We at JCO are proud to announce the winner of a new prize, the Eugene L. Gottlieb JCO Student of the Year Award, presented by American Orthodontics. The first recipient is Dr. Krystian Jarosz from Rutgers University, who distinguished himself in a wide field of competitors from orthodontic departments all over the country. He and the 11 other finalists are being profiled in installments on the JCO Facebook page, but Dr. Jarosz's interview appears in this issue as well, along with details of the selection process. We will also be honoring him during the upcoming AAO annual conference in Orlando, Florida. Suffice to say, the graduate orthodontic program at Rutgers has a lot to be proud of in Dr. Jarosz. Although his application and case materials were judged to be the "best" by my colleagues on the JCO editorial board, it was a very difficult decision to reach. It made me, as a senior clinician approaching the end of his career, thankful to see that the specialty is being inherited by such an excellent and worthy generation of upcoming clinicians.
This month's article describes an innovative combination of three-dimensional imaging software, cone-beam computed tomography (CBCT), and intraoral scanning that facilitates the placement of low-cost, generic brackets with prescription custom bases. Unlike customized systems that consider only crown morphology, the authors' process combines the crowns and roots to allow proper root positioning during alignment of the crowns. A true "straight-wire" system, it can be applied to any bracket type, slot, or prescription.
Can upper molars really be distalized? This elusive query comes up whenever the topic of Class II correction is raised, yet no conclusion seemingly achieves a consensus. At least, we periodically pretend not to comprehend how correction occurs (despite the substantial number of clinical and research reports on the subject) so as to promote methods that may be in current favor. The idea that the maxilla or the maxillary dentition can be moved posteriorly to resolve a Class II malocclusion is perhaps one of the oldest and least understood concepts in orthodontics. The application of some type of pushing force against the upper arch and teeth to correct a Class II has obviously worked well enough during the past 100 years of orthodontics to perpetuate the "orthopedic" side of the specialty. The term distalization is a neologism, made up in recent years for our convenience. But while it may be an example of "bad" English, it might still be good orthodontic practice. To address whether upper molars can really be distalized, we need to address how contemporary distalization methods do what they do.
Align Technology, the company behind Invisalign, shipped more than 422,300 clear-aligner prescriptions in 2013; as of 2015, the company supports 44,240 active providers, including both orthodontists and general practitioners. Perhaps the most important advantage of clear aligners, at least from the standpoint of patient acceptance and demand, is their esthetic appearance. To maintain that "invisible" look while achieving difficult movements such as rotation, composite attachments are bonded to the facial surfaces of teeth. Although Invisalign markets a dental restorative composite for making these attachments, some practitioners use orthodontic adhesives due to their convenience and availability. Because orthodontic adhesives are formulated for bonding brackets, however, their esthetic and mechanical properties may not be sufficient for making attachments. An aligner attachment needs to either match the color of the natural tooth or be translucent enough to blend with the underlying tooth. Translucency is preferable because it allows the use of one material for all patients and is more esthetic when working with polychromatic teeth. A second important esthetic consideration is the attachment's resistance to staining. Finally, the wear of composite attachments, as the patient repeatedly removes and replaces the aligners, is crucial because it may affect the retentive force of the aligner and thus lead to less efficient tooth movement.
In 2006, I described a technique for creating a chairside pontic by taking a bite-registration impression of the patient's adjacent or contralateral tooth. The method was presented as an alternative to reshaping a prefabricated denture tooth, which might not be readily available in an orthodontic office. This article describes another option for immediate chairside pontic fabrication, using flowable resin and a mixing pad.
Various methods have been proposed to accelerate orthodontic tooth movement, including local injection of prostaglandin; supplementation with vitamin D; stimulation of periodontal tissue remodeling with vibratory forces, pulsed electromagnetic fields, electrical currents, or low-energy laser devices; and surgical procedures such as corticotomy, alveolar distraction osteogenesis, or periodontal distraction. To date, the most complete body of evidence is for "surgery first" techniques, followed by low-level laser application and corticotomy. More comprehensive studies are needed, even for these methods.
One the most challenging movements to make with is rotation correction of the upper lateral incisors. Conventional attachments are often unable to prevent the aligner from slipping off the facial surface of the tooth. In this Pearl, Invisalign expert Dr. Jonathan Nicozisis describes his "sash" attachment design. Having used it numerous times, I promise it will become your favorite technique for controlling stubborn malrotated lateral incisors. NEAL D. KRAVITZ, DMD, MS, Associate Editor for Pearls
The Journal of Clinical Orthodontics is proud to recognize Dr. Krystian Jarosz from Rutgers University as the winner of the inaugural Eugene L. Gottlieb JCO Student of the Year Award, presented by American Orthodontics. Dr. Jarosz was selected over 16 other students from schools around the United States in a competition judged by members of the JCO editorial board. His prize includes more than $8,000 worth of materials and travel from American Orthodontics, JCO, and Dolphin, as well as a presentation ceremony during the AAO annual conference in Orlando, Florida.
The best way to learn orthodontics outside of clinical experience is to critically review case reports. Case-based review is the foundation of orthodontic residency education, and it is precisely the method used in this book by Drs. Thomas Southard, Steven Marshall, and Laura Bonner. In an interesting twist, these renowned clinicians and educators have written their text entirely in a question-and-answer format. The reader immediately becomes part of the academic discussion as the authors ask question after question aimed at providing resolution of the presented cases.
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