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Updates in Orthodontics (fact or fiction)

Orthodontic treatment is always changing and progressing. The promises of new orthodontic products and treatment, however, can often be exaggerated much like the latest weight loss drug or diet. Sometimes old technology is rebranded as new and the multitude of names given to similar modes of treatment confuses the picture. The point of this area of updates is to help inform prospective orthodontic patients of what is out there such that you are able to make educated treatment choices.

This section is a work in progress and will be updated as time permits (remember I have four kids, a wife who works, two dogs, a horse, a saltwater fish tank, I clean my pool myself- you get the picture). Anyway, if you have any questions about what I have written below or have questions about something else that you may have heard of, please ask me. Am I always right-no, my kids will tell you that. I do, however, attempt to give an unbiased review of what I see and know as I continue to learn.

Dr. “B”

Topics:
A. Accelerated Orthodontic Treatment
B. Early Orthodontic Treatment
C. Growth Modification

Accelerating Orthodontic Treatment: Everyone wants to get through treatment faster. More pain in orthodontic treatment, however, does not correlate with a shorter treatment time (probably a good thing, right?). We know through controlled research that too much orthodontic force compresses the ligaments surrounding the teeth to the extent that tooth movement stalls out. So, if we can’t force the teeth to move faster, what are our options?

Propel®- Propel claims to expedite orthodontic treatment by means of microperforations made in the bone with a specialized instrument adjacent to the teeth that you desire to move. This results in a mild inflammatory response that is believed to expedite bone turnover adjacent to the teeth and thus expedite tooth movement. Sounds painful, right? Actually, I had a colleague try it out on me with topical anesthetic (no shots) and there was no pain, only a little pressure. How much faster? Possibly twice as fast- two years of treatment in one year? Maybe. Interested? Ask me about it and I will let you know if I feel that it will make a significant difference in your treatment time.

Accelerodent®- Accelerodent claims to accelerate orthodontic treatment by means of ultrasonic vibration stimulating tooth movement. You bite into a vibrating mouthpiece for twenty minutes or so every day- while watching TV, driving, whatever. Pretty simple and minimal discomfort. Unfortunately the research is iffy and the units are expensive and not reusable- they are designed to last a specific number of uses and then stop working. If microperforatoions make you uneasy and cost is not an issue, you may want to give it a try. Accelerodent may be used with any type of braces or Invisalign. Ask me about it if you have questions or contact my staff if you would like to order a unit.

Damon System® and Speed System®- traditional braces utilize elastomerics (small rubber bands) to hold the wire that applies force to the brace and tooth in place. Self-ligating braces, braces that mechanically lock on to the wire, have actually been around for a long time but have become much more popular in recent years primarily due to heavy advertising by Damon and because they have become more refined and easier to use. There are dozens of manufacturers of self-ligating braces. I offer Damon and Speed because people ask for Damon by name and I was introduced to Speed when I was a resident at the Mayo Clinic and appreciate their unique and small design.
Theoretically self-ligating braces make sense as the force that elastomerics produce decreases over time (i.e. they lose their stretchiness), especially when immersed in saliva. As self-ligating braces do away with elastomerics for the most part, more consistent forces should exist throughout treatment. But, does this result in quicker treatment? Independent studies have yet to show this to be the case with any statistical significance. Regardless, they may allow for longer intervals between appointments and shorter appointment times with less discomfort.