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Profile: drjwyred@aol.com
User Name: drjwyred@aol.com
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Joined: Thursday, April 20, 2006
Last Visit: Thursday, September 9, 2010 7:38:26 AM
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Last 10 Posts
Topic: Oral Piercings in Orthodontic Patients
Posted: Thursday, September 9, 2010 7:38:25 AM
Even in a relatively conservative Michigan small town, body jewelry has found a niche (pun intended). We have, however, noted only two incidents of "trouble" and both involved lower lip piercings. The first was an active infection around a poorly maintained lip ring. As might be expected, oral hygiene was not a high priority behavior for this braces patient. I'm always surprised we don't find more chelitis accompanying these types of labial insults. The second incident involved a midline lower lip piercing (a provocative, spiked stud). The lingual portion of the device had apparently "rubbed-raw" the facial mucosa from one of the lateral incisors, yielding substantial recession. Sadly, that tissue loss is unlikely to dissuade this patient from continuing to wear their body bling.

I've been hoping to have a patient volunteer to allow us to incorporate their piercings into our biomechanics as a new innovation - "muscular implant anchorage." The tongue is the strongest muscle in the body, why not harness its tooth-regulation potential (tongue-in-cheek)? At the minimum, those orthodontic patients that do present with just a pinch of metal 'tween cheek and gum, well they should be warned about the possible damage to teeth and soft tissues. Plus, they would seem to be inherently perfect candidates for more "invasive" procedures such as miniscrews, plates, or surgery due to their badges of courage that they so readily display . . .

S. Jay Bowman, Portage, MI
Topic: Who places miniscrews?
Posted: Friday, June 13, 2008 1:13:30 PM
Here is a paragraph from the book chapter that I had published in the latest Moyer's Symposium book:

Procedure Orders: Location, Location, Location
"Who should place mini-screws? Ninety-five percent of mini-screw acolytes currently prefer to refer, but N.F.L. (Not For Long). Like many recent converts, they will likely find that convenience, control, and cost are compelling factors to D.I.Y. If, however, the decision is made to refer the patient to a periodontist or oral surgeon for placement of the TAD, then a narrative description of the exact position of the implant is critical. These instructions should include details of the position of the mini-screw relative to the mucogingival junction and marginal gingival, the insertion angle relative to the alveolar bone, and the orientation of the hole, slot, or bracket that may be featured in the head design of the screw. In addition, do you want the screw driven until the transmucosal collar touches bone or is partially embedded in the tissue and do you want the head of the screw compressing, just touching, or slightly above the tissues? 'Plan for the best, expect the worst, and be prepared to be surprised,' Denis Waitley."

I had 300 screws placed by others before doing the next 260 screws myself. We can do this and should do this ourselves.

S. Jay Bowman, DMD, MSD
Kalamazoo, MI

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