14 Industry & Products ORTHO TRIBUNE | FEBRUARy SUPPLEMENT KODAK 9500 Cone Beam 3-D System The KODAK 9500 Cone Beam 3-D System is now one of only a few advanced 3-D dental imaging systems certified by OraMetrix for use with its SureSmile® technology, which transforms cone-beam scans of the mouth and teeth into 3-D computer models for orthodontic planning and treatment. This new integration enables orthodontists to submit 3-D scans acquired by the KODAK 9500 3-D System to SureSmile for the manufacture of customized wires for patients. The SureSmile system is a digital therapeutic solution for orthodontics that replaces conventional manual treatment. Orthodontists can take a 3-D scan of the patient’s mouth, face and jaw and use this data in the SureSmile system for unprecedented control of treatment through virtual diagnostic simulations, instant quality grading tools, prescriptive planning capabilities and robotic arch-wire customization. The KODAK 9500 3-D System enables practitioners to quickly produce magnificent 3-D images — ranging from single jaw to full craniofacial images — at the lowest possible dose. With high-quality, anatomically correct 3-D images up to 0.2 mm voxel size, practitioners are able to provide more accurate diagnoses, improved treatment planning and better patient care. SureSmile www.suresmile.com PracticeWorks Systems (800) 944-6365 www.kodakdental.com Invisalign adds new features A lign Technology has introduced new features to the Invisalign product line that are designed to improve extrusions, rotations and root movements. Optimized attachments, Power Ridges™, and velocity optimization help provide greater control and precision for specific tooth movements across a broader range of patients. Optimized attachments are designed to improve extrusions of anterior teeth and canine rotations by optimizing aligner forces. These next-generation attachments are customized to a patient’s unique tooth anatomy and create a patientspecific solution for each case. Power Ridges, formerly available only on Invisalign Teen®, help deliver lingual root torque by optimizing forces on upper incisors. They can be used when up-righting retroclined upper incisors, such as in Class II Division 2 cases. Velocity optimization provides more controlled movements for the entire tooth, including the root, and works with improved ClinCheck® protocols to limit the speed of crown and root movements to optimal ranges. In addition, IPR improvements now allow IPR to be set up in later stages of treatment when crowded teeth are more aligned and may be easier to access. A new Invisalign Attachment Kit also helps achieve better bond strength, wear resistance and dimensional accuracy when used to create attachments, including the optimized attachments. To learn more, visit www. invisalign.com. OT f OT page 13 This overwhelming evidence clearly indicates the need for treatment to be geared toward correcting function, because it is function that affects form. Evidence-based orthodontics Since the epidemiologist Sackett (1986) observed that orthodontics was on par with scientology in terms of scientific legitimacy, the industry has made a concerted effort to transform itself. More orthodontists are embracing this paradigm-shift toward the weight of evidence, which rests firmly with early treatment and treating muscle function. A case in point is this 9-year-old girl with a narrow, retrusive maxilla and mandible, crowding of the upper arch and anterior flattening of the lower arch. An expansion appliance was used for the maxilla to create enough room for the tongue to posture correctly in the palate, together with a myofunctional appliance. By simply treating function, after only four months the overbite has reduced significantly, the lost lower right c-space has begun to re-open and the dental alignment has also improved. Obviously, the myofunctional phase of treatment is yet incomplete and the dental phase has not even begun; however, the improvement in the facial profile is already remarkable. (Figs. 1, 2) There is always going to be an important place for fixed appliances, because it is still the most efficient way to move a tooth. However, the two worlds are far from mutually exclusive: We can shorten the time needed for braces and greatly improve the stability of the result and fullness of the face if we Fig. 1: October 2009 intervene early with myofunctional therapy. A new dawn is breaking in the industry, one in which we can now use the best of both worlds for better faces as well as teeth. OT Fig. 2: January 2010 orbicularis oris and mentalis muscles in patients with Class II/1 malocclusion submitted to first premolar extraction. J Appl Oral Sci, 16(3):226–31. 7. Frost HM, 1997. Perspective: On our age-related bone loss: Insights from a new paradigm. J Bone Miner Res, 12:1539–1546. 8. Graber TM, 1963. The “three M’s”: Muscles, malformation and malocclusion. Am J Orthodontics, 19(6):418–450. 9. Harrison JE, O’Brien KD, Worthington HV. Orthodontic treatment for prominent upper front teeth in children. Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD003452. DOI: 10.1002/14651858.CD00345 2.pub2. 10. Justus R, 2008. Are there any advantages of early Class II treatment? Am J Orthod Dentofacial Orthop, 134:717–8. 11. Kiliaridis S, Bresin A, Holm J, Strid K-G, 1996. Effects of masticatory muscle function on bone mass in mandibles of the growing rat. Acta Anatomica, 155: 200–205. 12. Kiliaridis S, 2006. The importance of masticatory muscle function in dentofacial growth. Seminars in Orthodontics, 12:110–119. 13. Lu T-W, O’Connor JJ, Taylor SJD, Walker PS, 1997. Influence of muscle activity on the forces in the femur: Comparison between in vivo measurement and calculation. Trans Orthop Res Soc, 22:721. 14. Turpin DL, 2007. The longawaited Cochrane review of 2-phase treatment. Am J Orthod Dentofacial Orthop, 132:423– 424. 15. Willmot D, 2008. White spot lesions after orthodontic treatment. Seminars in Orthodontics, 14(3):2009–219. References 1. 2. 3. Andresen V, Haupl K, 1936. Functions-Kiefer Orthopadie. Berlin, Hermann Meusser. Angle EH, 1907. Treatment of Malocclusion of the Teeth, Philadelphia, SS White, 7th ed. Ballard DJ, Jones, AS, Petocz P, Derebdeliler MA, 2009. Physical properties of root cementum: Part 11. Continuous vs intermittent controlled orthodontic forces on root resorption. A microcomputed-tomography study. Am Journal of Orthod and Dentofacial Orthopaedics. Burr DB, 1997. Muscle strength, bone mass, and age-related bone loss. J Bone Miner Res, 12: 1547–1551. Cross JJ, 1977. Facial growth: Before, during and following orthodontic treatment. Am J Orthod, 71:68–78. De Souza DR, Semeghini TA, Kroll LB, Berzin F, 2008. Oral myofunctional and electromyographic evaluation of the OT About the author Dr. Rohan Wijey graduated in 2009 from Griffith University (Gold Coast, Queensland) where he took a special interest in orthodontics and especially in myofunctional orthodontics. He started working with Myofucntional Research in 2007, researching and writing articles on both traditional and myofunctional orthodontics. Wijey is now embarking on an extensive program of post-graduate studies in traditional and myofunctional orthodontics and TMJ disorder. 4. 5. 6.