtho

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Invisible Orthodontic Appliances: Clear Aligner vs. Individual Lingual System

May 6, 2018 2:05pm ‐ May 6, 2018 2:50pm

Invisible orthodontic appliances are the hotspot of orthodontic clinic and basic research at present. The clear aligner and individual lingual system are mainly two types of invisible orthodontic appliances. This lecture is to compare the advantages and disadvantages of the two types by case presentation and discuss. The clear aligner is good at molar distalization, anterior teeth intrusion and periodontitis orthodontic treatment etc. the individual lingual system is adept at arch expansion, deep overbite correction, anterior teeth en mass retraction and complex orthodontic case. The purpose of this lecture is to guide the selection of invisible orthodontic appliances for doctors and patients.

Learning Objective:

• Recognize the advantages and disadvantages of clear aligner.
• Identify the advantages and disadvantages of individual lingual system.
• Identify the most appropriate invisible orthodontic appliances.

• Zhihe Zhao, DDS, PhD

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Choose to Re-use: Tooth Autotransplantations

May 6, 2018 2:20pm ‐ May 6, 2018 2:50pm

Absent teeth are a frequent occurring dental anomaly and may negatively affect both function and esthetics. Fortunately, we have many predictable and man-made solutions but none of these have the potential to adapt to growth or developmental changes. Tooth autotransplantations is a surgical procedure which is cost effective, predictable and have high success rates.

Learning Objectives:

• Recognize the benefits of tooth autotransplantations.
• Describe the indications, contraindications, advantages and disadvantages of tooth autotransplantations.
• Discuss an additional treatment strategy with your patients.

• Dr. Stephen T. Tjoa, DDS, MS, MSc

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Long Term Results of Periodontally Accelerated Osteogenic Orthodontic Procedures

May 6, 2018 2:20pm ‐ May 6, 2018 2:50pm

The AOO clinical procedure will be discussed with a strong emphasis on understanding which procedures create the accelerated movements and which procedures contribute to the increased range of movements and increased long-term stability. Additional physiological benefits of the AOO procedure include greater periodontal support for the teeth following treatment, increased bone surrounding the roots of teeth in the direction of movement and the ability to cover some pre-existing bone loss. A thorough understanding of various types of orthodontically induced bone response is important in choosing the correct treatment plan for each of our patients. A variety of orthodontic treatments will be addressed including difficult situations and surgically assisted exposure cases with patients ranging from young adolescents to older adults.

Learning Objectives:

• Discuss which procedures create the accelerated effects and which procedures create the osteogenic effects.
• Recognize the variety of orthodontic problems that can be addressed with the AOO procedure and the clinical approaches needed to treat our patients. 
• Comprehend how treatment with the AOO Procedure is possible with fewer extractions but with improved long-term results.

• William M. Wilcko, DMD, MS

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Lessons from the Twin Study: What can we Expect from Genetics?

May 6, 2018 2:50pm ‐ May 6, 2018 3:20pm

Our knowledge of growth and development comes from information gathered from large groups of people, which can give us general patterns of growth. We can also use implant information to learn about specific patterns of growth. However, neither of these methods help us to understand which aspects of growth are determined by genetics and which are more under environmental control. The Forsyth Twin Study, which included annual records of approximately 500 pairs of twins, their parents, and their siblings, was gathered by Dr. Coenraad Moorrees and his staff between 1959 and 1975. It is a valuable resource for investigators seeking to learn about the relative contributions of environment and genetic control. Studies done over the past several years using this sample have begun to give us such information regarding lower incisor crowding, mandibular length, nasal growth, and facial asymmetry. This presentation will describe what the Forsyth Twins have taught us about facial growth.

Learning Objectives:

• Comprehend how lower incisor crowding and mandibular length are determined by genetics versus the environment.
• Analyze whether children tend to resemble one parent more than another.
• Identify whether mirror asymmetry occurs in the facial growth of twins.

• Leslie Will, DMD, MSD

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Is Accelerated Tooth Movement Real or Just a Placebo Effect?

May 6, 2018 2:50pm ‐ May 6, 2018 3:20pm

It has been reported that vibration, lasers and modifying the alveolar bone can expedite orthodontic tooth movement. However, it remains debatable whether these methods affect the long-term rate of orthodontic tooth movement and whether these methods produce a greater rate of tooth movement than placebo. In this lecture, we will review the current evidence, proposed biological mechanisms and potential side effects of accelerated tooth movement procedures.

Learning Objectives:

• Determine the efficacy of accelerated orthodontic tooth movement methods.
• Recognize the biological mechanism behind accelerated orthodontic tooth movement.
• Identify potential side effects of Accelerated tooth movement procedures.

• Sunil Wadhwa, DDS, CertOrtho, PhD, Columbia University College of Dental Medicine

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CBCT Assessment of Condylar Position in Patients with Temporomandibular Dysfunction

May 6, 2018 2:55pm ‐ May 6, 2018 3:40pm

Radiographic analysis provides useful and diagnostic information regarding the status of the joints. The objective of this study was to utilize CBCT data and viewing software tools to analyze and measure the condylar position within the glenoid fossae of patients presenting with various signs and symptoms of temporomandibular dysfunction. The condylar position of these symptomatic patients was then compared to a group of existing norms for normal condyle position within the fossa. Changes at the level of the occlusion resultant to condylar position change will be discussed and illustrated.

Learning Objectives:

• Recognize abnormal condylar positions on a CBCT.
• Anticipate potential changes at the level of the occlusion due to abnormal condylar position.
• Appreciate the relationship between TMJ dysfunction and condylar position.

• Richard Kulbersh, DMD, MS

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Milo Hellman Award Lecture: Control of Orthodontic Tooth Movement by Polymer Microsphere Controlled Delivery of Osteoprotegerin in Sprague-Dawley Rats

May 6, 2018 2:55pm ‐ May 6, 2018 3:15pm

Because orthodontic tooth movement is dependent upon osteoclast-mediated resorption of alveolar bone, biologic mediators that regulate osteoclasts can be utilized to control tooth movement. Our goal is to develop a novel method to locally enhance orthodontic anchorage, without significant systemic effects. We encapsulated recombinant osteoprotegerin (OPG) in polymer microspheres and tested the effectiveness of microsphere encapsulated vs. non-encapsulated OPG for enhancing orthodontic anchorage in a previously established rodent model of tooth movement.

Learning Objectives:

• Show that pharmacological approach to control of orthodontic tooth movement has the potential to be an effective adjunct to conventional orthodontic methods of anchorage preservation.
• Demonstrate the difference in local as well as systemic effects between the single and multiple dose of drug injections.
• Comprehend the limitation of current findings and to explore possible future directions.

• Dr. Inna Sydorak, DDS, MS

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Quo Vadis Orthodontics: Quality in Customized Lingual Appliances

May 6, 2018 2:55pm ‐ May 6, 2018 3:40pm

Treatment outcomes should depend on the orthodontist and not on the appliance of choice. Quality in orthodontic treatment can be assessed by different instruments including the ABO scoring system. Lingual treatment offers extremely accurate outcomes due to its customized nature; each lingual bracket has an individual prescription defined by the set-up following the orthodontist’s treatment plan. Recent studies indicate that this prescription can be transferred to the patient’s mouth with high degree of accuracy. An undisputed requirement for the successful use of these high-tech appliances are excellent orthodontic skills based on quality education.

Learning Objectives:

• Identify how quality control depends on the orthodontist.
• Discuss assessment of treatment outcomes.
• Comprehend the advantages of completely customized appliances.

• Dirk Wiechmann, DDS

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Harry Sicher Research Award Lecture: A Rodent Model using Skeletal Anchorage and Low Forces for Orthodontic Tooth Movement

May 6, 2018 3:20pm ‐ May 6, 2018 3:40pm

Animal models have been extensively used to understand the biological mechanisms of OTM. However, rodent models have disadvantages, including a reported reduction in bone volume during OTM. This presentation will answer the following questions: What was the success rate of skeletal anchorage in a rodent OTM model? What was the effect of a low force (~3cN) on inter-radicular bone volume during OTM in a rodent? What was the amount of tooth movement obtained at different time points with ~3cN force?

Learning Objectives:

• Demonstrate that skeletal anchorage offers important advantages in obtaining an appropriate force vector, minimizing animal husbandry and personnel time, and achieving predictable and efficient tooth movement in a rodent OTM model.
• Demonstrate that there was no dramatic reduction in BV/TV with the application of low forces.
• Validate an OTM model in rats with skeletal anchorage and low calibrated forces.

• Dr. Sudha Gudhimella, BDS, MS