Wednesday, September 17, 2014


Arbitration agreement
Litigation and Legislation; 2014; 146:399-401

Think about it. No more worries about patients suing you. No more having to undergo the stresses associated with civil litigation. No more having to take an untold number of days out of the office to defend yourself. No more wondering what a jury will decide. Maybe this really is the other way to skin the cat.

Is an arbitration agreement the answer to your problems? Or, are you just trading one set of complications for another? 

Larry Jerrold explains, in the month's Litigation and Legislation column.

Saturday, September 13, 2014


Ankylosed maxillary incisor with severe root resorption treated with a single-tooth dento-osseous osteotomy, vertical alveolar distraction osteogenesis, and mini-implant anchorage
By Neslihan Ebru Şenışık, Gülperi Koçer, Bulem Üreyen Kaya

Authors Neslihan Ebru Şenışık, Gülperi Koçer, Bulem Üreyen Kaya, of Suleyman Demirel University, Isparta,Turkey, present a treatment protocol for a patient with an ankylosed tooth with severe root resorption is presented. Distraction with elastics and mini-implant anchorage provided successful treatment results. Listen as they present a summary of the patient's problems and the treatment options they considered, then read the full report in the September issue of the AJO-DO.

Thursday, September 11, 2014


Ethics in Orthodontics 2014; 146(3):275
Abuse of power
You are called upon to make multiple decisions throughout the workday. Whether it is your expertise to address a patient's clinical question or to resolve an administrative issue that is beyond the realm of your most seasoned employee, or a business decision that has repercussions that could affect your income, “the buck stops” with you. You are ultimately responsible for all that emanates from your actions and your office staff. Your position of authority includes a sense of power—whether you perceive it or not.

So what do you do when faced with a tough ethical decision? One that carries some reals costs with it? Do you make the right call and face the consequences? Or do you bend the rules or worse...ask your employee to do so?

Peter Greco tackles the issue head-on in this month's Ethics in Orthodontics column.

Wednesday, September 3, 2014


A “midline dilemma” in an adult mutilated dentition 

Case of the Month Video - "midline dilemma"
In the first of two Case of the Month videos for September, author John Bilodeau previews his treatment of an adult patient with a mideline dilemma, published in the September issue of the AJO-DO.

Monday, September 1, 2014


Do orthodontic research outcomes reflect patient values?

Aliki Tsichlaki discusses the Systematic Review she conducted at the Department of Orthodontics, School of Dentistry, Manchester, United Kingdom, examining whether orthodontic researchers studied problems that are of interest to patients. Her advisor on the project was Kevin O'Brien. Watch her video, then read the full report in the September 2014 issue of the AJO-DO.

Thursday, August 28, 2014


Consumer alert on the use of elastics as “gap bands”

The use of elastics in dentistry is not new. One of the earliest applications was to extract teeth in patients with bleeding disorders, cardiac problems, or mental deficiency. The practitioner simply placed a rubber band around the tooth to be extracted. The rubber band would slowly work its way down the sides of the tooth roots, destroying the bone and soft tissues, and the tooth would just fall out. Elastics have also been used in periodontal research in animals, to destroy the periodontal attachment between the bone and the cementum and produce inflammation and lesions similar to that seen in periodontitis.

So, why is a consumer alert needed today?

The answer can be found on the Internet. A recent search on the term “gap bands” produced links to sites selling elastics directly to consumers, for home use in closing a dental gap. The sites promoted the speed and benefits of this do-it-yourself orthodontic treatment, but spent very little time at all informing potential patients of the risks.

But the risks are quite real, as these images from a 1988 article in the Journal of Periodontology show. For the authors take on this topic 25 years later, see the Editorial in the September issue of the AJO-DO.

Fig. (Top row) A 7-year-old boy had acutely inflamed tissues and Class III mobility of the central incisors. The initial radiograph showed localized bone loss, confined to the distal aspects of the central incisors, with probing depths up to 10 mm.  (Bottom row). After 18 months of palliative therapy and splinting, close approximation of the root tips and arc-like pattern of bone loss was evident on the radiograph.  Given the poor prognosis of the central incisors, a decision was made to perform exploratory periodontal surgery, which revealed an embedded elastic band.
These figures were originally published in the Journal of Periodontology and are reproduced
with permission from the American Academy of Periodontology.

References and Information

Adcock, J.E.  Exfoliation of maxillary central incisors due to misapplication of orthodontic rubber bands.  Tex Dent J. 1999;116:8-13

Aiello, G. and D'Andria, A.  [Iatrogenic risks in orthodontic treatment]  Av Odontoestomatol 1991;7:549-551.  In Spanish

Almeida, R.C., Carvalho, Fde. A., Almeida, M.A., Capelli J. Jr., and Machado, W.A.  Controlled tooth movement to correct an iatrogenic problem.  Am J Orthod Dentofacial Orthop. 2011;139:271-278

Al-Qutub, M.N.  Orthodontic elastic band-induced periodontitis – A case report.  Saudi Dent J. 2012;24:49-53


September 2014; 146(3)
On the cover: Teeth are imperfect structures; shape and dimension varies between tooth types, and also within a particular tooth type. Designers of straight wire appliances relied on average values for crown angulation, inclination, and crown prominence, but small variations from the norms can affect alignment, and larger deviations might require treatment customization. Traditional measures of tooth size, such as the mesiodistal and buccolingual diameters, do not always provide sufficient information. Kim andKwon and colleagues the Seoul National University used 3D technology and occlusal polygon methods to explore the shape differences of the maxillary first molar, to see if variability in morphology would be enough to affect alignment in patients treated with straight wire appliances.
The smiling patient on the cover is Cole Hunt. He was treated orthodontically by David Sarver, Birmingham, Ala.
The September 2014 issue of the AJO-DO is now online.