My predecessor as Editor of JCO, Dr. Larry W. White, a good friend and one of my personal heroes, used to give a presentation to orthodontic organizations entitled something like "The Best Ideas I've Ever Stolen". That lecture, which was always popular around the world, comprised many of the useful clinical ideas he had gleaned from various JCO authors during his tenure as Editor. Most of these had appeared in a special department that has appeared frequently in JCO over the years, consisting of what orthodontists refer to as "Pearls"--short, well-illustrated "pearls of wisdom", usually addressing specific clinical problems. In fact, Dr. White has recently published a book called Orthodontic Pearls--A Clinician's Guide, containing 200 pages of additional tips from 122 international authors (Ortho Arch Company, Inc.; www.orthoarch.com).
Similar articles from the archive:
- THE EDITOR'S CORNER Pearls of Wisdom February 2016
The clinical revelations that turn into Pearls frequently appear to individual practitioners in what can only be described as epiphanies. When I read one of these articles, I often experience what I call a "duh" moment: I slap my forehead, utter "duh", and ask myself, "Why didn't I think of that years ago?
JCO built its reputation as a practical publication on such pearls of wisdom, dating back to its founding in 1967 by Dr. Gene Gottlieb--who contributed many of the early ideas from his own practice. Sometimes these are labeled as Pearls, sometimes Technique Clinics or Clinical Aids, sometimes short articles, but each one contains a valuable gem that can make anyone's practice just a little more effective or efficient, as I can testify. In this issue of JCO, we celebrate that heritage by presenting a number of the best ideas we've received from around the world during the past year.
For example, one of the most important factors in the success of miniscrews is their location. Thorough presurgical planning, using x-rays of the recipient sites, allows the doctor to decide the optimal point of insertion. The hard part comes in trying to translate the radiographic plan to an exact site in the mouth. It is all too easy to be off by a millimeter or two--a distance that may seem trivial, but can be critical in actual application. This conundrum is solved quite nicely in a Technique Clinic by Drs. Hemanth, Patil, and Verma. Their simple guide, made in the office from readily available bulk archwires, is both accurate and inexpensive.
A common situation in the mature adult dentition is a distal molar that has tipped into an adjacent edentulous space. Prior to restoration with a fixed prosthesis or an implant crown, the tipped molar has to be uprighted. Drs. Greco, Meddis, and Giancotti had an epiphany involving a single miniscrew and three segments of elastic chain, which they utilize to achieve three-dimensional control without having to resort to springs or elaborate segmental wires. Placement time is minimal, and uprighting occurs rapidly. It's another clever idea that should have occurred to me long ago.
One of the situations I find most annoying is when a rapid palatal expander is producing good results, but the threads of the jackscrew runs out before it gains the full expansion needed to complete the case. Typically, I would remove the appliance, take a new impression, detach the framework, close the screw, and re-solder the support arms. This takes a considerable amount of time and generally results in frustration for both the doctor and the patient. In another Technique Clinic, Drs. Marchioro, Cardon, and Dolci propose simply adding new acrylic over the exposed Haas expansion screw arms in the mouth, allowing further expansion without the need for removal and disassembly of the appliance. Of course, when I saw this idea, I slapped my forehead and said, "Duh."
Similarly straightforward solutions to such clinical problems as holding fixed retainer wires in place prior to final bonding, helping patients place their intermaxillary elastics using a simple color code, and distalizing ectopic molars in the early mixed dentition are presented in this issue, along with several other unique ideas. All are ingenious in their simplicity, and all solve vexing dilemmas in expeditious ways. I plan to implement as many as I can.
Dr. Jack Sheridan's first Readers' Corner of 2012 also appears this month. As always, our readers address clinical issues and other topics of interest to the practicing orthodontist. Each subject is a kind of Pearl in the form of collective wisdom.
All in all, this issue proves the old adage that good things come in small packages. It's easy reading, but it can make a big difference in your practice.
RGK