Mini-Implants SymposiumDr. Bjorn Ludwig; Dr. Giorgio Iodice; Dr. Kee-Joon Lee
Björn Ludwig maintains a private orthodontic practice in Traben- Trarbach, Germany. He is scientific coordinator and Assistant Professor of the University of Homburg/ Saar, Department of Orthodontics. His focus of research work is cortical anchorage with mini-screws/miniplates and their further clinical development. He has published numerous papers and is editor of two books. He is editor in chief of the Quintessence publication “Kieferorthopädie” (Orthodontics). He is also co-editor of the Journal of Clinical Orthontics and Journal of Orthodontic Science.
Giorgio Iodice received the degree in “Dentistry”, the Specialty in “Orthodontics” and the PhD in “Oral Sciences” from the University of Naples “Federico II”. He received the Certificate of Excellence in Orthodontics in Italy (Italian Board of Orthodontics) and the E.B.O. (European Board of Orthodontics). Member of the IBO examining committee from 2013, and of the SIDO Model Display examining committee in 2014. Certificated for the Incognito lingual technique in 2009, from 2012 he is Clinical Professor at the Incognito Master in Naples. Adjunct Clinical Professor at the University of Naples Federico II and Honorary Senior Lecturer at the University of Otago (New Zeland), he is vicepresident of Sialign, active member of SIDO, EOS, SIBOS, AIDOr and SIDA.
Dr. Kee-Joon Lee is professor of the Department of Orthodontics, Yonsei University College of Dentistry, Seoul, Korea. He received DDS and PhD degree from Graduate school, College of Dentistry, Yonsei University. He completed the orthodontics specialty training in Yonsei University. He was a visiting scholar at the Department of Biochemistry, University of Pennsylvania School of Dental Medicine in 2002-2004 and at the Division of Plastic Surgery, the Children’s Hospital of Philadelphia in 2010-2011. He was an adjunct professor at the Department of Orthodontics, Temple University, and at the University of Pennsylvania (2010-2011). He has contributed many book chapters on biomechanics of miniscrew-driven orthodontics, non-extraction treatment in adults, up-to-date lingual orthodontic mechanics and surgery-first approached using TADs. He is the first who demonstrated the miniscrew-assisted rapid palatal expander (MARPE) for adults in AJO-DO, which was cited by many other authors. He has published many articles and case reports regarding the treatment of non-eruption, and total arch movement for hyperdivergent face in orthodontic journals including two cover issues in AJO-DO. His fields in research include clinical biomechanics regarding TADs application and the suture and bone responses to orthodontic stimulus. He has served as a reviewer in major orthodontic journals, including AJO-DO, Angle Orthodontists and European Journal of Orthodontics. He has been invited to many international orthodontic conferences around the world.
Dr. Björn Ludwig
TADs were one of the most frequently and intensively discussed topics of the last decade, experiencing an ever increasing interest over the last 10 years. Practitioners were enthusiastic about the possibility to counteract Newton’s third law. More than ten years later, many clinicians are frustrated about high loss rates and non-working biomechanics. The course will discuss the authors’ evolutionary process from enthusiasm to frustration and finally to a realistic, reliable and valid everyday strategy.
Currently, the alveolar process still is the most preferred insertion site among most clinicians. However, due to the varying bone quality and the risk of root contact, the survival rate of implants inserted into the alveolar ridge, especially interradicularly, still needs improvement. Other regions, such as the anterior palate for miniscrews and palatal-implants or the mental region for miniplates, provide much better conditions for screw insertion, since the amount and quality of the available bone is far superior. Implants with different types of abutments and connectors allow the construction of versatile appliances for a large variety of orthopedic and orthodontic applications. Utilizing TAD´s in the anterior palate and the mental region eliminates the risk of root injury and takes the implants out of the path of tooth movement. This course will show an overview of the up to date literature, current developments of screw design, appliance designs, main indications, placement techniques, and risk factors during placement and orthodontic treatment. It will especially focus on the success rate of mini-implants, palatal implants and miniplates and the biomechanics of the connected orthodontic appliance. The course will give a detailed explanation, mostly by clinical cases of the clinical use of palatal mini-implants and various miniplates in the mandible. It will focus on well working biomechanics and main indications.
Dr. Giorgio Iodice
Recognizing the necessary anchorage, knowing how to obtain and maintaining it during the treatment are certainly some of the fundamental points that lead to orthodontic success. For years orthodontists have applied complex systems and various devices to maintain the desired anchorage, sometimes only partially succeeding. Situations of absence of multiple dental elements or cases of compromised tooth support could sometimes make orthodontic treatment extremely complex, if not impossible. The introduction of Temporary Anchorage Devices (TADs), safe devices and simple clinical use, has revolutionized the orthodontic world, simplifying otherwise very complex treatments, and making possible treatments otherwise impossible. During the last ten years, the use of TADs has deeply transformed my daily orthodontic practice, leading to new protocols and simplified orthodontic biomechanics.
Nevertheless, in my experience, after every course, when the clinician is alone with his own patient the question is quite always the same: where I have to insert the TADs and how to use them? So this course will focus on which are the best sites to insert TADs, where we can have the best bone quality and quantity. Furthermore, from a clinician to clinicians, we will focus on several types of clinical situations, specifically analysing the best sites for insertion for every single situation. Clinical cases will be discussed, immediately followed by hands-on sections, inserting TADs on typodont for the specific orthodontic situation. Let’s screw, all together!
Dr. Kee-Joon Lee
Transverse discrepancy is not easily recognized by the patient and the orthodontic envelope of discrepancy is reportedly narrow in the transverse direction, which is why surgically assisted palatal expansion is recommended for the correction of maxillary transverse deficiencies in grown-up patients. However, in case of transverse deficiencies, the timing and modality for the transverse correction is often questioned. The validity of either surgical or nonsurgical treatment possibilities need to be discussed based on the following aspects.
1. Feasibility: Previous studies suggested that unlike the cranial sutures, true bony union in the facial sutures is rare even during adulthood, which supports the feasibility of nonsurgical maxillary expansion. In contrast, segmental expansion osteotomies caused significant relapse afterwards. Surgically assisted RPE would needs subsequent surgical relocation of jawbone following surgical expansion, which may not be justified in terms of morbidity and convenience. Clinical cases will be shown to demonstrate the diagnosis and treatment of various transverse discrepancies.
2. Tissue response: Our previous study revealed that the tensile stress applied to the suture mesenchyme in the aged group induced active bone formation associated with elevation and relocation of Erk positive cells, similar to the young group. Subsequent proliferation and differentiation of the bone cells were obvious but certain differences in bone turnover and expression patterns between groups were also observed. In spite of the slight delay in response, mesenchymal cells in the facial suture appear to retain remarkable potential for further proliferation and differentiation, implying significant bone formation activity.
Hence it was presumed that non-invasive expansion protocol to maximize bone formation activity along the suture needs to be encouraged. In this presentation, several cases showing maxillary transverse deficiency will be shown, with special emphasis on the role of the suture cells in the feasibility and the stability of maxillary expansion. According to the theoretical background and clinical examples, it appears that deficiency in the maxillary posterior region, not necessarily the anterior region necessitates true orthopedic expansion which secures the quality and stability of occlusal outcomes.
The course price includes:
• Required course materials, course manual, supplies and promotional materials
• Three coffee breaks a day and lunch
• Invitation to a special social event