Thursday, September 24, 2009

Wilckodontics

Hey all,

I have just signed up to be the head football coach of the 5th grade flag football team.
Now, if you have been a regular reader for over a year you know what this means. If you are just joining in well let me catch you up.
My son is in the 5th grade at our little Christian school. I want to live vicariously through my son. I want to turn these little meek boy scouts into lean mean flag-pulling machines.
I have been coaching since the first grade. I don't know what gets into me. When I coach I don't sleep for the whole season. I just get so excited that it takes over my head. Just yesterday I talked to the other coach and we, more like he, decided I was going to be head coach. I didn't sleep well last night thinking of plays.
Last year was great because I took a step down and I was the assistant coach. I slept like a baby. But this year, the head coach is coaching baseball and doesn't want to burn out.
The Christian league that we are in is so competitive. I see the same coaches out there doing the same thing I am doing.
But the thing is...the kids absolutely love it. I see them in school in March and they talk about football. I see them at church and they tell me they can't wait for the season.
Well it is almost upon us.
I need to get me some Ambien CR.

I will get right to it.
Remember I talked to you about how I went to this Florida Academy of Cosmetic Dentistry session? I am not going to talk about the whole thing yet, but I want to talk about this one part.
Well at the very end of the last day the speaker through up some photos of this new way of doing orthodontics called Wilckodontics or AOO (accelerated osteogenic orthodontics).
He showed a before picture of an adult that was a class II open bite (for you non-dental people, this is basically a very tough ortho case), and then he shows us this after that was PERFECT.
Then he says it was done without oral surgery and it only took 6 months.
WHAT?!!
Apparently this is some wonder treatment. Here is the thing. Before ortho you go to a periodontist, and he cuts slats in the bone between each tooth. I think they put bone grafting material in the slots, but this kick starts the bone to create the cells to move teeth.
Then the braces go on and whammo the teeth move "like butta" (and you have to say that in a Bostonian accent).

I got these two pictures off the Wilckodontics website.


SIX MONTHS.
I was impressed to say the least.
Again, you know how I feel about not being in the loop.
I just had an orthodontist tell me about these new things called TADs. Do you guys know what these things are? These are called Temporary Anchorage Devices. This is basically a mini implant that screws in the bone and the orthodontist uses them for anchorage.
So I felt kind of out of the loop there.
I feel like I am just now getting back in the loop and I hear about this AOO stuff.
But this AOO thing is really charging me up.
So I start talking to people.
I saw an orthodontist at church a couple of weeks ago, and I explained to him about what I heard.
He kind of rolled his eyes, kind of like you do when someone says, "This is the next best thing".
(Us dentists, we get so callous to hearing about the "next big thing". As a practicing dentist you can't just jump on every bandwagon.)
So he was not sold on this.
So I called a family friend that is a senior resident in his ortho residency at the University of Florida (Fighting Gators, National Championship in football 2006 and 2008 and basketball 2005 and 2006).
I figured the college of dentistry is just teaching young people to be dentist, and I don't think you would say they necessarily teach on the cutting edge (this is not a knock on dental school, it just is).
But, I figured maybe the specialty schools would be a little different.
We spoke. He told me that right now Wilckodontics is a "little out there."
He said that in most of his treatment planning sessions, with his professors, the TADs are part of the discussion. But AOO is not even in the room.
Hmmm?
So the general dentist don't even know about it. The orthodontist think it is another flash in the pan. The residence aren't even talking about it...but the Dawson Center's second in command is talking about it like everyone should be doing it.
Man does this tick me off.
So what am I suppose to do. I see some pictures and it looks awesome. I heard a lecture and he says it is awesome. But no one is doing it.
I think it is the responsibility of the lecturer to say, "this is great, but you may not find anyone doing this in your community" or "this thing is just getting off the ground so it may take a couple of years before you start seeing this in mainstream orthodontics."
But to say it is here and not use a caveat is where they lead you astray.

If you are an avid reader you know I have had this problem in the past. I don't know where to go with this. I don't know how to take a course and not get misled.
So, I can do a couple of things. I can buy into Crahnam's ideas and never see another lecturer.
Or Spear or Kois. You like a guy and spend $75,000 doing all their courses and never stray from your one guy. Or, you can hide in your office and do all your CE online (not that this is bad, it is just a way of not being misled)
But I am starting to get a little disenfranchised with the whole thing.
I don't have an answer. I guess this might just be the way it is. I don't think Crahnam was trying to sell anything. I don't think he was trying to do what he did. Maybe in his world AOO is very blowing up but...
I don't know what else to say.
I didn't mean to bring you down before the weekend.
Are you having this problem?
Did you know about AOO/Wilckodontics?
Is it something that is going to take off?
Let me know what you think.

Have a great weekend,
john





9 comments:

Dr. Dean Brandon said...

Pretty cool bog you have here. Looks like you have a lot more posts than I have on my blog: Pediatric Dentistry

There are really very few good dentistry blogs out there. I am attending Blogworld next month and hope to get some new ideas/inspirations. Again, great blog!

vicki said...

I dunno, but being a person who was in braces for 4 years, this sounds like a miracle to me! :)

Have a happy week!

Terry G Box DDS FAGD said...

Several of the orthodontists, oral surgeons and periodontists have been doig AOO cases for sometime here in NW Arkansas. It is an excellent option in adult cases, particularly when the buccal and labial alveolar process is thin and would be compromised in an arch expansion case, or if the patient is also a candidate for periodontal grafting and tissue regineration. When the treatment is coordinated with interdisciplinary planning, the results can be more than remarkable. The adult patients really appreciate the shortened treatment time even if that is not the primary reason for using AOO.
Some spin offs of this treatment has been that the oral surgeon/ortho team may select to do individual tooth osteotomies to move single teeth, or small segments of teeth,rapidly and with maximum preservation of suppoting bone. Mal-posotionedimplants can be moved this way as well by doing
the osteotomy around the implant and moving the implant and surrounding bon orthodontcally
If you would like more info you can email me and I'll connect you with the correct doctor to answer your soecific questions.
Terry G Box DDS FAGD
tgboxdds@boxbite.com

Connie said...

"he cuts slats in the bone between each tooth"

Whoa, that sounds frightening. (I am not a dentist, clearly!) It reminds me of these nightmares I sometimes have where all my teeth are falling out.

Dr. Dean Brandon said...

TADS are great and our orthodontist uses the ocassionally. I have to say, this article shows why it is so much better to get orthodontic treatment while the patient is still growing (in the pre-teen and teen years). Even so, as an adult, orthodontic treatment is still possible as we can see here.

Anonymous said...

John I am not sure how familar you are with current orthodontics, but I am a general DMD in Toronto who has been doing ortho for about 12 years. We have recently (4 years ago) switched to self-ligating brackets, specifically the Damon System. I would urge you to check out this system as you can get very similar results and lateral arch expansion, although it does take some time, without surgery. I have seen this system (Damon) in my own hands and can attest that it is nothing short of revolutionary in its approach and result - literally all the old orthodontic dogma is thrown out the window. Take a look and be amazed - I hope your orthodontist is using Damon.
Ken J

gatordmd said...

Ken,
I remember one of my orthodontists (who is very good) who uses Damon brackets was going to be on TV. He told everyone to watch the news because he was going to be on TV talking about the "new" Damon brackets (this was about 10 years ago). One problem, he didnt know that the TV was also going to interview other orthodontists. They all didn't speak very well of the brackets and hung this guy out to dry.
I felt so bad for this guy. He still to this day is the only one I know that is using the Damon system.
Thanks for the info Ken.
john

David said...

Hi Doc,
I am an ortho in Wisconsin and I just took the Wilckodontic course with a surgeon friend. I think this procedure is a great option for adult (women) ortho candidates where tooth extraction may have a negative impact on their profile (lip support). Better bone support and better stability long term??? Priceless!

gatordmd said...

David,
Can you please email me. I want to talk to you more about it.
I have asked all my orthodontist about it and they have heard about it but not taken any courses on it.
I would like to know more about it.
If you wouldn't mind dropping me a line at Jgammichia@aol.com
Thanks in advance
John

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