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THE EDITOR'S CORNER

JCO Orthodontic Practice Study

JCO Orthodontic Practice Study

The bad news coming out of the 1981 JCO Orthodontic Practice Study was that more than half of the respondents reported that their practices did not grow or actually declined. The good news is that the Study results provide a clear picture of what is working and what is not working in the building and managing of orthodontic practices. The complete, refined data and analyses of the data are now available in book form. Any orthodontist who will spend some time studying this report should be able to see the direction in which he should move in order to improve his income and growth potential. Worksheets are provided to simplify study of one's own practice and its comparison to the norms for similar practices in similar geographic locations. This exercise will have an echoing reward if each practice repeats it annually and compares its current figures to its past figures. If JCO repeats the Study on a regular basis, perhaps every two years, each orthodontist will be able to compare the trends in his practice with those of similar practices.

If there is one message that has come from the Study it is that few of us can sit back and "let it happen". The practices that have shown success in higher gross and net income, larger numbers of case starts and active cases, and lower overhead rates--and that have continued to grow when more than half their colleagues have not--are those that have paid attention to the management and practice building methods that build growth. The methods they use and the fees they charge, as well as their staffing patterns and staff management, form an important part of the data and analyses in the book. Properly used, it can serve as a guide to data collection, analysis, and management in the individual practice.

Fig. 1 16-year-old male patient with anterior crossbite and open bite and Class III canine and molar relationships before treatment.
Fig. 2 Coronal computed tomography (CT) cross-section, showing angulation and direction of micro-implant insertion between lower first and second molars.
Fig. 3 After two months, distalizing force applied to lower dentition from anterior hooks crimped between lateral incisors and canines.
Fig. 4A A. After 33 months of treatment, Class I canine and molar relationships and esthetic facial profile achieved by distalizing entire mandibular dentition (continued in next image).
Fig. 4B (cont.) A. After 33 months of treatment, Class I canine and molar relationships and esthetic facial profile achieved by distalizing entire mandibular dentition. B. Superimposition of pre- and post-treatment cephalometric tracings.
Fig. 5 Superimposition of axial CT cross-sections at crown level, showing 5mm movement of lower right second molar and 3.8mm movement of lower left second molar.
Fig. 6 Post-treatment CT images, showing contact between roots and lingual cortical plate of mandible. A. Yellow arrows highlight contact points on axial cross-section and posterior view of coronal cross-section. B. Medial cross-section, showing roots of lower second molars protruding through cortical bone. C. Sagittal cross-sections, showing root contact with cortical bone.
Fig. 7 Superimposition of maxillary and mandibular arches, illustrating broader basal arch in posterior mandible (red arrow) than in maxilla (black arrow).
Fig. 8 Pretreatment lateral CT images, with red lines showing distance between lower second molars and anterior borders of ascending ramus on right and left sides of mandible—insufficient space for achieving Class I molar relationships.
Fig. 9 Pretreatment CT images, showing posterior space available for distalization. A. Occlusal view of mandible. B. Axial cross-sectional view at apical third level, indicating 7.8mm of available posterior space between root and lingual cortex on right side and 4.8mm on left.
Fig. 10 Sagittal cross-sectional views of left and right lower second molars, showing 1.3mm intrusion of second molar distal root on right side and .4mm intrusion on left.

DR. EUGENE L. GOTTLIEB DDS

DR. EUGENE L.  GOTTLIEB DDS

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