Below you will find a number of articles that we have sent to peers in our field to illustrate success with cosmetic dentistry.
Is orthognathic surgery the only option to correct an openbite? Do we leave patients with an openbite, if the parents do not want surgery?
by Dr. Alborzi
The patient pictured below is not the only patient I have treated without surgery for openbite closure; however, I had some trepidation that I was pushing the envelope too far in this case.
As a result of combining the low forces of the Damon System with TADs (Temporary Anchorage Device, also known as Mini Screws), I present to you this amazing transformation – in less than two years (22 months)!
It is always a pleasure to serve the needs of your patients. Please let me know if you have any questions. I look forward to working with you in the near future!
Why would my young child need an Early Orthodontic Treatment Evaluation?
by Dr. Alborzi
Often a clinical examination of a patient appears very normal; however, it may be hiding eruption pattern issues that are quite severe.
Allison presented to my office at age nine with a Class II Div 2 occlusion. Her deep overbite was not ideal, but there was no major wear pattern. My initial thought was she could possibly wait and perhaps be treated in one phase!
After taking a panoramic X-ray, I found her cuspids erupting between the lateral and central incisors. Waiting to treat this issue at a later age would have been unfortunate.
I treatment planned Allison to correct her Class II with the Herbst appliance, simultaneously creating additional space for cupids. The Oral Surgeon bonded a gold chain to the cuspids and I distalized them into position.
Allison’s Class II is now corrected; cuspids are erupting in normal position and there is no resorption of lateral incisor roots. She will now be able to have a much simpler treatment in Phase II, possibly even utilizing Invisalign Teen!
Is Invisalign Only for Simple Cases?
by Dr. Alborzi
Being an Elite Invisalign provider and having treated over 750 Invisalign cases has enabled me to treat Invisalign cases today using special orthodontic techniques and tools previously reserved for braces only. Many cases that were previously "braces only cases" or "untreatable" with Invisalign can now be treated with Invisalign along with these tried-and-true orthodontic techniques!
Knowing what aligners can, and cannot do, allows me to create very speciﬁc strategies to now do what was not possible before.
Here's an example of one of my patients: A teenager came in wanting a beautiful and healthy smile, but was adamant about not having braces to ﬁx her bite. Most orthodontists would not attempt this kind of case without braces. Shy about smiling because of her teeth, Ashleigh presented with crowding, a deviated midline and a unilateral class II bite.
After extracting her upper left ﬁrst bicuspid, we started her Invisalign treatment. Ordinarily this kind of space closure is a very tricky process, as Invisalign aligners typically have trouble with root movement. By using segmented braces only in the extraction area, we were able to use Invisalign to a very satisfying result: an extremely happy patient, completed without the usual full braces!
Today I am able to treat a myriad of patients who would normally be out of the realm for Invisalign treatment. I have invested in an iTero (digital scanner) machine, which has made the ﬁt of aligners amazingly better. The new aligner material, the attachments and software improvements made by Align Technology have deﬁnitely paved the way for much better treatment outcomes.
As an orthodontist, I am sometimes able to reach deep into my bag of "orthodontic tricks” to make things happen! In my oﬃce, Invisalign is simply “another type of braces!"
Making a First Impression!
Adult Orthodontic Treatment— A New Vision!
by Dr. Alborzi
Today, more than ever, adults are seeking orthodontic treatment. They are the baby boomers having to compete in the job market with the young and tal- ented. I would like to share Mike’s orthodontic treatment with you so you, in turn, can help other adults who may think it is too late or too traumatic for them to get treatment.
Mike presented to my office with severe crowding and recession. He had been told the only option was to extract teeth.
Fortunately, I treated his niece successfully as an adult who had been told the same thing! I treated her—non-extraction!– with the Damon system!
Pictures are worth a thousand words! Also take notice of the gingiva: no further recession was caused!
I am so proud of Mike’s result...and Mike is so happy…”It was an excellent experience! It couldn’t have gone better. It was a quick process...almost pain-free! Dr. Alborzi and her team are true to their word and I appreciate the experience!”
Orthodontics without Extractions
by Dr. Alborzi
I wanted to present to you an awesome case I completed for a patient who was told she needed to have teeth extracted. The question often comes up— To Extract or Not to Extract? I’d like to share my experience with you on how I feel you can help improve clinical outcomes and patient satisfaction.
Often times we have to come to a decision with our patients whether to recommend an extraction or surgery. Wouldn't it be great to have more tools or choices in your treatment recommendations? This can not only improve your clinical outcome, it can also elevate your patient's opinion of you, affecting your future business and patient referrals.
I have found that offering a more progressive and conservative approach that patients can see and appreciate is one of the most effective clinical and practice building tools.
Here's an example of a type of case that would typically have extractions or surgery.
Jane* is a patient that came into my office, referred by her doctor for another orthodontic opinion on her care. She came in because of severe protrusion of her incisors resulting in a smile that she was very unhappy with.
Jane had seen other orthodontists that recommended either bicuspid extractions or orthognathic surgery. Her doctor wanted to see if there was a better way, and there was!
Jane was so relieved that she could avoid both extractions and surgery! She underwent care utilizing the Damon System. Jane was ecstatic with her treatment outcome, thanking her doctor for making the referral!
Rather than pulling permanent teeth in order to reduce her overjet, as is done with traditional braces, I used the Damon System to create needed space in the mouth without removing teeth. She simply wore elastics, which she would have needed with extractions as well.
Here's what I have often found when we can avoid extractions:
- Patient keeps all their teeth and avoids the trauma involved with the extraction
- No root resorption
- Shorter treatment time in most cases
- No extraction space that could re‐open
- Extraction remains an option if the patient does not cooperate (but in such a case, I am delighted that I didn’t extract in the first place!)
- Better facial esthetics
Interceptive Orthodontic Treatment
by Dr. Alborzi
The American Association of Orthodontics recommends referrals at age 7. The reason for this is that there is enough eruption of permanent teeth at this time to reveal many orthodontic problems. At this same age, if permanent teeth are not erupting, it may be an indication of excessive crowding.
Early interceptive (Phase I) treatment is an excellent choice for cases of severe crowding,severe over-jet, under-bites, open-bites, gummy smiles and posterior cross-bites that are causing a functional shift. Referring at this time insures the chances of an incredible smile and treatment outcome while reducing treatment time and expense for your patients.
Let me share with you this case:
Molly presented to my office at age 7.5 with severe crowding and a posterior cross-bite.
I used Damon Braces for 18 months to conservatively correct her crowding, her posterior cross-bite and to allow for the eruption of her remaining permanent teeth.
When her remaining permanent teeth erupted, her Phase IItreatment was now much simpler, with only minor crowding to correct. Molly and her mom were given the option of 'fine tuning' her bite with lnvisalign or Braces. Mom chose braces for Molly and we finished her to an awesome result in 16 months.
Let's consider the possibility that Molly's parents had not chosen (or been able to pursue) Phase 2 treatment for her. Wasn't it worth doing Phase Iso she was not faced with a severe orthodontic malocclusion as a teen? Idefinitely think so! In her case, I was thrilled at the opportunity to complete her treatment and finish her spectacular bite and smile! What a gem!