Download Sound Orthodontic Principles

Cosmetic Orthodontics
with
Sound Orthodontic
Principles
by
Dr Geoffrey
Hall, BDSc
(Melb) Cert
Orth (Uni
of Penn.)
Specialist
Orthodontist,
Melbourne
Editorial Note: A list of references is available from the publisher: [email protected]
M
ost dentists are looking for ways to increase profitability
whilst simultaneously raising the level of their dental treatment. For many, the addition of short-term orthodontics to their aesthetic
armentarium has proved to be a new and exciting proposition. Now available in Australia, Smilefast involves the use of clear
braces and tooth coloured archwires to transform smiles in three
to nine months. It is an innovative shift in orthodontic treatment
philosophy that can greatly benefit dentists and their patients,
while offering enormous advantages over other systems.
The vast majority of adult patients with crooked teeth do not
even consider conventional orthodontics as a viable option. This
fact makes most dentists spend little or no time recommending
orthodontics during a hygiene or new patient exam. When
these patients ask about cosmetic options, most dentists find
themselves trying to decide how much tooth structure they would
feel comfortable removing if using veneers. It’s a very typical and
frustrating situation. Consider the patients below. They have
severe crowding, and are considering undergoing veneer therapy.
If so, significant tooth structure would be removed, I would
consider this to be biologically negligent and leave the patient
with a lifetime of dental maintenance. Fig. 1a: Severe upper and lower
crowding
Fig. 1b: Smilefast for 8 months improved
aesthetics and required no
tooth
structure to be removed
Smilefast Magic Braces provides a reasonable, safe, effective and
affordable alternative for patients with crooked or spaced teeth. The fundamental approach with Smilefast is to give adult patients
a smile they have always wanted and to do it in a reasonable
amount of time. The short treatment time is derived from a shift
away from the comprehensive treatment goals normally associated
with conventional orthodontic treatment, such as obtaining a
perfect Class I occlusion, ideal overbite and overjet, and trying to
adhere to Andrew’s Six Keys of Occlusion.
Short-term orthodontic treatment focuses on addressing the
patient’s chief cosmetic complaint whilst not attempting to alter
the existing occlusal relationship. We are all taught in Dental School the goal of orthodontic
treatment is a Class I occlusion. The idea of using brackets and
wires to move teeth, whilst not always finishing with an ideal
Class I occlusion may at first be unusual to some dentists.
However, a few important concepts should be considered.
1. The literature shows overwhelmingly there is no relationship
between Angle Classification and TMJ dysfunction.
2. Straightening teeth without altering Angle Classification
can provide a dramatic cosmetic improvement and does
not increase the risk of dysfunctional pain.
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Australasian Cosmetic Dentist
An ideal Class I relationship is usually highly aesthetic. It would
be favourable if most adults would wear braces for as long as it
takes to reach the ideal occlusion, which is normally 18 months
to 2 ½ years. Since this is not the reality of the situation, Smilefast
allows for a practical alternative. Invisalign and other clear aligner
techniques can also be a good option for adults who will not
tolerate wearing braces.
In our practice though, over a period of three years, I have been
offering usually three different treatment options. Firstly, I always
offer them the ideal treatment plan which usually involves upper
and lower fixed braces for 24 months in conjunction with elastic
wear and if necessary extractions and/or orthognathic surgery. If they are a candidate for Smilefast Magic Braces, which 80%
of my adult patients are eligible for this approach, I offer that
as a second option and explain to them I am purely aligning the
teeth to improve the cosmetic result and not affecting the bite
relationship. Patients are informed that this approach will take
approximately six to nine months.
Finally, I also offer them Invisalign if they are eligible candidate
and I explain to them Invisalign will require attachments, IPR and
sometimes elastics - requiring 18 months to 2 ½ years of treatment. What we have found in our
practice is 90% of our adult
patients prefer the Smilefast
approach compared to the
conventional comprehensive
orthodontic care, or Invisalign Fig. 2a: Severe upper and crowding
requiring a new veneer on 21
therapy, which proves that the
main objection to conventional
orthodontic treatment, apart
from orthognathic surgery or
extractions, is the time in braces. I believe there is a psychological
Fig. 2b: Smilefast for 6 months in
barrier with patients. If we can preparation for veneer on 21
finish their orthodontic treatment
within 12 months, they feel very
comfortable with proceeding
with orthodontic alignment.
Most of our Smilefast Magic
Braces cases take approximately
Fig. 2c: Following veneer on 21
six to nine months to obtain
excellent cosmetic orthodontic outcomes.
More and more dentists are becoming frustrated with clear
aligner therapy as there are a variety of tooth movements which
are difficult to achieve with aligners and treatment can be
unpredictable unless it is in experienced and knowledgeable
hands. Smilefast Magic Braces allows dentists to take far better
control of these cases and ultimately provide a more attractive
and optimal aesthetic outcome.
In the United States and Asia, dentists are charging fees that are
comparable to traditional orthodontic cases but the treatment
time and associated chairside time is approximately a quarter. In Australia I am suggesting practitioners charge 75% of the
traditional orthodontic fee and this provides excellent profit for
each and every dentist. WHAT IS UNIQUE ABOUT SMILEFAST?
There are numerous differences between the Smilefast Magic
Braces program and other programs available at this present time.
Firstly, the courses Smilefast provides are presented by myself; a
trained Specialist Orthodontist, hence, you will be taught sound
orthodontic techniques to correct cosmetic problems and I have
been involved in teaching general practitioners for some years. Our aim is to provide you with a no stress and totally predictable
system which will work each and every time. Smilefast offers
various levels of courses ranging from Smilefast GO which is a
one-day cost effective program allowing you to treat very minimal
to mild crowding cases, to a two-day course, Smilefast PRO.
Smilefast PRO provides you with the knowledge to treat more
significant crowding cases, spacing cases, certain open bite cases
and Class3 malocclusions.
Fig. 4b: Ideal alignment and bracket placement in digital system
Fig. 4c: Brackets transferred to maloccluded model in digital system
Fig. 3a & 3b: Mild crowding and mild protrusion treated in 7 months after the Dentist
completed the Smilefast Pro course
We also offer an advanced course for doctors who have already
taken the two-day PRO Course. In the near future we will be offering
a Lingual orthodontic program addressing cosmetic alignment.
The second main difference of the Smilefast program compared to
any other program is our unique web portal where you have the
ability to load photos, x-rays of all your cases and have any technical
questions or issues addressed by myself. Having access to local
Specialist Orthodontic support is obviously very advantageous and
should be of great comfort to you and your patients.
This digital set-up is also a wonderful communication and
marketing tool for your patients. They can see the anticipated
result of the treatment, similar to a Clincheck from Invisalign.
This will definitely increase your conversion rate, ensuring many
patients accept this type of cosmetic orthodontic treatment. All
other indirect bonding systems that are available here in Australia
rely on a dental technician placing the brackets and this is fraught
with enormous errors for numerous reasons.
The use of indirect bonding makes attaching the brackets extremely
simple and mostly delegatable. The clear brackets are set perfectly
in the digital world and then transferred to the models of the
patient’s teeth, prior to the indirect bonding trays being fabricated. This makes applying the braces as easy as seating a bleaching tray. Thirdly, the most significant difference between Smilefast and all
other products is our patented, digital computerised indirect bonding
system. You will be taught at the courses how to make the correct
diagnosis and treatment plan for your patients (and if in doubt this
can be verified by ourselves at Smilefast,). The key to the ultimate
clinical outcome is perfect bracket placement in conjunction with
the elastic memory of Nitinol wire so as to straighten the teeth into
their ideal position in the most efficient manner. In our system we have a digital computerised indirect bonding
system where the set-up is performed via the computer. This digital
setup and bracket positioning in the virtual world is then sent to
you for approval or revision. Once you approve the anticipated
alignment of the teeth, the case is submitted and the indirect
bonding trays with brackets are fabricated providing the patient
with “perfect” bracket position. Fig. 5: Indirect bonding using a digital computerised system key to dentists easily mastering this approach
Fig. 6a: Bonding tray inserted
Fig. 6b: Braces and wires placed total
chairside time 30 minutes
The majority of general dentists strive to provide quality dentistry
with as little stress and as much success as possible. Smilefast
Magic Braces allows general dentists to accomplish all of these
goals. The procedure can be learned in a few days with minimal
financial outlay compared to the rewards you will enjoy.
Fig. 4a: Malocclusion in digital system
I look forward welcoming you at a Smilefast training course in the
near future and I’m excited for you to join the revolution!
Australasian Cosmetic Dentist
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