CONVENTIONNEWSORTHODONTIC

Diagnostics and Treatment Planning on the Internet

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LESS PROFILE + LESS FRICTION + LESS BINDING + MORE OPTIONS = LESS TREATMENT TIME

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SYNERGY’S LOW PROFILE, ROUNDED ARCH SLOT FOR

REDUCED DISCOMFORT BETWEEN APPOINTMENTS

ALONG WITH IT’S SMOOTH ROUND CONTOURS MAKE IT

EXTREMELY COMFORTABLE.

INDEPENDENT RESEARCH PROVES SYNERGY REDUCES

FRICTION AND BINDING (COMPARED TO OTHER BRACK-ETS) FOR EXCELLENT SLIDING MECHANICS. SYNERGY’S

MULTIPLE LIGATING OPTIONS OFFER ZERO-FRICTION

LIGATION ALONG WITH CONVENTIONAL LIGATION IN

ADDITION TO TWO DIFFERENT ROTATIONAL LIGATIONS.

SYNERGY’S PATENTED FEATURES ADD UP TO MORE

PATIENT COMFORT WITH REDUCED TREATMENT TIME.SYNERGY IS THE BEST OF A LOW PROFILE CONVENTION-AL BRACKET AND A SELF-LIGATING BRACKET ALL IN ONE.CONTACT YOUR RMO SALES REPRESENTATIVE OR CALL

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STRAIGHT WIRE, LOW FRICTION:

Synergy SystemTHE MAIN

PHILOSOPHY OFTHE SWLF IS:

• A simple technique to treat80% of the patients/maloc-clusions

• Maximum sliding and lessfriction to improve the biolo-gy of orthodontic toothmovement

• Individual control of theanchorage (tooth-by-tooth)

• Less wires with new super-elastic wires (3-4 arch wiresfor arch and treatment).

• The selection of wires isvery easy.

• Less appointments (every45-60 days)

• Less chair-time

• Less treatment time (lessthan 70% compared tostraight wire technique likeRoth, MBT, etc.)

• Less extractions in combi-nation with functional ortho-pedics, expansion and strip-ping

• Ideal to combine with func-tional orthopedics or orthog-nathic surgery

• More simple and lessexpensive than other lowfriction techniques (DamonSystem 2, etc.).

In the last ten years the maintherapeutic progress in the fieldof orthodontics has been theappearance of new superelasticnickel-titanium wires. This hasallows optimal orthodontic toothmovement and diminishes thelength of treatment. The align-ment phase has been drasticallyreduced due to the early use ofrectangular wires of nickel-titani-um. However, the new wiresneed new brackets with arenewed design capable of mak-ing the most of these new wiresand reducing the main problemthat faces us with these newalloys: Friction.

There are two problems relatedto the design of the traditionalstraight-wire bracket that pre-vents the early insertion of rec-tangular archwires, in spite of thefact that they generate very lightforces and have great capacity ofdeflection: the resistance to themovement produced by frictionand the appearance of forces andinadequate moments that mayproduce an excessive movementof the root in initial phases of theorthodontic treatment. Frictionproduces resistance to move-ment such that 60 per cent ofthe applied force may be lost inovercoming friction. Friction orbinding may also result in inhibi-tion of tooth movement andtooth tipping due to distortion ofthe archwire. Friction betweenbracket and archwire increaseswith reduced discrepancybetween archwire and bracketslot. When clearance existsbetween the archwire and thewalls of the slot, the material ofthe archwire and bracket deter-mine the coefficient of friction,which relates the frictional forceto the ligation force .

In agreement with RMO wehave developed an orthodontictechnique of great biomechani-cal simplicity and of high clinicalefficiency that we have namedStraight-Wire Low Friction:Synergy System. This allows us,using few wires and in combina-tion with mechanical stripping,to diminish dental extractionsand to reduce the number ofarchwires, patient´s visits and thelength of treatment.

Straight Wire Low Friction rep-resents the next generation ofthe straight wire technique andallows us to carry out quicker,shorter and more effective treat-ments by reducing the numberand length of appointments andthe number of wires. This tech-nique combines the new super-elastic archs and the low frictionbrackets with high efficiency.

The Synergy bracket presents asingular design that improvessliding, the speed of tooth move-ment and avoids the appearanceof force couples and momentsunsuitable diminishing the risk ofradicular resorption and/or loss ofperiodontal support (Fig. 1).

The Synergy bracket is not justone more bracket on the market.It represents an authentic revolu-tion since it allows the orthodon-tist to select the anchorage andthe degree of tooth movementindividually for each tooth solelyin function of the placement ofthe ligature and the wire-bracketsurface contact. In contrast toother self-ligating low frictionbrackets these do not presentproblems of fracture or breakingof closing mechanisms and it ismuch more economical.

received his MD from theUniversidad de Santiago deCompustela, Spain in 1982. Heearned his undergraduate degree inDentistry from the Universidad deOviedo in 1985, followed by hisorthodontic specialty in Valencia,Spain in 1987. Dr. Suarez beganhis exclusive orthodontic practicein 1987 and since then has writtenseveral theses, published 8 books,and written over 80 articles aboutdifferent orthodontic subjects. Dr.Suarez is the dean of the orthodon-tic department at the Universidadde Santiago de Compostela. Hehas received a number of scholar-ships and awards; including awardsfrom the European DentalMagazine (Revista Europea deEstomatología) and the NationalReal Academy of Medicine (RealAcademia Nacional de Medicina).He is the founder of the SpanishAssociation of Orthodontists(AESOR) and of the GallegoOrthodontic Society (SGO).

DR. DAVID SUAREZQUINTANILLA

PRACTICE BUILDERS

®

Wire selection and sequence arecarried out depending on thedegree of irregularity and dentalcrowding in the first phase ofalignment; the quantity of over-bite and the facial type in thephase of levelling; the anchorage,type of movement and the spaceto be closed in the phase of spaceclosure, and the need to carry outsmall occlusal and aestheticadjustments in the finishingphase of treatment. With thecombination of superelastic wiresand low friction brackets we havemanaged to diminish consider-ably the number of visits (25 percent) and the length of treatment(22 per cent) . It is importantthat clinicians are conscious thatthese superelastic wires have tobe left to work for enough time(from six weeks to three monthsminimum) and that have to be"reactivated" in every visit. Alsothey should pay special attentionto the way of placing elastic liga-ture on each tooth in order toobtain, for example, maximumsliding (ligating only centralwings) or minimum sliding, max-imum anchorage and maximumcontrol (ligating in the shape ofan "8"). It is very important thatclinical staff are aware of the

importance of the way of ligatingin this technique. Figure 4 showsthe criteria for wire selection andthe type of archwire that we use.We suggest initiating the align-ment phase with round super-elastic wires or braided wires of.014", as concerns adult patientswith periodontal involvement(with threshold of pain dimin-ished) and cases of great crowd-ing and irregularity treated withdental extractions. EachThermaloy or Neosentalloy's rec-tangular archwire has to be left towork for about 45 days and in thefollowing visits it will beremoved, reactivated outside themouth and replaced changing theway of ligation: ligating only thecentral wings of the bracket inthose teeth where we want max-imum sliding and with conven-tional ligation (including the lat-eral wings) when we want con-trol of the rotation and/or maxi-mum individual dental anchor-age. During the finishing phase oforthodontic treatment it isimportant to re-evaluate careful-ly and with the suitable tech-nique the position of every brack-et and replace those that areplaced badly. In the face of anydoubt or problem we recom-

mend removing all the bracketsand bonding them again with theindirect bonding method .

The treatment with SWLF iscomplemented with the use, inmany patients, of the reductionof interproximal enamel (strip-ping) with the aims of:- solving crowding (up to 6 mmfor dental arch and treatment),- improving dental morphology,- producing wider and stableproximal dental contacts,- coordinating mesiodistal dentalwidth in tooth size discrepancies(Bolton's index),- obtaining interproximal spaces

adequate to the periodontalhealth and aesthetics.

We carry out stripping by meansof a mechanical rotary dentalinstrument and special disks ofdifferent thicknesses (Ortostripby Intensive). This method ismuch more rapid and comfort-able for the patient and the clini-cian than manual stripping andsimpler, surer and more innocu-ous than other more aggressivemechanical systems such as bursand discs ( Fig. 5a and b).

Fig. 1-With the Synergy bracket it ispossible to use rectangular arch-wires of superelastic nickel-titaniumfor the alignment, levelling or spaceclosure from the first months oforthodontic treatment. This allowsus to reduce the number of visitsand the length of treatment.

Fig. 2- The Synergy bracket, when it is only ligated on its central wings,avoids the contact of the wire with the ligature and this joined to the openand rounded shape of the ends of the slot improves the sliding and allowsthe use of rectangular superelastic wires from the first phases of treatment.

Fig 3-When we study the Synergybracket through a magnifying glassand FEM ( Finite Elements Method)the areas of pressure are wider andhave a more balanced distributionthan those of the standard straight-wire bracket. They are situatedmore towards the medial area of theslot which means that they are notgoing to generate force couples andinadequate moments observed inthe standard straight-wire bracket.

STRAIGHT WIRE, LOW FRICTION:

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Fig. 4-Criteria of selection and types of wires used in the technique of the Straight Wire Low Friction. We con-sider every phase independently. In the phase of alignment we use the criterion of the index of irregularity (sumof the distances between points of contact of adjacent teeth) and in the phase of levelling the criteria of selectionof wires are overbite and the facial biotype. This selection is completed by others for mixed dentition (with by-pass archwires), open bites and cases combined with osteogenic distraction or orthognatic surgery.

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IRREGULARITY INDEX

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.017 x .025”Thermaloy®

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.019 x .025”Orthonol reverse curve of spee

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DEPENDING OF THE KIND OF TOOTH MOVEMENT AND TORQUE

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.019 x .025” 2 Looped Frictionless Nickel Iitanium Retraction Arches and

.019 x .025” 2 Closing Loop stainless steel arch wire

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Fig. 5-The mechanical systemOrtostrip has improved the rapidityand comfort of stripping and thepossible the avoidance of extrac-tions in many patients.

Fig. 6-A. Class I malocclusion withirregularity, crowding, overbite anddental midline symmetry. B. Upperarchwire of .019 x .025" two loopedfrictionless Nickel TitaniumRetraction. End of treatment.

OVERBITE + FACIAL HEIGHT

Synergy System

PRACTICE BUILDERSconventioN

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®

5a

5b

6a

6b

6c

Fig. 8- A-C: Class I malocclusionwith crowding, irregularity and den-tal asymmetry. D-F: Mechanicalstripping with Ortostrip systemafter initial alignment with rectan-gular archwires. G and I. End oftreatment. J and K. Smile before andafter treatment.

Fig. 7-A. Class I malocclusion withcrowding and moderate irregularity.B. Initial rectangular archwires. C.Finishing steel archwires of .019 x.025". D. End of treatment. E and F.Smile before and after treatment.Synergy SystemSTRAIGHT WIRE, LOW FRICTION:

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PRACTICE BUILDERS

IS IT REALLY ACCURATE? HOW MUCH TIME WILL IT SAVE ME?

RMO has created E-Ceph™,an online diagnostic servicethat can save you significanttime and money.

Now you can transmit your patient’srecords via the Internet and thepatient’s complete diagnosticworkup is emailed back to you! E-Ceph saves you time and moneycompared to mail-in services or in-office systems.

RMO’s analysts are the most-experi-enced with over 500,000 casesprocessed. The quality of E-Ceph issuperior to any other service withextremely accurate workups.

Your diagnostic package can be cus-tomized to contain any or all ofthese reports: lateral and frontaltracings; growth simulations tomaturity with and without treat-ment; significant considerations;visual treatment objective; heightprediction; visual norm; treatmentdesign; and alerts such as abnormalgrowth and sequence worksheets.

All of this information is availabledigitally so it can be stored on your

computer or shared with other den-tal or health professionals via email.E-Ceph is like having the best-trained staff using the best in-officediagnostic system without the over-head. E-Ceph is the most cost effec-tive, most complete, and the mostaccurate orthodontic diagnostic sys-tem available.

Package Contents:• Lateral Tracing• Comprehensive Cephalometric

Description and Significant Consider-actions

• Lower Arch Analysis• Key Superimpositions of the

Tracing to Visual Norms• Treatment Designs• Long Range Growth Compare-

isons, with and without treatment(soft tissue)

• Treatment Sequences Worksheet• Work-up Rationale Sheet• Treatment Alternatives Sheet• Height Prediction• Visual Treatment Objective (VTO)

To get started with E-Ceph go toRMO’s website, www.rmortho. com,or call 1.800.458.8884, or stop byRMO’s AAO exhibit booth #331.

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ICETOD™, an RMO Education Division, is dedicated in memory of Dr. BillHumphrey. Pedodontist, Denver, Co. Son of a former President of the AAO, Billalways referred orthodontic cases to AAO specialists. However, he prophetically said,“Orthodontics is the center of dentistry, but someday the larger portion of cases willbe treated by orthodontic involved pediatric and family dental practices.

ICETOD™ was founded with the idea of establishing an educational forum for all den-tists interested in the subject. Early treatment orthodontics deals with patients from 3to 12 years of age with the goal of comfortable, functional, healthy dental/facial rela-tionships for life. Interceptive, removable and fixed appliances will be included in thecurriculum. ICETOD™ will use live seminars, video, printed material and the Internetfor education and communication.

EDUCATION ICETOD

ANNOUNCING 6ICETOD™

COURSES

Look into RMO’sInternational

Center for EarlyTreatment ofOrthodontic

Disorders

FACULTYDr. Robert Ricketts, Dr. Robert Wilson,Dr. Leon Kussick, Dr. Michael Bubon,Dr. Richard Jacobson, Dr. Mel Collazo,Dr. Robert Vanarsdall, Dr. SergioSambataro, Dr. Mario Sergio Duarte, Dr.Gloria Valarde Lopez, Dr. BruceHaskell, Dr. Clark Jones, Dr. FrancisMiranda, Dr. Chris Baker, Dr. BudiKusnoto, Dr. Ruel Bench, Dr. DavidSuarez Quintanilla, Mr. Ken Alexander,Dr. David C. Page

LOCATIONRMO Facilities650 West Colfax AvenueDenver, Colorado 80204303 592-8200

TUITION$150 per seminar day per doctor$100 per seminar day per auxiliaryFor registration call1.800.RMO.ORTHO

HOTEL ACCOMMODATIONSHoliday Inn (2 blocks from the RMOFacilities). 1450 Glenarm PlaceDenver, Colorado 80204303 573-1450Mention RMO when you are makingyour reservation for a special rate.

ADD ON VACATIONDenver is located next to the RockyMountains, which offer incredible winterand summer recreation. Some of the worldsbest skiing is only hours away from Denver.Likewise some of the best hiking and fishingis only a short distance from Denver.

RMO has arranged with Tudor Travel pack-age vacations which can be added to youreducation experience. For more informationcall:Tudor Travel303 753-1282Ask for Marilyn Newman

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BIOPROGRESSIVE TODAY AND TOMORROWON PEDIATRIC INTERCEPTIVE ORTHODONTICS

September 12-13, 2003, January 16-17, 2004, April 9-10, 2004August 6-7, 2004Dr. Robertt Ricketts and Dr. Richard Jacobson

Attendees of this course will receive Dr. Ricketts four volumebook on Fixed Appliance Early Treatment. Equally important willbe the lecturing experienced from the unstructured discussionsthat will develop. You will graduate with renewed understanding,consideration and passion for excellence in your life.

Dr. Robert Ricketts has devoted his professional life to lecturing,teaching and practicing orthodontics for over 45 years. He attend-ed the Indiana School of Dentistry and the University of IllinoisGraduate School, Chicago. He is the cofounder of Bioprogressivetherapy and has been a major force in the development of com-puter-aided diagnostics. He has developed a variety of orthodonticproducts that are used throughout the world. Dr. Ricketts teachesand lectures at universities worldwide.

Dr. Richard Jacobson graduated form UCLA School of Dentistry,Department of Orthodontics in 1981. After graduation he wentinto practice with Dr. Ricketts in Pacific Palisades, California. He isthe post president of the Foundation for Orthodontic Research,which is currently developing an Internet university. He is aninstructor at UCLA and a lecturer at USC. Dr. Jacobson is inexclusive practice in Pacific Palisades and is currently treating over100 of Hollywood’s most famous actors and artists.

THE ANSWERS TO SOLVING YOUR ORTHODONTICPROBLEM CASES - USING THE WILSON® 3D® MODULES CAN

SIMPLIFY THE TREATMENT OF EARLY AND FULL TREATMENT CASES.October 17-18, 2003Dr. Robert Wilson

Dr. Robert C. Wilson will discuss and demonstrate the use of theWilson® 3D® Modular - Fixed/Removable System. The use ofthe 3D Modules can incorporated into any other orthodontic sys-tem or technique. Early or First Phase orthodontic treatment canbe simplified with the use of these efficient modular appliances.Full treatment can be simplified and treatment time reduced.

Topics to be covered with “hands-on” presentations:- Saving needed leeway space- Anchorage preservation- Rapid/easy distalization of upper molars

- Easy expansion of the upper arch (early or late) will all bediscussed. The simple steps for fabrication and adjusting for theseappliances will be explained.

Long term results will be shown, to demonstrate stability andproven benefits this orthodontic therapy. All will be presented insuch a way, that everyone can return to their practice with manypractical problem solving ideas.

DEVELOPING TREATMENT OBJECTIVES FROMCOMPUTER GENERATED INFORMATION – FOR PREVENTIVE/INTERCEPTIVE PEDIATRICORTHODONTIC TREATMENTNovember 14-15, 2003Dr. Robert Vanarsdall and Dr. Bruce Haskell

Topics to be covered:- Developing treatment objectives from computer generated

information- Using the Internet to access new orthodontic diagnostic

services- Treatment sequencing to obtain improved dentoskeletal

relations in 3 dimensions- Understanding the dentoskeletal transverse relation with RPE

treatment- Orthodontics as preventive dentistry- How malocclusion fosters unhealthy bacterial levels- How orthodontic forces change bacterial organisms- Solutions for improving long term retention

Dr. Robert L. Vanarsdall Jr. is Professor of Orthodontics andChairman of the Department of Orthodontics at the University ofPennsylvania School of Dental Medicine. He received his dentaldegree from the Medical College of Virginia and is board certifiedon both Orthodontics and Periodontics. Dr. Vanarsdall served asChairman of the Department of Periodontics, Department ofPediatric Dentistry and has directed Orthodontics at Penn since1981. Dr. Vanarsdall’s lecture material provides details on skeletalchange that has a profound effect on treatment success along withinsights that attendees can immediately put into practice.

Bruce Haskell, DMD, Ph.D. serves as Clinical Professor at theUniversity of Louisville School of Dentistry. His Ph.D. in anthro-pology/craniofacial biology was earned at the U of Pitt and hisorthodontic specialty was completed at Eastman Dental Center.He is in private practice of orthodontics in Louisville, Kentucky.

EDUCATION ICETOD

CURRICULUM2003-2004conventioN

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You want this feeling, don’t you?

You can win it! At the AAO Honolulu - May 3-6, 2003

Just stop by the RMO exhibit booth and place anorder. The more you purchase the better yourchances are to return from Hawaii with a brand newBMW Z4!

Drawing is May 6th at 12:00 pm. at the RMO exhibit. You don’t need to bepresent to win. Contact your RMO sales representative for details.

WINNING WITH WONDERFUL, OUTSTANDING &WORTHWILE CUSTOMER SERVICE!October 24, 2003Ken Alexander

Winning with wonderful, outstanding and worthwile customerservice does not happen by chance. It is the result of developingthe right purpose, the right perspectives and creating the rightsystems to power the organization forward with excellence. Inthis stimulating lecture. Ken Alexander will take his insightfulexperience of working with many of the world“s largest practicesand show what it takes to WOW your patients with excellentservice. This will be a fast paced, informational and motivationallecture that doctors and their entire staff will not want to miss.The Best of Millennium practical ideas will be given to allow yourpractice to immediately start Winning the WOW!

Seminar topics include:- Practice Power through Purpose, Perspective and Performance- Delivering WOW Customer Service- The Practice of Management- Understanding Doctor Time Scheduling- Motivating Patients for Cooperation- The Art of Relationship Selling- New Patient Enrollment Process- Team building for Success- Leadership - Maximizing People Potential- Motivation and Interpersonal Communications

BONE REMODELING ORTHODONTICSFebruary 20, 2004Dr. Leon Kussick

Bone Remodeling Orthodontic is a total pediatric orthodontic sys-tem for both maxillary and mandibular management. Boneremodeling interceptive orthodontics takes advantage of youngbone physiology and periosteal slippage. There are five (5) appli-ances: 1) Kussick Tongue Retrainer for correcting swallowinghabits and mild anterior open bites. 2) The Kussick MaxillaryDeveloping Arch for building anterior overjets, adding archlength, and rounding anterior arch forms. 3) The Kussick rapidadjusting headgear system for distalizing and expanding the maxi-la (without RPE), increasing arch length, closing open bites andreducing dramatic overjets. 4) The Kussick Orthopedic Inclinefor mandibular advancement, reduction of overjet, leveling curveof spee, opening the vertical and correcting deep bites, stimulatinggrowth of anterior mandibular alveolar bone thus increasing archlength and long-term lower anterior tooth stability. 5)Occasional lower lingual holding arches (Wilson® 3D® lingualsrecommended). It has taken years to transform Dr. Kussick’scomplicated laboratory appliances into a simple pre-fabricatedsystem. Likewise, RMO’s new Kussick system education with“hands-on” has had to go through an evolution. To become profi-cient in bone remodeling interceptive treatment, four one-dayseminars over a year of bone remodeling experience is needed.

During this year we will be fine-tuning our education program.In February 2004, we will open the Kussick seminars to interestedand committed attendees.

DUCATION ICETOD

The National Institute on Aging reports...a child born in 2003 has good odds of living to 100.To ensure a child’s health through life, doctors saytake care of the key systems of the body at an earlyage.

The jaw system is a high priority. The essentials oflife - the nutrients we eat and drink and the air webreathe - pass through our jaws. Jaws also affectour speech, self-image, and social relationships.

Making comprehensive interceptive orthodontic caremore widely available to children ages 3-12 will helptoday’s children live healthier and happier duringtheir longer lives.

Several highly effective pediatric orthodontic treat-ment approaches have been developed. These newinterceptive techniques now make it possible formost kids to be treated early. They can movethrough their early teens and later adult years withattractive, stable, healthy dento/facial functions.

Learn what your parents and patients want you to know.

Entertaining as well as educational, 28-minute InterceptivePediatric Orthodontic Video is excellent for staff, parents, par-ent/teacher and service club groups. Only $19.00

The 2.5 hour Kussick Bone Remodeling Overview reviewsscientific background and fundamentals of Bone RemodelingOrthodontics. Only $39.00To order call RMO Customer Service at 1.800.525.6375.

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SIGNATURE III CERAMICS

NEW and

IMPROVED

BIOPROGRESSIVE®, STANDARD EDGEWISE AND ROTH STRAIGHTWIRE

The ease of bonding and debonding with reduced friction. This makes a great alternative to metal brackets. Through extensive bond testingresearch, a new generation of ceramics, Signature III, incorporates the features and benefits of the original Signature ceramic bracket with newimprovements.

New patented dovetail base design has generous horizontal undercuts to capture adhesive for reliable mechanical bond retentionthroughout treatment as well as reliable debonding. These features make Signature III’s placement very secure, while making debond-

ing quick and clean.

Signature III’s arch slots are patented for strength and consistency. Ceramic brack-ets are inclined to fracture along the inside – right where the corners of the arch

wire meet the side of the bracket. Signature III eliminates these stresspoints by adding a rounded protrusion to the center of each slot, while

maintaining a continuous curve throughout the arch slot floor. The archwire rests only on the protrusion, putting the stress on the strongest

part of the bracket. This innovation drastically reduces bracketfracture. An added benefit to the rounded protrusions is that the

arch wire has less contact in the slot, thus reducing friction,which can be a problem with ceramic sliding mechanics.

patented arch slotprotrusion reducesbreakage and friction low underwing

ligation notchesfor easy ligation

dovetail base for reliablemechanical retentionthroughout treatment andreliable debonding

torque in basefor level archslot

smooth, round-ed surfaces forpatient comfort

CONVENTION

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ONLY $4.20 EACH!

CALL 1.800.RMO.ORTHO

BRUCE HASKELL, DMD, PHD

Historically,orthodontists have

relied on tonguecribs, hay-rakes andother sharp points,which employ anaversive negativestimulus to extin-

guish undesirable oralhabits. Aversive approacheshave proven to be only moder-ately effective, attaining somesuccess in cases when patientsdesire to end their habit. Incases where the patient isambivalent or non-cooperative,aversive approaches are general-ly ineffective or even counter-productive, and sometimes maytrigger other habits or unexpect-ed behaviors.Since its general introduction in1991 by Haskell and Mink, the"bluegrass appliance", or "habitcorrection roller", has obtainedgeneral approval both in thiscountry and internationally 1,23 the primary application of theHabit Correction roller is tointroduce friendly, non-destruc-tive oral habits replacing thecommon destructive habits:digit sucking and tongue thrust-ing. This new thoroughly effec-tive and "friendly" alternativehas drawn recent praise in habitcontrol for avoiding the tradi-tionally rooted principles of a

formidablep h y s i c a lb a r r i e r

("crib"), as wellas that of nega-

tive reinforce-ment ("spikes"). Instead, it actssimilarly to the habit-reversaltechniques practiced by behav-ioral specialists. Both digit suck-ing and tongue thrusting causemajor orthopedic alterations tothe skeletal structures of theoral cavity and lower face. Theresulting sequelae pose formida-ble challenges to orthodontistsin correcting and maintaining astable transverse dimension. Animproved and effective treat-ment methodology was clearlycalled for.When a free-spinning roller isplaced in proximity to the tip ofthe tongue, a "fascination"response is quickly imprinteddue to the intense sensitivityand neuromuscular nature ofthe tongue. Within a matter ofonly days the tongue will firmlyestablish the new non-harmfulhabit of "playing" with theroller. Establishing the new, non-destructive habit may takesomewhat longer with olderpatients. The operative psycho-logical mechanism is that thedestructive habit is simply sub-stituted with new, practitioner-

encouraged non-destructivebehavior. Roller-based habit cor-rection therapy must be main-tained for four to six months orlonger, depending on thepatient’s age, to insure that thenew habit is firmly established.(The original undesirable oralhabit may re-emerge if the newbehavioral accommodation isnot firmly established).Interestingly, the appliance hasreportedly been used in thetreatment of cerebral palsypatients to improve tongueplacement, assisting the controlof drooling.

The traditional quad-helix-typetranspalatal appliance worksparticularly well for positioningrollers appropriately in the vaultof the palate. The roller is usual-ly placed in close proximity to,but avoiding impingement inthe most superior / anterior por-tion of the palate. This is in aposition similar to that of theHays-Nance button.

Quad-helix therapy as popular-ized by Ricketts, in conjunctionwith habit correction therapycreates a particularly efficientdual-treatment modality: Thequad helix appliance is effectivein correcting the habit-causedorthopedic "damage" while at

the same time it provides anideal basis for the habit correc-tion (figures 1-5).

Thus, the first goal of ending thehabit is accomplished simulta-neously with a transverse ortho-pedic correction of the con-stricted maxillary arch usuallyassociated with vigorous andprolonged digit sucking. Thisauthor has found the dual-func-tion of such an approach to bemore efficient for both habitand morphologic modificationthan either action undertakenalone. Even though very effec-tive in conjunction with quad-based transverse correction,rollers are of course not limitedto application on quad-helices.They can be installed on anytype of laboratory or commer-cially produced pre-formedtrans-palatal appliance featuringa suitable transverse wire seg-ment as has been reported byBaker.

One drawback encounteredwhen using the first generation,one-piece bluegrass roller tocorrect both the habit and thesequelae of arch constriction isthe complexity associated withthe fabrication of a suitable,supporting trans-palatal appli-ance. As can be appreciated, the

Bruce Haskell, DMD, PhD serves as Clinical Professor and Distinguished Teaching Professor in the depart-ment of orthodontics at University of Louisville School of Dentistry. His PhD in anthropology/craniofacialbiology was earned at University of Pittsburgh and his orthodontic specialty was completed at University ofRochester Eastman Dental Center. H is a Diplomate of the American Board of Orthodontics and a Fellowof the American College of Dentists. Dr. Haskell lectures nationally and internationally, and he hasreceived the Dewell award from the AAO for his contributions to the scientific literature. His privatepractice of orthodontics is in Louisville.

CONSTRUCTION OF A HABITCORRECTION ROLLER WITHARCH EXPANSION

CHAIR SIDE APPLICATION OF A NEW 2-PIECEBONDABLE “BLUEGRASS” APPLIANCE.

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03PRODUCTS LATEST AND GREATEST

one piece, first generation blue-grass appliance must first bethreaded onto a suitable,straight piece of appliance wire.The appliance must then bebent and formed by hand, eitherat chair side or by a laboratoryaccompanied by impressions.Custom-formed appliances ofthis type are typically solderedto molar bands rather than fab-ricated to take advantage of ver-tical inserting or sheath-basedfixed/removable attachment.Because of these inherent limi-tations, the first generation, one-piece roller cannot be added tothe many currently availablepre-formed and pre-sized archwidth development products.Thus, the significant time andcost savings achievable throughuse of pre-formed appliancescannot be realized.

Using the old bluegrass-typeone-piece roller with a solderedappliance typically relegates apractitioner to making adjust-ments intra-orally and to havingaccess only to the two A-Ppalatal legs. A full adjustment ofsuch an appliance combination(figure 5) requires removal,reshaping with pliers or byhand, followed by re-cementa-tion.

Most of the commercially avail-able trans-palatal correctionappliances are based on afixed/removable ‘plug-in’attachment method. Chair sideadaptation and activation of

pre-formed appliances support-ing the new type of a chair sideor counter-top bondable rollercould be of great benefit. Aquad-helix with a habit roller orother similar assembly couldsimply be ‘popped out’ of thelingual sheaths, adjusted byhand (expanded), and easily re-inserted.

THE “SPLIT” (BONDABLE)HABIT ROLLERA new treatment approach isenabled, and the problemsdescribed above have beenresolved through the use thenew 2-piece, bondable versionrollers. They are cast from thesame medical grade material asis used for a successful andproven line of "composite" ure-thane orthodontic brackets.Like the successful brackets, theflat male and female features ofboth of the roller bonding facesare treated with a bond-strengthenhancing process called Micro-Rock™. The 2 halves are sim-ply bonded together with anyroutinely used bracket adhesivesystem, and thus capture a wiresegment in its free-spinning cen-ter. Secure and safe bondstrength is easily achieved sincethe bonded faces are flat andideal for bonding, as well as pro-viding significantly more bond-ing area than any orthodonticbracket. Further, the forces act-ing on a roller located in thepalate are obviously unlike theforces encountered by a muchmore precariously placed and

structurally challenged bracket.Typically, the assembled habitroller is positioned on the ante-rior leg of the quad-helix andcemented together extra-orally,and at chair-side if desired (fig-ures 6a, b, c, d).

The new 2-piece roller series

consists of 3 configurations: Ahexagonal version (5.25-mmmesio-distal length, is used asthe primary habit "re-trainer", asits facets and edges create thegreatest sensory feedback to thetongue. When bonded, an effec-tive diameter of the hexagonalroller of 7mm is achieved. Two

FIGURES

figure 1 figure 2

figure 3 figure 4

figure 5 figure 6a

NEW!

elastomericsRMO’s new line of elas-tomerics are tear resistant,low profile,stain resistantand now are available innew bright, vibrant colorsthat are matched toRMO® Energy Chain®.

Call 1.800.RMO.ORTHO

ELGILOY®

INTRODUCING

NATURAL ANDIDEAL ARCHES

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PRODUCTS LATEST AND GREATEST

other versions with smooth,round outer surfaces are avail-able in 5.25mm and 12mmmesio-distal lengths. These aresmaller in outer diameter, at5mm. All versions have an innerlumen of 1.5 mm allowing freespinning on any gauge wire like-ly to be used for constructingtrans-palatal appliances. Boththe hexagonal and round ver-sions of the 5.25 mm longrollers have concave endsdesigned to accommodate theleft and right palatal helices of aquad-helix, insuring smooth,friction-free spinning.

An unexpected side-benefit ofusing the habit correction rollertherapy is one of reducingtongue irritation in patientsundergoing traditional quad-helix or similar type expansiontherapy, independent ofwhether or not habit correctionis involved: During expansiontherapy, severe irritation or deepindentations in the tongue canfrequently occur, particularlywith patients with large unrulytongues or shallow palates. Suchirritation is caused by tongueinteraction with the appliance.In these cases, early removal ofthe appliance has been seen asthe only option available to theclinician. To counter this dilem-ma, the round versions of thebondable rollers can serve byproviding smooth tongue-shielding or tongue-protectingsurfaces on the central, anteriorsection of a quad-helix appli-ance. By adding a smooth rolleras a tongue protector, appliance-induced irritation and the inter-ruption of the physiologicalprocesses associated with palatalexpansion can usually be avoid-ed. (Figure 7)

Use of the new 2 piece bondablerollers can prevent a series oftime-consuming interruptionsinvolving the discarding of theoriginal expansion applianceand the undertaking of anentirely different means oftransverse correction.

TESTINGBecause the new appliance ismanufactured in a 2-piece con-figuration, it was essential to

confirm adequate bond strengthof the bonded assembly.24 rollers were subjected tobond testing using four popularorthodontic adhesive systems:Mono-Lok, Transbond XT,Master Dent Light Cure andFuji Light Cure10. The Mono-Lok-bonded sample halves wereheld in place for one minute andallowed to cure for 5 minutes.All other cements were bondedwith a 60-second light cure.Testing was performed at thelaboratory of the manufacturer;Advanced Products Inc., LelandNorth Carolina; a manufacturerof urethane orthodontic brack-ets and other orthodontic prod-ucts.

The rollers were pulled apartwith one wire looping up to theupper movable jaws of a DillonTensile Testing Machine withanother wire looped downwardsto the stationary jaws. Bothwires (.030 SS) passed throughthe lumen of the bonded rollerhalves. This protocol created aconcentration of forces at theends of the rollers and a peelingaction against the bond. Thepeeling motion permitted theroller to unnaturally flex due tothe concentration of forces atthe ends. Bond failure propa-gates as the material of the rollerflexes. Only a small portion ofthe bond actually becomesloaded to failure at any giventime during a test pull.

In testing the bond strength ofbrackets for example, knownfailure modes can be duplicatedby test fixturing. In the case ofrollers, it is much more difficultto anticipate destructive forcevectors since all forces are radial.The testing methodology usedby the manufacturer was there-fore thought to serve as provid-ing relative bond strength val-ues, useful for future reference.This means that the actual bondstrength is likely far higher thanreflected in the test.

RESULTS

FIGURES

AVERAGE BOND CONVERSION TOSTRENGTHS RANGES POUNDS PER INCH

Hexagonal 5.25mm 18.39 - 34.76 751 psiRoller: 28.92 lbs.

Round 5.25mm 22.46 - 38.00 927 psiRoller: 30.45 lbs.

Round 12mm 20.57 - 46.61 403 psiRoller: 27.68 lbs.OVERALL MEAN: 28.63 POUNDS

figure 6b

figure 6c

figure 6d

figure 7

BUYRMO® HABIT CORRECTION

ROLLER HEXAGONAL (HASKELL)OR A RMO® HABIT

CORRECTION AND TONGUE

PROTECTION ROLLER (HASKELL)(PACKAGE OF 4),

A 3D® LINGUAL TUBE

(WILSON®)(WITH OR WITHOUT GINGIVAL HOOK,

PACKAGE OF 10),

A 3D® QUAD HELIX

ASSORTED KIT (PACKAGE OF 6)

AND GET A

FREEMONOLOK2™

STARTER KIT!

CONVENTION SPECIAL

10 Lingual Tubes, 4 HaskellRollers, 6 Quad Helixes, and

MonoLok2 Kit: $150CALL 1.800.RMO.ORTHO

PRODUCTS LATEST AND GREATEST

N E W & I M P R O V E D

LUXI II™

ROUNDED HOOKS FOR PATIENT

COMFORT ON CUSPIDS AND

BICUSPIDS

INK MARKED FOR IDENTIFICATION

LOW PROFILE FOR

PATIENT COMFORT

18 KARAT GOLD-LINED

SLOT FOR STRENGTH AND

REDUCED FRICTION AND

ACCURATE POSITIONING

BIOCOMPATIBLEWITH NO NICKEL

TORQUE IN BASE FOR

STRAIGHT SLOT LINE-UP

GENEROUS TIE-WING

UNDERCUTS FOR EASY

LIGATION

DOVETAIL BASE FOR RELIABLE

MECHANICAL RETENTION

THROUGHOUT TREATMENT

AND RELIABLE DEBONDING

ROUNDED CORNERS FOR

PATIENT COMFORT

IMPROVED STRONGER

WING DESIGN

TWIN DESIGN FOR

ROTATIONAL CONTROL

THE ONE THING THAT SETS LUXI II APART FROM ALL OTHER

CERAMIC BRACKETS IS ITS 18 KARAT GOLD INSERT. LUXI II IS A

REDUCED-FRICTION CERAMIC BRACKET CONTAINING A BIOCOM-PATIBLE GOLD SLIDING GUIDE. CERAMIC BRACKETS CREATE

MORE FRICTION THAN METAL DUE TO THE SURFACE TEX-TURE. THE ARCH SLOT IN THE LUXI II BRACKET CON-TAINS A GOLD INSERT. THIS PATENT PENDING FEATURE

ENHANCES SLIDING MECHANICS BY REDUCING FRICTION

COMPARED TO CONVENTIONAL STAINLESS STEEL AND

CERAMIC BRACKETS. LUXI II, BECAUSE OF THE GOLD

INSERT, HAS BETTER SLIDING MECHANICS AND LESS

FRICTION THAN EITHER METAL BRACKETS OR OTHER

CERAMIC BRACKETS. THE GOLD INSERT REDUCES FRIC-TION COMPARED TO ALL-CERAMIC BRACKETS, INCLUDING

CLARITY™ WITH A STAINLESS STEEL INSERT.

LUXI II’S BASE HAS A NEW IMPROVED, PATENTED,DOVETAIL DESIGN THAT ENHANCES BOND STRENGTH

WHILE ALLOWING IT TO DEBOND EASILY. THIS GIVES THE

ADHESIVE A LARGE SURFACE AREA FREE OF AIR POCKETS,SO A STURDY, MECHANICAL BOND CAN FORM. THESE FEA-TURES MAKE LUXI II’S PLACEMENT SECURE AND DEBONDING

QUICK AND CLEAN. A GENTLE SQUEEZE AND THE BRACKET POPS

RIGHT OFF IN A SINGLE PIECE.

THE LOW PROFILE MAKES LUXI II MORE COMFORTABLE (LOWER

THAN CLARITY™*). THE UNMATCHED COMBINATION OF AESTHETICS

WITH GOLD STRENGTH, ALONG WITH THE SELF-ASSUREDNESS FROM

WEARING APPLIANCES THAT PERFORM AS BEAUTIFULLY AS THEY

LOOK, MAKE THIS A GREAT CHOICE.

CONVENTION SPECIAL:LUXI II $8.20 EACH!CALL 1.800.RMO.ORTHO

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03

1933

1933First preformedbandsmade

1933First multi-purpose welderand electrolytic polisher

70 Years of Rocky Mountain Orthodontics...

1933StainlessSteel Wire

1933First weldable flangedchrome alloy brackets,lingual and buccal tubes

1934First longcone x-raymaterials and techniqueeducation(Fitzgerald)

1934Introduction of Dr.Simon’s orthodonticdiagnostic systemwhich includedgnathastat (made inGermany) and spe-cial camera made byRMO, beginning ofCephalometrics

1941First national public relations campaign for orthodontics.

(Above) Cover of Life Magazineand an article in Parents Magazine

1948First chromecrown andpreventivematerials forchildren’sdentistry

As an independentcompany, RMO has pioneered manyproduct and servicedevelopments.

70 years in business – not manybusinesses are able to celebratethis anniversary – and very fewas independent business. We feelproud and fortunate to haveenjoyed success for 70 years andbe related to the dental healthfield, particularly the specialtyof orthodontics.

With the development of stain-less steel, coupled with the inge-nuity and foresight of Dr. ArchieBrusse, a pioneer Denver ortho-dontist, RMO began. RMO setabout developing the first set ofprefabricated orthodontic appli-ances. After much clinicalresearch and experimentation,the first preformed bands,attachments, stainless steel wire

and welder were introduced atthe 1933 AAO annual meetingin Oklahoma City. The impactof these prefabricated deviceson the world of orthodonticswas dramatic. They changed theface of dentistry. The wide vari-ety of appliances supplied byRMO enabled orthodontists totreat a diverse array of patientsmore effectively.

Dr. Brusse’s philosophy contin-ues today with his words: "Makeit fun, make it different thanregular business, and make somecreative contributions for thefuture."

RMO will remain dedicated toprovide both quality products

and services for the orthodonticspecialty in coming years. Withthis in mind RMO continues toserve all areas of orthodontics:

- Pediatric orthodontic prevention

- Interceptive pediatric orthodontics

- Mixed dentition orthodontics- Adult orthodontics- Reconstructive dentistry

orthodontics- TMJ orthodontics- Surgical orthodontics- Breathing/sleep problem

related orthodontics

Business can be judged by thecontributions it makes toimprove its industry and the

many environments in which itoperates. We are proud of theloyalty and efforts of theemployees and business partnerswho have helped RMO succeedand advance during the compa-ny’s history. RMO is, by allmeasures, an international stan-dard bearer poised to buildupon its legacy of excellence fordecades to come. We haveendeavored not only to harvestthe fruits of the tree of RMO’sinheritance – but equally impor-tant, to nourish the roots.

Thank you past and presentmembers of the AmericanAssociation of Orthodontists formaking these 70 years possible.

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1950First high technologywires and wire forms(Elgiloy)

1951Ford locknon-ligatingbracket

1957First pediatric functionalorthodontic preventionprogram

1957-1960First original contri-butions for manytechniques:Jarabak, Broussard,RickettsBioprogressive,Wilson ModularComponents,Kussick BoneRemodeling

1960First prefabricated completeprescription appliances

1965First direct bonding appli-ances

1967First computerizeddiagnostic softwareand services

1970First orthodonticpractice manage-ment services

1985First metal injectionmolding process fororthodontic products

1990First reduced frictionbracket system (Synergy)

2001First internet basedorthodontic diagnosticservice (E-Ceph)

2003

All RMO‘s clinicalappliances are manu-factured in our plantin Denver, Colorado.

P.O. Box 1785 Denver, Colorado 80217-0085PRSRT STD

U.S. Postage

PAIDPERMIT #2854

Denver, CO

Angulation Torque Distal Offset Right/Left .018 Arch Slot .022 Arch Slot

Maxillary0˚ -10˚ 15˚ R A05664 A056920˚ -10˚ 15˚ L A05665 A05693

Mandibular-1˚ -30˚ 0˚ R A05666 A05694-1˚ -30˚ 0˚ L A05667 A05695

The Roth First Molar Tubes are available now as loose tubesand prewelds; they soon will be available on an anatomicalbase

In response to many requests for a new RothSingle Convertible 1st Molar Tube, RMO ispleased to offer the following Maxillary andMandibular tubes, with hooks, in 0.018 and

0.022 arch slots. Dimensions and ProductNumbers for these tubes are:

New

Roth First Molar Tube