by Farooq Ahmed
Farooq brings the key points, references and understandings from keynote webinars and papers in a concise podcast. Providing easy access to gain the most from our esteemed speakers and experts. *Important to note the information is from our interpretation as individual professionals, and may incorporate our opinions*
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5/2/2020
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April 2, 2025
<p><strong>Orthodontics In Interview: Aligners, Limited or Just Misunderstood? tommaso castroflorio</strong></p><p><strong> </strong></p><p><strong>“The biggest difference in overcoming the limitation (of aligners) is to understand how to control aligner deformation”</strong></p><p><strong> </strong></p><p><strong>“We need to improve the available knowledge about aligners, because we need to control the companies, we do not need companies controlling us”</strong></p><p><strong> </strong></p><p><strong>“I think you can treat also complex cases, in my practice I treat extraction cases”</strong></p><p><strong> </strong></p><p><strong>“There are limitations in every technique, I think that the good orthodontist understands how to manage the limitation and how to overcome them”</strong></p><p><strong> </strong></p><p><strong>“Large mass 3D printing will represent an important evolution in orthodontics, aligners and braces”</strong></p><p> </p><p>Tommaso explores the current understanding ofaligners, there limitations in terms of an appliance and scientific research. We explored the debate of aligners treating complex cases, why attachment designs still have limitations, and the role of aligners as functional appliances. We discuss emerging concerns of micro and nano-plastic toxicity andenvironmental concerns of aligners.</p><p> </p><p></p><p>TIMELINE </p><p>00:00:00 Introduction of Dr Tomasso Castroflorio </p><p>00:00:51 Tomasso's Early Experiences with Aligners </p><p>00:08:21 What are the Limitations of Aligners? </p><p>00:11:24 How do we Overcome Limitations with Aligners? </p><p>00:17:59 Should Aligners be Restricted to Mild to Moderate Cases? </p><p>00:20:22 Research IndicatesAligners Only Tip Teeth into Extraction Sites, Do you Agree? 00:25:50 Importance of Visualization in Orthodontics? </p><p>00:29:27 Are Functional Appliance Aligners Advantageous over Conventional Functional Appliances? </p><p>00:35:08 Has There Been Over-emphasis on Attachment Design? </p><p>00:44:18 What are the Consequences of Microplastics and Aligners? </p><p>00:50:32 What is the Future of Aligners? </p><p>00:53:54 Who do you Admire the Most in Orthodontics</p><p>00:55:36 Advice from Tomasso to all Orthodontists</p><p>Click on the link below to view previous episodes, to refresh topics, pick up tricks and stay up to date.</p><p> </p><p><strong> </strong></p><p><strong>Please like and subscribe if you find it useful!</strong></p><p> </p><p><strong>Please visit the website for this interview podcast:</strong></p><p><a href="https://orthoinsummary.com/orthodontics-in-interview-aligners-limited-or-misunderstood-tommaso-castroflorio/" target="_blank" rel="ugc noopener noreferrer">https://orthoinsummary.com/orthodontics-in-interview-aligners-limited-or-misunderstood-tommaso-castroflorio/</a><strong></strong></p><p><strong> </strong></p><p> </p><p> </p><p>#orthodontics </p><p>#farooqahmed </p><p>#<strong>tomassocastroflorio</strong></p><p>#<strong>aligners</strong></p><p>#<strong>clearalignertherapy</strong></p><p><strong> </strong></p><p>#orthodonticsinsummary</p><p>#orthodonticsininterview </p><p> </p><p>Farooq Ahmed</p><p><br></p>
March 5, 2025
<p></p><p>Join me for a summary of recent long-term research of resorbed teeth due to impacted canines. This podcast is based on an excellent lecture by Julia Naoumova delivered at last year’s British Orthodontic Conference. Part 2 with focus on the prognosis of resorbed teeth from impacted canines, and follows on from part 1 with explored outcomes of open Vs closed exposures of impacted canines – see here for part 1. </p><p>Root resorption of incisors reported at 19-67% Erikson 2000 Walker 2005, Mitsea 2022</p><p>Anna Dahlén and Julia Naoumova 2024 retrospective CBCT study n =27 incisors</p><p>Mean Follow-up average 9 years (5.5-14.6)</p><p>Patient reported outcomes</p><ul><li><p>Survival 100%</p></li><ul><li><p>Horizontal grade 3 moderate resorption n=17 (resorption inner dentine not involve pulp moderate)</p></li><li><p>Horizontal grade 4 severe resorption n=12 (pulp exposed severe)</p></li><li><p>Vertical grade 3+ severe resorption n=7 (resorption 2mm-1/3rd moderate)o</p></li><li><p>Vertical grade 4 extreme resorption n = 1 (resorption 1/3rd +)</p></li></ul><li><p>No significant difference in any grade of resorption long term of the following:</p></li><ul><li><p>Symptoms </p></li><li><p>Mobility and ankylosis</p></li><li><p>Discolouration</p></li><li><p>Increase gingival pocketing but not clinically significant </p></li></ul><li><p>RR horizontal changes with time </p></li><ul><li><p>No change 81%</p></li><li><p>Worse 4%</p></li><li><p>Improve 15%</p></li></ul><li><p>RR vertical changes with time</p></li><ul><li><p>No change 43%</p></li><li><p>Worsen 57%</p></li><ul><li><p>Expected as had orthodontic treatment as well</p></li></ul></ul></ul><p>Previous research </p><ul><li><p>1-23 years Survival 93-100% Falahat 2008 , Bjerklin 2011, Becker 2005, Jönsson 2007</p></li><li><p>Jönsson 2007 showed grade 1 mobility when root length < 10mm </p></li></ul><p>Conclusion:</p><p>Extraction of asymptomatic based purely on root resorption should be routinely performed</p><p>Paper by Anna Dahlén and Julia Naoumova 2024 </p><p>Longitudinal study of root resorption on incisors caused by impacted maxillary canines—a clinical and cone beam CT assessment </p><p>https://doi.org/10.1093/ejo/cjae052</p>
February 19, 2025
<p>Join me for a summary of the management of impacted canines, the latest evidence regarding different techniques for alignment. This podcast is based on an excellent lecture by Julia Naoumova delivered at last year’s British Orthodontic Conference. </p><p>Part 1 will focus on recent findings of a modified open exposure technique Vs closed exposure, in terms of duration but also other key outcomes, health, pain, use of analgesics, time absent from school and costs. The next episode, part 2, will look at the prognosis of resorbed incisors related to impacted canines long term. </p><p>Previous research no difference between closed Vs open exposure for alignment, aesthetics, treatment time, surgical success, treatment times. Limited to 2D views Parkin 2017, Sampaziotis 2018, Cassina 2018. </p><p>Questionnaire of current decision making of open Vs closed: n=48 orthodontists = current clinical decision making by orthodontists based on preference Naoumova 2018</p><p>Multicentre RCT Margitha Björksved 2018, 2021</p><ul> <li><p>Modified open exposure with Glass ionomer OPen Exposure, first described by Nordenval 1999</p></li> <li><p>6/12 of spontaneous eruption</p></li> <li><p>Traction with orthodontic appliances</p></li></ul><p>Results</p><ul> <li><p>Total time: no difference 26 months (95% CI −3.2 to 2.9, P = 0.93)</p></li> <li><p>Canine eruption time: Open exposure quicker by 3 months 8.5 months Vs 11.5 months (95% CI 1.1 to 4.9, P = 0.002). With no traction in open exposure group </p></li> <li><p>No difference in periodontal status, root resorption, surgery time, complications, </p></li> <li><p>Pain: greater in closed group</p></li><ul> <li><p>Greater pain with bilateral open exposure</p></li> <li><p>Closed exposure more painful applying traction </p></li></ul> <li><p>Analgesics use (preliminary data):</p></li><ul> <li><p>Day 1 nearly all patients use</p></li> <li><p>Day 5 drops to less than 50% of patients use</p></li> <li><p>Day 10 most have stopped taking analgesics</p></li></ul> <li><p>Costs: – no difference </p></li><ul> <li><p>€3,400 healthcare costs</p></li> <li><p>€6,300 including patient costs</p></li></ul></ul><ul> <li><p>Missed days of school (preliminary data)</p></li><ul> <li><p>Day 1 - 76% open Vs 65% closed exposure </p></li> <li><p>Day 2 - 3% open Vs 6% closed exposure</p></li></ul></ul><p>Open exposure with GOPEX Not appropriate for:</p><ul> <li><p>Close to adjacent tooth, to avoid material on adjacent teeth</p></li> <li><p>Very high canine position </p></li> <li><p>Older patient – start traction straight away, probability of ankylosis increases Cernochova 2024</p></li><ul> <li><p>1% at age 15</p></li> <li><p>4% at age 20</p></li> <li><p>14% at age 25</p></li> <li><p>97% at age 45</p></li></ul></ul><p>Conclusion:</p><ul> <li><p>Both open and closed techniques are viable, however with open exposure of GOPEX technique the canine erupts spontaneously and quicker</p></li> <li><p>Less pain with open exposure unless bilateral</p></li> <li><p>Most patient will miss 1-2 days from school </p></li> <li><p>Pain relief common for the first 5 days, but maybe used until day 10</p></li></ul><p>Papers</p><p><a href="https://academic.oup.com/ejo/article/43/5/487/6296675">Open vs closed surgical exposure of palatally displaced canines: a comparison of clinical and patient-reported outcomes—a multicentre, randomized controlled trial </a></p><p><a href="https://academic.oup.com/ejo/article/43/5/487/6296675">Margitha Björksved</a></p><p><a href="https://academic.oup.com/ejo/article/43/5/498/6350292?login=true">Open and closed surgical exposure of palatally displaced canines: a cost-minimization analysis of a multicentre, randomized controlled trial </a></p><p><a href="https://academic.oup.com/ejo/article/43/5/498/6350292?login=true">Margitha Björksved</a><br></p>
Dr. Chris Cetta
Dr. Glenn Krieger
Dr. Lance Miller
HIP Creative
BBC World Service
Jill Allen
Kyle Fagala, DDS, MDS
DOAC
DeLuke Orthodontic Coaching, LLC
Goalhanger
Jaz Gulati
The Daily Wire
NPR
Mamamia Podcasts
History Hit
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