CAO BULLETIN - Spring 2009

Spring 2009

Association canadienne des orthodontistes

In this issue Message from the President In Memorium Committee Reports CFAO Graduate Student Posterboards - Part 2 of 2 Component Society Reports

CAO: We are Coast

to Coast!"

Upcoming Orthodontic Meetings From the Editor Diversions & Distractions

CAO Mission Statement The Canadian Association of Orthodontists is the national organization and official voice for registered orthodontic specialists and is dedicated to the promotion of the highest standards of excellence in orthodontic education and quality orthodontic care.

Message from the President Canadian Association of Orthodontists Association canadienne des orthodontistes 2175 Sheppard Avenue East, Suite 310 Toronto, Ontario M2J 1W8 Telephone (416) 491-3186 / 1-877-CAO-8800 Fax (416) 491-1670 E-mail cao@taylorenterprises.com Website www.cao-aco.org AND www.canadabraces.ca

2008/2009 Board of Directors OFFICERS President President Elect Past President 1st Vice President 2nd Vice President Secretary/Treasurer

Dr. Robert Cram Dr. Gerry Zeit Dr. Gordon Organ Dr. Howard Steiman Dr. Ritchie Mah Dr. Garry A. Solomon

REGIONAL DIRECTORS British Columbia Alberta Saskatchewan Manitoba Ontario Quebec Atlantic

Dr. Rick Odegaard Dr. Paul Major Dr. Ross Remmer Dr. Susan Tsang Dr. Helene Grubisa Dr. Jean-Marc Retrouvey Dr. Stephen Roth

COMMITTEES Communications Nominations President CFAO CAO/AAO Liaison Insurance Planning & Priorities

Dr. Dan Pollit Dr. Gordon Organ Dr. Bob Hatheway Dr. Howard Steiman Dr. Richard Marcus Dr. Robert Cram Dr. Ritchie Mah Dr. Gerry Zeit Dr. Howard Steiman

Membership

Dr. Gerry Zeit

Policy & Procedures

Dr. Amanda Maplethorp

World Federation of Orthodontics

Dr. Robert Cram Dr. Amanda Maplethorp

National Scientific Meeting Coordinator

Dr. Richard Marcus

CAO/CDA Liaison CCOE New & Younger Members Representative

Dr. Ritchie Mah Dr. Don Robertson Dr. Helene Grubisa/ Dr. Susan Tsang

CAO Web Master Assistant Web Master Bulletin Editor Directory Editor Historian/Archivist 2009 Scientific Meeting Chair GST Advisor

Dr. Daniel Pollit Dr. Jules Lemay III Dr. James Posluns Dr. Stephen Roth Dr. Garry A. Solomon Dr. Cliff Moore Dr. Garry A. Solomon

Dr. Robert Cram [Email: drbob@reddeerortho.com]

What a wonderful opportunity we all have been given to create a lifetime of beautiful healthy smiles for Canadians. Orthodontists are truly blessed, especially so in Canada.

As with all positions on the CAO Board of Directors, the President’s position is a volunteer position, but the reward is access to the knowledgeable, friendly, indispensable staff of Taylor Enterprises. Diane Gaunt and Alison Nash continue to pull the strings that keep me dancing!

As President I have had the opportunity to travel across the country to attend a variety of meetings and courses. On October 2nd 2008, I became the first CAO President to attend the Saskatchewan Annual Meeting, followed by a one day Forsus course by Robert Miller. Thank you to Ross Remmer for handling all the arrangements Next, it was off to Ontario to attend the bi-annual OAO General Business Meeting on the Thursday, the Toronto Study Club on the Friday, followed by a two day Media Training session given by Tripp Frohlichstein on the Saturday and the Sunday. Talk about a busy four days. I lost more weight in two days under the interview lights than I did in eight months with Jenny Craig!

I attended the Alberta Society Meeting on March 6th and 7th, the Manitoba meeting on April 23rd, and plans are in the works to attend the British Columbia meeting on May 8th, just after the AAO Annual Session in Boston. I will be travelling to the Quebec meeting in Montreal on May 25th, and to the Atlantic Provinces meeting on the 29th. With the arrival of better weather, I’m hoping I can squeeze in a few rounds of golf in between meetings!

I have been fortunate to be involved in a number of AAO meetings. The Leadership Conference was held February 4th and 5th in Orlando (Florida, in February.

Talk about a no-brainer) Topics included: ‘Gross National Happiness’, the ‘Generational Crisis’ found in current associations, government advocacy, communications and web technology including Web 2.0, Facebook, LinkedIn, Blogs, Wikis, and YouTube. The AAO-CAO Executive Meeting organized and chaired by our very own Howard Steiman, will take place during the annual AAO Scientific Session May 1st to 5th in Boston, Massachusetts.

One of the interesting issues currently affecting the CAO is the Agreement on Internal Trade (AIT). This Federal initiative has the potential to significantly impact dentistry and in particular, specialty dentistry. Details of the agreement are unclear

Consider supporting the advertisers and service providers referred to in this Newsletter, recognizing that they have been supporters of the CAO. Advertisements are paid advertising and do not imply endorsement of or any liability whatsoever on the part of the CAO with respect to any product, service or statement.

The author, the Canadian Association of Orthodontists, and its representatives will not be held liable in any respect whatsoever for any statement or advice contained herein. Authors’ views expressed in any article are not necessarily those of the Canadian Association of Orthodontists.

as of yet, however it appears to be more of a question of ‘when’ not ‘if’. Our Ontario members appear to be most acutely aware of the effect of AIT and we will call on them to provide details as they emerge.

The Ontario Dental Association and the Canadian Dental Association are passing the issue of specialty procedure codes for dental anesthesia services back and forth, each with the hope that the other jurisdiction will resolve the problem. So far, nothing has been resolved.

The Royal College specialty examinations will be reduced to one sitting per year, starting in the year 2010. There has been significant turn-over of senior administrative staff during the past year, in an effort to retool and restructure. Hugh Lamont of Victoria BC, a former provincial representative on our Board of Directors, was elected as a Councilor in orthodontics, succeeding Don Taylor of Montreal Quebec. To date, no progress has been realized in our quest to be awarded Official Observer status at RCDC Council meetings.

Richard Marcus initiated discussions with the AAO in regards to the insertion of the CAO logo into the AAO “More Than a Smile” print campaign. The AAO listened and made it happen.

Recent guideline changes have made it much easier for component and constituent AAO associations to utilize the AAO campaign materials by modifying or by adding their own logo and/or tag line into various media. Individual orthodontists or groups of orthodontists may now make use of the AAO radio, TV, and print materials. The AAO advertising agency is available to assist with the requested modifications.

The restructuring (again) of the CDA is ongoing and convoluted. Unfortunately it appears as though the specialist community (i.e. COSA) is slowly being squeezed out of any formal role within the CDA. The NDSO’s organization needs to be proactive as it becomes our only effective representation on the national landscape.

The Canadian Dental Regulatory Authority Federation has exerted considerable pressure on the Royal College of Dentists of Canada to allow foreign-trained specialists to obtain their Fellowships in an expedient manner. The RCDC has been steadfast in its position that that there be only one way for specialists to obtain their Royal College qualification, citing that there is only one examination process for all domestically and foreign trained dental specialists.

I have been interviewed twice as CAO President: Once for the on-line edition of Readers’ Digest and once for an upcoming edition of What’s Up Kids family magazine. Thank you CAO Media Training!

Thank-you to all Board of Directors, Committee Members, Line Officers and Past-Presidents whom have been tremendous support to me over the course of this year.

Rapport du président Quelle chance nous avons de passer notre vie à donner de beaux sourires et des dents saines aux Canadiens! Les orthodontistes sont vraiment privilégiés, surtout au Canada.

Comme tous les postes des membres du Conseil d’administration de l’Association canadienne des orthodontistes (ACO), celui de président n’est pas rémunéré, mais sa rétribution est d’avoir accès au personnel compétent, amical et indispensable de Taylor Enterprises.

Diane Gaunt et Alison Nash continuent de me communiquer leur enthousiasme! À titre de président, j’ai eu l’occasion de parcourir le pays pour assister à une variété de rencontres et de cours. Le 2 octobre 2008, j’ai été le premier président de l’ACO à assister à l’Assemblée annuelle de la Saskatchewan, qui a été suivie d’un cours d’une journée donné par Robert Miller sur les forsus. Je remercie Ross Remmer de s’être chargé de tous les préparatifs. J’ai assisté le jeudi suivant à l’assemblée générale semestrielle de l’OAO (l’Association des orthodontistes de l’Ontario); le vendredi, à une rencontre au Toronto Study Club, puis à une séance de formation sur les médias d’une durée de deux jours donnée par Tripp Frohlichstein, les samedi et dimanche. Ces quatre journées ont été si bien remplies que j’ai perdu plus de poids sous les feux de la rampe en deux jours qu’en huit mois chez Jenny Craig!

Je me prépare à assister à une rencontre de l’Alberta Society les 6 et 7 mars, ainsi qu’à des réunions qui se tiendront respectivement au Manitoba, le 23 avril, et en Colombie Britannique, le 8 mai, juste après la séance annuelle de l’AAO (American Association of Orthodontists) qui aura lieu à Boston. Je me rendrai ensuite au Québec pour assister à une rencontre à Montréal, le 25 mai, puis dans les provinces de l’Atlantique pour assister à une autre réunion, le 29. Avec le beau temps qui s’en vient, j’espère pouvoir glisser quelques parties de golf entre ces réunions!

J’ai eu la chance de participer à un certain nombre d’activités de l’AAO, dont la Leadership Conference, qui a eu lieu les 4 et 5 février à Orlando (la Floride en février : de vraies vacances!). Parmi les thèmes au programme figuraient « le bonheur national brut », « la crise générationnelle » qui secoue présentement les associations, les activités de représentation auprès du gouvernement, les technologies de communication et les outils Web, incluant Web 2.0, Facebook, LinkedIn, les blogues, les sites Wiki et YouTube.

La réunion des administrateurs de l’AAO/ACO, organisée et présidée par notre estimé collègue Howard Steiman, se Continued…

Spring 2009 • CAO Bulletin

3

tiendra pendant l’Assemblée scientifique annuelle de l’AAO, du 1er au 5 mai, à Boston, dans le Massachusetts.

L’un des questions intéressantes qui touchent présentement l’ACO est l’Accord sur le commerce intérieur. Cette initiative fédérale risque d’avoir des répercussions importantes sur la médecine dentaire, et en particulier la dentisterie spécialisée.

Certains détails de l’Accord demeurent encore à préciser, mais ce n’est apparemment plus d’une question de temps.

Comme nos membres de l’Ontario semblent être les mieux informés des effets de cet accord, nous ferons appel à eux pour nous tenir au courant des faits nouveaux.

L’Association dentaire de l’Ontario et l’Association dentaire canadienne se refilent à tour de rôle la responsabilité du code de procédure des services d’anesthésie dentaire, chacune espérant que l’autre se chargera du problème, qui n’a pas été réglé jusqu’à maintenant.

Les examens des spécialités dentaires du Collège royal des chirurgiens dentistes du Canada (CRCDC) n’auront lieu qu’une fois par année à partir de 2010. L’année dernière, l’équipe de direction a subi des remaniements organisationnels importants à des fins de restructuration.

Hugh Lamont, de Victoria, en Colombie-Britannique, qui représentait auparavant la province au Conseil d’administration, a été nommé conseiller en orthodontie, succédant à Don Taylor, de Montréal, au Québec. Jusqu’à présent, aucune suite n’a été donnée à notre vœu de participer aux réunions du Conseil du CRCDC à titre d’observateur officiel.

Richard Marcus a abordé avec l’AAO la question de l’insertion du logo de l’ACO dans la campagne de publicité imprimée More Than a Smile. Sa demande a été entendue et acceptée par l’AAO. Les récents changements apportés aux lignes directrices facilitent grandement l’utilisation du matériel publicitaire de l’AAO par ses associations membres

et affiliées, qui peuvent modifier ou ajouter leur propre logo ou signature dans divers supports média. Les orthodontistes et les groupes d’orthodontistes peuvent désormais utiliser le matériel publicitaire radiophonique, télévisuel et imprimé de l’AAO. L’agence de publicité de l’AAO est à leur disposition pour les aider à effectuer les modifications requises.

La restructuration de l’Association dentaire canadienne (ADC) poursuit (toujours) son cours et ses méandres.

Malheureusement, il semble que la communauté des spécialistes, ou plus exactement, le COSA (Committee on Specialist Affairs), soit progressivement écarté de toute fonction officielle au sein de l’ADC. La NDSO (National Dental Specialty Organization) devra se montrer proactive, car elle sera bientôt le seul organisme habilité à nous représenter à l’échelle nationale.

La Fédération canadienne des organismes de réglementation dentaire (FCORD) a exercé des pressions considérables auprès du Collège royal des chirurgiens dentistes du Canada pour qu’il accorde rapidement l’autorisation d’exercer aux spécialistes formés à l’étranger. Le CRCDC a cependant maintenu sa position et déclaré qu’il n’y a qu’une seule façon pour les spécialistes d’obtenir leur agrément du Collège royal, soulignant que tous les spécialistes en médecine dentaire sont assujettis au même processus d’examen, qu’ils aient été formés au pays ou à l’étranger.

J’ai été interviewé deux fois à titre de président de l’ACO : la première, pour le magazine en ligne Sélection du Readers’ Digest, et la deuxième, pour un numéro à venir du magazine familial What’s Up Kids. Je suis bien content d’avoir suivi la formation de l’ACO sur les médias!

Je remercie les membres du Conseil d’administration, les membres du Comité, les gestionnaires et les précédents présidents pour le soutien exceptionnel qu’ils m’ont apporté tout au long de l’année.

Whistler Educators Meeting Back row L-R: William Wiltshire (Manitoba), Antonios Mamandras (Western), Anthony Orfanides (3M Unitek), Tim Brown (3M Unitek), Bryan Tompson (Toronto), Claude Remise (Montreal) Front row L-R: Richard Marcus (CAO), Carlos Flores-Mir (Alberta), Don Robertson (CAO), Gerry Solomon (CAO)

The CAO thanks 3M Unitek for their continued support of Orthodontic Education in Canada by organizing this 7th Annual Meeting.

4

CAO Bulletin • Spring 2009

In Memorium

Dr. George Street Dr. George Street passed away on Tuesday, December 2, 2008 at the age of 85 years. Dr. Street was born in Castor, AB. Dr. Street served his country during WWII in the dental corps and is the recipient of several Canadian War Medals. He graduated from the University of Alberta in 1951 with a DDS, and from the University of Toronto in 1954 with M.Sc. in Dentistry.

Dr. Street was a Past President of the Calgary and District Dental Society, Past President and Life Member of the Canadian Association of Orthodontics and Chairman of the CDA accreditation team. He served on various committees of the Alberta Dental Association, including twenty-five years on the Orthodontic Screening Committee, a Life Member of the ADA, and a Fellow and an Examiner of the Royal College of Dentists of Canada.

Dr. Michael Burlington Dr. Michael Burlington was born in Toronto but North Bay, Ontario was home. He obtained his BSc from the University of Toronto and his DDS and MClD from the University of Western Ontario. Mike practiced in North Bay and surrounding areas including Sudbury, London and Huntsville for 28 years.

In addition to his professional successes, Mike was Secretary of the North Bay Dental Society and a Past President of the Rotary Club.

Outside the office, Mike liked to fish, hunt, ski, snowmobile, be a hockey Dad and hang out at the cottage. He is survived by his wife Barbara and his two sons Scott and Todd.

Spring 2009 • CAO Bulletin

5

Committee Reports Treasurer’s & Sponsorship Report Dr. Garry Solomon Treasurer

$380,604.60 on December 31, 2008.

Taylor Enterprises administrative staff, hours increased significantly from 95 hours in 2007 ($6,175.00) to 137.5 hours in 2008 ($8,937.50). Increased hours in accounting, donations, and operations management accounted for about 70 percent of the allocated time.

[Email: hellener@lks.net]

Sponsorship Report

Treasurer’s Report - CAO The general operations of the CAO for 2008 created net revenues of $ 58,168.70, higher than the original 2008 budget proposal, as a result of overall greater income and lower expenses. The Winnipeg Scientific Session created net revenues of $9,644.32. When combined with the general operations of the CAO, total net revenue of $67,813.02 was realized.

Taylor Enterprises administrative staff hours increased to 101.96 percent of the 1100 contracted hours at a cost of $67,248.00. Approximately 50 percent of these hours were allocated to accounting, Board matters, membership issues and operations management. The CAO membership directory is independently contracted at $50.00 per hour of which Taylor made use of 225 hours and then discounted the costs by $2,000.00 for a total cost of $9,712.50. In 2007, the utilization rate was 96.5 percent of the contracted hours.

Overall, the CAO remains in a strong financial position with positive net revenues.

Treasurer’s Report - CFAO The CFAO created a net revenue loss of $50,124.18 in 2008, largely due in part to a $30,000 disbursement for a McGill University research grant, a continuation of the CFAO’s mandate to support orthodontic research. CDSPI investments lost $9,239 as a result of decline in global markets.

The CFAO Board of Directors has voted to secure Stephen Sutherland, CA, a new accounting firm, to administer the CFAO books, and to ensure that all CRA requirements are carried out in a timely manner.

The CDSPI investments showed a net revenue loss of 0.24 percent from December 31, 2007 leaving a balance of

6

CAO Bulletin • Spring 2009

The CAO’s faithful sponsors supported our Scientific Session in Winnipeg, Manitoba with continued enthusiasm. The CAO received $45,100 in sponsorship support in 2008.

Sponsorship represents 468 percent of the $9,644.32 net revenue realized by the CAO to both organize and facilitate the Scientific Session. Without our sponsors, the Scientific Session would have run at a $35,455.68 deficit. As always, the Scientific Session would not be possible without the knowledge, skill and dedicated efforts of Taylor Enterprises.

I encourage any members with any corporate contacts for future sponsorship of the CAO to contact me. The more sponsorship we can attract, the lower will be our membership and registration dues.

Membership Report Dr. Gerry Zeit, CAO Membership Chair [Email: gzeit@sympatico.ca] Membership in the CAO continues to be strong. The Membership Committee has been actively monitoring 2008 renewals and is on track in comparison to previous year’s numbers. The Committee will be working with the provincial directors on a membership blitz to try to sign up any non-renewed members.

Over the past summer the CAO staff expanded its database to include the contact information of nearly all orthodontists in Canada including non-CAO members. This information allows the CAO to assess how its membership relates to the total overall orthodontic population. The CAO represents approxi-

Committee Reports mately 84 percent of all orthodontists in Canada. In the fall of 2008, with the help of the provincial directors, the Committee contacted as many non-CAO-member orthodontists as we were able to. Thank you to Jean Marc Retrouvey, Helene Grubisa and Richard Marcus for help with translation into French.

The greatest number of orthodontists not joining the CAO continues to be in the most populous provinces with the greatest total number of orthodontists (i.e. Ontario, Quebec, BC and Alberta). The main reasons that non-members cite for not joining the CAO are changes in practice status including retirement, the receipt of similar member benefits through the AAO or their provincial orthodontic associations and a lack of desire to attend the CAO Annual Scientific Session. It is too early to know if the efforts made to date have been at all successful in recruiting new CAO members. The recent survey on membership provided a palpable understanding of just how diverse is the CAO membership.

The duties of Membership Chair will be transferred to Paul Major at the end of this year. I would, at this time, like to express my gratitude to the committee: Richard Marcus, Amanda Maplethorp, Jean-Marc Retrouvey and Helene Grubisa for their help and guidance throughout the year. Special thanks also to the provincial directors for all their hard work. Finally, and especially, I would like to extend my most sincere thanks to the CAO staff including Diane Gaunt, Alison Nash and Beth McKenzie without whose unfailing commitment, hard work and excellence, I could not have done my job.

continue this service at a significant cost to the CDA, or to continue while trying to find a prospective buyer, resulted in much debate. Ultimately, the decision was made to continue iTrans as part of the CDA at present, but to re-visit this issue in April 2009, to allow time for several potential profitable contracts to be realized. The question still remains: Should the CDA get out of the ‘business’ side of dentistry?

The CDA has had two issues concerning specialists. The first is the designation of new Unique ID numbers for dental anesthesiologists in Ontario. In much of the correspondence within the CDA, dental anesthesiology is referred to as a specialty, even though it has previously been denied. Several letters to CDA from the Canadian Association of Oral and Maxillofacial Surgeons ensued to remind the CDA that it can not simply recognize dental anesthesiology as a specialty.

In addition, the CDA has been examining the restructuring of committee functions including COSA. This initiative is of significant concern to members of COSA since discussion has been non-existent to date. The CDA appears to be proceeding with its own agenda, without input from the dental specialists. The need for a well organized National Dental Specialty Organization (NDSO) becomes even more evident as the role of COSA diminishes. John Perry, COSA Chair, has sent a response to the CDA and this issue is up for discussion at the CDA Annual General Meeting in April of 2009. The meeting will include input from stakeholders asking them to send responses to the committee review process.

COSA Report Dr. Ritchie Mah CAO/CDA Liaison [Email: ritchiemah@yahoo.ca]

The CDA is under a restructuring plan to increase member relevance, by attracting increased support from Ontario and Quebec, where CDA membership is optional. Input from all stakeholders, including specialists and academics was sought and discussion ensued; a positive sign for the relationship between the CDA and the dental specialists.

The future of iTrans, a product developed and owned by a CDA subsidiary to deal with electronic dental claims from individual dental offices to insurance companies, was recently reviewed. iTrans has cost the CDA membership several million dollars in the past. The decision as to whether or not to dis-

Solo practice located in a desirable and rapidly growing community 30 minutes from Calgary. Excellent growth potential.

Four treatment chairs plus separate exam/consult/private treatment room.

Pan and Ceph. Well-equipped ortho lab.

Owner is relocating but will assist with transition. Close to all the Rocky Mountains have to offer. For more information on this opportunity, please contact the CAO office and refer to File #08-0418, or contact Alan at Practice Solutions Inc. (403) 201-1231.

Spring 2009 • CAO Bulletin

7

Committee Reports New and Younger Members Dr. Helene Grubisa, New and Younger Members Representative [Email: drgrubisa@sympatico.ca] On November 24, 2008 the CAO held a dinner for fourteen University of Toronto residents. The meeting was convivial and allowed residents to share what they knew, and did not know, about the CAO. There was a lot known about insurance (thank you Richard!) but little regarding the objectives, the mission and the organization of the CAO. Questions focused on the differences between the role of the provincial and national associations and the CAO’s involvement in liaising with the government regarding hot topic issues like the foreign trained specialists and the AIT agreement.

The University of Western Ontario dinner took place March 30th, 2009. Thank you to Anthony Mair, last year’s NYM

speaker, for helping organize and promote this event to the residents. Susan Tsang met with the University of Manitoba’s residents on December 4th, 2008. We look forward to the upcoming dinners at the University of Montreal and University of Alberta. These dinners facilitate the communication between the CAO and residents by way of a board member who speaks to the needs and concerns of the residents.

This year’s GORP meeting is taking place at the University of Minnesota July 31 to August 2nd, 2009.

John McGowan, a Toronto employment lawyer, will speak to the NYM luncheon group at the next CAO Scientific Session in Kelowna on the potential pitfalls when hiring and firing employees. He will be addressing the particularities of employment regulation throughout the provinces. \

CAO/AAO Report Dr. Howard Steiman CAO/AAO Liaison [Email: straightsmile@sympatico.ca]

CALGARY, ALBERTA Fantastic Opportunity! Premier orthodontic practice seeks a caring orthodontist to purchase practice.

Offers exceptional quality lifestyle in an excellent location. This practice includes established referral sources, dynamic, experienced orthodontic team and beautiful facility. This well-established practice has a great reputation in providing quality care to the familyoriented community of Calgary and surrounding area.

Please reply in confidence to: The Sletten Group, Inc. 303-699-0990 Fax: 303-699-4863 pam@lifetransitions.com

8

CAO Bulletin • Spring 2009

The CAO and the AAO. Normally, one might consider the interplay between these two powerhouse organizations to be somewhat dry and boring. Such is NOT the case! The following topics are spicy and interesting. You will want to read them over and over again. With the help of some great song titles, here are the juicy details about what our friends are up to south of the 49th parallel: 1) “Money” (Pink Floyd) There have been eleven awardees receiving full-time faculty teaching fellowships ranging from two to three years each. These fellowships are awarded to orthodontic residents or junior faculty associated with an accredited program. In turn, the awardees must commit to teaching in an accredited program for a term equal to that of the award.

Awards have yielded a commitment equivalent to sixty years of orthodontic education.

The House of Delegates has approved a $600,000 expansion of the fellowship program to improve on its Educator Recruitment and Retention Initiative through the approval of a number of new awards ranging from two to five years in length. These awards include the Academy for Academic Leadership Award (four faculty members receive awards to attend a two week program for the de-

Committee Reports velopment of teaching skills in return for a one year teaching commitment), the First Faculty Award ($30,000 each, ten available, given to newly hired faculty members during their first year of teaching who pledge a two year commitment) and the Faculty Development Award (up to $30,000 to an accredited program, distributed to selected faculty members as a recognition and retention incentive).

All of the above awards are the responsibility of the AAO Task Force on Recruitment and Retention, comprised of orthodontic educators, liaisons from the AAO Board of Trustees and two dental school Deans. My understanding is that this task force loves chocolate, so if you want to jump to the front of the line for some bucks, you now have the inside track!

2) “Photograph” (Def Leppard) The next phase of the AAO Consumer Awareness Media Campaign is underway and encompasses a mixture of print, online and cable television advertising. The target audience is mothers of children aged five to seventeen.

Canadian magazines include Chatelaine, Today’s Parent and What’s Up Kids. National cable television stations encompass ABC Family, HGTV, Food Network and Discovery Health. Online keyword search engines are the familiar Google and Yahoo while on-line banners include Ads-Yahoo.ca, Canada.AOL Ad Networks, Chatelaine.com and Today’s Parent.com. Within all of these media, the Canadian exposure is significant and expansive.

regarding potential BPA exposure from dental composites or sealants”. They further quote the US Department of Health and Human Services and a study out of the AJO that “orthodontic resins have not been found to release BPA”.

5) “I Found Someone” (Michael Bolton) (with sincere apologies to the aforementioned performers)

The AAO has initiated a centralized, national service to address the need for temporary practice coverage in cases of maternity leave, vacation, sudden disability, medical leave, etc. Although there has been some initial interest, the service has not lived up to its full potential. Listing forms are now available on-line.

Shhhhh! Don’t say this too loud, but at the recent CAO ad-interim meeting, the Board decided to start a similar service on the CAO website. Members can advertise that they are looking for, or want to apply to, member listed locums. The best part is that this service will be FREE! Watch for announcements coming soon!

Canadian Orthodontic Educators Report Dr. Donald Robertson Chair, Conference of Canadian Orthodontic Educators [Email: mouthtraps@shaw.ca]

3) “Whole Lotta Love ” (Led Zeppelin) The goal of the AAO is to build relationships with their colleagues. During the 149th ADA Annual Session, the AAO hosted their Annual Dessert Reception for the ADA Delegates, Leaders and AAO/ADA Members. To emphasize this goal, nine of thirteen AAO Board of Trustee members were in attendance. The CAO has similar goals, but based on way that things are going between the CDA and COSA (See Ritchie Mah’s report), we won’t be hosting anything at the CDA Annual General Meeting anytime soon.

4

“I Feel Good” (James Brown) Get up and wave those Canadian flags because Harper’s team can proudly say that he is miles ahead of Obama’s gang on the whole Bisphenol A issue. The AAO has finally issued a statement on BPA, repeating the ADA recommendation that there is “no cause for concern at this time

The CCOE / CCGOPD met last September 2008 in Winnipeg, Manitoba as part of the CAO Annual Scientific Session. All departments reported that they were fully staffed and it was therefore difficult to advance the recruitment and retention of orthodontic educators as a crisis issue. The situation remains constant at present.

Accreditation of foreign-trained specialists as mandated by the federal government continues to be a priority issue for the Educators Group. The Educators Group was able to participate in the development of a national protocol to provide for the assessment (and in some circumstances gap training) and the ultimate credentialing of foreign-trained dental specialists. The Association of Canadian Faculties of Dentistry (ACFD) has formally approved and adopted the proposed protocol and has established an application and examination process, including a schedule of applicable fees.

Continued…

Spring 2009 • CAO Bulletin

9

Committee Reports Concurrently, the Agreement on Internal Trade (AIT) has the potential to provide for labour mobility of dentists and dental specialists within Canada. As licensure falls under the jurisdiction of the provincial and regional regulatory authorities and not the ACFD, there is concern that under AIT, dental specialists could be licensed in Canadian provinces with the least stringent requirements and then be eligible for licensure anywhere within Canada free and clear of previous practice history.

Representations are being made to AIT to prevent it from providing an alternative licensure stream for foreign-trained dentists and dental specialists. It is assumed that the National Assessment Protocol will be agreed to and be accepted by the provincial and regulatory authorities as the only protocol leading to licensure of foreign-trained dentists and dental specialists.

The Educators Group met again at Whistler BC in early April 2009 to deal with these and other issues. Special thanks and recognition is again extended to 3M-Unitek Canada for their continuing financial support for orthodontic education in Canada.

CFAO Report Dr. Bob Hatheway CFAO President [Email: drbob@nb.aibn.com] This is my inaugural report as “acting” President of the CFAO. Thank you to Dr. Doug Beaton for his years of service as CFAO President. I have had the pleasure of serving on the CFAO Board under Doug’s guidance and he set the bar very high for future Presidents of the fundraising wing of the CAO. I must emphasize my position as the “acting” President. After nine years of service in one capacity or another on the CAO Board, including serving as President in 20062007, it is time to make room for the immense talent that resides within our ranks. I will remain as CFAO President and responsibly direct answers to recently faced challenges. At the same time, job applications are now being accepted!

The CFAO Annual Meeting took place during the February CAO ad-interim meeting in Toronto. For 2008 the CAO had disbursements in excess of revenues totalling $50,124.18 due in large part to the $30 000 disbursement in support of the McGill University electronic orthodontic education project. The CFAO is proud to have been a contributor to this impressive endeavour. Additional expenditures include the legal and administration staff hours fees generated in

10

CAO Bulletin • Spring 2009

response to the ongoing Canada Revenue Agency audit. These expenditures, coupled with a decrease in the value of CFAO investments, contributed significantly to sizable shifts within the CFAO financial position.

A detailed description of the audit will be presented at the CAO Annual Scientific Session in Kelowna. I am pleased to report that with the assistance of our administrative team, led by Diane Gaunt, Treasurer Dr. Garry Solomon and our legal advisors, no penalty incurred as a result of the audit. CRA did raise some concerns with the structure of the Foundation and have permitted a window of three years for regulation compliance as a Canadian charitable foundation. In the best

CFAO Donations (Since November, 2008) McIntyre Fellows Dr. Perry Kurz Donors Ontario Associatoin of Orthodontists In honour of Dr. Bob Cram, CAO President, guest speaker at recent general meeting Ms. Nancy Ross In honour of Dr. Brian Rinehart Canadian Association of Orthodontists In memorium of Dr. George Street Canadian Association of Orthodontists In memorium of Dr. Byron Johnston Dr. M.J. Watkins In honour of Dr. Ian Milne Canadian Association of Orthodontists In memorium of Dr. Michael Burlington

Committee Reports interest of the CFAO, the Board has engaged a new accounting firm to complete its annual reports.

I look forward to the meeting in Kelowna and to having the opportunity to discuss the above mentioned audit in detail. Please do not hesitate to contact me anytime with any questions or concerns.

Website Report Dr. Daniel Pollit, CAO Web Master

Canadian Association of Orthodontists UPCOMING ORTHODONTIC MEETINGS

[Email: dpollit@sympatico.ca]

2009 May . . . . . . . . . . . . .Quebec Association of Orthodontists AGM

The new and improved CAO Website is now up and running sporting a fresh new look and a spiffy new address www.canadabraces.ca. The original URL http:/www.caoaco.org will still work in the interim, but is in the process of being phased out. New members-only features will be incorporated on a regular basis, so be sure and visit your new website whenever time permits.

Provincial websites will soon be hosted through the national website. This novel feature was initiated by the British Columbia Society of Orthodontists and theirs will be the first be formally linked.

A discussion forum for CAO members is in the process of being set up, similar to the Yahoo Groups forum for the New and Younger Members. Keep an eye out for information with respect to this new discussion forum and for details on how to sign up.

Plans are in place to continue with our successful Monkey Surveys. Previous surveys have provided the communications committee with valuable insight into the varying viewpoints on a number of important topics. Upon receipt of the next survey, please be sure to let us know what you think.

May . . . . . . . . . . . . .British Columbia Society of Orthodontists AGM Spring . . . . . . . . . . .Manitoba Association of Orthodontists AGM May 1-5 . . . . . . . . . .AAO Annual Session, Boston, Massachusetts June 10-14 . . . . . . .European Orthodontic Society Annual Session, Helsinki, Finland Sept. 10-12 . . . . . . .CAO Annual Session, Kelowna, B.C. Sept. 23-27 . . . . . .SAO Annual Session, The Homestead, Hot Springs, VA Oct. 8-11 . . . . . . . .RMSO Annual Session, Santa Fe, NM Oct. 14-17 . . . . . . .MSO Annual Session, Minneapolic, MN (tentative) Oct. 22-25 . . . . . . .PCSO Annual Session, Phoenix Arizona (tentative) Oct. 28-Nov. 1 . . . .GLAO Annual Session, Toronto, ON Nov. 3-8 . . . . . . . . . .SWSO Annual Session, Cancun Mexico (tentative) Nov. 3-8 . . . . . . . . . .MASO Annual Session, Atlantic City, NJ (tentative) Nov. 12-16 . . . . . . .NESO Annual Session (tentative) 2010 Feb. 6-9 . . . . . . . . . .7th International Orthodontic Congress (WFO), Sydney Australia Apr 30-May 4 . . . . .AAO Annual Session, Washington, DC Sept. 23-25 . . . . . .Joint CAO-CAOMS Scientific Session, Whistler, BC 2011 May 13-17 . . . . . . . .AAO Annual Session, Chicago, Illinois Sept 23-25 . . . . . . .CAO Annual Session, Halifax, NS 2012 May 1-4 . . . . . . . . . .AAO Annual Session, Hawaii

Spring 2009 • CAO Bulletin

11

CFAO Graduate Student

Posterboards Abstracts from the 2008 CAO Annual Scientific Session – Part 2 of 2 part series

University of Alberta DENTAL AND SKELETAL CHANGES PRODUCED BY BONE ANCHORAGED MAXILLARY EXPANSION - A SYSTEMATIC REVIEW

University of Manitoba ACCURACY AND RELIABILITY OF DIRECT BONDING VERSUS INDIRECT BONDING - A SYSTEMATIC REVIEW Authors:

Authors:

Brent Cote*, Marguerite Ntiamoa, Manuel Lagravère, Carlos Flores-Mir

The aim of this systematic review was to investigate the short-term skeletal and dental changes following bone-anchored maxillary expansion (BME) and surgically-assisted bone-anchored maxillary expansion (SARME). Several electronic databases were searched for studies relevant to these topics. The following inclusion criteria were applied to the returned titles and abstracts: (1) Maxillary expansion was accomplished by a bone- rather than a tooth-anchored appliance; (2) Subjects were human. Nineteen articles fulfilled these criteria, and their reference sections were manually searched for other potentially useful studies. The remaining studies were then excluded if quantitative data relating to skeletal and/or dental measurements were not presented at the pre-expansion time point as well as at a time point at least 3 months post-expansion. Only two studies ultimately fulfilled all criteria for inclusion in this systematic review. Both pertained to SABME, and one compared changes on stone models while the other compared changes on computed tomography (CT) scans. The rigorousness of the retained studies was assessed by way of a Methodological Quality Checklist; the CT study scored higher than the stone model study, but both had important shortcomings. Their results must therefore be interpreted with caution.

CONCLUSIONS: (1) SABME produces an increase in the maxillary transverse dimension in the short-term; (2) Other short-term skeletal changes (vertical and sagittal) produced by SABME are inconclusive; (3) SABME produces buccal-tipping of the maxillary teeth; (4) The current literature contains insufficient information to comment on the short-term dental and/or skeletal effects of BME.

Marie-Alice Mandich*, Sayeh Ehsani, Carlos Flores-Mir

OBJECTIVE: To assess the reported accuracy and reliability of bracket placement comparing direct bonding to indirect bonding technique in an orthodontic setting in malocclusion cases.

METHODS: An electronic database search was conducted (Medline 1950 to Present, Medline In-Process and other Non-indexed Citations, Pubmed, All EBM Reviews (Cochrane Database of Systematic Reviews, American College of Physicians Journal Club, Database of Abstracts of Reviews of Effects and Cochrane Central Register of Controlled Trials), and Thomson’s ISI Web of Science).

Initially abstracts were selected according to title/abstract using the initial selection criteria, then full articles were retrieved and further selected according to secondary criteria. The finally selected articles’ references were hand-searched for publications that may have been missed in the electronic database searching.

RESULTS: Only four articles succeeded to final selection, and the overall validity and reliability of them are limited. Three of the four studies concluded that there is no clinical difference between direct and indirect bonding techniques even though statistical differences are noted. The fourth study concludes that there is a twofold increased significant accuracy with the indirect bonding technique.

CONCLUSIONS: Although several factors influence the accuracy of bracket positioning; in a controlled environment indirect bonding does not show a significant advantage over direct bonding. It appears though that the range of error was greater for direct bonding than indirect bonding. Under the available evidence the decision to use indirect bonding is therefore more related to practice management and not necessarily to the accuracy of the technique itself.

(*Presenter)

Spring 2009 • CAO Bulletin

13

CFAO Graduate Student Posterboards University of Manitoba THE FUTURE PROVISION OF ORTHODONTIC CARE FOR PATIENTS WITH CRANIOFACIAL ANOMALIES AND CLEFT LIP AND PALATE

To ensure the provision of care for these patients, orthodontic training programs may wish to institute improved formal training programs in the treatment of patients with cleft lip and palate and craniofacial anomalies.

Authors: James Noble*, Nicholas Karaiskos, William A. Wiltshire BACKGROUND & PURPOSE: There is a growing concern in North American that there may be a future deficiency in the provision of orthodontic care for patients with craniofacial anomalies and cleft lip and palate. This may be due to the potentially increased complexity and difficulty of treatment, long lasting care and often minimal financial benefit. The purpose of this study was to determine if orthodontic specialty programs in North American provide formal training to residents in the treatment of patients with craniofacial anomalies and cleft lip and palate and if residents will treat these patients in their future practices.

METHODS: An email with a personalized link to a multi-item on-line anonymous questionnaire was sent to all 54 Canadian and 364 of the approximately 700 US orthodontic residents. Two questions that were asked were, “Do you plan to include the treatment of cleft lip and palate and craniofacial anomaly patients in your practice?” and “Does your program contain formal training in treating patients with cleft lip and palate and craniofacial anomalies?”

RESULTS: A total of 44 of the Canadian and 136 of the US residents responded. In Canada, 30% said they plan to treat patients with cleft lip and palate and craniofacial anomalies after graduation, 14% said no, 48% said maybe and 9% were unsure whereas in the US, 53% said yes, 7% said no, 36% said maybe and 4% were unsure. When asked if there program offers formal training in the treatment of these patients, 45% of Canadian residents said yes, 34% said no and 20% were unsure while 82% of US residents said yes, 12% said no and 5% were unsure.

DISCUSSION AND CONCLUSIONS: According to residents, most orthodontic programs in the US and approximately half in Canada, provide formal training in the treatment of patients with cleft lip and palate and craniofacial anomalies. More than half of US residents and almost one third of Canadian residents plan to be involved in the care for these patients after their graduation which is considerably less than the number of residents who receive training. Orthodontic programs need to deliver improved training programs in the form of multidisciplinary seminars and courses, hospital rotations and specialized craniofacial clinics to stimulate all residents to become eager and proficient participants in the care of these patients upon graduation despite the challenges in treatment and low financial benefits. Orthodontic programs also have a responsibility to accept students who express an interest in the treatment of this population.

14

CAO Bulletin • Spring 2009

University of Manitoba DENTAL ANOMALIES IN PATIENTS WITH BILATERAL CLEFT LIP AND PALATE IN MANITOBA, CANADA Authors: James Noble*, Richard Halpern

OBJECTIVE: To describe the variation in anomalies and location of the permanent teeth in non-syndromic complete bilateral cleft lip and palate (CBCLP) patients from the Manitoba Centre for Craniofacial Difference (MCCD).

METHODOLOGY: Records of 1570 patients from the MCCD dating back to 1958 were assessed. A retrospective chart review was undertaken including demographic information, provider notes, photographs and radiographs. All findings were documented in MS Excel™. Exclusion criteria included: not having complete bilateral clefting of the primary palate, having a Simonart’s Band, having an anondontia-, hypodontia- or cleft-associated syndrome, having insufficient or indistinguishable radiographs and incomplete records.

RESULTS: This is the first study specifically assessing dental anomalies and location of permanent teeth in a non-syndromic CBCLP population. A total of 38 patients met the inclusion criteria; 29 were male and 9 female. Interpretation Method One: Considering the largest tooth between the maxillary central incisor and canine to be a lateral incisor first and supernumerary second, 50.0% of cleft sites had a lateral incisor distal to the cleft; 29.9% had none and 11.8% of sites it was mesial. Ten supernumerary teeth were found at nine cleft sites in seven patients and 80% were distal to the cleft. Interpretation Method Two: When considering a tooth on each side of the cleft site to have developed from a single lateral incisor tooth bud, the pattern X was assigned if a tooth was found only mesial to the cleft, Y if only distal, XY when mesial and distal and AB when none was found. Pattern Y predominated 46.1% of the time; AB 38.2%; X 10.5%; and XY 5.3%. Only four patients had supernumerary teeth and all were found immediately distal to tooth Y. Teeth outside the Cleft Site: Aside from third molars, in the maxilla, agenesis occurred in 11.9% of second premolars and 10.5% of central incisors. In the mandible, agenesis occurred in 4.0% of second premolars, 2.6% lateral incisors, 2.6% central incisors and 2.6% of second molars. No supernumerary teeth were detected outside the cleft site.

CONCLUSION: The lateral incisor was most commonly found distal to the cleft site and supernumerary teeth present may derive from

CFAO Graduate Student Posterboards the lateral tooth bud. Agenesis of the lateral incisor and teeth outside the cleft site was more common than in non-cleft populations.

Table-2

Bracket

University of Manitoba PRELIMINARY EVALUATION OF STATIC AND DYNAMIC FRICTION OF DIFFERENT SELF-LIGATING BRACKETS Authors: L.M. Piedade*, T. Bonstein, M. Lekic, W. Wiltshire OBJECTIVES: To determine the differences in static and dynamic friction resistance of 8 self-ligating brackets (active and passive) and 2 conventional bracket systems when using rectangular stainless steel wires.

METHODS: Ten different maxillary 0.022 premolar brackets (See Table-1) were tested with 0.019 x 0.025 inch rectangular stainless steel archwires (American Orthodontics, Sheboygan, Wisconsin) under dry conditions (n=10). The archwire and bracket were paired such that only one archwire was drawn through its paired bracket using a Zwick mechanical testing machine. Each bracket/wire pair for all samples was tested at 0° of angulation. The magnitude of the static and dynamic frictional forces for each sample was then measured. The average frictional forces for all the samples were compared with regards to friction resistance. Data was analyzed using ANOVA single factor (α=0.05).

RESULTS: No statistical significant difference was found between static and dynamic friction (p>0.05) for all bracket systems. A statistically significant difference was found between self-ligating and conventional brackets, as well as, between active and passive self-ligating bracket systems (p<0.05) (See Table-2).

Conclusion: Passive self-ligating brackets produce less friction than both active self-ligating and conventional bracket systems. This may improve clinical performance especially when using sliding mechanics during space closure.

Table-1 Bracket Ovation Ovation-R Ovation-C

Speed

Type Conventional Self-ligating (active) Esthetic Self-ligating (active) Conventional Self-ligating (passive) Esthetic Self-ligating (passive) Self-ligating (active)

Damon3 Time2 Quick

Self-ligating (passive) Self-ligating (active) Self-ligating (active)

Victory Smartclip Clarity SL

Manufacturer GAC International Inc, Bohemia, New York GAC International Inc, Bohemia, New York GAC International Inc, Bohemia, New York 3M Unitek, Monrovia, California 3M Unitek, Monrovia, California 3M Unitek, Monrovia, California SPEED System Orthodontics, Strite Industries Ltd., Cambridge, Ontario Ormco Corporation, Orange, California American Orthodontics, Sheboygan, Wisconsin Forestadent, Pforzheim, Germany

Ovation Ovation-R Ovation-C Victory Smartclip Clarity SL Speed Damon3 Time2 Quick

Mean Static Friction (N) at zero degrees 1.49±0.36 0.43±0.22 0.45±0.32 1.40±0.89 0.35±0.23 0.10±0.14 0.91±0.32 0.12±0.14 1.05±0.42 0.43±0.14

Mean Kinetic Friction (N) at zero degrees 1.22±0.43 0.37±0.17 0.41±0.30 1.29±0.95 0.27±0.22 0.07±0.12 0.76±0.34 0.08±0.14 0.91±0.45 0.41±0.14

University of Manitoba QUANTIFICATION OF FORCES DISSIPATED THROUGH BONE WHEN USING RAPID MAXILLARY EXPANSION Authors: Nicholas E. Karaiskos* AIM: To Quantify the Forces Dissipated Through Bone When Using Rapid Maxillary Expansion MATERIAL AND METHODS: Stress-strain gauges (Intertechnology, Don Mills, Ontario) were attached to human adult cadavers and bonded to the bone adjacent to the mid-palatal and intermaxillary sutures using the MBond 200, cyanoacrylate adhesive (Intertechnology, Don Mills, Ontario). The gauges were attached to a P3 machine and forces exerted on the craniofacial complex using a modified RME. Values generated were converted to force in gram units.

RESULTS AND DISCUSSION: After complete activation of the modified RPE appliance, maximum values were compiled and compared. The mean maximum force values for the mid-palatal suture was 986.58 grams (±203.72), while the intermaxillary suture site was 759.99 grams (±143.77). These forces are all at the level of orthopaedic in nature. Using a paired student t-test, it was found that there was a statistically significant difference in force values between the mid-palatal and intermaxillary sensor sites (p<0.05). No specimens were found to have either the mid-palatal or intermaxillary suture become patent following complete activation. The difference in values could indicate that the force generated by the modified RME becomes dissipated by the hard and soft tissues in the craniofacial complex and that the further away from the RME, the lower the recorded value. This may further support the theory that piezoelectricity mediates orthodontically induced alveolar remodelling by orthopaedic orthodontic appliances in the craniofacial complex.

CONCLUSIONS: Forces generated by RME devices are dissipated through the bone at levels that exceed orthopaedic force range. The further away from the site of force delivery, the lower the recorded Spring 2009 • CAO Bulletin

15

CFAO Graduate Student Posterboards values, suggesting dissipation involves many factors such as amounts of hard and soft tissue.

University of Montreal THE EFFECT OF SURGICALLY ASSISTED RAPID PALATAL EXPANSION ON YOUNG ADULTS AS OBSERVED IN A SLEEP LABORATORY Authors: Dr Normand Bach*, Dr Gilles Lavigne, M. Pierre Rompré, Dr Claude Remise, Dr Athena Papadakis INTRODUCTION: Rapid Palatal Expansion appears to correct abnormalities beyond posterior crossbites. Several treatment options are available to correct maxillary transverse deficiencies, each having a separate influence on expansion stability and periodontal health. One option in adult subjects is Surgical Assisted Rapid Palatal Expansion. This procedure has the potential to decrease nasal airway resistance and enhance respiration and sleep. This improvement has not been thoroughly demonstrated in the literature. Objective: The goal of this study is to analyse the effects of Surgical Assisted Rapid Palatal Expansion on the sleep structure of young adults through observations from a polysomnographic sleep laboratory examination.

MATERIALS AND METHODS: 14 subjects, 7 male and 7 female, have completed the study. Following an otolaryngologist’s examination, all subjects underwent a sleep architecture evaluation for two (2) consecutive nights. Subsequently, a Surgical Assisted Rapid Palatal Expansion was performed. After a 6 month retention period, all subjects returned to the sleep laboratory for another two (2) con-

Thanks to GAC for their support of the CFAO Posterboards 16

CAO Bulletin • Spring 2009

secutive nights. A complete set of pre-surgical and post-retention orthodontic records were analysed.

RESULTS: The results demonstrate a significant increase in sleep stages 3&4 (deep sleep) after SARPE and a tendency to reduce micro-arousals during sleep.

CONCLUSION: The results allow us to presume a potential benefit of Surgical Assisted Rapid Palatal Expansion on physiological quality of sleep. Studies are currently in progress to identify and understand the source of this effect on sleep.

University of Montreal THE HYBRID ORTHODONTIC ARCHWIRE AND ITS EFFECT ON TORQUE EXPRESSION: A COMPARATIVE STUDY Author:

Serge Yacoub*

Due to the widespread popularity of the "Straight Wire Appliance" system, the clinician is constantly exposed to manufacturers latest purported technological advances that are introduced with very little scientific basis. Recently, a company has commercialized a hybrid archwire that includes four flat sides as well as four curved surfaces that interconnect the four flat sides. According to the manufacturer, these rectangular hybrid archwires provide the advantages of both rectangular and round archwires, with torque control equivalent to standard rectangular archwires.

The aim of the present study was to evaluate and compare in vitro, the torque control of two stainless steel archwires having similar dimensions but different cross-sectional configurations. The first part of the study compared the torque expression between the two archwire configurations using ten types of currently popular orthodontic brackets. The second part of this project was to evaluate the effect the hybrid archwire had on torque expression among the ten types of orthodontic brackets. Both wires were 0.021" x 0.025" stainless steel.

Ten different orthodontic brackets were chosen (Smartclip®, Speed®, Damon 3®, In-Ovation-R®, Minitwin®, Victory®, Omniarch®, Clarity®, Mystique® and Ice®). The wires were mounted on a U shape support and placed on an Instron 4201 machine.

The results demonstrated that a hybrid configuration greatly influences torque expression. In fact, the force system generated tends to diminish significantly when the hybrid archwire is used instead of the rectangular archwire and this effect is consistent among all the brackets used in this study. Moreover, the brackets varied in their sensitivity to changes in the cross-sectional configuration of the wire when torque control was evaluated. The Speed® bracket showed very little sensitivity whereas the Victory® bracket was very sensitive to these changes.

CFAO Graduate Student Posterboards University of Toronto AN EVALUATION OF COMPUTER-AIDED LEARNING IN ORTHODONTICS Author:

Harold Rosenberg*

INTRODUCTION: Both objective and subjective outcomes have been widely documented in the literature, however to date, there does not appear to be a study that attempts to correlate these two outcome measures.

METHODS: The main objective outcome measured was performance on a written test covering material found in the ODET administered to 92 fourth year undergraduate dental students. The main subjective outcome measured was a 12 statement questionnaire to elicit studentsâ&#x20AC;&#x2122; perception of the ODET and CAL as teaching modalities.

RESULTS: When analyzing male and female subgroups, a statistically significant difference in mean lecture test scores favouring females (72.46%) over males (67.08%) was observed (p=0.05).

Nevertheless, this difference was not observed for mean ODET test scores (p=0.52). Although responses to the questionnaire were for the most part positive, students are not prepared to replace lectures with CAL tutorials. Responses revealed that male students preferred self-instruction as a mode of learning more than female students did (p=0.05). When linking objective and subjective outcomes, mean ODET test scores demonstrated a statistically significant (p=0.025), but weak, positive correlation (r=0.243) with self-reported time spent reviewing the ODET but not with any other statement in the questionnaire.

CONCLUSIONS: Despite a difference in lecture test scores between male and female students there was no difference in mean ODET test scores between the two subgroups which may be explained by gender differences with male students preferring self-instruction more so than female students did. Improved performance on the ODET test was noted for students that reported longer times spent reviewing the tutorial. Because students are not prepared to replace lectures with CAL tutorials, from their perspective the ODET should continue to be used in conjunction with traditional modes of learning.

Spring 2009 â&#x20AC;˘ CAO Bulletin

17

Component Society Reports

British Columbia

Alberta

Dr. Rick Odegaard

Dr. Paul Major

[Email: dr.odegaard@shawcable.com]

[Email: major@ualberta.ca]

The CAO Annual Session will take place in Kelowna, British Columbia September 10th to 12th 2009. September is a spectacular time of year to visit the BC interior for what is certain to be an educational and fun-filled meeting for doctors, staff and family members.

The Faculty of Dentistry at the University of British Columbia, under the leadership of Dean Charles Shuler, is working towards a comprehensive slate of dental specialty programs of which orthodontics is but one. The current proposal is to establish a program targeting foreign-sponsored students and producing graduates interested in an academic career. The BCSO is concerned that there is no guarantee that the students will commit to long term to academics and that new graduates may instead enter private practice in a province that already has the largest influx of new practitioners. In addition, the UBC program will be a potentially large draw on a limited patient pool.

The next step is for the graduate orthodontic program proposal to go to the UBC Senate for a vote. If approved, the program could start as early as 2010. Dr. Alan Lowe has been selected as the Foreign Trained Specialists Assessment Program Coordinator. A mechanism for assessment is being developed to determine if a candidate is suitable for gap training.

The target date to begin the assessment process is June 2010.

The BCSO is in development of a web page to be part of the lager CAO website. Dr. Amanda Maplethorp has distributed a template to be reviewed by all provincial directors with consistency between the provinces being the overall objective.

The next Annual General meeting for the BCSO will be Friday, May 8th, 2009 at the UBC Golf Club. The BCSC is pleased to announce that Dr. Lesley Williams of Vancouver BC was appointed Secretary Treasurer of the PCSO at their annual meeting in Palm Springs in November 2008.

The 2008-2009 executive of the Alberta Society of Orthodontists includes Dr. Biljana Trpkova (President), Dr. Keith King (Vice President) and Dr. Mike Bleau (Secretary-Treasurer). The Annual Scientific Meeting of the ASO, featuring Dr. Vince Kokich Jr., was held in Banff on March 6th and 7th 2009 in conjunction with the Alberta Prosthodontists Society annual meeting. Τhe ASO has recently surveyed its membership regarding current staff compliment, staff compensation, and difficulties with staff recruitment and retention. The ASO approved a budget for ongoing media marketing which will target major local Alberta newspapers. The ASO continues to support the CAO mediation process and have formed a Mediations Committee chaired by Dr. Gary Stauffer.

Τhe Alberta Dental Association and College (ADA&C) has proposed new sterilization guidelines in response to requests originating from the Alberta Government. Compliance with the first draft has the potential to significantly increase practice overhead costs. In response, the ASO has provided input regarding realistic sterilization guidelines for orthodontics. A second draft is anticipated in the near future.

The College of Dental Assistants of Alberta has approved several expanded duties for orthodontic dental assistants including the initial try-in of appliances, cementation of orthodontic bands, the removal of excess adhesive, the bonding of passive orthodontic appliances, the indirect bonding of orthodontic brackets, and the placement of attachments along with the insertion of Invisalign aligners.

Spring 2009 • CAO Bulletin

19

Component Society Reports Saskatchewan Dr. Ross Remmer [Email: dr.remmer@sasktel.net] The Saskatchewan Society of Orthodontics held its Annual General Meeting in October in conjunction with a continuing education day with Dr. Robert Miller. The SSO extends its sincere appreciation to Tony Orfanides of 3M Unitek for sponsoring the event. President Bob Cram was in attendance; the first occasion that a CAO president has been at a meeting of the SSO (a throwback to détente no doubt!) Bob, a facepainting, maniacal Rough Riders fan, managed to see his team win their game that same weekend. All were pleased to see President Bob leave happy!

To mark October as Orthodontic Awareness Month, the SSO has sponsored radio announcements touting the advantages of consulting with an orthodontic specialist. Thank you to Dr. James Stephenson for coordinating this worthwhile endeavour. There has been interest in an annual campaign, although it remains in the early planning phase.

There has been a six-month reduction in the orthognathic surgery waiting list as a result of increased operating room time and improved scheduling efficiency by the oral and maxillofacial surgeons. Unfortunately, patients are still waiting up to eighteen months from the time that they are deemed ready for surgery, but hey, Rome wasn’t built in a day!

Manitoba Dr. Susan Tsang [Email: s_tsang2@hotmail.com]

The spring Manitoba Orthodontic Society dinner meeting took place on April 23rd, 2009, and featured CAO President Bob Cram.

Recent continuing education lectures included presentations

by Dr. Brian Preston from New York University in December 2008 and Dr. Nelson Oppermann in January 2009. Dr. Anthony Gianelly was in Winnipeg in April 2009 to present to the Manitoba residents and local orthodontists.

A by-law was passed at the Manitoba Dental Association Annual General Meeting in January, clarifying the licensing

20

CAO Bulletin • Spring 2009

protocol of foreign-trained full-time academic specialists.

Academic foreign-trained specialists are permitted to practice using a limited-scope dental license under the supervision of a certified specialist until the RCDC exam is passed within five years. Successful completion of this exam provides for full licensure application as a specialist in Manitoba.

Ontario Dr. Helene Grubisa [Email: drgrubisa@sympatico.ca]

The membership of the Ontario Association of Orthodontists has expressed a desire for a public relations media campaign to emphasize the “Orthodontics by an Orthodontist” message. The OAO Executive arranged for Schupp Media to present the Ontario proposal to the general membership at the bi-annual business meeting on April 2, 2009. The membership asked questions and voted in favour of the proposal, which is to take place in the autumn of 2009.

The Ontario Dental Nurses and Assistants Association (ODNAA) continues to push for self-regulation through the formation of their own College to allow for expanded duties.

There has been no progress with respect to allowing the dental assistants to use the skills obtained in the Orthodontic Module. Hygienists now have the right to independent practice in Ontario. The dental hygienist fee guide was released in November 2008, and among other codes, includes one for cephalometric films!

The potential merger between the CDA and the ODA is in the early phases of discussion according to ODA president Dr. Larry Levin. Ontario and Quebec are the only provinces in Canada that do not have mandatory membership in the CDA, and has generated concern as it appears to force the hand of ODA as well as CDA members.

In September 2008, the Agreement on Internal Trade (AIT) was signed by all of the Provincial Premiers. Briefly, registration in a profession or trade in one province guarantees registration in all regions across Canada. This raises the concern in dentistry as to weak ports of entry and the inability to license applicants according to specific provincial guidelines. The Royal College of Dental Surgeons of Ontario wrote a strongly worded letter to the Ontario Premier to explain why AIT is not in the best interest of the

Component Society Reports public and to request an exemption for dentists and dental specialists. There has been no response to date. The AIT agreement is scheduled to take effect August 2009.

Dentistry is the only profession being investigated by the Competition Bureau in 2009. The Competition Bureau has stated that they support the work done by dental hygienists in principle, and that they view the Royal College of Dentists National Specialty Examination as a barrier to practice. The Fairness Commissioner is examining dentistry, among other professions, and has accused dentistry of being restrictive with registration at the RCDSO. The report was expected from the Commissioner in February of 2009.

Quebec Dr. Jean-Marc Retrouvey [Email: jmretrouvey@videotron.ca] The Canadian Association of Orthodontists meeting in September 2008 coincided with the North Eastern Association of Orthodontists Annual Meeting. It is the sincere wish of the Quebec Association of Orthodontists (QAO) to hold these two meetings on alternate weekends to improve overall representation at both.

The QAO met on October 3rd, 2008. Drs Jean-Patrick Arcache, Dr Eric Lessard and Ms Stefanie Patterson presented on the diagnosis and treatment of masticatory system dysfunction. None of the presenting practitioners are orthodontists, providing the membership with a novel perspective on this complex condition.

Spring 2009 â&#x20AC;˘ CAO Bulletin

21

Component Society Reports On November 21st, 2008, Dr Francois Bérubé, an orthodontist renowned for his ability to manage complex cases to a very high standard, presented the multidisciplinary approach involving a number of dental specialties. As our population ages, the material discussed by Dr Bérubé will only become more and more relevant On January 30th, 2009, the Alumni Association of the Université de Montréal invited Dr Mohamed Razavi from Case Western Reserve University for a one-day lecture to discuss the use of micro-implants in orthodontic treatment. Dr Sugawara was our invited speaker for ‘la Journée Paul-Geoffrion’ on March 27th 2009. He spoke on micro-implant and miniplate anchorage as he did during the 2008 AAO Annual Session in Denver Colorado. The next Quebec Association AGM will be held during ‘Les Journées dentaires internationales du Québec’ on May 25th 2009. Dr Etsuko Kondo, a well-known practitioner from Tokyo Japan will address the complex topic of Class III with anterior openbite.

The QAO’s new Executive Board Members for 2009-2010 will be elected as part of the AGM. The Quebec Association of Orthodontists is comprised of 144 active and 15 retired members. Any CAO colleague interested in attending one of the QAO meetings should contact the QAO’s secretary at (450) 441-0852.

Past director Sonya Lacourcière was gracious in her assistance in producing this initial report: Thank-you Sonya on the behalf of all CAO members for your time and effort in representing the orthodontists from Quebec at the CAO Board throughout your term.

Rapport de la province de Québec La réunion de l’ACO a malheureusement eu lieu en même temps que la NESO en septembre 2008. Il en a résulté une participation diminuée des orthodontistes québécois à Winnipeg. L’association Québécoise espère pouvoir tenir ces deux événements à des dates différentes pour encourager une plus forte participation de ses membres.

L’Association Québécoise des orthodontistes a lancé la programmation d’automne avec une conférence au sujet des problèmes temporomandibulaires réunissant des conférenciers locaux. Dr Patrick Arcache, Dr Éric Lessard et Madame Stéphanie Patterson nous ont présenté leur approche diagnostique et de traitement des problèmes impliquant le système masticatoire. Ce groupe de conférenciers, étrangers au milieu orthodontique, a su présenter une approche différente du traitement des dysfonctions temporomandibulaires.

Le 21 novembre 2008, nous avons eu le plaisir d’écouter le Dr François Bérubé, un orthodontiste reconnu pour sa capacité de traiter avec succès des cas difficiles, voire impossibles. La conférence fut très intéressante et présentait un grand nombre de cas impliquant des praticiens chevronnés dans diverses spécialités de la dentisterie. La présentation du Dr Bérubé, étoffée de cas particulièrement pointus présentera certainement un intérêt croissant au fur et à mesure que notre population vieillit.

L’Alumni de l’Université de Montréal a invité le docteur Mohamed Razavi, professeur à l’University Case Western Reserve, le 30 janvier dernier. Le thème de cette journée était l’utilisation des micro implants pour le renforcement de l’ancrage en orthodontie. Pour continuer dans la même voie, le Dr Jungi Sugawara sera notre invité pour “la Journée PaulGeoffrion “ du 27 mars prochain. Un conférencier de renommée internationale, il nous parlera de nouvelles ‘’mini plaques’’ comme il l’a fait à Denver l’an dernier.

22

CAO Bulletin • Spring 2009

Component Society Reports Notre prochaine AGM se tiendra durant les “Journées internationales du Québec” qui auront lieu du 24 au 27 mai 2009. Le 25 mai, le docteur Etsuko Kondo, une orthodontiste pratiquant à Tokyo nous présentera une conférence portant sur les classes III et les occlusions ouvertes, des sujets affichant un haut degré de difficulté et de frustration potentielle en orthodontie. Le nouvel exécutif de votre association vous sera alors présenté.

L’association Québécoise compte actuellement 144 membres actifs et 15 membres retraités.

Sonya Lacoursiere a généreusement prêté assistance à la rédaction de ce rapport initial. L’association Canadienne des Orthodontistes tient à la remercier au nom de tous ses membres pour le temps et les efforts déployés à representer les orthodontistes du Québec au comité de l’ACO tout au long de son mandat.

Atlantic Report Dr. Stephen F. Roth [Email: stephenroth@bigfoot.com]

The Atlantic Orthodontist’s Association Annual Meeting is May 29th and 30th. A relaxing retreat is organized for orthodontists and their guests at the Rodd Crowbush Resort on Prince Edward Island, the first time our meeting is to be held on P.E.I. The AOA also looks forward to the NESO meeting in New York City November 12th to 15th where Lee Erickson of Bedford, Nova Scotia will be installed as President.

Kathy Russell and Lee Erikson of the Division of Orthodontics at Dalhousie University are introducing a senior elective program in advanced orthodontics to expose senior students to advanced clinical cases and to provide additional didactic knowledge at the level of the general practitioner.

The Nova Scotia Dental Association is re-visiting the issue of expanded duties for certified dental assistants. The Committee continues to examine the details of the proposal and will potentially present to the Provincial Dental Board of Nova Scotia in the near future.

A HISTORY OF ORTHODONTICS IN CANADA After many years of hard work, we are pleased to announce the publication of “A History of Orthodontics in Canada”.

Many years of hard work were lovingly undertaken by author Dr. Rowland Dalton Haryett to offer Orthodontic Specialists in Canada a comprehensive history of our profession. With much effort and assistance by Dr. Amanda Maplethorp to complete the editing and typesetting of this, it is finally ready for all Orthodontists.

Look for more information regarding this exciting venture!

Spring 2009 • CAO Bulletin

23

From the Editor

Dr. James L. Posluns, Bulletin Editor [Email: james.posluns@utoronto.ca]

When I grow up, I wanna be a…

My 18 year-old daughter is finishing her first year of university and knows exactly what she wants to do. She loves kids, or as they are known to her, ‘little minis’.

She babysits and is a camp counselor during the summer months. She’s going to be an elementary school teacher and is extremely excited. Now, like her old man, my kid is no Rhodes Scholar, but will make a fabulous teacher because it’s what she was born to be. I couldn’t be happier. It’s a long life.

Back when I was an awkward, skinny, glasses-wearing youth with an untamable head of hair, my mother pulled me aside and asked me exactly what did I think I was doing with my life. I remember the day clearly, as it continues to seemingly live in infamy forever. We were in the kitchen. I said I liked going to my orthodontist, Dr. Landsberg. She said that being an orthodontist sounded like a good idea. Case closed, problem solved.

Like King Arthur and his brave-hearted Knights of Camelot, so began my personal quest. My science and math teachers said that I didn’t have the aptitude.

But what did they know, they worked for the government.

During my first day of dental school as a an awkward, skinny, glasses-wearing young adult with even more, yet still untamable hair, the lights went low in room 170 as the Kodachromes came to life.

“What the heck is this?” I exclaimed to myself. “Teeth, gums, blood. This is horrible! ” Never being accused of being a quitter, I stuck with it. It kind of grew on me, like some sort of benign lesion. Following a rather ugly incident at the start of Third Year, the Dean called me to his office for a chat. He asked me the same question as my mother. “A mechanic,” was my brilliant response this time around. He understood, but said not to give up: There was hope for me yet.

Upon completion of my fourth year, the Clinic Director shook my hand and said “Congratulations. You’ll never make it in private practice”. Stuff like that has a way of sticking with you.

Fast forward a few years to interview day at the University of Toronto. Exactly which interview day I can’t recall; there were so many. I rode the elevator with the then head of the restorative department. “Here for the orthodontic interviews?” he asked in his distinctive, yet still-frightening unique dialect. As I smoothed the hairs on the back of my neck back into place, I mumbled something to the affirmative. “That’s a good specialty for you“, he concurred. For years, I wondered what exactly he meant by that. Was it because I never really got the hang of cutting a Class V cavity prep?

During first year I was assured that they could teach a chimpanzee to fill teeth.

Perhaps they were mistaken; maybe I should have eaten more bananas. Was it because I could handle the academics, yet continually pestered the dispensary staff for a steady supply of Valium during the clinical sessions? Ahh. The memories. So many meltdowns, so little time.

Or maybe it was because he knew something that I, as of yet, did not. That being

an orthodontist is as close to being a mechanic as a dentist can get, without getting grease all over his or her clothes. I say this respectfully. Think about it.

Every program has a course called ‘biomechanics’. There’s never a meeting without that term appearing in one form or another somewhere on the docket.

Torque is everything. We’re surrounded by pliers, wires, springs and screws. Mr. T. could build an airplane out of this stuff and still have the time to teach us all to fly.

Now I’m an awkward, skinny, glasseswearing middle-aged adult with even less, yet now very tamable hair finding myself in a rather reflective mood on a regular basis. Eighteen years into dentistry, did I make the right choice? Did Momma really know best? Who can say for sure?

Have you ever leaned back at the end of a hard day, let out a big sigh and said to yourself “I should have been a (enter alternate occupation here)”. I’m willing to bet that just about everyone has, at some point or another. That’s not such a bad thing. I’m also pretty sure that after the thoughts of being a golf-pro, a Caribbean sailboat captain or a photographer of supermodels fade to black, in reality, most of us are secure in our career choice. As a dentist, could you see yourself practicing any other specialty? Orthodontics is a pretty cool profession and there’s no shortage of those jumping at the chance to be one: It sure beats the socks out of being in the financial business these days. But even after living the dream day in and day out, as one bounces down the rocky road known fondly as life, one can’t help but wonder…

Exactly how green is that grass over yonder?

Enjoy the summer folks.

Kelowna.

See y’all in

Spring 2009 • CAO Bulletin

25

Diversions and Distractions The four leading yachts in this Lake Ontario 300 are approaching the finish. Can you match the yachts (as seen in the diagram below) to their names as well as determine the colour of each boat’s hull and the year in which it was built.

Direction of of Travel Direction

The Andromeda is further ahead in the race than the Saucy Sue which, in turn, is further ahead in the race than the boat built two years earlier than the Andromeda.

The vessel with the blue hull was built either three years earlier or three years later than the Fandango.

The Jamboree has a white hull and is further ahead in the race than the yacht built two years later than the one with the green hull.

Thanks for all of the previous submissions. The last puzzle was known to be much more challenging than the first.

Time for additional incentive. The first correct submission will, and I promise, win a prize and be recognized in the next edition!

Good Luck Last Edition’s Answer: Damian, Age 7 - 5 Sweets; Ella, Age 6 - 4 Sweets; Liam, Age 4 - 8 Sweets; Micky, Age 5 - 6 Sweets; Nancy, Age 8 - 7 Sweets

Clinical Tip Mothers driving you mad? Fathers making you falter? Kids climbing the walls? There is a legal way to keep control without resorting to anesthetics or analgesics. Turn off the rock and roll and crank up the Mozart! It works. Seriously. The wildest of your patients will lie back and drift off right before your eyes. Classical music takes the ‘fight’ right out of ‘em, especially in the early morning and late afternoon, with nary a complaint from anyone within earshot. Your days will be smooth as silk and stress-free. Try it. It’s the best!

Got a clinical tip you’d like to share? Please remit to james.posluns@utoronto.ca and you will be famous!

26

CAO Bulletin • Spring 2009