When should we take CBCT of the orthodontic patient?

Earlier this week I published a tongue-in-check piece which has suddenly become one of my most popular texts on this blog. Today I want to switch back to more serious tone and try to answer a simple question:

“When should we take CBCT of the orthodontic patient?”

How many times online or during the conference we have seen a practitioner advocating for the routine use of CBCT? To justify this the orthodontist would often show the images of scanned airways or primary dentition before and after. “3D images helped me to diagnose airway constriction and crowding, I can’t even imagine how I would now practice without this marvellous technology!” – such specialist would say. This, of course, are strong statements, and looking closer you will likely find an affiliation of the practitioner with the manufacturer of diagnostic equipment.

Let’s now throw away all the possible speculations and draw our attention to the current research data.

A fragment of the artwork for my orthodontic seminar by a US-based designer, Oleg Kremeshnoy
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How to win orthodontic patients and cash in on ignorance?

In a competitive field of orthodontics it is imperative to develop a proper marketing strategy to succeed financially. After all, we are all in this to make some cash, not to waste our precious time on tracing cephs, bending wires and understanding all those boring research papers, right?

Being the number-one marketing guru in orthodontics, I’d like to give 10 powerful tips and tricks to my devoted followers. Please read them at least three times, then highlight the ones you find the most important and next implement this new knowledge into your practice. If done correctly and with enthusiasm, these great life-changing hints will bring you not just thousands, but millions of dollars. 

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Apparently the best clinical guide for a beginner orthodontist

I want to start this year with a review of a wonderful textbook which is a great help for many orthodontists, especially those freshly out of school. 

The 20 principles of the Alexander Discipline is the first part of a trilogy by a famous American orthodontist, Richard Wick Alexander. It was published by Quintessence in 2008.

I bought my copy on the 3rd year after graduation. This is a landmark period in a young specialist’s life: you have just finished several dozens of your first cases and, hence, have a possibility to look back at the results, documentation and biomechanics used. And if you are quite honest with yourself, you are not too excited about how this all looks. “I need more structure in what I do”, – said I to myself then. And luckily, the book was right there at my disposal.

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A very short blog post on apathy

According to Wikipedia, apathy is a lack of feeling, emotion, interest, or concern about something. Last year, most people around the globe experienced this in one form or another because of the COVID crisis. I was one of the affected. I had spent about 2 months without seeing the patients and this distraction from the regular routine coupled with inability to travel was psychologically challenging. 

Here are three measures I find feasible to fight the miserable state of apathy. At least, these work for me.

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An antidote to orthodontic fantasies

Orthodontic fantasies – just as many other gimmicks of modern-day snake oil salesmen – are continuing to spread. We constantly see people online promising to grow children’s mandibles, avoid extractions at all costs with magical appliances or even treat malocclusions with extravagant tongue exercises. 

Of course, in countries with developed orthodontic infrastructures such nonsense is objected by powerful orthodontic organisations (national societies, orthodontic boards), academia or even advertising authorities. However, developing countries, such as Russia, are left alone to suffer from the insatiable appetite of dental charlatans. And it seems that no-one is in charge of this chaos.

About two years ago, I started doing video reviews of orthodontic textbooks. These silent paperback agents are one of few sources that could resist the utter ignorance of market at the outskirts of orthodontic civilisation. The first video I recorded was dedicated to a wonderful book titled Evidence-Based Orthodontics. Today I want to have a fresh look on the text. I think it is still my favourite orthodontic book.

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On Kevin O’Brien’s orthodontic blog

Impartiality is a rare quality. Especially in a competitive, market-driven and technologically advanced field of orthodontics. Today I decided to review one of the most valuable online resources about the specialty. In my view, it provides the most impartial information on the most important orthodontic topics.

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Class II functionals under scrutiny

Is there one source from which I can learn about the whole spectrum of functional appliances? This is a prudent and expected question a resident or a young orthodontist would ask. Luckily, I have a positive answer!

Today I would like to draw my readers attention to an interesting book that aims to provide a thorough and evidence-based assessment of the most popular Class II functional appliances: Twin Block, Herbst, Forsus, Jasper Jumper, etc. It also briefly covers the use of functional appliances in the correction of Class III malocclusion.

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An ultimate guide to the modern-day fixed appliances mechanics

Contemporary fixed orthodontic appliances are deceptively simple. Wire bending is minimised and bonding techniques are enhanced. Moreover, some manufacturers claim that premolar extractions are almost unnecessary implying the role of an orthodontist is just to change a few wires.

Such delusions usually disappear the moment a young orthodontist steps into the real clinical environment. And at this very moment it is imperative to have a reliable guide which will help to wrap the mind around the incredibly simple and uniquely sophisticated tool: the modern-day day fixed orthodontic appliances.

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Never be at crossroads about the mixed dentition again

I can’t help feeling that many young orthodontists often find mixed dentition cases quite tricky. I think this is partly due to the fact that these patients are growing so it takes years to fully appreciate the process of dentition development, and partly because of the constant flow of unscientific and erroneous claims heated by the market.

I had spent almost four years after the residency working exclusively with children and teenagers, so I know this confusion first hand. It whittles down with experience… or with the help of a good book.

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Don’t we need some education? A look from the East.

It was a breezy afternoon in the middle of the week, April 2018. I popped out from the Russian Healthcare Ministry building located in the very center of Moscow. I had just handed to the authorities the Young Russian Orthodontists’ Manifesto and been through a useless debate on if we need any improvements in the orthodontic education in the country. The authorities made it quite clear to me: they are not going to move a finger to make any change.

Few months ago, I made a promise to myself not to write anything more on the post-Soviet orthodotniya. This steals my time and ruins my mood. However, the topic of orthodontic education is a global and critical issue which affects the most vulnerable in the community: the young specialists. This probably excuses me for writing this piece.

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