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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Troublesome laterals: the elephant is in the front!

“Lateral incisors were found to be among the most incorrectly angulated teeth.”

Lawrence Andrews

Despite our tremendous efforts to correct occlusion in all three dimensions, idealise interdigitation and finish without much proclination, our patients are commonly focus their most attention on the upper front teeth. As a result, we have to be very vigilant not to make mistakes in this esthetically sensitive area. 

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Should we rapidly expand children in the absence of cross-bite?

When I just started working as a specialist orthodontist, I would provide a lot of rapid maxillary expansion (RME) to my mixed dentition patients. Even in the absence of posterior cross-bite. I would tell the parents that this will help the teeth to erupt in a better position. I would especially emphasise the potential problems with the permanent canines that I was hoping to prevent with the RME.

I would say and do this because I hadn’t had enough clinical experience and wasn’t familiar with the research data on the subject. I also would probably want to impress the parents with my “comprehensive approach” expecting them to return for the second phase of treatment in a few years. 

Today I still do RME in children in the absence of cross-bite. But in the very particular situations. In this blog post, I want to look at some brilliant papers which helped me better understand the topics of the mixed dentition RME and canine impaction. Hopefully, it will be of benefit for some of my readers…

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The limits of tongue

I have recently been asked by a colleague to explain why do I use English language for professional communication? This is a reasonable question since my first language is Russian. I know it way better and speak much clearer. However, I can’t help feeling that my mother tongue is not suited well for orthodontic purposes. I wrote about this issue three years ago and am going to return to it now. At the moment, I am having a long railroad trip across Russia. So I am in the right mood to reflect on Russian, English and where we are heading…

So, why do I use English for orthodontic purposes? I am going to narrow down my answer to three C’s: certainty, communication, and conservatism.

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Novoyaz. How to poison a language?

Novoyaz is a mutilated version of Russian language that was imposed by the communists in the 1920s. This was done to bring the political agenda to the masses. As a result, many new words with very vague meaning had been infested into the language. Even the name of the country, the USSR, was for the most part a non-sensical abracadabra.

I can’t help feeling that this has contributed to the fact that Russian language is barely functional these days. Interestingly, almost all significant Russian writers of the 20th century at some point of their careers switched to other languages (mostly English): Vladimir Nabokov, Ayn Rand, Joseph Brodsky, etc. Moreover, if you go out to the streets of Moscow today, you most likely won’t hear people speaking Russian. It would be either a language of some former Soviet republic or a word salad consisted of some Soviet cliches, bureaucratic jargon and swearing.

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The 10 orthodontic commandments: the great truths or the ancient prejudices?

Charles Tweed is truly a Moses figure for orthodontics. He lead his people out of Edward Angle’s non-extraction realm, opposed the golden calf by stating that there is a limited number of patients one could handle, and – the most striking similarity – his teachings have solidified into the 10 orthodontic commandments.

Last year, I wrote about the Tweed’s 10 rules from the perspective of contemporary evidence-based care. I got pretty ambivalent feedback as a result. Some people would say these are still the great truths, others would disparagingly tell me these are nothing but the ancient prejudices…10 commandments interpretation Continue reading “The 10 orthodontic commandments: the great truths or the ancient prejudices?”