By Farooq Ahmed
5
66 ratings
The podcast currently has 123 episodes available.
Join me for a look at CBCT and its use in the diagnosis of the transverse problem, and if it offers the solution to the debated topic. The podcast is based on a lecture by Chun Hsi Chung at this year’s AAO and appraises established methods of assessment, the Curve of Wilson and the WALA ridge line through the lens of a CBCT, as well as how to use a CBCT to assess the maxilla and mandible, which although revealed an ideal measurement, may not be telling the full story.
What is ideal?
inclination
Curve of Wilson – CBCT study
Vertical distance buccal and lingual cusp, 1mm vertical difference
Buccal inclination upper 5 degrees Alkhatib 2017
Lingual inclination lower 12 degrees Alkhatib 2017
Andrews WALA ridge 2000
Bucco-lingual distance from crown ( FA point) to the most prominent portion of mandibular buccal alveolar bone (coincident with mucogingival junction)
Hypothesised teeth over the basal bone , Glass 2019
1st molar = 2mm
Ideal mandibular intermolar width FA – FA = WALA-WALA distance minus 4mm
Normal width CBCT
CBCT age 13 N = 79 Miner 2012
Maxilla slightly smaller
mid point molar root on lingual bone -1.22 +/- 2.91mm
CBCT Age 22.7 years Koo 2017
Measure CoR furcation 1st molar Mx – Mn = -0.39+/- 1.87mm
CBCT 56 adults normal occlusion Lee 2022 PENN STUDY
Buccal – buccal on crestal bone, furcation, 6s
Lingual – lingual crestal furcation 6s
Reliable reading on lingual aspect – buccal shelf bone prevents reliable readings
Maxilla narrower than mandible -1 +/- 3mm
Previous literature Tamburrino 2010 describes 5mm cortical plate level of furcation buccal aspect, however Lee 2022 showed for males 1.1mm +/- 4.5mm and 1.6mm +/- 2.9mm
Without cbct can transverse diagnosis occur?
Models = lingual surface at furcation level (4mm vertical below gingival margin) maxillary width slightly narrower than mandible -2+/- 3mm
Issue with CBCT for diagnosis
Standard Deviation is large = +/- 3mm, range from -4mm-+2mm falls into SD
Issue with study model transverse analysis from 4mm at the gingiva
Not validated
Join me for a summary looking into the increasingly popular
OSA - Defined upper airway dysfunction causing complete or
Sleep = Slow wave sleep – constructive phase of sleep
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Outcomes to paediatric patients of SDB: (AASM)
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First line medical treatment – adenotonsillectomy
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Effect palatal expansion
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Expansion other outcomes - school performance Bariani 2024
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Mandibular advancement
Move mandible forwards and open space behind the tongue – oropharynx
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Orofacial features in children with obstructive sleep
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AADSM 2024 – consensus statement
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More about OSA?
To hear more about OSA, please check out the last interview
Interview
Join me for a summary looking at The Posterior Bolton Discrepancy,
Wayne Bolton established the Bolton’s ratio:
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What is the posterior Bolton’s ratio
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Ratio confirmed by Mongillo 2021
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The effect of 4 premolar extractions on the posterior
Study: Mongillo 2021 (extraction of all 4s) Holton 2023 (extraction
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Clinical options
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Join me for a look into a recent digital innovation within
What is Lightforce
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Stages
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Other advantages
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What are the proposed advantages and claims around Lightforce
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Proposed advantages and claims around Lightforce ithout
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What are my thoughts?
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Papers and videos on Lightforce
https://www.jco-online.com/media/42415/2023_09_500_waldman.pdf
JCO retrospective study
https://www.jco-online.com/media/43897/2024_05_273_wheeler.pdf
Youtube videos from Lightforce company, Alfred Griffin
https://www.youtube.com/watch?v=zSNkYVgZ69I&t=2s&ab_channel=People%2BPractice
Disclaimer
The podcast is opinion and may not be 100% accurate or
Contributions
Contents and editing
Farooq Ahmed
Join me for a podcast summary looking at the effects of
PICO
Population adults, 22 maxillary arches, 20 mandibular arches
Intervention – expansion with aligners, average 3.7mm
Control – minimal expansion, average 0.6mm
Outcome – bone height and width from CBCT
What was the bone loss?
Maxilla
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Mandibular
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What movement took place of the incisors?
Maxilla
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Mandibular
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What were the overall changes?
Dental changes
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Similar bone loss with aligners expansion from other studies,
Should CBCT’s debate within the literature regarding voxel
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My thoughts: no difference in cbct and gold standard,
Predict bone loss
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Systematic review of orthodontics 48 articles de
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Does bone loss = gingival recession?
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Significant retraction of upper incisors and intrusion Kim
Hypothesis
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What I liked about Greg’s lecture was that he started with
“Airways are like TMD controversy on steroids”
“it amazes me we still think we can grow mandibles”
“We have an appliance (expansion) and are trying to fit it into a diagnosis”
“it is unethical to call yourself an airway orthodontist”
Sanjivan describes why there is controversy in
Click on the link below to view previous episodes, to refresh topics,
YouTube
https://youtu.be/m2NIp1XhnxQ
#orthodontics
#farooqahmed
#sanjivankandasamy
#westaustralianorthodontics
#airwayorthodontics
#airway
#OSA
#SDB
Join me for a summary exploring an innovation of the use of bone-anchored plates in class 2 correction. This was a clinically novel idea presented by Hugo De Clerck, who has been an innovator in the use of bone-anchored plates and has published seminal papers on the topic for class 3 treatment.
Join me for a summary looking into
Introduction
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Staging and synergistic movements can reduce
Incisor extrusion
Why is Incisor extrusion difficult?
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Incisor extrusion staging steps:
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Posterior intrusion
Why is it difficult?
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How to improve posterior intrusion
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Controlled expansion
Why is it difficult
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How to improve posterior intrusion
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Conclusion:
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Jay Bowman
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Contributions
Contents:
Edited
Join me for a
Moaiyad Pacha’s
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Advantage of Hanks Herbst
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Disadvantages
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Qualitative
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Conclusion was profound
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Time to reconsider, and having both options, as well as both
Join me for a summary podcast exploring the topic of white spot lesions, and up-to-date
Four treatment
Whitespot
Remineralisation
Most rapid
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Fluoride
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§ require plaque removal and wire removal
§ Not often used in clinical practice and requires
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Resin infiltration Gray 2002
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MI paste (CPPACP) Frencken 2012
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Microabrasion
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2022 Lammert
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§ 13.2 – 4.3
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§ 7.4 X
Clinical implication
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§ Perhaps
Conclusions:
1. Patients
2. Microabrasion
The podcast currently has 123 episodes available.
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