THE READERS' CORNER

Topics are office leasing and bicuspid extractions.

1. Do you lease your main or satellite office space?

Nearly half (46%) of the respondents to this survey leased their main office space. Forty percent of the clinicians had at least one satellite office, and 80% of these leased that space. Although only a few of the orthodontists who owned their main offices had satellites at all, many of the renters of main offices had satellites, which they usually rented.

The satellites were predominantly rented from general practitioners, but main offices were rented from a wide variety of landlords. The usual main office lease agreements ran from three to five years, with a few as short as one year and several as long as 10 to 15 years. On the other hand, satellites were often leased for only a year at a time; some respondents rented month to month, and only a few had three-to-five-year leases.

What is your square footage?

The average size of the main offices in this survey was 1,724 square feet, with 35% less than 1,500 square feet and 28% more than 2,000 square feet. Satellite offices averaged 1,158 square feet (or about two-thirds the size of the main offices), with 59% between 1,000 and 1,500 square feet and only 10% more than 1,500 square feet. Satellites ranged in size from 540 to 2,100 square feet, but the most popular sizes were 900 to 1,000 and 1,200 to 1,400 square feet.

How much is your monthly rental?

The rent for main offices ranged from $800 to $3,700 per month, with the mean at $1,643. Satellite rentals ranged from $250 to $2,600 per month, with the mean at $968. There was little difference in monthly rent per square foot--main offices averaged $11.40 and satellites $10.10.

Do you have a triple-net lease? If not, what expenses are paid by the landlord?

Triple-net leases were reported for about half of the main offices, but only a few of the satellite offices. Expenses that were paid by the landlord varied widely, but usually included gas, electric, and maintenance, with cleaning mentioned occasionally.

Do you have an option to make major improvements at your expense? Do you have the option to sublease?

Virtually all of the main office renters and more than half of the satellite renters had the option to make major improvements at their own expense. Subleasing was an option for most renters of main office space, but only for a few renters of satellite offices.

2. In bicuspid extraction cases, how do you parallel the roots in the extraction sites?

More than two-thirds of the clinicians reported using either anchorage bends or changing bracket positions on adjacent teeth, and about half used both techniques. A few said they used auxiliaries, primarily with the Begg appliance.

Do you find root paralleling to be more of a problem with a straightwire appliance than with other appliances?

The readers were almost unanimous in finding that straightwire appliances did not produce any additional problems. Many commented that the preangulation of the brackets actually helped in root paralleling.

Do you have any problems with spaces reopening?

Space reopening seemed to worry about half of the respondents, and it seemed to be more of a problem with adult patients than with children. The two most popular methods of dealing with spaces were figure-8 ligature wire around the teeth adjacent to the extraction sites and spiral-wire retainers of the Zachrisson type.

Specific comments included:

"I routinely tie a ligature around the adjacent teeth for a three-month period to allow bone and soft tissue adjustment."

"Space closure is done as early as possible and tied securely during the remainder of treatment. Additional time is allowed in treatment of extraction cases to maintain space closure. No retainer wires cross through the areas of the extractions."

"I use sectional retraction springs with maximum posterior anchorage and light, continuous forces. l have very little root paralleling to do after space closure."

"I don't place my closing loop in the extraction site, but between the two teeth in front of the extraction site, thereby leaving a greater degree of support in the extraction site. l feel this prevents dumping and root paralleling problems."

"Using Begg you are able to over-treat rotations and over-parallel root divergences, avoiding to a greater degree the memory effect of tissue."

"If the tissue is bunched in an extraction site (e.g., gingival fold or cleft), l have the family dentist perform a gingivoplasty in that area."

"Root paralleling is not more of a problem with a straightwire appliance because the tip in the cuspid bracket counteracts the distal tipping more effectively. It does increase your anchorage needs, however."

"Occasionally spaces will reopen, and I usually bond molar tubes on the first molars and have the patient wear a ¾" light elastic from molar to molar. When the space closes I make the patient a wraparound removable retainer."

JCO wishes to thank the following contributors to this month's column:

Dr. Thomas L. Ahman, Lima, OH

Dr. Wayne A. Aspito, Oak Brook, IL

Dr. Bruce G. Atkinson, Holland, OH

Dr. Richard B. Aubrey, Dallas, TX

Dr. James J. Brennan, Cumberland Hill, RI

Dr. Andrew P. Collins, Durham, NC

Drs. Del L. Donovan and Richard C. Roush, Ottumwa, IA

Dr. James F. Fruge, Jr., Baton Rouge, LA

Dr. Chalk Fry, Cincinnati, OH

Drs. Lloyd A. Green and C. William Dabney, Richmond, VA

Dr. William M. Hang, Rutland, VT

Dr. Gary Hirsh, San Diego, CA

Dr. Vernon C. Howerton, Lynchburg, VA

Dr. Amelia C. Jacobs, Louisville, KY

Drs. Lamont B. Jacobs and John E. Chesher, Fairfield, OH

Dr. Ralph L. Jensen, Paoli, PA

Dr. Donald L. Jorgensen, Fort Collins, CO

Dr. David M. Lebsack, St. Joseph, MO

Dr. William E. Lisenby, Macon, GA

Dr. Robert L. Loeb, Oakland, NJ

Dr. J. Brent McFarland, Dothan, AL

Dr. Richard E. Morris, Coeur d'Alene, ID

Dr. Craig E. Newell, Spirit Lake, IA

Dr. George V. Newman, West Orange, NJ

Dr. Jeffrey R. Norkin, Georgetown, CT

Dr. Joseph A. Persichetti, Holland, PA

Dr. Donald R. Picard, Palm Beach Gardens, FL

Dr. Donald P. Rollofson, Elk Grove, CA

Drs. John Russell, Jr., and John Russell III,Columbus, MS

Drs. Marshall L. Seidman and Martin I. Seidman, Bloomfield, CT

Dr. David M. Solomon, Cedar Grove, NJ

Dr. Tom R. Stewart, Stillwater, OK

Dr. Daniel M. Taylor, Snohomish, WA

Dr. David M. Wadler, Houston, TX

Drs. William Wallert and M. Alan Bagden,Springfield, VA

Drs. George A. Weiss and Karen H. Lewkowitz, Bayside, NY

Dr. Robert E. Williams, Mountain View, CA

Dr. Jay R. Wright, Solvang, CA

Dr. Henry S. Zaytoun, Raleigh, NC