Clinical Pearls session
Join me for this years clinical pearls session at the British Orthodontic Conference.
Topics covered included; gold brackets, pontics and fixed appliances, new tools for space measurement in hypodontia, social media, ligation and video consultations.
Speakers: Preetpal Bhogal
All that glistens is gold Preetpal Bhogal
- Plastic and composite brackets
- Lack strength, deform, wear
- Ceramic appliances
- Main alternative to metal
- Challenge: Bond strength which does not harm dentition
- Enamel wear – Douglas 1989
- Special instruments – Sishi pliers, 3m debonders, Damon debonders
- Heat on debonding – increase temperature of pulp
- Possible use of high speed to remove bracket
- Preet experience with ceramic
- Monocrytaline
- Polycryrtaline
- Conventional ligating – staining of modules
- Self ligating
- Challenging brackets
- Aesthetic wires
- Tried many – chip of wire
- Performance inferior than un-coated
- Gold brackets – what can it not do and undo – Sha
- American Orthodontics Iconic brackets
- Same as master series
- Aesthetics – lighter / Champaign
- Easy upsell from metal, cheaper than ceramic
- Sliver modules and pearl work well – as stain blend in better with bracket
- Advantages Vs ceramic
- Cheaper
- Less friction
- Deeper tie wings
- Vertical slots and power pins
- Gentler to enamel, wear opposing arch
- Easier debond and reposition
- No special instruments / wire
- American Orthodontics Iconic brackets
A trick to make the pontic stick Ian Murphy
- Traditional approach
- Impression, stock tooth, lab bond bracket and ligated to archwire
- Issues
- Debond: Not supported at gingival aspect = occlusal loading = bouncing
- Composite weak in compression
- Pearl
- Labial and lingual flange
- Undercut made where bracket is planned
- Placed intra-orally – supported by gingiva, then bracket placed in supported position
- Debond: Not supported at gingival aspect = occlusal loading = bouncing
LISA: what can she do for you? Jayne Harrison
- Measuring spaces for hypodontia case
- Liverpool Implant Space Assessment
- Precision milled space analysis
- Lisa 2
- Curved design to measure curvature
- Use on study models
- Inter-rater reliability 0.84 – very good
- Before use and after
- Use of LISA: Space achieved in hypodontia
- Before use of LISA 43% achieve ideal space
- After use of LISA 72% achieved ideal space
- Odds ratio 3.4 on achieving ideal spaces – stat significant
- Not commercially available yet
- Use of LISA: Space achieved in hypodontia
Harnessing Social Media to market, educate and set up an Orthodontic Practice
Mohammed Al -Muzian
- 5 elements for setting social media for marketing
- Target (what we wish to achieve), Select platform, manager, deliver (consistently)
- Engage
- Share simple results – morph tools Fantamorpth / MortphX
- Try to be cool!
- Engage in challenges
- Sponsor local school teams / businesses
- Supporting charities
- Customer-oriented business developments
- For example cleaning robot to entertain patients as well
- Opportunity to share on social media
- Red carpet, clip boards
- In house lab
- QR code per patients to see their own models being made
- Friends – encourage friends to promote, they will be our manager
- Tooth brushing – American style room with photo opportunity- can then share on social media
- Instagram like counter in the window
- Varied content – fish eye camera live streamed on youtube
- Teaching and social media
- Orthodontic Mastery Group
- 10k members
- 300 webinars ran for free
- Kevin O’Brien’s social education recommendations
- Squat surgery established September 2020
- Orthodontic Mastery Group
Use Floss to ligate Malaligned Teeth Safoora Keshtgar
Floss used to pull the archwire into the slot in palatal direction
- Wax floss advised
- Creates space to allow ligature tie
In praise of the video-consultation Megan Hatfield
- Advantages of video
- Replace TCO consult
- Reduce direct contact
- Before consult
Process
- Patient enquiry
- Booked into diary 30 minutes
- Email invite with additional information request
- Request for photos prior to appointment
- BOS link of how to take photos
- Video
- Additional lighting
- Checklist of items to discuss
- Typodonts to hand
- Child and parent together
- Conduct same as clinic – check history, MH, form of clinical assessment
- Remind just a guide, clinical exam required
- Provisional plan possible, payment options, book exam for follow up
Pre and post video
- Conversion rate
- 21% Vs 35%
Advantages
- Low risk – free
- Low commitment, easy to fit in to the day
- Initial fact finding
- Enable multiple consults
Practice advantages
- Meet patients
- Nurse not needed
- Streamline records visit
- Reduce wasted appointments
Disadvantages
- Inability to examine
- Poor connection
- Admin time