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Orthodontic practice US 10 2013 vol4 No 5 Tạp Chí Chỉnh Hình Răng Miệng 10-2013
Go to page 3 and just say “OM.” to be sure. PAYING SUBSCRIBERS EARN 24 CONTINUING EDUCATION CREDITS PER YEAR! clinical articles • management advice • practice proles • technology reviews October 2013 – Vol 4 No 5 PROMOTING EXCELLENCE IN ORTHODONTICS BioDigital Orthodontics: part 5 Dr. Rohit C.L. Sachdeva A golden opportunity for dentists: dental sleep medicine: part I Dr. Harold F. Menchel Practice profile Drs. Shalin Shah and Ryan Tamburrino The frontal cephalometric analysis – the forgotten perspective Dr. Bradford Edgren Treating digitally and the new orthodontic practice Dr. Randall Moles Twins Digital Auxiliaries Practice Development Education Self Ligation Aligners Tubes/Bands Archwires Lab Products Twins Digital Auxiliaries Practice Development Education Self Ligation Aligners Tubes/Bands Archwires Lab Products ormco.com Damon ® Clear ™ is the self-ligating bracket whose beauty is more than skin deep. Validated by multi-site in vivo studies and third-party research*, Damon Clear combines the look image-conscious patients demand with the strength discriminating clinicians need. Its crystal-clear design is resistant to staining, while its robust construction facilitates effective torque expression and rotation control for meticulous fi nishing. And now, with Ormco Lifetime Rewards, self ligation is more attractive than ever. Earn points to redeem for free products and seminars. Advanced Aesthetics – Uppers and Lowers Crystal-clear appliance with innovative SpinTek ™ slide for effi cient wire changes. Precision Design Patented laser-etched pad for optimal bond strength and easy, comfortable debonding. © 2013 Ormco Corporation Practice Growth Proven practice marketing support, including consumer-focused Damon Doctor Locator, to drive more patients to your practice. On Both Arches *Clinical research and performance data available at ormco.com/damonclear January 15–18, 2014 | Phoenix, Arizona Register at damonforum.com Ormco-OrthoPrac-DamonClear-Oct2013.indd 1 9/17/13 2:18 PM Twins Digital Auxiliaries Practice Development Education Self Ligation Aligners Tubes/Bands Archwires Lab Products Twins Digital Auxiliaries Practice Development Education Self Ligation Aligners Tubes/Bands Archwires Lab Products © 2013 Ormco Corporation January 15 –18, 2014 | Phoenix, Arizona Year after year, thousands of orthodontic professionals have attended the Damon ® Forum to learn the latest advancements in orthodontic treatment. In 2014, you can experience the Damon ® System, digital technology and more through 30 plus interactive sessions for clinicians, treatment coordinators, front office staff and chairside assistants. Register your practice today and learn new treatment modalities, progressive technologies and practice differentiation strategies. Register Today damonforum.com ormco.com Ormco-OrthoPrac-DamonForum-Oct2013.indd 1 9/23/13 6:21 PM October 2013 - Volume 4 Number 5 EDITORIAL ADVISORS Lisa Alvetro, DDS, MSD Daniel Bills, DMD, MS Robert E. Binder, DMD S. Jay Bowman, DMD, MSD Stanley Braun, DDS, MME, FACD Gary P. Brigham, DDS, MSD George J. Cisneros, DMD, MMSc Jason B. Cope, DDS, PhD Neil Counihan, BDS, CERT Orth Eric R. Gheewalla, DMD, BS Dan Grauer, DDS, Morth, MS Mark G. Hans, DDS, MSD William (Bill) Harrell, Jr, DMD John L. Hayes, DMD, MBA Paul Humber, BDS, LDS RCS, DipMCS Laurence Jerrold, DDS, JD, ABO Chung H. Kau, BDS, MScD, MBA, PhD, MOrth, FDS, FFD, FAMS Marc S. Lemchen, DDS Edward Y. Lin, DDS, MS Thomas J. Marcel, DDS Andrew McCance, BDS, PhD, MSc, FDSRCPS, MOrth RCS, DOrth RCS Mark W. McDonough, DMD Randall C. Moles, DDS, MS Elliott M. Moskowitz, DDS, MSd, CDE Atif Qureshi, BDS Rohit C.L. Sachdeva, BDS, M.dentSc Gerald S. Samson, DDS Margherita Santoro, DDS Shalin R. Shah, DMD (Abstract Editor) Lou Shuman, DMD, CAGS Scott A. Soderquist, DDS, MS Robert L. Vanarsdall, Jr, DDS John Voudouris (Hon) DDS, DOrth, MScD Neil M. Warshawsky, DDS, MS, PC John White, DDS, MSD Larry W. White, DDS, MSD, FACD CE QUALITY ASSURANCE ADVISORY BOARD Dr. Alexandra Day BDS, VT Julian English BA (Hons), editorial director FMC Dr. Paul Langmaid CBE, BDS, ex chief dental officer to the Government for Wales Dr. Ellis Paul BDS, LDS, FFGDP (UK), FICD, editor-in-chief Private Dentistry Dr. Chris Potts BDS, DGDP (UK), business advisor and ex-head of Boots Dental, BUPA Dentalcover, Virgin Dr. Harry Shiers BDS, MSc (implant surgery), MGDS, MFDS, Harley St referral implant surgeon PUBLISHER | Lisa Moler Email: lmoler@medmarkaz.com Tel: (480) 403-1505 MANAGING EDITOR | Mali Schantz-Feld Email: mali@medmarkaz.com Tel: (727) 515-5118 ASSISTANT EDITOR | Kay Harwell Fernández Email: kay@medmarkaz.com Tel: (386) 212-0413 EDITORIAL ASSISTANT | Mandi Gross Email: mandi@medmarkaz.com Tel: (727) 393-3394 DIRECTOR OF SALES | Michelle Manning Email: michelle@medmarkaz.com Tel: (480) 621-8955 NATIONAL SALES/MARKETING MANAGER Drew Thornley Email: drew@medmarkaz.com Tel: (619) 459-9595 PRODUCTION MANAGER/CLIENT RELATIONS Adrienne Good Email: agood@medmarkaz.com Tel: (623) 340-4373 PRODUCTION ASST./SUBSCRIPTION COORD. Lauren Peyton Email: lauren@medmarkaz.com Tel: (480) 621-8955 MedMark, LLC 15720 N. Greenway-Hayden Loop #9 Scottsdale, AZ 85260 Tel: (480) 621-8955 Fax: (480) 629-4002 Toll-free: (866) 579-9496 Web: www.orthopracticeus.com SUBSCRIPTION RATES 1 year (6 issues) $99 3 years (18 issues) $239 © FMC 2013. All rights reserved. FMC is part of the specialist publishing group Springer Science+Business Media. The publisher’s written consent must be obtained before any part of this publication may be reproduced in any form whatsoever, including photocopies and information retrieval systems. While every care has been taken in the preparation of this magazine, the publisher cannot be held responsible for the accuracy of the information printed herein, or in any consequence arising from it. The views expressed herein are those of the author(s) and not necessarily the opinion of either Orthodontic Practice US or the publisher. I’ve been practicing orthodontics for more than 40 years, and one of the most important things I’ve discovered is that your practice and the patients whose lives you change are your legacy. The ability to provide patients with enhanced self-esteem, build lifelong relationships, and create an environment that nurtures a “practice family,” is a gift that we have the opportunity to take advantage of. I run a high-tech practice where we treat with Ormco’s Damon ® System, Insignia ™ Advanced Smile Design ™ , and Lythos ™ Digital Impression System. The progressive technology helps us deliver patients the best possible care with comfort and speed, but, our treatment philosophy extends far beyond straightening teeth. Our mindset is whole- health treatment. I encourage all to consider this approach. From breathing habits to sleep concerns and tongue thrust, we’re looking to improve each patient’s quality of life. Yes, we all need to make a living (there is no denying that!), but not all decisions can be driven by the bottom line. I’m an advocate for treating patients and team members like family, which requires investing time. At our office, we start every day with a morning huddle and end it with a prayer. Our objective is to keep the truth that we are here to serve our patients and our community top-of-mind. Our motto is “Enriching lives and smiles.” It’s all about investing in the people around you. As my team says, “We’re not saving lives here, but we are changing them!” The profit/loss numbers cannot be ignored, but what stays with you is how you’re able to change lives in a profoundly positive way. My advice: take the time to be involved in your community, be a mentor, and care deeply about your team and your patients — it will be your legacy. Dr. Jim Lyles Dr. Jim Lyles has been practicing orthodontics for more than 40 years and treats patients at Smiles by Lyles Orthodontics in Spring, Texas. Dr. Lyles assembled a group of exceptional restorative dentists and dental specialists with the purpose of continued growth and education in the field of dentistry. He served with the Air Force Reserve and spent 4 years with a MASH unit, completing military service with the rank of Major. Dr. Lyles began college at the age of 17 with two scholarships and majored in pre- dental medicine at the University of Texas. After completing undergraduate studies at University of Texas, Dr. Lyles continued with 4 years of dental school at the University of Texas Dental Branch in Houston. He is an active member of the American Association of Orthodontists and a past-president of the Houston Regional Society of Orthodontists. You can visit Dr. Lyles’s website at: http://www.smilesbylyles.com. Investing in your legacy 2 Orthodontic practice Volume 4 Number 5 INTRODUCTION suresmile.com to be sure. May 2011 Initial intraoral July 2011 Planned result May 2012 Actual result © 2013 OraMetrix, Inc. All rights reserved. suresmile is a registered trademark of OraMetrix. surezen. To learn more about NEW suresmile 7.0 or request Clinical Report No. 2, call 877.787.7645 The anticipation is the reality. Dr. Melisa Rathburn Atlanta, GA Yoga_Ad_Rathburn_OPUS_FNL.indd 1 9/24/13 1:53 PM TABLE OF CONTENTS 4 Orthodontic practice Volume 4 Number 5 Case study Bite turbos Drs. Nathan Yetter and Donald J. Rinchuse discuss the pros and cons of bite turbos 16 Orthodontic concepts BioDigital Orthodontics: Management of Class I non extraction patient with “Fast– Track” © – 6-month protocol: part 5 Dr. Rohit C.L. Sachdeva discusses a treatment for Class I non-extraction patients 18 Practice profile 8 Drs. Shalin Shah and Ryan Tamburrino: Center for Orthodontic Excellence These analytical, intellectual, and business-savvy clinicians have found their purpose in serving their patients and their community. Corporate profile 14 Carestream Dental A history of proven technology, a future dedicated to innovation. ON THE COVER Cover photo courtesy of Dr. Bradford Edgren. Article begins on page 28. • One system with superior 3D exams with multiple elds of view, 2D panoramic imaging and optional one-shot cephalometric imaging • Optimize your image quality and dosimetry • Cut treatment time by 30% with SureSmile certication • Make accurate assessments and diagnoses • Experience seamless integration To learn more about what a great image can do for your orthodontic practice, visit carestreamdental.com/3DOP or call 800.944.6365 today. © Carestream Health, Inc. 2013 9438 OR 93 AD 0713 The CS 9300C Select is ready to work hard for your practice. This technologically-advanced system will finally give you clarity, flexibility and, most importantly, complete control of your image quality and dosimetry. It will also show your patients how dedicated you are to their dental health. It’s amazing what a great image can do for your practice. 8634_Ortho_3D_Ad_Chosen.indd 1 7/23/13 4:08 PM 6 Orthodontic practice Volume 4 Number 5 Continuing education The frontal cephalometric analysis – the forgotten perspective Dr. Bradford Edgren delves into the benefits of the frontal analysis 28 A golden opportunity for dentists: dental sleep medicine: part I Dr. Harold F. Menchel offers a wake- up call to clinicians to explore an evolving niche in dentistry 36 Research TMD/orofacial pain survey of orthodontic residents in the U.S. and Canada Drs. Amanda Guess, Mark Causey, John Stockstill, Donald Rinchuse, and Eladio DeLeon explore dental students’ education regarding occlusion, TMD, and orofacial pain .42 Treating digitally and the new orthodontic practice 46 TABLE OF CONTENTS Technology Treating digitally and the new orthodontic practice Dr. Randall Moles illustrates how the digital world has changed his role as an orthodontist .46 The art of orthodontic efficiency Dr. Neil Warshawsky discusses the speed factor in orthodontics .54 Product profile Reliance Orthodontic Products addresses today’s problems with effective solutions .56 H4 ™ Self-Ligating Bracket System .57 Book review Orthodontics, Volumes I, II and III By Dr. Chris Chang and Dr. W. Eugene Roberts 58 In memoriam Dr. Craig Andreiko, noted innovator and educator .59 Practice development Apply current tax laws to improve patient care Bob Creamer explains Section 179 and Bonus Depreciation 60 Practice management New office or major renovation? Andrew Greene offers some tips to take the stress out of planning a new office .62 Industry news .63 Materials & equipment 63 Touch the Future with the New DENTSPLY GAC Insider Knowledge. Outside-the-Box Thinking. You already know how the DENTSPLY GAC legacy has shaped the practice of orthodontics. Now discover how our visionary thinking will shape the future of orthodontics. We’re developing new products that will help you practice more efficiently and effectively. We’re generating practice building programs to help you foster new business relationships and create new revenue streams. And we’re pursuing educational ideas that will inspire new ways to approach each case. Stay in contact with what matters and touch the future with DENTSPLY GAC. 800.645.5530 newdentsplygac.com Advancing the Art of Orthodontics FROM START TO FINISH 13-DGAC-117 Visionary Male Ad - Oct OP FA HR.pdf 1 9/18/13 9:50 AM What can you tell us about your background? Shalin Shah (SS): Although my wife brought me to settle down in New Jersey, I am a true Philadelphian at heart. Having grown up in the suburbs of Philadelphia and gone to the University of Pennsylvania for all my education (where I also met my future wife), I am a die-hard fan of all things Philadelphia, especially the sports teams. Ryan Tamburrino (RT): I am a Pittsburgh boy who still holds a strong allegiance for my Pittsburgh sports teams, even though my wife brought me to the eastern part of Pennsylvania. I traveled out of the state for a brief period to complete my undergraduate training at Duke University, but I eventually returned to the Keystone State for my dental and orthodontic education at the University of Pennsylvania. Remarkably, we both agree on almost everything that we jointly undertake, but neither of us is willing to give in that the other’s city has the best sports fans! Why did you decide to focus on orthodontics? Our love of orthodontics stems from a variety of passions. The most important to us is giving each person the ability to love his smile. The profession as a whole has many opportunities and challenges, which allows us to draw upon our non-traditional backgrounds and interests while keeping us excited at the same time. Orthodontics is unique in that every case allows us to continue to hone our analytical skills, develop our intellectual curiosities, and fine-tune our business skills from marketing to IT to negotiations. Every day is a true joy! How long have you been practicing, and what systems do you use? The Center for Orthodontic Excellence looks to bring patient service, peer education, and orthodontic solutions together to provide patients with the best possible care utilizing the latest technology. All three areas are interests of ours, and we view the merger of the three as synergistic. We also look to effectively integrate Shalin’s focus in the basic sciences with Ryan’s passion for clinical application to develop novel methods and products. The practice has been operational out of two major locations for the last 2 years. The systems we use include the In-Ovation ® bracket system (Dentsply GAC), i-CAT ® FLX (Imaging Sciences International), topsOrtho ™ , AD2 articulators, Quick Ceph ® (Quick Ceph Systems, Inc.), and Anatomage, among many other products and systems. We remind ourselves, as well as our students, that it is not the system that makes a great orthodontist. Rather, it is a comprehensive understanding of how to use what you have (strengths and limits) to meet the needs of your diagnoses and treatment plan. What training have you undertaken? We bring a unique educational background to the Center for Orthodontic Excellence. Both of us completed our dental school and orthodontic training at the University of Pennsylvania. While in orthodontic residency, we also both pursued additional training in functional occlusion through a 2-year program in Detroit, Michigan (Advanced Education in Orthodontics), as well as completing both Andrews’ Six Elements of Orofacial Harmony and Tim Tremont’s Four Faces of Orthognathic Surgery courses. Ryan attended Duke University for his undergraduate education. His extensive background in Biomedical Engineering and Mechanical Engineering/Material Science has led him to new innovations and research in the field of orthodontics. Additionally, he has leveraged this extensive education to develop two patent pending devices to date and author several manuals and articles, as well as a textbook chapter. Shalin attended University of Pennsylvania for his undergraduate education. His passion for basic science research led him to pursue a Masters of Science in Oral Biology while completing his orthodontic residency. Additionally, while at Penn, he achieved his board certification from the American Board of Orthodontics, which made him the second person in the history of the department to complete such a feat. Shalin’s interest in research led him to accept a position as Abstracts Editor for a peer-reviewed orthodontic journal. Drs. Shalin Shah and Ryan Tamburrino 8 Orthodontic practice Volume 4 Number 5 PRACTICE PROFILE Center for Orthodontic Excellence Dr. Tamburrino (left) and Dr. Shah (right) took their friendship and mutual aspirations to the next level by partnering to provide the highest quality of orthodontic care at the Center for Orthodontic Excellence . 621-8 955 MedMark, LLC 157 20 N. Greenway-Hayden Loop #9 Scottsdale, AZ 852 60 Tel: (480) 621-8 955 Fax: (480) 629-4002 Toll-free: (866) 57 9-9496 Web: www.orthopracticeus.com. practice proles • technology reviews October 2013 – Vol 4 No 5 PROMOTING EXCELLENCE IN ORTHODONTICS BioDigital Orthodontics: part 5 Dr. Rohit C.L. Sachdeva