Spring 2013
Bulletin
CANADIAN ASSOCIATION OF ORTHODONTISTS / ASSOCIATION CANADIENNE DES ORTHODONTISTES
Site of the 65th Annual CAO Scientific Session! Fairmont Banff Springs Hotel
• Message from the President • CAO Bylaw Revisions • Committee Reports • CFAO Graduate Student Posterboards - Part 2 of 2 • Component Society Reports • Get Involved in the CAO! • Webinar Update • From the Editor
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
2012/2013 Board of Directors
Message from the President Dr. Paul Major [Email: major@ualberta.ca]
Since September, my primary focus has been reviewing and revising the terms of reference for the various committees and liaison positions. All now have consistent wording and represent the current needs of the CAO. At the Ad Interim meeting, the Board appointed Chairs for the Committees and, where required, made formal appointments for the liaison positions. Additional liaison positions are advertised in this edition of the Bulletin.
OFFICERS President President Elect Past President 1st Vice President 2nd Vice President Secretary/Treasurer
Dr. Paul Major Dr. Garry A. Solomon Dr. Ritchie Mah Dr. Helene Grubisa Dr. Jean-Marc Retrouvey Dr. Michael Patrician
REGIONAL DIRECTORS British Columbia Alberta Saskatchewan Manitoba Ontario Quebec Atlantic
Dr. Rick Odegaard Dr. Robert D. Kinniburgh Dr. Mike Ziglo Dr. Susan Tsang Dr. Sheila Smith Dr. Sonya Lacoursiere Dr. Dan A. Stuart
COMMITTEES Communications Nominations President CFAO COSA Rep CDSA Rep Insurance Planning & Priorities
Dr. Dan Pollit Dr. Ritchie Mah Dr. Stephen Roth Dr. Jean-Marc Retrouvey Dr. Ritchie Mah Dr. Robert Cram Dr. Paul Major
Membership
Dr. Helene Grubisa
Policy & Procedures
Dr. Amanda Maplethorp
Sponsorship
Dr. Michael W. Patrician
World Federation of Orthodontics Conference Advisory Committee Chair
Dr. Paul Major Dr. Howard Steiman
CAO/CDA Liaison Canadian Orthodontic Educators New & Younger Members Rep RCDC Liaison
Dr. Bob Cram Dr. Gerry Solomon Dr. Susan Tsang Dr. Hugh Lamont
CAO Web Master Bulletin Editor Historian/Archivist CAO Helpline Task Force GST/HST Advisor
Dr. Daniel Pollit Dr. James Posluns Dr. Garry A. Solomon Dr. Howard Steiman Dr. Michael W. Patrician
The new Conference Advisory Committee and the Scientific Content Committees are functioning well. Dr. Howard Steiman has been providing excellent guidance for these groups. Dr. Amanda Maplethorp and the Ad Hoc By-laws Committee have made excellent progress in reworking the by-laws in accordance with the new government legislation. Once the new by-laws have been ratified, the ‘policies and procedures’ will then be reviewed and updated. Part of this process will involve placing the primary governance documents on-line so that they are easily accessed by all Board members. As we go forward with the process of updating and revising our ‘policies and procedures’, it is important that this opportunity is utilized to critically challenge the rationale for how business is conducted at the CAO. It is expected that as the various policies and procedures are examined, there will be numerous policies that require re-evaluation. I look forward to serving the second half of my term as President.
Rapport du président Depuis septembre dernier, j’accorde la priorité à l’examen et à la révision des attributions des divers comités et des titulaires des postes de communication. Toutes ces attributions sont maintenant uniformisées et représentent les besoins actuels de l’ACO. Au terme de la réunion intérimaire, le conseil a nommé les présidents des comités et, au besoin, a effectué des nominations officielles aux postes de communication. Des postes à combler dans cette fonction sont annoncés dans le présent bulletin. Continued…
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Le nouveau Comité consultatif sur le congrès et le Comité du contenu scientifique vont bon train. Dr Howard Steiman a fourni d’excellents conseils à ces deux groupes. Dr Amanda Maplethorp et le Comité spécial sur les règlements ont réalisé d’excellents progrès à la refonte des règlements conformément aux nouvelles lois. Dès que la nouvelle version des règlements aura été ratifiée, les « politiques et les méthodes » seront révisées et mises à jour à leur tour. Ce processus suppose notamment la mise en ligne des principaux documents de gouvernance, de sorte que les membres du conseil pourront les consulter facilement. Au fil de la mise à jour et de la révision de nos « politiques et méthodes », il importe que cette occasion serve à remettre en question de manière critique les motifs qui sous-tendent nos activités à l’ACO. Il est prévu que, au cours de l’examen des diverses politiques et méthodes, nombre d’entre elles seront réévaluées. Je me réjouis à la perspective d’entamer la deuxième moitié de mon mandat à titre de président.
GET INVOLVED IN THE CAO! Recently, the CAO Board revised the Terms of Reference as they relate to the Committees and Liaisons within the organization. As the CAO grows and evolves, so must the way we involve our members. In an effort to provide all CAO members the opportunity to provide input and serve the Association in a capacity in which they have a desire, the CAO Board is now accepting nominations for the following positions: New & Younger Members Committee Chair (2 year term) Communications Chair (3 year term) Insurance Committee Chair (2 year term) Conference Scientific Content Chair (3 year term) By-Laws, Governance & Parliamentary Chair (3 year term) Bulletin Editor (3 year term) Webmaster (3 year term) Helpline Liaison (3 year term) RCDC Liaison (1 year term) *All terms begin in September 2013 The CAO Board encourages all members to get involved in the direction of the CAO by becoming active on one of the organization’s committees as a member or a Chair. A variety of time commitments and skill sets are required to ensure that the CAO remains the Voice of Orthodontic Specialists in Canada. A written report to the CAO Board is required twice a year (February and September) and you may be asked to attend a board meeting in person in order to discuss issues surrounding the portfolio. If you are interested in serving, or have any questions about one of these positions, or would like to nominate yourself or a colleague, please notify the CAO Office at cao@taylorenterprises.com or 416-491-3186/1-877226-8800 by June 14, 2013. All those who express an interest will be notified of a decision by June 30, 2013.
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CAO Bulletin • Spring 2013
CANADIAN ASSOCIATION OF ORTHODONTISTS BY-LAW REVISIONS A by-law revision is mandatory by 2014 to permit the CAO to continue operations under the new Canada Not-for-profit Corporations Act (CNCA). Phase I of the by-law revision process addressed changes to the membership structure (Article 5) of the Association and was adopted at the 2012 Annual General Meeting. Phase II will be presented at the 2013 AGM. Changes to the by-laws are highlighted below: 1. Implementation of the new membership structure approved in September 2012 Article 6 requires small changes to permit the Board to set dues administratively, to ensure that upon loss of membership in the CAO, former members no longer have rights in CAO property and to allow membership reinstatements to be administrative in nature only. 2. The wording of the by-laws to bring current practices in line with CNCA: Article 4 establishes that component societies are not members of the CAO, but are in a contractual relationship with the CAO and removes the duration of the Component Society Agreement from the by-law to make it easier to vary the duration if necessary. Article 8 changes the maximum size of the Board to include executive officers, specifies executive officers, clarifies ‘succession track’ of officers and identifies the process to be followed when a person on that track cannot advance. Article 8 also clarifies the terms of office and defines the requirements to serve as a director or an executive officer. Added provisions enable the Board to schedule meetings and to allow the electronic waiver of notice by fax or e-mail. Article 11 clarifies that committee chairs and committee membership are appointed by the president in consultation with the Board (also reflected in Article 12). Article 11 also clarifies that the president-elect or 1st and 2nd vice-presidents may chair a board meeting in the absence of the president. The article also clarifies that the officials (i.e. the CAO staff) are subject to a contract with the CAO and that committee chairs and members may be removed by a majority vote of the board.
Article 18 replaces auditor with public accountant, in accordance with terminology used by the CNCA. 3. Compliance with the CNCA Article 7 aligns the notice of meeting period with that of the CNCA, specifies the content of notice, alters the provisions regarding requisitioned meeting and permits the use of electronic ballots. Article 8 establishes the nominations process for the board and the election of directors by the membership. It also removes the provision for ex-officio members and replaces them with advisors, establishes that board meetings may be held electronically by teleconference, Skype or any other means and provides for removal of a director by an ordinary resolution of the Board. Article 13 replaces original wording from the Canada Corporations Act with new wording from the CNCA. Article 14 adds wording from the CNCA regarding conflict of interest. Article 17 changes the proportion of votes to approve by-laws changes to be in accordance with the Act (in most cases, a simple majority suffices) and makes provision for class voting where required by the Act. 4. Changes to reflect current practices Changes in Article 8 (Board of Directors) and Article 21 (Rules and Regulations) serve to have rules, regulations and policies subject to board approval. The policy manual will be available on-line for member review. Further information regarding these proposed changes will be included in an upcoming mailing. Information not mailed will be be posted to the CAO Members Only website for members to review in advance of the September Annual General Meeting. Thanks to the committee and to the resource persons all who have worked very hard on this proposal; Amanda Maplethorp (Chair), Richard Marcus, Garry Solomon, Dan Stuart, Susan Tsang, Ritchie Mah (ex-officio) and Paul Major (ex-officio), CAO staff (David Petrie, Diane Gaunt, Alison Nash) and Victoria Prince (legal advice).
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Committee Reports Treasurer’s Report Dr. Michael Patrician Treasurer [Email: drpatrician@bellnet.ca] As of December 31, 2012 the general operations of the CAO generated net revenues of $13,121.13. The Scientific Session generated net revenues of $19,006.38. The net income of the CAO in 2012 was $32,127.51. Members’ equity is $608,652.86. The annual dues for 2013 increased by $20.00 to $595.00+HST partly in response to costs arising from the Canadian Dental Specialty Association, the legal and accounting expenses to rewrite the CAO governance model and by-law changes, and the upgrades to the CAO website. The total hours accumulated by Taylor Enterprises for 2012 is 1,244.15. The contractual hours are 1200 hrs per year.
could be assistance to a member who handles orthodontic insurance as it has traditionally been handled for the past 25+ years, however I would not be the right person to help a member who wishes to utilize procedure codes and/or accept assignment because I have never done either during my 33+ years in practice. Prior to the Board accepting the Task Force’s recommendations, the Task Force will need to meet with the Canadian Life and Health Insurance Association in order to inform them of any potential changes in our recommendations to our members as the current orthodontic insurance recommendations were a product of discussions between our two organizations twenty-five to thirty years ago. The unique relationship between our two organizations has served our membership well, and we would like to maintain it.
CFAO Report Dr. Stephen Roth CFAO President [Email: stephenfroth@mac.com]
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Insurance Report Dr. Robert Cram Chair, Insurance Committee [Email: rjcram@shaw.ca] The CAO is forming a Task Force to revisit the insurance guidelines. The two to four member Task Force will likely require three or four meetings over a period of six months to present their recommendations and report to the Board. The insurance committee of the future must reflect the diversity with which our members are handling orthodontic insurance. This objective can best be met by including members on the Task Force (as well as on the insurance committee) who provide their own patients with diverse advice and varying levels of support. In the future, when our members approach the CAO staff with questions, it will be very helpful to the staff to be able to refer the member to an insurance committee member who can be of most help to them, given the member’s particular approach to orthodontic insurance. For example, I
It is an exciting time to be involved with the Canadian Foundation for the Advancement of Orthodontics. Over the last few years, the Board of Directors has been investigating ways to permit the Foundation to achieve its full potential. A significant number of initiatives have been introduced to date with others on the way. Supporting the Next Generation - The CFAO continues to support the Student Posterboard Program at the CAO Annual Session. Posterboards have always been a tremendous opportunity for the residents to share their research with the orthodontic community. Posterboards also serve as a way to welcome students to the profession. The CFAO is working with the CAO’s Scientific Session Committee to develop new ways to increase students’ involvement in the scientific program. Bringing the Best to Banff - The CAO Scientific Session Committee has selected Dr. James Koehler to present the 2012 McIntyre Lecture at the 2013 CAO Annual Session. The CFAO is proud to provide financial support to bring such excellent speakers to our meetings. Continued… Spring 2013 • CAO Bulletin
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Committee Reports Sowing Seeds - The CFAO underwrites an Undergraduate Orthodontic Award to dental schools across Canada. The objective is to expand this relatively new program recognizing outstanding achievement by third and fourth year dental students, cultivating interest in the field. Spreading the Word - The CFAO has recently launched a unique website - CFAO.ca The site provides information about the CFAO and includes a searchable database of recent abstracts presented at the Student Posterboard Program. FUNdraising - Another relatively new initiative of the CFAO is the Annual Silent Auction at CAO Gala Banquet. The auction has proven to be an enjoyable and worthwhile experience for all participants and the momentum has increased from Ottawa in 2012 to Banff in 2013. Plan to join in the fun by visiting the auction or donating an item. These initiatives are but a small example of what the CFAO can potentially be. The continued growth of the Foundation depends on member involvement. Assistance is required through support of these programs and through financial support of the Foundation. Don’t forget to make your yearly CFAO contribution and to consider becoming a McIntyre Fellow. The future of the profession thanks you for your generosity.
CFAO Donations CFAO Donations since October 2012 Dr. Ronald W. Komm McIntyre Fellow CAO In memoriam of Dr. Kumie Pather CAO In memoriam of Dr. G. Herbert Hanson CAO In honour of Dr. Jean-Marc Retrouvey for facilitating the Sleep Apnea Webinar
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CAO Bulletin • Spring 2013
CAO/AAO Report Dr. Garry Solomon CAO/AAO Liaison [Email: hellener@lks.net]
CONSUMER AWARENESS PROGRAM (CAP) UPDATE: Athorn, Clark & Partners took over the media campaigns by 2011-2012 and the tag line evolved to “My Life, My Smile, My Orthodontist”. This AAO CAP reached 140 million combined impressions (number of views) mainly via cable television as well as print and online advertising. The campaign expanded the focus on adult orthodontics and targeted adults from 18 to 49 years of age with a household income over $50,000 per annum. The 2012-2013 CAP will keep the same demographic but will target the adult market separately from the child and the teen market. The advertisements will still emphasize that orthodontists have specialized expertise and training. The AAO Board of Trustees (2012) authorized the videotaping of the CAP presentation by Athorn, Clarke & Partners. It is available on the website (www.aaoinfo.org) as of December 15th, 2012. AAO members can customize the CAP advertisements to market their own practices through accessing Practice Marketing Solutions on the AAO. Similarly, AAO members can incorporate the new AAO logo onto their business cards, letterhead, brochures and other advertising materials by downloading the logo from the AAO website (click on ‘my practice/support materials and forms’).
THE CANADIAN SPIN ON THE AAO CAP: In 2011, The Ontario Association of Orthodontists (OAO) had set aside $100,000 for cable television and media advertising. The OAO requested a redistribution of the Ontario portion of the AAO membership budget ($107,000) to help fund their media campaign. This proposal was rejected; however, George Clarke of Athorn, Clarke & Partners said that if the OAO (or any other province) wanted to piggyback their funds onto the AAO CAP, then the AAO would be interested in cooperating. This proposal has been accepted by the OAO. The cable television initiative is now underway throughout Ontario with the OAO logo on the AAO advertisements. Similar opportunities exist for the other Canadian provinces. The AAO Bulletin is now available in both hardcopy and online.
Committee Reports CBCT: The draft position of the AAO on the use of CBCT technology will not be included in the AAO Clinical Practice Guidelines. The AAO left that responsibility to each orthodontist to determine if a CBCT was in the patient’s best interest.
AAO WEBSITE: The consumer website (braces.org) has been changed to www.mylifemysmile.org to coincide with the CAP tagline. The CAO communications committee is creating a consumer website independent of the members’ website.
New and Younger Members Dr. Susan Tsang New and Younger Members Representative [Email: s_tsang2@hotmail.com]
Drs. Helene Grubisa (Membership Committee Chair) and Susan Tsang are pleased to welcome Drs. Paul Morton and Amy Archambault from Quebec and Dr. Sheila Smith from Ontario as new representatives on the NYM committee. Please feel free to approach any of the committee members with questions, suggestions or feedback. We hope to see everyone at the NYM luncheon lecture at the CAO Annual Session in Banff. Following up on an informative lecture in 2012 on Google search engine optimization, Mr. David West from Kayk Marketing Incorporated of Calgary, Alberta will speak on the use of social media in practice marketing. The annual GORP meeting will take place at the University of North Carolina, Chapel Hill from August 2nd to 4th, 2013. The CAO will be there to connect with the graduate orthodontic residents at the meeting who have plans to return home at the completion of their studies. Join the NYM group on-line through the BraceSpace discussion forum on the CAO’s website (canadabraces.org) to post comments, questions, or thoughts. The CAO is a valuable resource when starting one’s career. If the CAO can assist in any way, please feel free to establish contact.
What does the CFAO do with my donations? The CFAO was established in 1978 with the mandate to “advance the branch of dentistry known as orthodontics”. Those new to the profession might not be familiar with all of the programs of which the CFAO is involved. Here is a primer on how the CFAO makes use your donation. Student Poster Presentations - The future of the profession lies with the residents in the graduate programs. The CFAO provides funds to facilitate student research and presentations at the CAO Annual Session. These presentations are an excellent introduction to the world of orthodontic academics and organized orthodontics. It also provides an opportunity to meet the newest members of the profession. The CFAO is working with the Conference Advisory Committee to fine-tune the poster program, to increase the prominence of the posters at the annual meeting. McIntyre Lecture - Every year, the CAO strives to bring the brightest minds in orthodontics to the membership. One speaker is given the honour of being the McIntyre lecturer. The CFAO provides funds for this lecture so that all can benefit. CAO Educational Webinar Series - Technology is constantly changing, including the method of accessing the latest in orthodontic information. The CFAO supports the CAO Educational Webinar Series providing the opportunity to watch and to actively participate in educational lectures from the comfort of familiar surroundings. Undergraduate Dental Awards - The CFAO has recently initiated a program to recognize outstanding achievement in orthodontics within the Canadian undergraduate dental programs. This program has the potential to encourage the brightest dental students to consider orthodontics. Special Projects of the Graduate Programs - As a notfor-profit organization, the CFAO is required to disperse the majority of funds it receives. When donations exceed current commitments, donations can be made directly to the Canadian graduate orthodontic programs. These donations are greatly appreciated by the program directors and have enriched the learning experiences of the orthodontic recipients. The CFAO is constantly looking for new ways to fulfill its mandate and novel initiatives are in the works. The success of any CFAO program depends on the support of its generous donors. Please visit the CFAO website at cfao.ca to find information on how to contribute. With the help of the membership, the CFAO will remain an important part of orthodontics in Canada.
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Committee Reports CDSA Report Dr. Ritchie Mah CDSA Liaison [Email: ritchiemah@gmail.com] Since September, the Canadian Dental Specialists Association (CDSA) has held several conference calls involving both the CDSA representatives and presidents of the nine national dental specialist organizations (NDSOs). The most recent call was held January 13th, 2013. CDSA President Dr. Calvin Pike has had extensive communication with CDA President Dr. Rob Sutherland, and a proposal for the CDA to support the CDSA has been put forth. This proposal has been received with guarded enthusiasm by the CDSA Board and by the NDSO Presidents in that assurance is required that the CDSA will remain independent of the CDA, even if financial and logistical support are accepted. Dr. Sutherland has alluded to the potential dissolution of the CDA’s Committee on Specialist Affairs (COSA), once the CDSA is better established. This dissolution has been one of the goals of CDSA from the outset. Two significant steps have been taken in establishing CDSA’s presence on the national dental organization front. Following its formation in 2011, letters were sent from CDSA asking for input regarding specialty issues to both the Canadian Dental Regulatory Authorities Federation (CDRAF) and the Royal College of Dentists of Canada (RCDC) who are the organizations responsible for the recognition and licensing of dental specialists and the testing of specialist candidates respectively. CDSA had asked for permission to attend the CDRAF and RCDC board meetings for information and has been granted permission for observer status at the next CDRAF board meeting in October 2013. Recently, the RCDC has requested the CDSA to send representation to the RCDC Council meeting in September 2013. The CDSA will present rationale as to why CDSA should attend future RCDC Council meetings as observers. The CDSA Annual General Meeting was held on April 18th, 2013, coinciding with the CDA Annual General Meeting in Ottawa. This arrangement allows the CDSA to meet with the incoming CDA Executive and to discuss its future relationships. The CDSA hopes to solidify the offer that CDA has proposed and to plan the next steps, thereby establishing the CDSA as the official national voice of dental specialties.
ing its finances. The need to increase dues in the future will depend on whether the CDSA accepts the support of the CDA or continues with support solely of the NDSOs. The CDSA will likely accept the CDA’s support as long as there is no attempt to interfere with its mandate or its function. A legal review of the CDSA by-laws has been initiated to ensure that CDSA is in compliance with the new not-for-profit legislation. There are concerns at the Board level about realized value for the large portion of CDSA start-up monies provided by the CAO. With all that the CDSA has achieved, the Board is recommending to continue its support of the CDSA going forward.
RCDC Report Dr. Hugh Lamont Orthodontic Councillor, RCDC/RCDC Liaison Dr. Hugh Lamont of Victoria B.C. is the new Vice-President of the Royal College of Dentists of Canada. Due to the ever-increasing numbers of candidates being examined annually, it is necessary to consider an alternate location for the written and oral portions of the examination. The executive director, Peter McCutcheon is looking into alternate venues in Toronto for years 2014 and beyond.
HST Report Dr. Michael Patrician Treasurer [Email: drpatrician@bellnet.ca] In 2012 there was no communication with CRA with regards to HST. The CAO has received no notification of any changes to the HST rebate mechanism. The CDA is no longer publishing the GST/HST manual as a membership service/benefit.
Internally, the CDSA is developing its website and is organizSpring 2013 • CAO Bulletin
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Committee Reports WFO Report Dr. Amanda Maplethorp WFO Committee [Email: a_maple@shaw.ca] The latest meeting of the WFO was a conference call. The next in-person meeting is Thursday September 19th, 2013 in conjunction with a site visit of the ExCel Convention Centre in London, in preparation for the meeting in 2015. The AAO will host the WFO breakfast at the Annual Session in Philadelphia. The CAO President, Dr. Paul Major will be invited as the CAO Country Representative. Because the CAO has enough members to qualify for a second representative, Dr. Jean-Marc Retrouvey will become the Member-at-Large. His duties include serving on the WFO Council (which meets face-to-face at the WFO IOC held every 5 years.) Between these in-person meetings, it is possible that a council decision may require electronic votes of which he would have one. Canada will want to have two representatives at the Council meeting at the 8th IOC in London September 27th to 30th, 2015. Ideally the 2015 CAO President, Dr. Jean-Marc Retrouvey and one Member-at-Large will attend.
Communications Report Dr. Daniel Pollit CAO Web Master [Email: dpollit@rogers.com] The working group has been busy with the redevelopment of the CAO website. Requests for quotes were sent out to three companies. One was reviewed and found suitable. The new site will include more orthodontic imagery and increased videography to better convey the benefits of orthodontic treatment. In addition, social media will be integrated to help promote the website.
HOWDY PARTNER! Round ‘em up for the 2013 CFAO Silent Auction at the CAO President’s Banquet in Banff, AB! Dr. Stephen Roth, CFAO President knows y’all support the CFAO and one great way to do that is by donating an item for the CFAO Auction. Our bidders have a hankerin' for items such as:
✯ ✯ ✯ ✯ ✯
One of a kind art/jewellery pieces
Use of a Resort condo or “Time Share”
Tickets to Sporting Events or live Theatre Spa/Restaurant Certificates
Sports Memorabilia (think “The Goal Heard ‘Round the World”!)
We don’t want any gun-slinging, but we do want a brawl over hot items at the auction table. It’s time to pony up exciting new items for this year’s Auction that supports a number of CFAO Programs and Initiatives. Please contact the CFAO office at (416) 491-3186 for more information.
It’s time to Giddyup!
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CAO Bulletin • Spring 2013
CFAO Graduate Student
Posterboards Abstracts from the 2012 CAO Annual Scientific Session – Part 2 of 2 part series University of Manitoba CEPHALOMETRIC EVALUATION OF DENTAL CLASS II CORRECTION USING THE XBOW APPLIANCE
final position of the lower incisor and thus deciding on an appropriate retention protocol following Xbow treatment.
Authors: Chana RS*, Hechter FJ, Wiltshire WA
University of Manitoba A COMPARISON OF THE ACCURACY OF HAND TRACING AND DOLPHIN IMAGING SOFTWARE IN LATERAL CEPHALOMETRIC ANALYSIS
OBJECTIVE: To determine the magnitude of the dental movements in subjects with different facial patterns following Class II correction using the Xbow appliance. SUBJECTS AND METHODS: A retrospective sample consisting of 134 subjects exhibiting Class II malocclusions was used. Subjects were categorized into three growth types according to pre-treatment cephalometric variables (MPA, Y-axis, LFH), which yielded 27 brachycephalic, 70 mesocephalic, and 37 dolichocephalic subjects. Data collection was accomplished by performing digital cephalmetric analysis on the pretreatment (T1) and post-treatment (T2) radiographs. A mixed procedure repeated measures model (t-test) was used to investigate the differences between the three facial groups at T1 and T2 time points. RESULTS: Dental changes induced by the Xbow appliance during Class II correction included; proclination of the lower incisors (L1-MP 7.3-12.3o±1.0o p<0.05), protrusion of the lower incisors (L1-APo 2.1-3.8mm±0.3mm p<0.05), mesial movement of the mandibular first molar (5.5-6.9mm±0.7mm p<0.05) and retrusion of the maxillary incisor (2.4-3.5mm±0.4mm p<0.05). No significant association between the amount of tooth movement and dolichocephaly was found, but there was an increased trend of proclination and protrusion of the lower incisor in the brachycephalic group. Retroclination of the maxillary incisor (U1-PP 0.2-0.5o±0.9o p>0.05) and distal movement of the maxillary molar (0.4-0.7mm±0.3mm p>0.05) were not significantly influenced by Xbow treatment. CONCLUSIONS: Correction of Class II malocclusions with the Xbow appliance is the result of mesial movement of the mandibular molar, proclination/protrusion of the lower incisor and retrusion of the upper incisor. Facial growth pattern appears to be unrelated to the amount of dental movement and there is a trend for pronounced dental movements of the lower incisor in brachycephalic patients. Orthodontists should take these appliance induced effects into consideration when treatment planning the
Authors: Nick G. Playfair*†, William A. Wiltshire†, Frank J. Hechter†, Steve I. Ahing † University of Manitoba, Faculty of Dentistry, Division of Orthodontics OBJECTIVE: The purpose of this study was to compare the accuracy of hand tracing and Dolphin Imaging software in lateral cephalometric analysis. MATERIALS AND METHODS: Twelve lateral cephalometric radiographs, obtained from the University of Manitoba, were randomly selected, evaluated for quality, hand-traced on acetate paper by two orthodontic residents and analyzed using a modified Steiner analysis, Ricketts, Harvold and McNamara analyses. The values from these measurements were used to assess inter- and intra-evaluation correlation. Subsequently, sixty lateral cephalometric radiographs (twenty Class I, twenty Class II and twenty Class III) were randomly selected from the same database and analyzed by hand-tracing on acetate paper and by Dolphin Imaging software. Measurements obtained were analyzed using t-test statistics. All tests were set with a level of significance of p≤ 0.05. RESULTS: Inter- and intra-operator correlation was assessed and showed no significant difference (p<0.05). No statistical differences between most measurements obtained by handtracing and by Dolphin Imaging software was found. However, highly statistically significant differences (p<0.001) were found for UI-NA (degrees) (0.87±1.18) (mean difference ± SE), LI-APog (mm) (-21.3±0.5), and LI-MP (degrees) (0.87±1.18). CONCLUSION: Apart from several incisor positions and inclinations, Dolphin Imaging software appears as reliable as hand tracings. Orthodontists should be cognizant of the apparent inaccuracy of incisor positioning with automated software analyses.
(*Presenter) Spring 2013 • CAO Bulletin
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CFAO Graduate Student Posterboards Université de Montréal INDIRECT BONDING METHOD: SHEAR BOND STRENGTHS OF METAL BRACKETS CEMENTED TO PORCELAIN Authors: Dr. Stéphanie MAI; Dr. A.J. ST-GEORGES; Dr. J. TALBOT; Mr. P. H. ROMPRÉ; BACKGROUND: Orthodontists will be required to work on restaured tooth surfaces as more adults seek orthodontic treatments. Bond strength at the metal-ceramic interface of auto-polymerizing resins used for orthodontic indirect bonding has yet been evaluated. OBJECTIVE: 1) Compare shear bond strength (SBS) between metal brackets and differently treated porcelain surfaces. 2) Suggest a practical and predictable literature-based clinical protocol. METHOD: 90 leucite discs (6 groups; n=15/group) were prepared following 6 combinations of mechanical (+/- bur roughening) and chemical (hydrofluoric acid, primer, silane) treatments according to manufacturers’ recommendations. SPEED brackets with custom Transbond XT composite bases were bonded with Sondhi A+B Rapid Set. Samples were stored (distilled H2O, 24hrs), thermocycled (distilled H2O, 500 cycles, 5o and 55o Celcius) and tested in compression with the Instron testing machine. Maxiumum SBS was recorded for each sample and examined under scanning electronic microscope to evaluate the adhesive remnant index (ARI). Statistics were performed on ranks since data was not normally distributed. RESULTS: Group medians ranged from 17 MPa (-bur+HFA) to 27 MPa (+bur+HFA+silane). Only (-bur+HFA) showed a significantly lower SBS (p<0.04) and ARI (p<0.001) while all other surface treatement combinations showed no significant differences in their SBS and ARI.
Thanks to GAC for their support of the CFAO Posterboards
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CAO Bulletin • Spring 2013
CONCLUSION: All suggested surface preparations provided clinically acceptable bond strength for orthodontic tooth movement. Primer followed by silane treatment is clinically attractive as it is safe and easy to apply. Patients should be warned about the risk of unesthetic porcelain fractures at time of bracket removal.
Université de Montréal DOES RAPID PALATAL EXPANSION DECREASE SLEEP BRUXISM IN CHILDREN? Author Presenters: Audrey Bellerive, DMD; Andrée Montpetit, DMD, Msc; Hicham El--Khatib, DMD, Msc; Clothilde Carra, DMD, PhDc; Claude Remise, DMD, Msc; Nelly Huynh PhD ABSTRACT: Keywords: rapid palatal expansion, sleep bruxism, polysomnography, maxillary deficiency, children Sleep bruxism (SB) is a parasomnia described as an involuntary mastication movement during sleep. This parafunction is observed in 14-38% of the child population. A link was found between respiratory events and episodes of bruxism. Rapid palatal expansion (RPE) in children is an orthopedic treatment that is effective in correcting maxillary transverse deficiency and in reducing obstructive apnea syndrome (OAS) by increasing airway capacity. OBJECTIVES: Since bruxism is related to respiratory events and RPE increases respiratory capacity, the objective of this study is to evaluate the possible reduction of bruxism after RPE therapy. METHODS: This prospective randomized controlled clinical pilot study is in progress, with 27 children currently in treatment (8-14 years old, 8 boys, 19 girls). These patients were seeking treatment for transverse maxillary deficiency (5 mm or more) at the orthodontics department of the University of Montreal. Patients underwent an ambulatory polysomnography before (T0) and after expansion (T1). RESULTS: The preliminary results show a significant interaction between groups (control/bruxers) and before/after treatment (p=0.02, ANOVA repeated measures), where the mean rhythmic masticatory muscle activity index of bruxers decreased from 2.4 ±0.3 before to 0.9±0.1 after rapid palatal expansion (p=0.059, paired t-test). There is no difference between groups and before/after treatment for sleep and respiratory variables (Snoring index, apnea/hypopnea index, total sleep time, sleep efficiency, sleep stage 1,2 and REM sleep), however, sleep stage 3 increased for bruxers after treatment (p=0.02, paired t-test).
CFAO Graduate Student Posterboards CONCLUSION: These preliminary results, though promising, require additional subjects to support the link between the reduction of bruxism following RPE therapy.
Université de Montréal ÉVALUATION DE LA STABILITÉ DE L’OSTÉOTOMIE DE TYPE LEFORT I MULTISEGMENTAIRE Author: Hélène ENGEL Lorsque la maturité squelettique est atteinte, une procédure chirurgicale est nécessaire afin de corriger une déficience transverse du maxillaire. Celle-ci est souvent associée à une autre anomalie de positionnement, qu'elle soit dans le sens vertical ou bien antéro-postérieur. L'ostéotomie de type LeFort I multisegmentaire permet de corriger les différents problèmes composant la malocclusion squelettique en une seule chirurgie. L'objectif de cette étude est d'évaluer la stabilité de cette procédure chirurgicale à moyen (fin du traitement orthodontique) et long termes (au moins deux ans après la fin du traitement orthodontique) dans les trois plans de l'espace (transversal, antéro-postérieur et vertical), sur un échantillon de trente-et-un patients traités en clinique privée, ayant eu une chirurgie LeFort I multisegmentaire en deux, trois ou quatre morceaux, et ayant terminé leur traitement orthodontique. La collecte des données a été réalisée sur des modèles et des radiographies céphalométriques latérales pris à des temps précis tout au long du traitement orthodontique ainsi que pendant la période de contention. Une récidive transverse significative, mais très faible cliniquement, est constatée aux niveaux prémolaires et molaires entre la chirurgie et la fin du traitement orthodontique. Elle est corrélée avec l’expansion totale réalisée. Une variation de certaines mesures antéropostérieures et verticales statis-tiquement significative, mais faible cliniquement, est également notée entre la chirurgie et la fin du traitement orthodontique. Aucun changement n'est statistiquement significatif suite au traitement orthodontique. Pour l'échantillon étudié, la stabilité de l'ostéotomie de type LeFort I multisegmentaire est très bonne, dans les trois plans de l'espace étudiés.
University of Toronto LEVELING OF THE CURVE OF SPEE IN DEEP OVERBITE CASES TREATED WITH THE INCOGNITOTM LINGUAL ORTHODONTIC APPLIANCE SYSTEM: A RETROSPECTIVE CEPHALOMETRIC ANALYSIS Authors: J NARDONE*, B TOMPSON, A METAXAS, S SURI An excessive curve of Spee (COS) is a common finding amongst orthodontic patients, particularly in those with a deep overbite (OB). The method by which this curve is leveled and the deep bite is corrected is dependent on the orthodontic technique used. Studies investigating leveling techniques using conventional labial appliances have been carried out, but to date, little data exists for lingual systems. The purpose of this retrospective cephalometric analysis was to determine the method of leveling and deep bite correction in patients treated with IncognitoTM, a fully customized lingual orthodontic appliance system. Pre-treatment and post-treatment cephalometric radiographs were collected and compared for 34 adult patients each with a deep OB and an excessive COS treated with a fully customized lingual bracket and archwire system, IncognitoTM. Radiographs were examined using Dentofacial Planner v9 Beta (Dentofacial Research Inc., Toronto Canada) and paired t-tests were performed on the data. The mean pre-treatment and post-treatment COS was 1.78 mm (SD: 0.36 mm) and 0.37 mm (SD: 0.41 mm) respectively, indicating a significant amount of occlusal plane leveling (-1.41 mm, SD: 0.49 mm, p<0.001). The mean pre-treatment and post-treatment OB was 5.80 mm (SD: 1.26 mm) and 2.91 mm (SD: 0.86 mm) respectively, demonstrating a significant reduction in the amount of incisor overlap (-2.89 mm, SD 1.27 mm, p<0.001). COS Leveling and deep OB correction was accomplished by mandibular incisor intrusion (-0.92 mm, SD: 0.87 mm, p<0.001), mandibular premolar extrusion (0.85 mm, SD: 0.91 mm, p<0.001), mandibular molar extrusion (0.50 mm, SD: 0.89 mm, p<0.05), in addition to a considerable but variable degree of incisor proclination (mandible: 6.86O, SD: 5.10O p<0.001, maxilla: 2.61O, SD: 5.82O, p<0.05). In this sample of adult patients treated with the IncognitoTM lingual appliance system, COS leveling and deep OB reduction were achieved primarily by incisor proclination, and a slightly greater (but not significant) amount of mandibular incisor intrusion versus premolar and molar extrusion.
Spring 2013 • CAO Bulletin
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CFAO Graduate Student Posterboards University of Toronto CERVICAL VERTEBRAL MATURATION IN PATIENTS WITH COMPLETE UNILATERAL CLEFT LIP AND PALATE Authors: C.Caro, R.B.Ross, B.D.Tompson, E.W.N.Lam BACKGROUND: It is well known that the lateral view of cervical bodies changes with growth. The cervical vertebral maturation (CVM) method has been proposed as a diagnostic factor for assessing skeletal maturation in orthodontic patients. In addition, cephalometric studies have shown that there are facial differences in populations with and without clefts suggesting that the presence of cleft lip/or palate is associated with other physical developmental anomalies. This study is the first to investigate skeletal maturation using the CVM method in children with complete unilateral cleft lip and palate. OBJECTIVE: The study was designed to evaluate the skeletal maturation associated with children with non-syndromic unilateral cleft lip and palate as compared to non-cleft individuals using the cervical maturation (CVM) method. MATERIAL AND METHODS: This retrospective cohort study included 336 lateral cephalometric radiographs from 62 children (34 boys and 28 girls) with non-syndromic complete unilateral cleft lip and palate from the Hospital for Sick Children and from 50 non-cleft children (25 girls and 25 boys) from the Burlington Growth Centre were included to assess cervical stage (CS) at age 10, 12 and 14. The CVM was assessed using the 6-stage method described by Baccetti and coworkers. One investigator performed all the CVM classifications for both groups and data for males and females were assessed separately. RESULTS: The reproducibility of classifying CVM stages was high, with an inter-rater reliability (ICC) with the gold standard (Baccetti and coworkers) = 0.85 and intra-rater reliability =0.8. Overall, CVM stage for that boys and girls with UCLP were significantly lower than their peers without a cleft at age 10, 12 and 14.Conclusion: The results suggest that in patients with UCLP will show delayed skeletal maturation in comparison to non-cleft patients.
University of Western Ontario AN IN-VITRO STUDY EVALUATING THE FRACTURE RESISTANCE OF COMMONLY USED SELF-DRILLING MINIIMPLANTS UPON INSERTION INTO SYNTHETIC HIGH DENSITY MANDIBULAR BONE Author:
A.L. Smith 1, Y.K. Hosein 2, A.Tassi1, C.E. Dunning 2,3 Graduate Orthodontics Program, Biomedical Engineering Graduate Program, Department of Materials & Mechanical Engineering
1 2 3
INTRODUCTION: Self-drilling mini-implants are commonly used in orthodontics, but there is little information regarding their fracture resistance in areas of high density bone. Purpose: To determine the peak fracture torques of six commonly used self-drilling mini-implants, and compare with measurements of peak torques obtained from mini-implant insertion into synthetic mandibular bone. MATERIALS AND METHODS: Fifteen mini-implants from six different manufacturers were drilled into Plexiglas blocks using a custom-made insertion device incorporating a 6-DOF load cell for torque measurements. Peak fracture torques were recorded and compared for each of the six manufacturers. Additionally, ten mini-implants from each manufacturer were inserted into non pre-drilled mandibular bone substitutes (Sawbones®), and measures of peak insertion torque for each manufacturer were compared to their respective fracture torques. Groups that experienced fracture upon insertion into the bone substitutes underwent further testing of insertion torques, specifically following their manufacturer pre-drilling recommendations. RESULTS: Statistical analysis revealed significant differences (p<0.05) in the peak fracture torques among all manufacturer mini-implants, as well as between fracture and insertion torques for Unitek, Vector, Dual Top and OrthoEasy. Tomas and Aarhus experienced fractures during insertion into the non-pre-drilled bone substitutes. When manufacturer’s pre-drilling recommendations were followed, Aarhus continued to experience fractures during insertion. CONCLUSIONS: Based on the results of this in-vitro study, Unitek, Vector TAS, Dual Top, and Ortho Easy can be safely inserted into areas of thick and dense cortical bone without pre-drilling. Tomas-Pin can be safely inserted provided manufacturer pre-drilling recommendations are adhered to. The manufacturer's recommendations for the use of Aarhus in areas of thick cortical bone may need to be modified. (Key words: Orthodontics, anchorage, mini-implant, miniscrew, TAD, temporary anchorage device, fracture, insertion torque, predrilling, pilot-hole, high density bone, cortical bone thickness.)
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CAO Bulletin • Spring 2013
Component Society Reports
British Columbia Dr. Rick Odegaard [Email: dr.odegaard@shawcable.com] Since the last report, the BCSO met on September 17th and November 26th, 2012. The BCSO is proceeding with development of a new website using funds raised through a membership levy. As of November 26th, 2012, 94 of the required 115 contributions had been received. The website will proceed and any shortfall will be addressed through the BCSO general account. Development of the mentorship committee is progressing under the direction of Dr. Lun Wang. The committee is currently arranging for members to act as mentors. It is the 100th anniversary of the PCSO. Dr. Robin Jackson of British Columbia received the 2012 Annual Session Honoree Award. The PCSO Bulletin is converting to a digital format.
Alberta Dr. Bob Kinniburgh [Email: drbob@ncortho.ca] The Alberta Society of Orthodontists (ASO) Annual General Meeting was held March 15th and 16th 2013 at the Rimrock Hotel in Banff, Alberta. Dr. David Paquette spoke on the integration of technology into orthodontic practice, a non-surgical approach to impacted canines and advanced esthetics. The current executive of the ASO includes Past-President Dr. Cory Liss, President Dr. Warren Cohen, Vice-President Dr. Ivan Hucal and Secretary-Treasurer Dr. Darren Tkach.
The legislated infection control protocols for the province were formally mandated in January 2012 and office visitations continue from the ADA&C to ensure compliance. The ASO continues to weigh options in the redesign of the outdated ASO website. The ADA&C continues to restrict Alberta specialists from advertising membership in accredited specialty associations (AAO, CAO, PCSO). Fellowships, other than the fellowship in the Royal College of Dentists of Canada, are also restricted. A complaint relating to the website of two Calgary orthodontists has resulted in requests to the CAO from members to remove their names from the “Find an Orthodontist” link on the CAO website. Utilization of this feature on the CAO website has been viewed as a violation of the ADA&C Code of Ethics.
Manitoba Dr. Susan Tsang [Email: s_tsang2@hotmail.com] The fall Manitoba Orthodontic Society (MOS) dinner meeting was held on October 24th, 2012. The MOS is assessing the feasibility and the cost of running local advertising campaigns based on the most recent AAO Consumer Awareness campaign materials. The information gathering process is ongoing and will be discussed further at the MOS spring meeting. Concurrently, the design of a new website through Televox continues. The Manitoba Dental Association will be starting office assessments on a six-year cycle. All dental offices will be required to have a comprehensive office manual and an infection prevention protocol in place. The spring MOS meeting took place on April 4th, 2013.
The Alberta Dental Association and College (ADA&C) continues to revise and to amend its CBCT guidelines. The ASO has made submissions to represent the interests of its members and to address the restrictions placed on interpretation of CBCT imaging by the orthodontic specialist. Spring 2013 • CAO Bulletin
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Component Society Reports Ontario Dr. Sheila Smith [Email: stuart.smith4@sympatico.ca] The Ontario Association of Orthodontists (OAO) launched the latest version of its Consumer Awareness Program (CAP) in January 2013. The campaign utilized 15 and 30 second commercial spots placed on CTV, CTV2 and E! Channel over an eight-week period. A highlight included a spot during the Golden Globes award presentation. The OAO customized the ‘Your Life, Your Smile’ creative developed by Athorn Clark, by using the OAO logo and website address. Athorn Clark completed the media buy at an approximate cost of $76,000 USD. The media campaign was discussed with CAO-AAO liaison committee in Ottawa and was designed to dovetail with the AAO Canadian CAP. Although the campaign may benefit non-CAO members, the benefit to the profession overall is considered significant. The campaign also raised the profile of the profession throughout the country. The OAO believes that a long term national public awareness campaign is a necessary service for its members. Both the OAO logo and website have been updated to correspond with the visuals of the PAC. Dr. Michael Sherman, an OAO Past President, is the President of the GLAO. Dr. Lou Ann Visconti attended the January 18th, 2013 executive meeting and discussed the changing environment in dentistry. Her report noted that patients do not trust their primary
Congratulations on 25 years of membership to the following people: Dr. Richard Bezanson Dr. Josee Dulude Dr. Lawrence Jackman Dr. Stanley Kagetsu Dr. David MacLeod Dr. Danielle Venne
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CAO Bulletin • Spring 2013
practitioners but trust their hygienists more. The Ontario Dental Association has been working to enhance practitioners’ communication skills with patients and continues to struggle with hygienists that are working to expand their scope of practice to include the writing of prescriptions and the torqueing of dental implants. The OAO is investigating the option of hosting a combined continuing education, social and political event in June 2014. The weekend meeting will have both a staff and a doctor component. All the current University of Toronto graduate residents attended a CAO dinner on December 6th, 2012. All are student members of the CAO. The UWO Graduate Resident Dinner on April 17th, 2013.
Quebec Dr. Sonya Lacoursière [Email: lacedge@videotron.ca] Congratulations to Jean-Marc Retrouvey who has accepted the CAO’s 2nd Vice President position becoming president in 2015. On October 12th, 2012 the Quebec Association of Orthodontists (QAO) welcomed Montreal prosthodontist Dr. Ngoc Tuan Dinh, The conference entitled “La cooperation multidisciplinaire en médicine dentaire: la vision prosthodontique” held everybody’s attention throughout. The QAO reconvened on November 30th 2012 to hear Toronto oral and maxillo-facial surgeon Dr. Marco Caminiti. His conference “Surgery and TADs” was well received and was appreciated by all who were present. Later, a special presentation was conducted by QAO president Dr. Luigi Di Battista emphasizing the importance of an advertising campaign to reinforce the distinction between an orthodontist specialist and a general dentist. Dr. André Ruest pointed out that over the last two years, the average orthodontists’ income has decreased by as much as twenty percent, potentially attributable to three factors; the global recession and slow economic recovery, the changes in population demographics and the amount of orthodontic treatment provided by non-orthodontists. The latter factor is the only factor potentially sensitive to the effects of a marketing campaign. Four pub/marketing firms were approached and Groupe Rinaldi Communications was retained for a presenta-
Component Society Reports tion to our membership. Following this presentation, the members will receive a postal ballot. A 75 percent majority is required in favor of this campaign for the adoption of a three-year special assessment. On March 22nd 2013, Dr. Robert Vanarsdall spoke on periodontal /orthodontic interactions. The next annual general meeting of the QAO will be held on May 27th, 2013, during “Les Journées dentaires Internationales du Québec”. Dr. Dewitt C. Wilkerson will speak on the temporomandibular joint and occlusion. This fall, the QAO is planning two more scientific sessions to be held on October 18th and November 29th 2013 featuring Dr. C. Greene and Dr. Alain C. Aubé respectively. If any CAO collegues plan to attend a QAO meeting they may contact the QAO’s secretary at (450) 441-0852.
orthodontistes sont les seules personnes possédant l’expertise pour réaligner la dentition. Quatre firmes de publicité/marketing ont été consultées et le Groupe Rinaldi Communications a été retenu pour faire une présentation aux membres. Suite à cette présentation, les membres devront se prononcer par vote postal en faveur (majorité 75%) de l’adoption d’une cotisation spéciale pour les 3 prochaines années afin de financer cette campagne. Le 22 mars, l’AOQ accueillera le Dr Robert Vanarsdall qui nous entretiendra des problèmes Paro-Ortho. Notre assemblée générale annuelle est prévue pour le 27 mai prochain pendant les Journées Dentaires Internationales du Québec. Le Dr Dewitt C. Wilkerson (Occlusion et TMD) sera notre conférencier invité lors de cette rencontre. Cet automne, les deux rencontres scientifiques de notre association se tiendront le 18 octobre et le 29 novembre prochains. Les conférenciers invités sont les Drs C. Greene et Alain C. Aubé respectivement.
Rapport de la province de Québec Tout d’abord, j’aimerais féliciter le Dr Jean-Marc Retrouvey d’avoir accepté la position de second vice-président à l’ACO. Dr. Retrouvey est en ligne pour la Présidence en 2015. Le 12 octobre dernier, l’Association des orthodontistes du Québec (AOQ) a accueilli le Dr Ngoc Tuan Dinh, prosthodontiste de Montréal. La conférence intitulée « La coopération multidisciplinaire en médecine dentaire : la vision prosthodontique » a su retenir l’attention de son public jusqu’à la fin de la journée. L’AOQ s’est réunie le 30 novembre dernier pour entendre le Dr Marco Caminiti, chirurgien maxillo-facial de Toronto. Cette conférence “Chirurgie et TAD” fut fort appréciée par les nombreux confrères/consœurs qui étaient présents. Lors de cette rencontre, une réunion extraordinaire a été présidée par le Dr Luigi Di Battista, président de l’AOQ. La réunion avait pour but de présenter aux membres l’importance de financer une campagne de sensibilisation sur la distinction entre le rôle de l’orthodontiste et celui du dentiste généraliste. En résumé, le Dr André Ruest nous a présenté la problématique suivante : diminution du chiffre d’affaires des orthodontistes allant jusqu’à 20% depuis les deux dernières années. Ce phénomène repose sur trois causes principales : 1- Crise économique mondiale & reprise qui tarde à venir; 2- Changements démographiques et 3- Service d’orthodontie offert par des non-orthodontistes. La dernière cause étant la seule pouvant être influencée à cours ou moyen terme par une campagne de sensibilisation informant le public que les
En terminant, je voudrais rappeler à nos confrères/consoeurs de l’ACO que si vous êtes intéressés à vous joindre à nous pour une des conférences de l’AOQ, vous n’avez qu’à communiquer avec le siège social de l’AOQ au (450) 441-0852.
In Memoriam
Dr. Kumendran (Kumie) Pather Born in Durban, South Africa on April 13th, 1970, Kumie passed away on February 3rd, 2013. Kumie was president of his high school graduation class. He obtained his Bachelor of Science from the University of Western Ontario, his DDS from Northwestern University where he was class valedictorian, and his Masters of Science in orthodontics from the University of Michigan. Kumie is survived by his wife Sandra, his daughter Thea, his parents, Indrani and Radhakrishna and his brother Vivek. The CAO extends its deepest condolences to the entire Pather family during this time of great loss.
Spring 2013 • CAO Bulletin
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Component Society Reports
WEBINAR UPDATE Dr. Gerry Zeit
Atlantic Report Dr. Dan Stuart [Email: danstuart96@hotmail.com] The Atlantic Orthodontist’s Association held its spring annual general meeting June 22nd to 24th, 2012 in Moncton, New Brunswick at the Delta Beausejour Hotel. CAO President Dr. Ritchie Mah made the long trek from Vancouver, BC. The membership appreciated the detailed synopsis of the current state of affairs in orthodontics. NESO President, Dr. John Callahan was also in attendance. The briefing by Dr. Callahan was informative and focused on the AAO Consumer Awareness Program, including the use of French posters. Doctors, spouses, staff and company representatives enjoyed a golf tournament at the Fox Creek course in Dieppe organized by Mike Leger of 3M Unitek. All were appreciative of such a well-organized event. The Atlantic meeting had a solid continuing education list of speakers. Dr. Adam Schulhof spoke on lingual treatment with the Incognito system. Dr. Sam Daher, the world’s biggest solo provider of Invisalign, presented cases and shared valuable clinical tips. Dr. Jamie Reynolds showcased the Insignia system using treated cases to illustrate the significant clinical benefits of this system. Thank you to 3M Unitek, Invisalign and Ormco for their continued support. This year the band Bittersweet was sponsored by Grant Thorton and BMO Nesbitt Burns. Everyone danced the night away with a party in fine Maritime style. The current slate of officers for the AOA includes PastPresident Dr. Stephen Roth as Secretary Treasurer Dr. Don Johnston is the current Vice-President and is also the Atlantic component representative to NESO. Dr. Brien Stackhouse remains a member of the executive committee as a recent Past President. The date of our next annual meeting is Friday, May 24th, 2013 in Halifax, NS. This meeting is administrative in nature to welcome our incoming president Dr. Don Johnston. There will be a short business meeting followed by a dinner for doctors and spouses at a location to be determined. It has been a pleasure to serve the members of the Atlantic Region and to be a part of the CAO Board of Directors.
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CAO Bulletin • Spring 2013
Sleep Apnea The Sleep Apnea webinar was held on Tuesday, November 26th, 2012. The presenter was Dr. Jean-Marc Retrouvey. There were 46 registrants for the webinar. Dr. Retrouvey was a knowledgeable and well-prepared speaker. The presentation was excellent and was received with interest by all the participants. Continuing education certificates were distributed to the participants and the presentation is now archived and available for viewing on the CAO website. The original intent was to offer the webinar in both French and English, on consecutive evenings. Dr. Retrouvey was prepared to do both. Since there was only one registrant for the French presentation it was subsequently cancelled. This webinar was the first webinar with online registration in addition to the traditional paper based system. More than 85 percent of registrants used the online registration process.
All participants were invited to complete an online evaluation after the presentation. With the exception of certain technical considerations, all aspects of the webinar including, content and the speaker himself were rated either “above average” or “excellent” by the majority of respondents. Some individuals did report difficulty hearing the speaker and/or asking questions. All respondents said they would participate in another webinar if offered. All respondents found the time of the presentation appropriate. When asked about future webinars, all respondents expressed interest in presentations on clinical orthodontics. Other topics with a high level of interest include practice management, current research and new products. There was no interest in further insurance webinars. Reliance on this evaluation information should be tempered by the small number of responders. Members were asked if they would participate in a webinar if there was a nominal charge attached. Five out of six respondents said they would and one member skipped this question. Two commented that it would depend on the speaker and the fee and one expressed mild displeasure with the idea. Thank you to Dr. Retrouvey for his presentation and to Alison Nash and to Jackie Wilmore for their administrative assistance. A donation was made to the CFAO in honour of Dr. Retrouvey.
The next webinar was held on April 23rd, 2013 and featured Dr. Jose Lanca speaking on bisphosphonate medication and its relevance to orthodontic treatment. Please forward suggestions for future speakers and topics of interest at your convenience.
From the Editor Dr. James Posluns [Email: james.posluns@utoronto.ca]
Survey Says!!!! Have you ever been booting along the highway, trying to ignore the iPhone beside you on the passenger seat only to pull up behind a truck with a big sticker on its backside that implores you to answer the question “How’s my driving? Call 1-800-You-Haul,” or something like that. I’ve always meant to call but never have. I can only imagine the conversation. “U Haul Trucking. Mack here.” “Hi Mack. Last weekend I was driving with my family to Cleveland to visit the Rock and Roll Hall of Fame and I noticed that one of your trucks was driving erratically. When I pulled up beside him to pass, the driver put down his newspaper, rolled down the window and flipped me the bird.” “And?” “And what? “ “Did you get his name?” “We were travelling at 110 Kilometers an hour!” “So you were speeding.” “What?” “You were speeding. It’s you who was driving erratically.” “Mack. Your driver flipped me the bird with my kids in the car.” “Consider it sign language. Thanks for the call.” I’m amazed by the number of companies and organizations that are so interested in obtaining our feedback through tele-
phone numbers, websites, emails and apps. With all that feedback, you’d think customer service would be off the chart in this part of the world. But it’s not even close. So what happens to all that feedback? Not much I reckon. Here’s an example of what I speak: I’m not a drinker so I substitute my empty caloric intake with Dairy Queen (DQ). I’m an incredibly loyal subject. For my last birthday, I received a gift card equivalent to my age, so the card was pretty full. When I went to use it, the cashier
the illustrious dental program of which I’m affiliated was accredited. I had a line of questioning that went something like this; “Do you distribute post-treatment surveys to patients?” “Yes” “What do you do with them?” (Awkward pause). “I’m not sure. I’ll have to ask my secretary”. (Later that day) “Hey Sandra, what do we do with the patient exit surveys?” “Nothing”. “Really. Good to know”. That’s what I think happens to the majority of surveys. Lots of questions. Brilliant smoke and mirrors. Looks good on paper but not much to show for all the effort. Kinda reminds me of my orthodontic thesis. I’m not sure what’s going through the minds of the survey writers, but do they honestly think that folks are just sitting around waiting to fill out a page with a number of questions on it for their own alleged benefit?
fiddled around and inadvertently charged me twice. I consulted the DQ website and sent an email the Queen herself. I received a lovely email back, thanking me for being a loyal subject and promising that they would investigate. Then nothing. I followed up. Still nothing. Sure I still frequent DQ, but I want my 7 bucks back! It killed me to write this one off. Quality assurance is the name of the day. Everyone wants to send out a survey. Help me help you. Dentistry has got to be one of the worst offenders. Last year,
The AAO loves surveys. And they love on-line communication. How many emails have you received of late asking for ‘member input’? Again, sounds like a good idea, but it can only lead to too many cooks in the kitchen. Maybe the survey is really a safety net. If an idea is put forth and it fails, blame the data upon which the idea is based. How can one go wrong with that? Funny, one never really hears about survey data when a successful idea is implemented. Nope. We came up with this all on our own. Sounds familiar. Ever notice that you only hear from your broker when he or she is making you money? Interesting. Continued… Spring 2013 • CAO Bulletin
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I’m in favour of doing away with the multitude of surveys. Since that isn’t going to happen, I have but two straightforward requests. One: Keep the questioning to a minimum; short and sweet. One page maximum. Lots of check boxes and yes or no answers. Have mercy on us; we are but simple folk. Two: Please, don’t survey every little thing. Make a decision and let the chips fall where they may. No one will hate you for it, and you’ll be a much stronger organization in the long run. So, as you travel down the highway known as life, be careful before you ask about or comment on one’s driving. If you do ask for feedback, be willing to do something constructive with it. If you offer feedback, be prepared to be given the heave-ho. It’s not just life, it’s customer service.
Due to rumours that there was a world shortage of chewing gum, everyone was stocking up on packs. By the time I’d got to the store, they had sold out! However, there were two people at the till who had already bought 4 and 5 packs respectively and they kindly offered to share their packs with me. After the sharing, we all had the same number of packs each and I paid them $9 for my packs. How did they share the $9 between them?
Thanks for calling. Jimmy P
We’d like to hear from You! Send in your pictures from your local meetings and events. Show us what you’ve got! If something of interest happens in your area, let us know. We are interested and are confident others will be as well. Send to: James Posluns, Bulletin Editor Email: james.posluns@utoronto.ca
Straight Shooters
Canadian Association of Orthodontists UPCOMING ORTHODONTIC MEETINGS 2013
Why did the orthodontist switch to endodontics? He couldn’t get his mind out of the gutta (percha).
June 26-30 . . . . . . .European Orthodontic Society Annual Session, Reykjavik, Iceland
Why did the orthodontist take up scuba diving? He was so into his practice, he wanted to swim with Dolphin!
Sept. 19-22 . . . . . .MSO Annual Session, Kansas City, MO
Sept. 19-21 . . . . . .CAO Annual Session, Banff, AB Sept. 26-29 . . . . . .GLAO Annual Session, Colorado Oct. 2-6 . . . . . . . . . .SAO Annual Session, Hilton Head Island, SC Oct. 10-13 . . . . . . .SWSO Annual Session, Dallas, TX
Deep thoughts
Oct. 16-20 . . . . . . .PCSO Annual Session, San Diego, CA
Creative orthodontists build practices and make money.
Oct. 31- Nov. 5 . . .American Dental Association Annual Session, New Orleans, LA
Creative accountants go to jail.
Nov. 14-17 . . . . . . .MASO/NESO Joint Annual Session, Puerto Rico (tentative) 2014 Sept 4-6 . . . . . . . . .CAO Annual Session Montreal, QC
Puzzle Answer: $3 and $6. As there were 9 packs in total, we each received 3 packs. The first person therefore gave me 1 pack, and the second person gave me 2 packs. So the money had to be shared in the same ratio, 1:2.
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CAO Bulletin • Spring 2013
2015 Sept 17-19 . . . . . . .CAO Annual Session, Victoria, BC