Clinical Pearls Session. BOC 2021. October 6th 2021. Episode 140

6, October 2021

Hosted by

Farooq Ahmed

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

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

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

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