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Ortho Tribune Middle East & Africa No.1, 2018

E7 ◊Page E6 VISIT NO 5: 21 MONTHS Seven months later, the family returned to the office over the summer break. A long appointment was scheduled to—if all went well—remove the appliances and put a retainer in place. The day of the visit, the decision was made to proceed. When I announced that the treatment would be completed that day, the patient and his parents had quite a memorable reaction: “Already? It went so fast! Thank you! He is going to have the best summer break!” The results, although not perfect, were remarkable. The end-of-treatment re- cords clearly show good tissue quality (periodontal and root integrity), undoubt- edly thanks to the use of minimal force with long rest periods, a minimal number of archwires, and bonding which allowed for continuous improvement through- out the entire treatment, from beginning to end. That same day, we began treatment for the youngest sibling, using the same protocol. VISIT NO 6: POST-RETENTION PHOTOS +12 MONTHS Today, 37% of my patients fitted with multibracket appliances are non-residents, meaning they live in another country, or even on another continent. These treat- ments would be impossible without this new flexible scheduling. Even with these new treatment modalities, a certain level of precaution and or- ganization is required in order to ensure continuous improvement (the promise touted by each new system on the market today): • An appropriate prescription for the anterior torques. • A SOLID bonding protocol (brackets and bite turbos) that eliminates the risk of bond failure almost entirely. • Extremely precise brackets placement, reducing the need for repositioning. • Biomechanical foreplanning: sufficient wire supply for leveling – proper place- ment of stops – lasting activation devices (coils, for example, rather than power chains) – anticipating biomechanical effects with the use of mini-screws, etc. CASE NO 2 This patient, aged 15 years, was treated in 5 visits spread over 31 months. These photos show the treatment stages and the intervals between appoint- ments. A Damon System was used to treat this case of a Class III malocclusion, with incredible results observed in the teeth and facial features. ORTHO TRIBUNE Dental Tribune Middle East & Africa Edition | 1/2018 Total Tx Time: 22 months – 5 appointments 12 months of retention – Stable results – Dental and facial esthetics – Stability Photos from appointments 1 to 5b showing treatment progress despite infrequent visits: Initial bonding / 12 months / 19 months / 26 months / 33 months / Before and after photos CASE NO 3 This “spread-out” scheduling approach can also be applied to treatments involving extractions. In this case, the patient moved to Canada in the middle of her treatment (at 11 months), still with several spaces left to be closed. Having already undergone an initial 3 year treatment (see photos), the patient wanted to remain with the same orthodontist and agreed to travel from Canada every 6 months to continue her treatment. After moving away, she was seen just 3 more times, including the debonding appointment. ◊Page E1 ◊Page E1 Smile before treatment Smile after treatment At 11 months of treatment, when the patient moved to Montreal 6 months later (at 17 months) 6 months later (at 23 months) Photos taken at the end of treatment (total of 23 months – 2 appointments in 12 months)

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