THE EDITOR'S CORNERThe Burden of Student DebtROBERT G. KEIM DDS, EdD, PhDThis issue of JCO contains a very interesting and, in many ways, disturbing report on the indebtedness faced by today’s orthodontic students. Drs. Dawn Pruzansky, Brittany Ellis, and Jae Hyun Park, all of the Arizona School of Dentistry and Oral Health, surveyed 174 recent graduates and current residents in advanced orthodontic programs. Their aim was to ascertain not only the level of indebtedness the respondents have incurred in attempting to become orthodontists, but how that indebtedness has affected their personal career, practice, and lifestyle decisions. Although the results should not be surprising to most of us, they are still eye-opening with respect to what the specialty may look like in the years ahead. |
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A Three-Dimensional Digital Insertion Guide for Palatal Miniscrew PlacementB. GIULIANO MAINO MD, DDS, EMANUELE PAOLETTO, LUCA LOMBARDO DDS, GIUSEPPE SICILIANI DDSMiniscrew anchorage has significantly reduced the need for patient compliance and allowed orthodontic treatment of more types of cases without surgery. Despite its increasing popularity, however, miniscrew placement may be dangerous if the clinician lacks adequate information on the anatomy of the insertion area. Various surgical guides based on digital volumetric imaging, such as cone-beam computed tomography (CBCT), have been proposed as aids to allow precise insertion of miniscrews into the interradicular spaces. |
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MANAGEMENT AND MARKETINGInfluence of Student-Loan Debt on Orthodontic Residents and Recent GraduatesDAWN P. PRUZANSKY DMD, BRITTANY ELLIS DMD, JAE HYUN PARK DMD, MSD, MS, PhDThe cost of college and the ability to repay student loans are major topics of debate in our universities today. For example, should a private college stop offering degrees in teaching when the tuition reaches $60,000 per year? Similarly, how do orthodontic students grapple with their debt loads as tuition continues to escalate faster than anticipated income? This month's column addresses the issues of student loans and mounting debts, as well as their impact on the lifestyle and expectations of current residents and recent graduates. |
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OVERVIEWSurgical Uprighting of Lower Second MolarsNEAL D. KRAVITZ DMD, MS, MARK YANOSKY DMD, MS, JASON B. COPE DDS, PhD, KIMBERLY SILLOWAY DDS, MEHRDAD FAVAGEHI DDS, MSOrthodontic correction of impacted lower second molars is challenging due to the limited access. Both nonsurgical and surgical treatment options have been reported. If the impacted molar is submerged deep below the soft tissue, surgical uprighting provides a safe and efficient solution with minimal tooth morbidity and a good long-term prognosis. Although the technique is most commonly applied to mesially angulated lower second molars, it can be used on other impacted teeth that have limited access or have failed to respond to standard bracket-and-chain methods. |
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CASE REPORTCorrection of Bilateral Class II Malocclusion Using Heat-Activated Nickel Titanium WiresALESSANDRO SCALIA DDS, GIUSEPPE PERINETTI DDS, MS, PhD, RANIERI LOCATELLI MD, MS, LUCA CONTARDO DDS, MSVarious extraoral and intraoral fixed appliances have been used in Class II cases to distalize the upper molars without extractions. The main disadvantage of these appliances is anchorage loss, which may cause mesial tipping of the anterior teeth unless skeletal anchorage is added. There is also some controversy regarding the effectiveness of distalizing appliances once the second and third molars have erupted. This case report describes the use of heat-activated nickel titanium wires for molar distalization, referred to as the Loca-System, to correct a Class II malocclusion with skeletal asymmetry. |
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Clear-Aligner Treatment of Overerupted Upper MolarsVERED BARZILAY DMD, MHA, WILLY DAYAN DDSLoss of teeth is often followed by overeruption of the opposing teeth and consequent esthetic, functional, and occlusal issues. Such overerupted teeth must be corrected prior to any prosthetic rehabilitation. Since coronal-reduction techniques may require additional endodontic and periodontal treatment before final crown restorations, overerupted teeth are typically treated with orthodontic intrusion. Surgically assisted methods such as corticotomy or surgical impaction increase the risks and cost of treatment. Extraoral devices require patient cooperation. Orthodontic correction using fixed appliances and bite planes may cause extrusion of the anchorage unit. Miniscrews can provide absolute skeletal anchorage without the need for patient cooperation, but are more invasive. This article suggests a way to intrude overerupted upper molars using anchorage from clear aligners. |
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Treatment of Complications Associated with Lower Fixed RetainersJOSEF KUCERA MUDR, PhD, JAN STREBLOV MUDR, IVO MAREK MUDR, PhD, TOMAS HANZELKA MUDR, PhDBonded retainers are often used to maintain orthodontic treatment results, especially for an increasing number of practitioners advocating long-term or even lifelong retention. Although fixed retainers have been described as effective, safe and predictable, and compatible with periodontal health, long-term retention is not without risks. Failures of fixed retainers, as evidenced by debonding or fatigue wire fracture, are relatively common. Long-term use of fixed retainers is associated with increased calculus and plaque accumulation, with a consequent risk of gingival recession and increased probing depths. |
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BOOK REVIEWSDental RadiologyThis book by Dr. Andreas Fuhrmann is designed not only as a step-by-step guide for students learning dental radiography, but as a reference manual that will help private dental practices, hospitals, and institutions achieve optimal results from their x-ray diagnostics. Straightforward and easy to follow, the text clearly explains the fundamentals of x-ray physics with essential information and practical instructions. |
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This issue of JCO contains a very interesting and, in many ways, disturbing report on the indebtedness faced by today’s orthodontic students. Drs. Dawn Pruzansky, Brittany Ellis, and Jae Hyun Park, all of the Arizona School of Dentistry and Oral Health, surveyed 174 recent graduates and current residents in advanced orthodontic programs. Their aim was to ascertain not only the level of indebtedness the respondents have incurred in attempting to become orthodontists, but how that indebtedness has affected their personal career, practice, and lifestyle decisions. Although the results should not be surprising to most of us, they are still eye-opening with respect to what the specialty may look like in the years ahead.
Miniscrew anchorage has significantly reduced the need for patient compliance and allowed orthodontic treatment of more types of cases without surgery. Despite its increasing popularity, however, miniscrew placement may be dangerous if the clinician lacks adequate information on the anatomy of the insertion area. Various surgical guides based on digital volumetric imaging, such as cone-beam computed tomography (CBCT), have been proposed as aids to allow precise insertion of miniscrews into the interradicular spaces.
The cost of college and the ability to repay student loans are major topics of debate in our universities today. For example, should a private college stop offering degrees in teaching when the tuition reaches $60,000 per year? Similarly, how do orthodontic students grapple with their debt loads as tuition continues to escalate faster than anticipated income? This month's column addresses the issues of student loans and mounting debts, as well as their impact on the lifestyle and expectations of current residents and recent graduates.
Orthodontic correction of impacted lower second molars is challenging due to the limited access. Both nonsurgical and surgical treatment options have been reported. If the impacted molar is submerged deep below the soft tissue, surgical uprighting provides a safe and efficient solution with minimal tooth morbidity and a good long-term prognosis. Although the technique is most commonly applied to mesially angulated lower second molars, it can be used on other impacted teeth that have limited access or have failed to respond to standard bracket-and-chain methods.
Various extraoral and intraoral fixed appliances have been used in Class II cases to distalize the upper molars without extractions. The main disadvantage of these appliances is anchorage loss, which may cause mesial tipping of the anterior teeth unless skeletal anchorage is added. There is also some controversy regarding the effectiveness of distalizing appliances once the second and third molars have erupted. This case report describes the use of heat-activated nickel titanium wires for molar distalization, referred to as the Loca-System, to correct a Class II malocclusion with skeletal asymmetry.
Loss of teeth is often followed by overeruption of the opposing teeth and consequent esthetic, functional, and occlusal issues. Such overerupted teeth must be corrected prior to any prosthetic rehabilitation. Since coronal-reduction techniques may require additional endodontic and periodontal treatment before final crown restorations, overerupted teeth are typically treated with orthodontic intrusion. Surgically assisted methods such as corticotomy or surgical impaction increase the risks and cost of treatment. Extraoral devices require patient cooperation. Orthodontic correction using fixed appliances and bite planes may cause extrusion of the anchorage unit. Miniscrews can provide absolute skeletal anchorage without the need for patient cooperation, but are more invasive. This article suggests a way to intrude overerupted upper molars using anchorage from clear aligners.
Bonded retainers are often used to maintain orthodontic treatment results, especially for an increasing number of practitioners advocating long-term or even lifelong retention. Although fixed retainers have been described as effective, safe and predictable, and compatible with periodontal health, long-term retention is not without risks. Failures of fixed retainers, as evidenced by debonding or fatigue wire fracture, are relatively common. Long-term use of fixed retainers is associated with increased calculus and plaque accumulation, with a consequent risk of gingival recession and increased probing depths.
This book by Dr. Andreas Fuhrmann is designed not only as a step-by-step guide for students learning dental radiography, but as a reference manual that will help private dental practices, hospitals, and institutions achieve optimal results from their x-ray diagnostics. Straightforward and easy to follow, the text clearly explains the fundamentals of x-ray physics with essential information and practical instructions.
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