Dental Tribune International
Clinical
Efficiency is the key to a prosperous and fulfilling orthodontic practice

February 20, 2009

While growing up, I always enjoyed brain teasers. When my career in orthodontics began, I was intrigued because everything seemed like a puzzle. While working as a clinical assistant, I was mystified by mechanics and anchorage and their bearing on clinical procedures. As a treatment coordinator, I have experienced the obstacles presented with payment plans, recall systems, follow-up with patients pending a decision to pursue treatment, facilitating and sequencing visits. During my years of training some 200 assistants, I have come to view the causes of malocclusions, facial changes, treatment types, stages and treatment timing as brainteasers or puzzles as well. For me, the entire concept of orthodontics is a puzzle. All the pieces must fit or work together well in order to render an optimal result.

Accurate orthognathic surgery predictions for the obstructive sleep apnea patient

February 19, 2009

Orthognathic surgery has been performed routinely since the mid- 1970s to correct severe skeletal malocclusion. Since its inception, various forms of prediction have been utilized to attempt to educate the patient regarding potential profile changes. Initially, lateral cephalometric tracings were used to create a visual treatment objective. Later, with the advent of computers and computer imaging, multiple computer programs were developed to assist the process. Now, surgical predictions have become a routine part of the standard of care for offices recommending orthognathic surgery to their patients.

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Adolescent Hypodontia: Management

February 19, 2009

Teamwork is essential in the management of hypodontia. Multidisciplinary consultation at the treatment planning stage and coordination and appropriate timing of subsequent inter-disciplinary dental care enables the clinician to provide optimum care. This is particularly critical in the management of hypodontia in adolescence, where a prolonged period of time is involved. This is illustrated in our case report of a 12-year-old Caucasian female. She required a combination of or­thodontic, oral surgery and restorative care to successfully treat her marked hypodontia.

Biomechanics in the orthodontic treatment of complex multidisciplinary problems

February 19, 2009

In recent years, the purview of orthodontics has grown to include an increasing number of adult patients, many of whom present with complex malocclusions that demand complicated treatment plans. Often, these more mature patients are referred by the restorative dentist because it is impossible to fabricate an adequate prosthesis for the missing teeth. These malocclusions are difficult to restore esthetically and functionally. This prosthetic challenge might include missing teeth, canted occlusal planes, overeruption of posterior teeth into opposing edentulous areas, impinging deep bites, and inappropriate intra arch space distribution.

Effects of professional oral care on oral infection in the elderly

February 19, 2009

The population is ageing rapidly because of the prolonged life expectancy evident in most industrialised countries in the world. Accordingly, the number of bedridden elderly requiring systemic care in residential and nursing homes is increasing. Institutionalised, elderly individuals who need systemic care have poorer oral health than those who live independently at home.1–3 In particular, the oral hygiene of the bedridden elderly is often poor.6

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An introduction to oral biofilms

February 19, 2009

Bacteria in nature usually exist in the form of biofilms. The dense accumulation of bacteria was first reported by Black in 1898.1 Biofilms are an accumulation of bacteria, fungi, or protozoa on solid surfaces, and can be found in many places in the environment such as drain pipes, building exteriors, etc. In the human body, they exist on tissue cells, teeth and artificial implants. Biofilms are medically important since few diseases are caused by microbes that are living in a planktonic state, that is, non-adherent and free-floating. Recently, the United States National Institutes of Health stated that over 80 per cent of microbial infections in the body are caused by bacteria growing as biofilms.2

Child abuse—Are we powerless to help?

February 19, 2009

Whilst you are reading this article, somewhere in the world a child is suffering deliberate harm, inflicted by someone who is supposed to care about them. Many families provide all that is necessary for their child to grow and develop within a loving, supportive and protective environment—but what of those that are not so lucky? These children live in fear and suffering and many will be scarred for life (both physically and mentally). These children may become abusive parents themselves and so the cycle continues. However, significant numbers of children will die—no hope, no future.

Staff promotion: Is ‘potential’ enough?

February 19, 2009

Anyone who has managed employees for any length of time has seen it. The rising star with all the potential to succeed is promoted to a new position and fails. Why does it happen? How does it happen? It’s agonizing for the employee, and it’s certainly no treat for the doctor either. After all, this is someone you were sure you could count on. She/he showed all the signs of being truly excellent. But, as many dentists have discovered, a promotion is no guarantee that your rising star will become a superstar. Just ask Dr Morton.

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