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Restorative Materials in Orthodontics

Like most senior orthodontists, I've attended hundreds of lectures on both orthodontics and dentistry as a whole. I have always taken a special personal interest in lectures involving interdisciplinary treatment - cases requiring the services of multiple specialists, with the restorative dentist finally establishing an optimum result. The late Dr. Vincent Kokich was perhaps my favorite speaker on this topic. Among his many professional and personal talents, he had an extraordinary ability to see the big picture in complex cases and to provide exemplary orthodontic care as part of a multidisciplinary team. In the last presentation I attended by Dr. Kokich before his untimely death in 2013, he opened with a statement that will always stick with me: that of all of the things he had accomplished in his professional life, he was most proud of having become a dentist. This probably explains why Vince was one of the best interdisciplinary orthodontists I have known.

All too often, I have a tendency to forget that I, too, am essentially a dentist. I tend to get lost in the realms of facial growth and development, orthodontic biomechanics, force systems, and retention, overlooking the wide world of restorative techniques and materials at my disposal. Gestalt psychologists refer to this "getting lost" as functional fixedness: the inability to conceptualize or utilize an object in a way other than the way it is commonly used. As orthodontists, we sometimes fail to see the potential of restorative materials to solve a number of clinical problems. For example, direct bonding to enamel with composite resins - now the standard method for attaching brackets - has eliminated the need to band every tooth in the mouth. This orthodontic application of tooth-colored restorative materials proved to be a significant advancement for doctors and patients alike. The orthodontists who discovered it had stepped beyond the boundaries of functional fixedness and recalled that they were, as Dr. Kokich put it, dentists first and foremost.

In the current issue of JCO, Drs. Jan Hourfar, Patrizia Lucchi, Bjorn Ludwig, Charles Ruff, Marco Rosa, and Georgios Kanavakis present another clever application of restorative materials to an orthodontic problem. Cases with congenitally missing upper lateral incisors are fairly common, but always challenging to the treatment team. When canines are mesialized to fill the edentulous spaces, they just don't look like lateral incisors. The authors of this article describe the use of prefabricated nano-hybrid-composite enamel shells, originally used in cosmetic smile makeovers, to address that esthetic issue as part of an interdisciplinary effort. Their results are quite impressive.

Once again, Dr. Kokich has been proven right: remembering that we are dentists, it pays for us to think outside our functionally fixed clinical boxes.


Changing of the Guard

This month we celebrate the retirement of four JCO mainstays and announce some exciting new directions for the journal. Dr. Jack Sheridan, who joined the editorial board in 1987, has been one of our longest-serving editors. Well known for his work on retention and interproximal reduction, he has edited The Readers' Corner since 1998. In that role, he will actually be succeeded by his predecessor, Dr. Peter Sinclair of the University of Southern California. Upcoming Readers' Corners will be offering then-and-now comparisons with past surveys, as well as exploring new clinical and administrative issues of interest to our subscribers.

Dr. W. Ronald Redmond, a noted expert on practice management and digital applications, has been our Technology Editor since 2003. He will be succeeded as editor of The Cutting Edge column by Dr. Marc Lemchen of New York City. A founder of Dolphin Imaging & Management Solutions, Dr. Lemchen brings a wealth of experience in three-dimensional technologies.

Business Manager Lynn Bollinger and Circulation Manager Carol Varsos have each served JCO for more than 30 years. Most of you have encountered their friendly faces and appreciated their professional attitude at AAO meetings or over the phone. We'll miss them greatly at the office, but they won't be far away - both plan to spend their retirement years in Colorado. Phil Vogels, who has been promoted to Vice President of Marketing and Business Development, will be filling both positions for the present (though we will soon be hiring a customer service manager to handle subscriptions). Contact him at phil@jco-online.com with any advertising or circulation issues.

At the same time, we are leaving our little old house on Boulder's Pearl Street, where JCO has kept its offices since 1974. We have moved to a space in the Denver Tech Center, the hub of technology and communication on the south side of Denver. Our phone numbers and e-mail addresses remain the same, but our mailing address has changed (you can find it on the previous page). In line with our increasing emphasis on technology, our new website and mobile-friendly digital edition will be ready soon. Watch your monthly issues and your e-mail inbox for complete details.



Dr. Keim is Editor, Journal of Clinical Orthodontics, 1828 Pearl St., Boulder, CO 80302. Email at editor@jco-online.com.

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