CAO BULLETIN - Fall 2014 by LS Graphics

CANADIAN ASSOCIATION OF ORTHODONTISTS / ASSOCIATION CANADIENNE DES ORTHODONTISTES Your Smile is Our Specialty!

Bulletin Fall 2014

In this Issue… ■

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Message from the President Message from the Outgoing President Highlights of the 66th Annual Scientific Session

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2014 CAO Award Winners

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Committee Reports

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Component Society Reports Outstanding Post Graduate Orthodontic Programs

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Student Posterboards

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In Memoriam

Message from the President Canadian Association of Orthodontists Association canadienne des orthodontistes 2800 14th Avenue, Suite 210 Markham, Ontario L3R 0E4 Toronto, Ontario M2J 1W8 Telephone (416) 491-3186 / 1-877-CAO-8800 Fax (416) 491-1670 E-mail cao@associationconcepts.ca Website www.yoursmileourspecialty.ca AND www.canadabraces.ca

2014/2015 Board of Directors OFFICERS President President Elect Past President 1st Vice President 2nd Vice President Secretary/Treasurer

Dr. Helene Grubisa Dr. Jean-Marc Retrouvey Dr. Garry A. Solomon Dr. Robert D. Kinniburgh Dr. Rick Odegaard Dr. Michael Patrician

REGIONAL DIRECTORS British Columbia Alberta Saskatchewan Manitoba Ontario Quebec Atlantic

Dr. Gerald Philippson Dr. C. Todd Lee-Knight Dr. Michael Wagner Dr. Susan Tsang Dr. Sheila Smith Dr. Michel Di Battista Dr. Donald E. Johnston

COMMITTEES President CFAO CAO/CDSA Liaison Insurance Committee

Dr. Stephen Roth Dr. Robert D. Kinniburgh Dr. Mike Wagner Dr. Don Johnston

Membership Committee

Dr. Helénè Grubisa Dr. Todd Lee-Knight

Sponsorship Chair

Dr. Michael W. Patrician

WFO - Country Rep

Dr. Helénè Grubisa

WFO - Member-at-Large Conference Advisory Committee Chair New & Younger Members Rep CAO/AAO Liaison Planning & Priorities By-Laws Task Force Communications Nominations Canadian Orthodontic Educators RCDC Liaison

Dr. Jean-Marc Retrouvey Dr. Howard Steiman Dr. James Posluns Dr. Rick Odegaard Dr. Helénè Grubisa Dr. Amanda Maplethorp Dr. Dan Pollit Dr. Garry Soloman Dr. James Posluns Dr. Thomas R. McIntyre

CAO Web Master Bulletin Editor Parliamentarian/Historian/Archivist CAO Helpline Task Force GST/HST Advisor

Dr. Daniel Pollit Dr. James Posluns Dr. Amanda Maplethorp Dr. Howard Steiman Dr. Michael W. Patrician

Dr. Helene Grubisa Email: drgrubisa@sympatico.ca

As I sat down to the daunting task of writing the President’s Message, I really wasn’t sure what you would like to know about current CAO activities, the Board of Directors, or the current president. So I asked my husband Eric what he thought. His reply was to “be brief”! My son piped in with “soit drôle maman” (be funny). Funny? Me? Not so much. So here is my best shot at brevity. The Board of Directors and the associated committees have made substantial accomplishments in recent years, including improvements to the Scientific Session, the website and the ever-popular Consumer Awareness Program (CAP). The CAP strives to educate the public on the merits of seeing an orthodontist. The CAO branded its logo onto the AAO advertisements for use on Canadian national television. This past year, the television ads were also translated and dubbed into French to improve exposure across Canada via SRC (Société Radio Canada). This seemingly simply task is, in reality, no small feat. The campaign will continue in 20142015 with new AAO commercials, print ads and an improved online presence. The television ads will again air in both official languages with CAO buying airtime and using ads with the CAO logo. The CAO website (www.yoursmileourspecialty.ca) was restructured, updated, and fully translated. This project was completed to satisfy Canadian French television regulations associated with the French versions of the CAP and for the benefit of our French-speaking members and patients. The Canadian Foundation for the Advancement of Orthodontics (CFAO) is currently working on a very exciting project. The CFAO Executive has approved and provided funds to implement the Smiles 4 Canada program. This program provides orthodontic treatment to deserving, low-income young people on a pro-bono basis. The CFAO, along with president Stephen Roth, are hoping to launch a pilot program in a defined area in the next 12 months and to launch the program nationwide within 24 months. Stay tuned for the details and instructions on how you can get involved. People often ask what made me get involved with the CAO. The question is a fair one given the fact that I have two young children, Christian (4) and Noëlle (2), and that I work fulltime as a solo practitioner. While there are a number of reasons for getting involved, for me, the main reason is that as orthodontics changes, I feel that the Board should reflect these changes to remain current and reflective. There are more and more women in orthodontics. When teaching in the University of Toronto’s graduate orthodontic program, I am astounded to see how many women continue to enter the profession in comparison to when I graduated in 2002 (which wasn’t THAT long ago…). The questions that the residents ask me are often about the specific challenges faced by female orthodontists, namely maternity leaves, balancing family responsibilities, and relationships with staff when the “boss” happens to be a woman. Orthodontics is the same whether you are a female or a male practitioner, but staff and patient dynamics can be markedly different. I am proud to represent the francophone members. There is a wealth of experience, Continued…

FALL 2014 • CAO Bulletin

enthusiasm and talent in Quebec and in other provinces that make up this community. Please don’t let a perceived language barrier be a barrier and please don’t be shy to have your voice heard.

des publicités imprimées et une présence en ligne accrue. À la télévision, les annonces seront encore diffusées dans les deux langues officielles; l’ACO achètera en effet du temps d’antenne et utilisera des annonces où figurera notre logo.

The reality today is that there are larger numbers of young orthodontists in Canada than ever before. There are more students that have traveled in the US taking the Royal College exams than there are Canadian students and each comes with unique experience. Debt, the availability of associate positions and having to work in multiple offices are all issues that young orthodontists today must face. We need to hear of these experiences so the organization can continue to serve the needs of its members.

Le site Web de l’ACO (www.yoursmileourspecialty.ca) a été restructuré, mis à jour et entièrement traduit. Ce projet a été mené à bien pour satisfaire aux règlements sur la télévision en français canadien en lien avec la version française du PSC et au bénéfice de nos membres et patients francophones.

Numerous presidents’ messages have included an appeal to get involved in the organization and I echo that appeal. I call not only on our established and our experienced orthodontists but on our younger orthodontists, and yes, those ladies out there to take part in committees and Board of Directors matters. Yes, we have kids, (my son attended his first board meeting at 6 weeks old), spouses, rewarding careers, and many family obligations to balance, but the CAO needs you. If you don’t speak up, your opinions cannot be heard. Like Maman and Pere have always said, “if you don’t speak up, don’t complain when no one listens to you”. Thank you for the opportunity to be involved in such a fine organization. I am honoured to work with such great colleagues, many of which have become great friends.

Message de la président Alors que je m’attaquais à la tâche redoutable de la rédaction du message de la présidente, je me suis interrogée sur ce que vous aimeriez savoir au sujet des activités actuelles de l’ACO, du conseil d’administration ou du président actuel. J’ai alors demandé à mon mari Éric ce qu’il en pensait. Il m’a répondu : « Sois concise »! Mon fils a ajouté « sois drôle, maman ». Drôle? Moi? Pas tout à fait. Voici donc ce que je peux faire de mieux en matière de concision. Le conseil d’administration et ses comités associés ont accompli des réalisations considérables au cours des dernières années, dont des améliorations à l’Assemblée scientifique, au site Web et au toujours populaire plan de sensibilisation des consommateurs (PSC). Le PSC a pour but d’informer le public sur les avantages de la consultation d’un orthodontiste. L’ACO a inséré son logo dans les annonces de l’AAO aux fins de diffusion à la télévision nationale canadienne. Ajoutons que, l’an dernier, les annonces télédiffusées ont été doublées en français, de sorte à augmenter la visibilité partout au Canada par l’entremise de la SRC (Société Radio-Canada). Cette tâche, en apparence simple, représente une prouesse dans les faits. La campagne se poursuivra en 2014-2015 avec de nouvelles annonces de l’AAO,

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La Fondation canadienne pour l’avancement de l’orthodontie (FCAO) poursuit à l’heure actuelle un projet très emballant. La direction de la FCAO a approuvé le programme Smiles 4 Canada et l’a appuyé d’un financement. Ce programme offre un traitement orthodontique bénévolement à de jeunes personnes méritantes et à faible revenu. La FCAO, de même que son président Stephen Roth, espèrent lancer un programme pilote dans un secteur défini au cours des 12 prochains mois et de l’étendre à l’échelle du pays dans un délai de 24 mois. Demeurez à l’affût des détails et des instructions sur votre participation éventuelle à ce programme. On me demande souvent ce qui m’a amenée à participer aux activités de l’ACO. C’est une question tout à fait justifiée si on considère que j’ai deux jeunes enfants, Christian et Noëlle, âgés respectivement de 4 et de 2 ans, et que j’exerce seule à temps plein. Si une telle participation peut s’appuyer sur une foule de raisons, pour ma part, je crois surtout que le Conseil doit suivre l’évolution de l’orthodontie pour demeurer actuel et en prise avec elle. L’orthodontie compte de plus en plus de femmes dans ses rangs. Lorsque j’enseigne au programme de premier cycle d’orthodontie à l’Université de Toronto, je m’étonne du nombre de femmes continuant d’intégrer la profession comparativement à la situation qui prévalait, en 2002 (il n’y a pas SI longtemps…), lorsque j’ai décroché mon diplôme. Les questions que les résidentes me posent gravitent souvent autour des défis particuliers que doivent relever les femmes orthodontistes, notamment aux chapitres des congés de maternité, de l’équilibre travail-famille et des relations avec le personnel lorsque le patron est une patronne. Qu’elle soit exercée par une femme ou par un homme, l’orthodontie demeure l’orthodontie, mais la dynamique avec le personnel et les patients peut différer considérablement. Je suis fière de représenter les membres francophones. Au Québec et dans d’autres provinces, cette communauté s’appuie sur des trésors d’expérience, d’enthousiasme et de talent. Je vous prie de ne pas laisser la perception d’une barrière linguistique se poser en obstacle et n’hésitez pas à faire entendre votre voix. À l’heure actuelle, le Canada compte plus de jeunes orthodontistes que jamais. On recense davantage d’étudiants qui ont séjourné aux États-Unis et passé les examens du Collège royal qu’il y a d’étudiants canadiens, et chacun d’eux est nanti d’une expérience unique. Aujourd’hui, l’endettement, la disponibilité de postes d’associé et l’obligation de travailler dans de multi-

ples cabinets représentent autant de défis avec lesquels les jeunes orthodontistes sont tenus de composer. Ils doivent nous relater leurs expériences, de sorte que l’organisation puisse continuer de répondre aux besoins de ses membres. Nombre de messages du président comportent un appel à la participation à l’organisation que je reprends à mon tour. Et je m’adresse autant à nos orthodontistes établis et chevronnés qu’à leurs homologues plus jeunes et, oui, mesdames, siégez aux comités et participez aux enjeux qui relèvent du conseil d’administration. Bien sûr, nous avons des enfants (mon fils a assisté à sa première réunion du Conseil dès l’âge de 6 semaines), un conjoint, une carrière épanouissante, de multiples obligations familiales à équilibrer, mais l’ACO a besoin de vous. Nous ne connaîtrons jamais votre opinion si vous ne prenez pas la parole. Comme l’ont toujours dit ma mère et mon père : « Si tu ne t’exprimes pas, ne te plains pas que personne ne t’écoute ». Je vous remercie de m’offrir l’occasion de participer à une organisation aussi extraordinaire. Je suis honorée de collaborer avec des collègues remarquables, dont nombre sont devenus des amis tout aussi remarquables.

Message from the Outgoing President Dr. Garry A. Solomon [Email: hellener@lks.net] Following ten years on the Board of Directors, my respect for this association and this profession continues to grow. It truly has been a privilege to serve the CAO as your president, and I thank you for this honour. This year there have been countless conference calls, emails, committee meetings in addition to the provincial society meetings, the CAO-AAO Liaison meeting in New Orleans and the CDA meeting in Ottawa. The tireless efforts of the line officers and the entire Board are the reason why the CAO operates so smoothly. Without the help and guidance of Association Concepts (AKA Taylor Enterprises), none of this would be possible. I truly thank everyone for their professionalism, guidance and support throughout my presidency. When I started my term, I sent out a Monkey Survey to establish what the membership wanted and what they expected from the CAO to better serve their needs. The results were used by the Board at the February strategic planning session to guide the CAO into the future. The Consumer Awareness Program (CAP) was the overwhelming priority. Communications is to become a significant CAO focus in the future.

HST /GST continues to be a major issue for many members. The CAO has met with the CDA, and will soon meet again with the CDA and with CRA to better understand why CRA is disallowing input tax credits (ITCs). The best guideline to remember is that HST is a multiple supply issue. There is both an appliance component and a service component. If the orthodontist does not separate the services (adjustments) from the appliances on the patient’s bill or contract, then the CRA will disallow the ITC. Likewise, if the appliance component (estimated to be up to 35 per cent of the treatment fee) is not accurately reconciled on your year-end tax return to the actual amount instead of the 35 per cent estimate, then the ITC will be disallowed. The Insurance Committee, with the help of the CDA, is investigating the possibility of electronic submissions for predetermination of orthodontic benefits while still maintaining the basic CAO guidelines. These guidelines include no codes, no assignment, no provision of records, and the use of the standard CAO information form for payment. The CDSA (Canadian Dental Specialists’ Association) is rapidly becoming the new voice for dental specialists throughout Canada. As a result of the emergence of the CDSA, CDA has disbanded COSA (Committee on Specialist Affairs) and now interacts with only the CDSA on specialty issues. The CDSA has been granted observer status by the CDRAF and by the RCDC. While chairing the CAO-AAO Liaison meeting in New Orleans, a CAO-AAO Master Agreement was signed by the AAO and CAO presidents. This Memorandum of Understanding acknowledges the differences between our two countries and how to best serve our memberships in view of these differences. The policy and procedures manual is analogous to an instruction manual for the day-to-day running of the CAO. This manual is a work in progress. The Board has made recent changes to simplify future administrative needs in response to the Not-ForProfit legislated requirements. Anonymous helpline contact phone numbers are now listed in the CAO Bulletin and in the members’ website to assist in times of crisis. Ontario, Manitoba and BC utilize CDSPI and the remaining provinces use other professional support organizations. The Scientific Session in Montreal was attended by approximately 600 attendees, and continues to be a valued member benefit. The Cirque de Soleil banquet theme was one of the most unique in CAO history. It will be remembered as a highlight of the meeting. On behalf of the membership, I sincerely thank Howard Steiman and all of his committee members, as well as Association Concepts, for their dedication and hours of hard work. Their efforts made the ordinary simply extraordinary! My final thank you is to my wife Helen. Without her strength, dedication, support and understanding, the presidency would have been impossible. I thank her for allowing me to give up our precious time together over the past year for me to serve the membership. Continued… FALL 2014 • CAO Bulletin

Message du président sortant Au terme d’une présence de dix ans au sein du Conseil d’administration, mon respect à l’égard de cette association et de cette profession ne cesse de croître. Assumer la présidence de l’ACO, et la servir, ont été un privilège, et je vous remercie de l’honneur que cela représente. Cette année a été marquée par d’innombrables conférences téléphoniques, courriels et réunions de comité qui s’ajoutaient aux réunions des sociétés provinciales, à la réunion de liaison ACOAAO, à la Nouvelle-Orléans, et à la rencontre de l’ADC, à Ottawa. C’est en raison des efforts constants des cadres hiérarchiques, et du Conseil tout entier, que l’ACO fonctionne sans heurts. Sans l’aide ni l’orientation d’Association Concepts (alias Taylor Enterprises), rien de tel ne serait possible. Je les remercie sincèrement tous de leur professionnalisme, de leurs conseils et de leur soutien tout au cours de ma présidence. Lorsque j’ai amorcé mon mandat, j’ai lancé un sondage SurveyMonkey pour déterminer ce que les membres voulaient et ce qu’ils attendaient de l’ACO pour qu’elle comble encore mieux leurs besoins. Le Conseil a utilisé les résultats de ce sondage à la séance de planification stratégique, en février dernier, pour guider l’ACO à l’avenir. Le plan de sensibilisation des consommateurs (PSC) a occupé une place prépondérante parmi les priorités. Les communications deviendront également un enjeu important de l’ACO à l’avenir. La TVH/TPS constitue toujours un enjeu d’envergure pour nombre des membres. L’ACO a rencontré l’ADC, et la rencontrera encore sous peu, en compagnie de l’Agence du revenu du Canada (ARC), en vue de mieux comprendre pourquoi l’ARC n’accorde pas de crédits de taxes sur les intrants (CTI). La meilleure ligne directrice dont il convient de se rappeler est que la TVH représente un enjeu aux facettes multiples en matière d’approvisionnement. En effet, il existe un volet « appareils » et un volet « services ». Dans le cas d’un orthodontiste qui n’établit aucune distinction entre les services (ajustements) et les appareils dans la facture du patient, ou dans son contrat, l’ARC ne permettra pas l’application de CTI. De la même manière, si le volet « appareils » estimé (à quelque 35 pour cent des frais des honoraires de traitement) n’est pas concilié avec exactitude dans votre déclaration d’impôt de fin d’année avec le montant réel qu’il représente, le crédit pour CTI ne sera pas admis.

taires partout au Canada. De ce fait, l’ADC a dissous le CAS (Comité sur les affaires liées aux spécialistes) pour interagir maintenant avec l’ACSD exclusivement dans le cas des enjeux liés aux spécialités. La Fédération canadienne des organismes de réglementation dentaire (FCORD) et le Collège royal des chirurgiens dentistes du Canada (CRCDC) ont accordé un statut d’observateur à l’ACSD. Alors que je présidais la réunion de liaison ACO-AAO à la Nouvelle-Orléans, les présidents de l’AAO et de l’ACO ont ratifié une entente-cadre liant ces deux associations. Les différences entre nos deux pays sont reconnues dans ce protocole d’entente, de même que la manière de mieux servir nos membres à la lumière de ces différences. Le manuel des Politiques et des méthodes s’apparente à un recueil de directives d’exploitation quotidienne de l’ACO. Ce manuel est un travail évolutif. Dernièrement, le conseil l’a modifié pour simplifier les besoins administratifs futurs en raison des exigences des règlements sur les organisations à but non lucratif. Les numéros d’un service téléphonique d’aide anonyme sont maintenant donnés dans le bulletin de l’ACO et dans le site Web des membres à titre de ressources en période de crise. L’Ontario, le Manitoba et la Colombie-Britannique ont retenu les services du CDSPI et, les autres provinces, d’autres organismes de soutien des professionnels. L’Assemblée scientifique, qui a eu lieu à Montréal et a réuni quelque 600 participants, demeure un avantage fort apprécié des membres. Le banquet, placé sous le thème du Cirque de Soleil, restera dans les annales de l’ACO en raison de son caractère particulier. Il sera évoqué comme un des faits saillants de l’Assemblée. Au nom des membres, je remercie sincèrement Howard Steiman et tous les membres de son comité, de même qu’Association Concepts, de leur dévouement et de leur travail acharné. Grâce à leurs efforts, l’ordinaire est devenu extraordinaire! Mes derniers remerciements s’adressent à ma femme, Helen. Sans sa force, son dévouement, son soutien et sa compréhension, il aurait été impossible d’assumer la présidence. Je la remercie de m’avoir permis de sacrifier des moments précieux qui nous étaient réservés au cours de l’année écoulée pour servir les membres.

Le comité de l’Assurance, avec l’aide de l’ADC, étudie la possibilité d’effectuer des déclarations électroniques aux fins de prédétermination des avantages orthodontiques tout en maintenant les lignes directrices fondamentales de l’ACO. Ces lignes directrices excluent les codes, la cession, le dépôt de dossier et le recours au formulaire d’information standard de l’ACO aux fins de paiement. L’ACSD (Association canadienne des spécialités dentaires) devient rapidement la nouvelle voix des spécialistes en soins den-

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CAO 2014-2015 Board of Directors

2014 CAO AWARD WINNERS 2014 CAO Distinguished Service Award Winner Dr. Robert H. Cram When one thinks of a positive representation of orthodontics, one doesn’t have to look any further than Dr. Bob Cram. It is obvious how much he has loved the profession he chose by pursing the various ways he has contributed over his career. Dr. Cram was born and raised in the small prairie town of Indian Head, Saskatchewan. He attended the Universities of Saskatchewan and Manitoba while obtaining his Bachelor of Science. Bob was in the third class to graduate from the newly minted College of Dentistry at the University of Saskatchewan. During this time, Bob completed some work at the University of Adelaide and with the Department of Public Health in South Australia. As orthodontics was his objective from the start, he chose to spend two years with the Saskatchewan Dental Plan as one of their nomadic dentists, examining and planning treatment for thousands of children. He returned to the University of Western Ontario to obtain his specialty education in orthodontics, and then returned to the University of Saskatchewan to teach orthodontics. In 1980, Bob and his wife, Jane, relocated to Red Deer, Alberta where he embarked upon his career in private practice. From social clubs, to organized dentistry and orthodontics, Bob was involved in everything both on a local and national level. His work with the CAO officially began in 2003 when he joined the Insurance Committee, the committee of which he eventually would serve as Chair. In 2006, he began rising up the Line to eventually become the president in 2008. During his time as a CAO Officer, Bob became the CDA liaison, focusing his efforts on promoting the work of orthodontic specialists with COSA. Also at this time, Bob worked tirelessly to help CAO members with individual insurance issues that arose in their practices, and liaised with the FNIHB to try to establish continuity and understanding in this area. When Bob retired from practice, he did not officially retire from the Board. He continued to act as a liaison between CAO members and insurance companies whenever problems arose, and made himself available to any member with a question, even from his new life in Qualicum Beach, BC. Additionally, he worked to constantly update the Standard Information Form to best serve the needs of orthodontic offices and patients. In 2013, he continued serving as the Chair of the Insurance Task Force, leading the group to examine the possible directions of insurance support to CAO members for the future. Somehow, he has still found time to spend with his wife Jane, and kids Graeme and Lindsay. But, most of all, he has finally gotten to enjoy watching his beloved Saskatchewan Roughriders win the Grey Cup in 2013! It is because of Bob’s tireless and dedicated work in the area of Insurance on behalf of all CAO members, done with a positive and friendly attitude, that we are proud to honour him with the Distinguished Service Award.

by Dr. Ritchie Mah

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Highlights of the 2014 An

Meeting with friends.

“CAO The Lounge” - Dancing the night away.

Plenary Session - a full house.

Ms. Isabelle Fontaine speaking to the auxiliary delegates.

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Plenary Speaker - Dr. Reginald Goodday

Dr. Duncan Higgins presents at the Plenary.

Dr. James Mah presents to the doctor’s session.

Mme. Pauline Lavoie presenting at the French auxiliary program.

Great discussions at the Round Tables.

Plenary speaker - Dr. Sylvain Chamberland.

nnual Scientific Session!

Enjoying the Culinary Bike Tour

Round table discussion.

Dr. Dan Pollit with his Award of Merit.

CAO Conference Auxiliary Content Subcommittee - Ms Deanna Ghesquiére, Melody Baldry and Susan Helwig.

Mr. George Clark talking about the Consumer Awareness Program at the AGM.

Viewing displays on the trade floor.

Bidding at the CFAO Silent Auction.

Retiring Board member, Dr. Paul Major.

Dr. Andrée Montpetit presents to auxiliary delegates.

CAO Booth - visiting webmaster and viewing conference photos.

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Highlights of the 2014 Annual Scientific Session!

THE PRESIDENT’S SOIREE

Prize Winners: Dr. Louis Cadotte Textbook Ortho Essentials Mme Chantal Doucet Whitening Gift Pack Ortho Essentials Dr. Eric Fortier Bose Speaker 3M Unitek Mrs. Galina Shaloumova Whitening Gift Pack Ortho Essentials Ms. Marie-Claude Hamel Whitening Gift Pack Ortho Essentials Dr. Manuel Lagravere Textbook Ortho Essentials Mrs. Nola Levesque Sonicare Toothbrush Philips Dr. Connie Ling Opal Prize Pack Ortho Essentials Dr. Humam Saltaji Samsung Gear Watch CDSPI Ms. Chantal Van Wolvelaer Go Pro Camera Dentsply GAC

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CAO Board Meeting in Progress

Past Presidnts of CAO

20 14 CAO AWAR D WI N N E R S

Award of Merit Dr. Daniel Pollit For the past 15 years, Daniel has been involved with the CAO as its official webmaster and Communications Chairperson. His first duty as webmaster was revamping the site back in 1999, and then again in 2013. He has devoted countless hours to attending Board meetings, to maintaining the site, keeping it current, and to giving the CAO an online presence. Daniel can always be seen at the annual meeting, manning the CAO web booth on a full-time basis, and offering computer time to registrants. A native Torontonian, Daniel began his post-high school studies in Arts and Science at the University of Toronto, and then spent four years at U of T’s Faculty of Dentistry, receiving his DDS in 1982 and his MSc (Ortho) from the University of Manitoba in 1987. A year as a dental intern at Toronto’s Mount Sinai Hospital was spent between his dental and his orthodontic university years. In a voluntary capacity, he has been a staff orthodontist at Mount Sinai Hospital in Toronto, has served on the executive of Toronto Alpha Omega Alumni Chapter for more than 20 years, and has run the Alpha Omega Dental Volunteer program very successfully for the past 14 years. Daniel is married to Janet and they have two children, Adam and Lori, both enrolled in engineering at the University of Waterloo. Daniel’s spare time activities include spending time with his family, biking in summer, cross-country skiing in winter, rock climbing year round, and flying his quadcopter in between. Dr. Earl Haltrecht

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Highlights of the 2014 Annual Scientific Session!

Thank You CAO Being a member of the baby-boomers generation, I am a product of my environment, so I am not taking the blame for anything I did wrong, or anyone I offended along the way! But, the other side of that equation is that I need to thank everyone who helped me accomplish the things that I did manage to accomplish. My parents supported (including financial) my boyhood dream of becoming an orthodontist. My Mom was a graduate in home economics and my Dad was a PhD geneticist. Dad’s post-secondary education was interrupted by WWII, during which he was shot down and spent the last 18 months as a POW in various European locations. Much of my orthodontic career in practice was modelled after Dr. CR (Ron) Hill, who was my University of Saskatchewan orthodontics teacher; and incidentally he has retired to the same community on Vancouver Island that I have. Dr. Hill practiced orthodontics in the same fashion as my Dad did his research: 24/7, throughout their working years. Both men were an inspiration to me and excellent mentors during my first years in practice. After I completed my graduate program at Western, I associated in a group practice in Saskatoon half time, and taught at the University of Saskatchewan half time. One year later I started my own private practice in Red Deer Alberta, while continuing my half time teaching position at the University of Saskatchewan for another year. In those days, the new guy or girl in practice, was appointed by their provincial association to various association boards, and somehow I was appointed to represent Alberta to the CAO. I attended meetings in Toronto and Montreal, where I was privileged to meet some of the giants in Canadian orthodontics: Drs. Frank Shamy, Robert Faith, and Oleg Kopytov from Montreal, Jack Dale, Richard Pass, and Don Woodside from Toronto, and Yale Malkin, Michael Wainwright and Robert Hicks from Vancouver, during those first few years on the Board. For some reason, I became obsessed with orthodontic insurance, maybe because of my daily mind battles with Alberta Blue Cross? Looking back on my early experiences with ABC, I suspect that Richard Pass and Richard Marcus were egging me on, just to get me hooked on the challenges of negotiating with the clerks and beaucrats with the big insurance companies. The best part of participating in the activities of the CAO has been the opportunity to make so many great friends, coast to coast to coast: Drs. Richard Marcus, Arlene Dagys, Gordie Organ, and Gary Solomon in central Canada, Bob Hatheway and Lee Erickson on the east coast, Amanda Maplethorp, and

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Ritchie Mah on the west coast, as well as Diane and Alison at CAO world headquarters. Orthodontics was my passion and I was very blessed to have been able to have eaten, breathed, and dreamt orthodontics 24 hrs/day, 7 days/week, for 35 years. While I was doing that, Jane worked at our office, and carried the load at home, raising two wonderful young people whom I’m so proud to be able to call my kids. A very special thank-you to Jane for being my best friend, business and employee consultant, and ski and golf buddy for over 35 years. Honestly, I don’t know why Jane ever went out with me a second time, given that I introduced her as Judy to my classmates, on our first (blind) date, a Grey Cup party. I wasn’t nervous at all! I want to conclude by quoting from a recent email I received (author unknown): The Three Simple Rules in Life If you do not go after what you want, you’ll never have it. If you do not ask, the answer will always be “NO”. If you do not step forward, you’ll always be in the same place. I am humbled and very thankfull to the Board of Directors of the Canadian Association of Orthodontists, for awarding the Distinguished Service Award to me. Robert H. Cram, Orthodontist

Helpline Numbers Available for Member Assistance Programs (MAP) This list of contact numbers will provide support to any CAO member who might need or seek additional support in a crisis situation affecting their personal lives. These are anonymous contacts and will provide support and resources for a variety of situations. Nova Scotia Professional Support Program (PSP) - 902-468-8215 Quebec (Medi-Secours) - 514-440-4520 Ontario and Manitoba (CDSPI) English - 1-800-265-5211 French - 1-800-363-3872 Saskatchewan (PAR Consulting) – Saskatoon: 1-800-978-8282 or 306-652-3121 Regina: 1-877-352-0680 or 306-352-0680 Alberta (Confidential Assistance Program – CAP) - 1-800-226-6433 British Columbia (CDSPI) – English - 1-800-265-5211 French - 1-800-363-3872 or Dental Professional Assistance Plan (DPAP) - 1-800-661-9199

CAO ANNUAL SCIENTIFIC SESSION SPONSORS

FALL 2014 • CAO Bulletin

2014 CAO AWARD WINNERS CAO Award for Orthodontic Accomplishment Dr. Claude Remise Dr Remise is officially the Director of the Section of Orthodontics at the University of Montreal; however, he has also been known as ‘Le Père’ to generations of graduate orthodontic students. Dr Remise emigrated from France, landing at Pier 21 in Halifax and has never looked back. He received his dental degree at Université de Montréal in 1970 and his MSc in Orthodontics from Indiana University in 1972. He became an Assistant Professor in the Université de Montréal Orthodontic section in 1972, an Associate Professor in 1978, and a Full Professor in 1991. In 1974, Dr. Remise was named Head of the Orthodontic Section, a position he held until 1983 when he decided to relinquish it. He reassumed being Head of Orthodontics in 1991 and has served with distinction in that capacity since that time. Dr. Remise’s commitment to the Orthodontic Section can best be described in two words – total devotion. He has steadfastly strived to foster a residency program of the highest standard; one that maintains academic and research excellence in order to form the best possible orthodontists, as well as one that provides for the highest quality of patient care. Amongst these graduates are those who have achieved success not only as practicing orthodontists, but also as full-time university professors, as clinical lecturers and instructors and as representatives to dental organizations and dental governing bodies. Dr. Remise has worked tirelessly to attract excellent clinicians to mentor and to supervise the residents, and has dedicated himself to raise the profile of the Université de Montréal orthodontic program locally, nationally and internationally. His dedication and love of teaching have endured all these many years, and his efforts have been most appreciated by the residents who are proud alumni of the only francophone program in North America. His efforts in nurturing a successful graduate training program have been appreciated and rewarded by the Université de Montréal, who in 2011 constructed a brand new facility to house the orthodontic residency program. Dr. Remise studied orthodontics in Indianapolis under Charlie Burstone. Consequently, his biomechanics course is as thorough and tough as they come. Many a first year resident has suffered a bruised ego during the wire bending and multi-loop exercises. For his course, Dr. Remise translated Dr Burstone’s textbook into French, leaving no excuse for not understanding the material at hand. To the residents, biomechanics are hard enough to understand in English, let alone in French! His time studying in Indianapolis gave him a taste of America. Surprisingly, his favourite Château is not in France, but Cinderella’s, in Orlando! Every first year resident has enjoyed a break from the biomechanics world at his last lecture before Christmas and been treated to a slideshow of Dr. Remise’s family vacations to Walt Disney World. True to his roots, Dr. Remise enjoys good food and good wine. During his travels, he has enjoyed some of the world’s best restaurants, however ‘la plus grande table’ is the one prepared by his wife, Françoise. Though Dr. Remise projects a tough exterior, he softens when he speaks about Françoise. She is his constant companion, the love of his life. As ‘Le Père’ to his three grown children and nearly one hundred and fifty current and former residents, Dr. Remise really does have a large family! He is demanding of his residents, expecting a strong work ethic, as a father would expect of his growing children. He is proud of his program and the success of his residents over the years. He continues to be dedicated and devoted to creating excellent orthodontists and has set the bar high for many former residents who hope to live up to his high standards. by Dr. Paul Major

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Committee Reports

Treasurer’s Report Dr. Michael Patrician Treasurer Email: drpatrician@bellnet.ca The Board of Directors at the 2014 Annual General Meeting of the CAO in Montreal voted to increase the 2015 annual membership dues to $635 plus GST/HST. The CAO general operations are proceeding according to plan. A decrease in net operating income is anticipated by year end, principally due to the CAP (Consumer Awareness Campaign). A three-year cycle is planned. The CAO monkey survey, conducted last year, indicated that a dues assessment of up to $350.00 on top of the annual membership dues was the preferred method of choice to fund the CAP. The 2014 and 2015 CAP expenditure will be taken from CAO reserves. In 2016 and 2017, an assessment of $250.00 plus HST likely will be added to the annual dues. This assessment permits the CAO to clear the balance of the three-year CAP expenditure by the end of 2017 and to build up reserves for an ongoing campaign should the BOD decide to continue the program at a reduced level.

Insurance Report Drs. Mike Wagner & Don Johnston Co-Chairs, Insurance Committee Email: wagner.orthodontics@gmail.com johnston.donald@gmail.com The newly formed Insurance Committee is diligently working on several new projects to assess the state of the system for claims submission. In particular, electronic claim submission, electronic forms, and submission protocols are being reviewed. The committee is actively investigating the manner in which orthodontic claims are administered and the guidelines and protocols that are currently in place. In particular, the administrative difference between how claims are sub-

mitted for orthodontists and for general dentists is a topic of interest. Strategies are being formulated on how to accomplish better communication and submission with provincial-based insurance offices. Member assistance with issues that arise is being provided in consultation with Bob Cram and Garry Solomon.

CAO/AAO Report Dr. Garry Solomon CAO/AAO Liaison Email: hellener@lks.net The CAO-AAO Liaison meeting was held in New Orleans April 27, 2014. The first CAOAAO Master Agreement that recognises the differences between Canada and the United States was signed by the presidents from each national organization. The main focus of this meeting was the Consumer Awareness Program (CAP) that is administered by the AAO. The CAP target audience for 2014-2015 is adult females 25 to 54 years of age. Fifty percent of the budget will be allocated to digital ads on the internet, and 50 percent to cable television. The AAO has conducted several follow-up studies on advertising that have produced some very interesting results, some of which are listed below: 1. Thirty-three percent of the time, the AAO logo made a difference with the public’s decisions about treatment. 2. Negative advertising had the same effectiveness as positive advertising; however, in the long term the negative ads were more destructive. The AAO will only conduct positive advertising. Chris Vranis stated that the number one deterrent is the trust factor patients have with their dentist. They resent being told that they are foolish or wrong with this trust. 3. The public watches the video advertising but they do not read the script. Continued… FALL 2014 • CAO Bulletin

Committee Reports 4. The primary reason a general practitioner refers to an orthodontist is good communication. The extra training, associations and logos had little effect. 5. Consumers define the outcomes. This is the swipe-andthrow away generation. Consumers want simple, immediate solutions and quality was of less importance. This explains why clear aligners are exactly what this generation is drawn to. Thank you for the privilege of serving as your CAO-AAO Liaison for the last four years. As I assume the duties of the past president, the torch is passed to second vice president Rick Odegaard.

program within the next year, followed by the launch of a national program within the next two years. The CFAO is looking for people from across the country willing to help administer the program. Please contact stephenfroth@mac.com if you are interested.

RCDC Report Dr. Tom McIntyre Orthodontic Councillor, CAO/RCDC Liaison Since June 2013, there have been several developments at the RCDC. Hugh Lamont was installed as president of the RCDC at the 2014 annual meeting in September. Congratulations to Hugh.

CFAO Report Dr. Stephen Roth CFAO President Email: stephenfroth@mac.com The CFAO Silent Auction at the Gala Banquet in Montreal was another big success. Thank you to all the individuals and to the provincial associations that donated items this year. Thanks also go to those that bid on the auction. Thanks to everyone’s generosity we were able to raise $4,000 for the foundation. The annual Charity Golf Tournament was held at Golf Saint Raphael in conjunction with the Annual Session. It was a fabulous day for golf and a fun time was had by everyone. The CFAO appreciates Cerum Ortho Organizers for sponsoring and for helping to organize the golf tournament again this year. The Student Research Symposium at the Annual Scientific Session was a huge success. The CFAO was very pleased to financially support this new addition to our annual meeting. Congratulations to all the student presenters who participated. The CFAO Board of Directors is pleased to announce that it has passed a motion to proceed with “Smiles 4 Canada”, a program to facilitate the orthodontic treatment of deserving young people. Stephen Roth has been appointed to a three year term as National Program Director with Dan Pollit, Jim Posluns, Phil Williamson and Brien Stackhouse each appointed as members of the National Program Board of Directors. The Board of Directors will work to organize and to implement the program. The CFAO hopes to launch a pilot

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Chief Examiner Lesley Williams has put together a group of examiners with diverse academic and clinical backgrounds. Lesley and her team have worked tirelessly to produce a reliable and a valid exam. Thank you to Dr. Williams and the entire team of examiners. The Executive implemented an electronic format for the Component I [written] exam, permitting the exam to be written in various locations across Canada, thereby minimizing cost and disruption to the candidates. The launch occurred on March 1, 2014. Dr. Lee McFadden, RCDC president, summed it up well by saying, “Unfortunately, after extensive planning and testing prior to moving towards using an electronically delivered exam, there was a router failure. This was a problem that occurred with the hotels equipment. In spite of this unfortunate occurrence, we do have an examination which Dr Bashook [psychometrician] feels is both valid and fair to all candidates.” In the interest of fairness, as a result of the router incident, all candidates who failed were given an additional exam on May 10, 2014. In addition there were some issues with regard to the French translation. Both of these concerns have prompted extensive discussion on the appropriate measures to be implemented to prevent these issues from reoccurring. William Wiltshire as chair of the Canadian Council of Graduate Orthodontic Program Directors [CCGOPD] requested a meeting of the RCDC and their representatives to discuss a number of issues. It was decided to invite representatives of the CCGOPD to attend the Component II [oral and case

Committee Reports analysis] examination in June 2014 for both a meeting and to observe the exam in progress. Discussions included the aforementioned intention to provide an electronic exam available at several sites across Canada, the timing of the oral exam to minimize disruption to the students and the quality of the French language translation with possible solutions and continued dialogue with the RCDC. Both the representatives of the CCGOPD and the members of the RCDC felt that it was a mutually beneficial meeting. From the perspective of the RCDC, some of the suggestions to continue to improve and refine the process and the exam can be implemented. The RCDC convocation and annual meeting were held on September 20 and 21, 2014, respectively. Occasionally, as in the past and unfortunately in 2015, the CAO Scientific Session and the RCDC meeting conflict. It is hoped that with improved communication between both parties future dates can be arranged, avoiding this conflict.

New and Younger Members Report Dr. Susan Tsang New and Younger Members Representative

tinue to make this group a fantastic and useful resource for all new and younger members (and for those who are young at heart). Remember to connect with fellow new and younger members online on the BraceSpace forum (located on the Members side of the CAO website).

CDSA Report Dr. Robert Kinniburgh CDSA Liaison [Email: drbob@northo.ca] The Canadian Dental Specialties Association (CDSA) continues to represent the Canadian dental specialties. Ritchie Mah is to be commended for his time at the CDSA representing the CAO and for his service on the CDSA executive, having just completed his year as president. The CDSA Annual General Meeting was held April 10, 2014, in conjunction with the CDA Annual General Meeting in Ottawa, Ontario. Highlights of the meeting include:

Email: s_tsang2@hotmail.com This year’s GORP meeting took place July 31 to August 3, 2014, at the University of Michigan in Ann Arbour. Jim Posluns represented the CAO and met enthusiastically with Canadian residents attending American and Canadian orthodontic programs in order to strengthen their relationship with the CAO. The next GORP meeting that the CAO will attend will be in 2016, when the meeting returns to the University of Michigan. The 2014 NYM luncheon at the CAO annual meeting in Montreal featured Mr. David Lind from Professional Practice Sales speaking on various aspects of practice transitions. It was a well attended lecture and attendees came away with a new perspective of what should be considered in a practice transition whether they are the buyer, the seller or an associate. The NYM committee is presently planning the next NYM lecture series and welcomes any suggestions for topics and/or speakers. I am pleased to welcome Jim Posluns as the new Chair of the NYM Committee. It has been an absolute pleasure to have worked on this committee for the past six years and Jim will con-

Robert Barsky (Canadian Association of Pediatric Dentists) is the incoming president. Ernie Lam (Canadian Association of Oral Maxillofacial Radiologists) was nominated as the secretary-treasurer. In addition, CDSA awards were presented to founding members Aaron Barry, Leland McFadden, John Perry, and Chris Robinson. The CDSA had a formal opportunity to meet with CDA representatives (Peter Doig, president, Gary MacDonald, presidentelect and Alastair Nicol, vice-president). Currently 10 percent of dentists in Canada have subscribed to eReferral. The CDA is looking for feedback and is open to templating the portal for unique specialist needs going forward. Of the 19 000 dentists in Canada, 1300 have not signed up to utilize CDANet of which the majority are orthodontists. Third parties have expressed to the CDA that they would like to minimize paper submissions of claims. The CDA has expressed a willingness to work with the CAO in discussions with third parties in developing a digital claim submission process as well as a possible digital predetermination submission process. CDSA was formally recognized by the CDA as the specialist Continued…

FALL 2014 • CAO Bulletin

Committee Reports representative to the CDA so COSA has been formally disbanded. The original two year commitment to fund the CDSA board expenses to the CDA AGM has expired. The CDA formally renewed this commitment for another two year period (2015 and 2016) and will reassess again in 2016. The Director of Orthodontic Services at NIHB was recently dismissed. The outcome of this dismissal on future orthodontic NIHB claims is unknown. Observer status has been granted to CDSA with the Royal College of Dentists of Canada and the Canadian Dental Regulatory Authorities Federation. CDSA has also been granted a representative to NIHB through the CDA. The National Dental Forum was facilitated by the CDSA on April 11, 2014, and examined specialist-generalist communication. The Saskatchewan registrar presented complaints and discipline hearings for discussion as to how these situations may have been avoided through better communication between the generalist and specialist. An ad hoc committee has been struck by the CDA to assess the impact of corporatization on dentistry, to define as it as favorable or unfavorable and to develop documentation for sellers and for buyers.

Communications Report Dr. Dan Pullit Communications Chair Email: dpollit@rogers.com Jean Marc Retrouvey and others have worked diligently to translate the new website content into French. The CAO website is currently being revised. Public content is being reviewed so that it is no longer incorporated into the members’ section. A policy regarding the viewing of CAO webinars is being developed. Other associations were canvassed to discuss existing policies. Most organizations do not incorporate disclaimers; when members register, they are encouraged to invite others (members and non-members) to join in to the webinar. The committee decided to identify the webinars as ‘For the benefit and sole use by CAO members only’. The statement is generic, yet identifies the intentions of the CAO. Congratulations to Amanda Maplethorp for being named CAO historian. The historian researches, compiles and organizes the historical records of orthodontics in Canada. Welcome to Eric Selnes who was invited to join the Communications Committee as part of the strategic plan initiative.

GST/HST Report Dr. Michael Patrician Treasurer Email: drpatrician@bellnet.ca Despite an increase in the number of CRAGST/HST audits of orthodontic practices across Canada, there has been no new communication with CRA over the past year. In response, Mike Patrician and Garry Solomon have requested a meeting with CRA to try to investigate how the Canadian orthodontist can best submit input tax credits (ITCs) for GST/HST rebates. Mr. Kal Ruprai from the accounting firm MNP, who presented the last GST/HST webinar for the CAO, will present the CAO position to CRA. A recent CAO webinar focused on basic GST/HST information required when preparing to submit GST/ HST ITCs for refund. The presentation was general in nature and did not coach or advise specific case ITC questions. For specific advice, participants were requested to seek the assistance of their personal accounting professional.

WFO Report Dr. Amanda Maplethorp WFO Committee Email: a_maple@shaw.ca Garry Solomon attended the WFO Breakfast Meeting in New Orleans on behalf of the CAO. General registration and abstract submissions are now open for the IOC September 27 to 30, 2015, meeting in London, England. Ideally, two representatives of the CAO should attend the London meeting. Jean-Marc Retrouvey will be CAO president at that time and will likely attend. Currently Jean-Marc is the member-at-large, but when he becomes president, a new memberat-large will be required. It would be beneficial to choose someone who is on or has a connection to the Board and who coincidentally plans on attending the meeting in London.

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The Latest Advances in Canadian Orthodontic Research Outstanding Post Graduate Orthodontic Programs Canada has six outstanding post graduate Orthodontic programs which have achieved international recognition for their published areas of research. At this year’s Annual Scientific Session in Montreal, this inaugural symposium program, post graduate students from Canadian orthodontic institutions, presented abstracts of their current research projects.

University of Alberta STABILITY OF RAPID VERSUS SLOW MAXILLARY EXPANSION IN PATIENTS WITH POSTERIOR CROSSBITE Authors: Connie P. Ling*, Humam Saltaji, Navdeep Dhaliwal, Alejandro Iglesias-Linares, Manuel O. Lagravère, Carlos Flores-Mir. PURPOSE: To evaluate the stability of rapid (RME) versus slow maxillary expansion (SME) through a systematic review and meta-analysis. METHODS: An electronic search of seven databases was performed. The inclusion criteria consisted of controlled clinical trials which assessed maxillary expansion outcomes after expansion and at least after 6 months of follow-up. Outcomes were clustered into: short-term follow-up (0.5 to 1 year), and long-term follow-up (1.5 to 3 years and 3.5 to 11 years). Study selection, risk of bias assessment and data extraction were performed in duplicate.

intermolar width increase in younger patients compared to RME. Limited evidence also suggests the tendency for SME (Quad-helix) expansion to produce greater intermolar relapse than both SME (Removable plate) and RME (Hyrax/ Haas).

University of Montreal EFFECT OF OSTEOGENESIS IMPERFECTA ON ORTHODONTIC TOOTH MOVEMENT IN A MOUSE MODEL Author: Rizkallah, Dr. Jean INTRODUCTION: Osteogenesis imperfecta (OI) is a heritable bone disorder that affects collagen type I production and bone remodeling. Orthodontic tooth movement (OTM) involves the underlying process of alveolar bone remodeling. The objective of this study is to evaluate OTM in a mouse model of OI.

RESULTS: Twenty-five reports of low to moderate methodologic quality met the final eligibility criteria, including 4 randomized clinical trials. The two studies that were eligible for a meta-analysis showed non-significant dentoalveolar relapse 3 years post-rapid-expansion. A RME intermolar width relapse of 4.7% (0.32mm) was found for a typical 6mm screw activation. Higher intermolar relapse of 21%-33% (1.1mm to 1.7mm) was reported in the SME (Quad-helix appliance) group, while no statistically significant relapse was reported in the SME (Removable plate appliance) group after a mean of 2-5mm intermolar width increase.

METHODS: Twenty four, 10 week-old female mice were divided into 4 groups: 1- OI treated with zoledronate, 2- OI untreated, 3- Wild-type (WT) treated with zoledronate and 4- WT untreated. A nickel-titanium closed coil spring (10 g) was attached between the incisors and the right maxillary 1st molar. The contralateral side was used as control. Zoledronate (0.05mg/kg) was administered sub-cutaneously 1 day prior to surgery. Seven days after the procedure, the distance between 1st – 2nd molars was measured by micro-CT.

CONCLUSIONS: Current limited evidence suggests that SME (Removable plate) produced less relapse but also less

RESULTS: OI mice presented significantly more OTM than WT mice when comparing within untreated groups (p<0.05).

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Outstanding Post Graduate Orthodontic Programs Zoledronate treatment had no significant effect on OTM within OI and WT groups. CONCLUSIONS: These results suggest increased OTM in mice with OI. The dose of zoledronate administrated 1 day prior to surgery had no significant effect on OTM. Keywords: osteogenesis imperfecta, orthodontic tooth movement, mice, bisphosphonates, micro-CT

University of British Columbia EFFECT OF ORTHODONTIC TREATMENT ON THE UPPER AIRWAY VOLUME Author: Tam, Dr. Isaac

University of Western Ontario CRANIOFACIAL MORPHOLOGY AND SLEEP DISORDERED BREATHING IN CHILDREN Authors: Brian L. Phee*, Ali Tassi, Michael Shimizu BACKGROUND: Obstructive sleep apnea (OSA) is a sleep related breathing disorder characterized by partial or complete blockages of the airway during sleep. Left untreated, OSA can lead to cardiovascular and cerebrovascular disease, fatiguerelated accidents and neurocognitive deficits, with an increased mortality rate over time. Maxillo-mandibular advancement (MMA) is currently regarded as the most effective surgical technique for the treatment of OSA in adults. However, research in this area is limited and some still question the widespread suitability of MMA because of a perceived lack of data and the potential for increased morbidity. PURPOSE: The primary aim of this study was to compare the clinical effectiveness of maxillomandibular advancement surgery for the treatment of severe OSA. Other variables that will be assessed include demographic, upper airway changes, and subjective patient self-assessment. MATERIALS AND METHODS: A retrospective cohort analysis of patients who underwent MMA surgery for the treatment of severe OSA at the University of Western Ontario between 2000 and 2013 was designed and implemented. Pre- and post-surgical polysomnograms, cephalometric radiographs, and patient questionnaires will be analyzed and statistical analysis will be performed to determine changes related to MMA surgery. RESULTS AND CONCLUSIONS: Data are anticipated to be useful for clinicians to aid in selection of treatment alternatives and for patients to aid in achieving fully informed consent with regard to expected outcomes and risks of procedure.

Dr. Isaac Tam being presented his plaque by sponsor Mr. Ian Still and Dr. Howard Steiman, Chair, CAO Conference Advisory Committee.

University of Manitoba PROVISION OF ORTHODONTIC CARE BY DENTISTS PRACTICING IN CANADA AND CERTIFIED ORTHODONTISTS’ PERSPECTIVES Authors: Aucoin, M.O.*, Wiltshire, W.A., Hechter, F., Torchia, M.G. PURPOSE: In order to obtain perspectives of Canadian dentists on the quality of the undergraduate education received in orthodontics and the extent of orthodontic services provided, a descriptive survey was constructed. METHODS: An anonymous web-based survey was created using Survey Monkey® (Palo Alto, USA) which was distributed to registered dentists in Canada via links in newsletters and mass emails. RESULTS: There were 427 responders. 70.9% (n=261/368) of dentists provide orthodontic treatment with 66.9% (n=172/257) offering removable or fixed appliances. 58.5% to 93.4% reported being uncomfortable or very uncomfortable with these treatment modalities. The undergraduate education was deemed good or excellent by 41.8% (n= 168/402) and 50.5% (n=203/402) for their ability to diagnose accurately in Continued… FALL 2014 • CAO Bulletin

Outstanding Post Graduate Orthodontic Programs the mixed and permanent dentitions. These percentages decrease for their ability to treatment plan and provide treatment. CONCLUSIONS: The number of dentists providing orthodontic services to their patients is similar to the 76.3% reported in the USA. It is concerning that dentists report being uncomfortable or very uncomfortable with various orthodontic treatment modalities they commonly use. The quality of orthodontic education provided has improved compared to the 1987 Canadian data, although some amelioration in the undergraduate orthodontic curriculum may be beneficial.

Haryett Collection one of the largest donated to University Hospital Foundation Retired orthodontist Dr. Rowland Haryett and his wife Muriel, donated more than 200 paintings to the University Hospital Foundation on Tuesday, Sept. 16, 2014. Some of the couple’s collection are on display at the McMullen Art Gallery in the University of Alberta Hospital. It is the largest single acquisition of art to the foundation since it started acquiring art in 1986, and curator, Saskia Aarts says it is the most complete collection of Alberta art she has ever seen.

Thanks to GAC for their support of the Latest Advances in Canadian Orthodontic Research Symposium and the CFAO Posterboards

Reprinted from the Edmonton Journal Website

The CAO Consumer Awareness Program The CAO has worked closely with the AAO and Athorn, Clark and Associates to develop a national Consumer Awareness Program (CAP). The AAO commercials, “My life, My smile, My orthodontist” have been aired from October 2013 through May 2014 on HGTV, Food Network, DIY and E! Network in English and RSC in French nationally. The Alberta Society of Orthodontists provided additional funds to increase the number of commercials played in Alberta. These commercials played from February to April 2014 and were aired on the CBC during popular programs such as the primetime Olympics and Downton Abbey. The ads may also be viewed on digital sources such as Hulu and Pandora throughout the year. The new CAP commences in English starting in October 2014, on the “W” network nationally and in French starting in December 2014 on RSC. The commercials were shot

CAO Bulletin • FALL 2014

with the objective to improve the quality of the French dubbing. The CRTC requires that as of September 2014, all commercials aired in Canada be closed captioned. The CAO will provide the translation and dubbing of the commercials in French to improve member benefit. All of the provincial organizations have been provided with the opportunity to increase exposure of the commercials in their respective regions. Athorn, Clark and Associates will assist each province in providing maximum coverage and optimal programming tailored to their unique needs. The CAP is funded through the Canadian portion of the AAO annual assessment and through funds provided by the CAO. The CAO provided funds for the CAP last year and will continue to do so until September 2015. At that time an assessment of the membership may be required. Dr. Sheila Smith

Student Posterboards Abstracts from the 2014 CAO Annual Scientific Session – Part 1 of 2 part series

University of British Columbia OCCLUSAL CHANGES SECONDARY TO SERIAL EXTRACTIONS COMPARED TO LATE PREMOLAR EXTRACTIONS AND CONTROLS Authors: Feldman, E*, Kennedy, DB, Aleksjuniene, J, Hannam, A, and Yen, EY. INTRODUCTION: To determine the relationships between tooth tipping and occlusal curvature (OC) patterns in serial extraction (SE) cases as compared to late premolar extraction (LPE) cases and controls. METHODS: Mandibular dental casts and cephalometric radiographs were collected from 90 subjects (30 Class I controls, 30 SE cases, 30 LPE cases) at 3 time points: baseline (T0) for controls and SE, after natural drift/pre orthodontics (T1) for controls, SE, and LPE, and after comprehensive orthodontic treatment (T2) for the SE and LPE groups. The casts were scanned and rendered as virtual models using the Ortho Insight 3D™ scanner. OCs were measured by spherefitting (least-squares method) to cusp tip landmarks (RhinocerosTM). Digitized radiographs related long axes of the central incisor, canine, and first molar to palatal plane to determine the direction and amount of tipping that occurred between the time points. RESULTS: T0 and T1: SE differed from other groups, with steeper OCs. T0-T1: SE had a tendency for incisor and canine distal tip, and mesial molar tip. T1-T2: SE had steeper OCs, mesial tip of the incisor and canines, with distal molar tip.

University of Alberta ORTHODONTIC TREATMENT DECISION-MAKING BASED ON PLASTER OR DIGITAL MODELS: A SYSTEMATIC REVIEW Authors: Pachêco-Pereira C*,a De Luca Canto G,b W. Major P,c and Carlos Flores-Mir.d PURPOSE: Recently digital models have been proposed to replace plaster models in some clinical situations. The objective of this systematic review was to determine in which clinical scenarios digital models are valid as replacement for plaster models during orthodontic treatment planning. METHODS. An attempt to identify all pertinent published information was made. Retained articles were those where a decision-making process leading to differential orthodontic treatment plans based on either method were compared. Individual database search strategies were developed. The references cited in these articles were also crosschecked and a partial grey literature search was undertaken. The methodology of selected studies was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies. RESULTS. Two studies were finally selected for the qualitative/quantitative synthesis. In one, the overall treatment plan agreement regarding orthognathic surgery in Class II malocclusion ranged between 78% and 87%. In the other one, 6% of orthodontic treatment plans based on digital models were changed after secondary assessment of plaster models. Continued…

CONCLUSIONS: SE tends to produce steeper OCs post drift and post treatment vs LPE and controls. In general, post SE orthodontics involved incisor and canine proclination with molar uprighting.

(*Presenter)

Poster Presenter: Dr. C. Pacheco-Pereira FALL 2014 • CAO Bulletin

CFAO Graduate Student Posterboards CONCLUSION. Digital models could be used to replace plaster models in Class II malocclusion treatment planning. Unfortunately the included articles did not provide sufficient evidence to conclude that digital models are a valid replacement for other malocclusion types. KEY WORDS. Dental models, plaster models, digital models, decision-making, review. Affiliations *aDDS, Master student, Clinical Instructor, School of Dentistry, Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Canada. bDDS, MSc, PhD, Adjunct professor, Department of Dentistry, Federal University of Santa Catarina, Florianopolis, SC, Brazil. ‘Present address’: Postdoctoral Fellow, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada. cDDS, MSc, FRCD©, Professor and Chair, School of Dentistry, Senior Associate Dean, Dental Affairs, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada. dDDS, DSc, FRCD(C), Associate Professor, Division Head of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada.

University of Alberta RADIOGRAPHIC ASSESSMENT OF EXTERNAL ROOT RESORPTION ASSOCIATED WITH JACKSCREW-BASED MAXILLARY EXPANSION THERAPIES: A SYSTEMATIC REVIEW

manual searches of reference lists of relevant articles were completed to identify additional publications not identified by electronic searches. The lowest levels of evidence accepted for inclusion were case–control studies or consecutively treated series of cases. Two authors independently reviewed and extracted data from selected studies. RESULTS: A total of 83 original articles were identified from the electronic database and limited grey-literature searches. Once selection criteria were applied, only three articles satisfied all inclusion criteria, and individual analysis of the selected articles was undertaken. CONCLUSIONS: Two-dimensional periapical radiographs do not fully reveal the amount of external root resorption associated with maxillary expansion therapy, except for frank apical root resorption. Three-dimensional cone-beam computed tomography radiography displays statistically significant root volume loss associated with maxillary expansion therapy. However, when considering volume-loss percentages, no statistical significance was found. Affiliations: *Orthodontic Graduate Program, Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta **Private Practice, Edmonton, Alberta ***TMD Graduate Program, Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta ****Division of Orthodontics, Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada

Authors: Darren Forst*, Simrit Nijjar**, Yasser Khaled***, Manuel Lagravere**** and Carlos Flores-Mir**** PURPOSE: To evaluate in adolescents and young adults if jackscrew-based maxillary expansion therapies result in external root resorption as measured in vivo via any radiological method. METHODS: The authors conducted a systematic search of several electronic databases (MEDLINE, EMBASE, PubMed, Scopus, CINAHL, Evidence based Medicine Reviews, LILACS) with the assistance of a senior librarian specialized in Health Sciences database searches through 25 August 2013, as well as a limited grey-literature search (Google Scholar). Human, in vivo studies of adolescents or young adults with transverse maxillary deficiency undergoing non-surgical maxillary expansion therapy through the use of a jackscrew-based maxillary expander with a radiographical assessment of root resorption were selected for full article review. Additionally,

CAO Bulletin • FALL 2014

Poster Presenter: Dr. Darren Forst

CFAO Graduate Student Posterboards University of Manitoba THE PROCLINATION OF MANDIBULAR INCISORS IN NON-EXTRACTION CROWDED INVISALIGN® CASES

There were no statistically significant differences in lower incisor position between the mild and moderate crowding groups.

Author: Duncan L*, Wiltshire WA

CONCLUSIONS: Invisalign® treatment can successfully resolve mandibular arch crowding using a combination of modalities i.e. buccal arch expansion, interproximal reduction and lower incisor proclination. When there is <6mm of crowding, lower incisor position remained relatively stable. In more severely crowded dentitions (>6mm) the lower incisor proclined and protruded to allow for arch alignment.

OBJECTIVES: Investigate the position of the mandibular incisors in crowded non-extraction Invisalign® patients, with or without interproximal reduction. SUBJECTS AND METHODS: A retrospective chart review was undertaken on 61 Caucasian non-growing patients (older than 18 years); including 17 males and 44 females. The average treatment time was 14.50 ± 4.75 months. Subjects were categorized into 3 groups based on the value of pre-treatment crowding of the lower dentition; 20 mild (2.0-3.9mm), 22 moderate (4.0-5.9mm) and 19 severe (>6.0mm). Cephalometric radiographs were digitized and parameters were measured to determine the change in lower incisor position from T0 (pretreatment) to T1 (post-treatment). Interproximal reduction (IPR) and buccal expansion were recorded as contributing parameters to crowding resolution. Statistical evaluation of T0 and T1 values using paired t-tests and ANCOVA were used to evaluate the changes in the means, as well as a comparison of final lower incisor position to the accepted norms. RESULTS: There was a statistically significant increase in buccal expansion in each of the 3 groups. Dental changes induced by Invisalign® treatment were statistically significant in the severe group as follows; 1. Lower incisor proclined: (L1-NB 4.71±4.79°, L1-MPA 3.95±4.72°, L1-APog 4.82±4.94°p<0.001) 2. Lower incisor protruded: (L1-NB 1.56±1.40mm, L1APog 1.74±1.62mm p<0.001)

University of Montreal LONG TERM EFFECT OF CONTINUOUS WEAR OF INVISALIGN® TRAYS ON THE TEMPOROMANDIBULAR JOINT AND THE MUSCLES OF THE FACIAL COMPLEX Authors: J Brien*, N Huynh, E Desplats, L Mayer, P Rompré, A Montpetit INTRODUCTION: The temporomandibular joint (TMJ) is a complex articulation and is often related to pain due to dysfunctions. About 50% of the population shows some signs of TMJ dysfunctions with a higher prevalence in females. The etiology of temporomandibular disorders (TMD) is still under investigation. Different potential factors, such as stress, occlusion, and degenerative joint problems may be involved. A well-accepted treatment for TMD is the occlusal splint. Previous studies have shown that disarticulation of the jaws helps improve TMJ symptoms and reduce bruxism/clenching events at night. Based on these studies, it seems plausible to assume that an orthodontic treatment using Invisalign® trays should also benefit the patients with TMJ symptoms. Clinically, some patients Continued…

Poster Presenter: Dr. Laura Duncan

Poster Presenter: Dr. Jennifer Brien FALL 2014 • CAO Bulletin

CFAO Graduate Student Posterboards observed a reduction of morning headaches and orofacial pain following the start of their Invisalign® treatment while others reported more clenching and muscle soreness. At the present time, there is no published study that objectively measured the effect of aligners regarding the TMJ and the orofacial muscles. OBJECTIVE: This prospective clinical study aims to evaluate the effect of continuous wear of Invisalign® trays on the TMJ and the orofacial muscles. MATERIALS and METHODS: The effect over time of Invisalign® trays on the TMJ and the muscles of the orofacial complex was assessed using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The number of bruxism/clenching events were measured using electromyograph (EMG) recordings during sleep and daily reported by the patients with self-administrated questionnaires. Repeated measurements were taken at specific moments: at baseline evaluation (T0), 2 weeks (T1), and 6 months (T2) after the start of the treatment. Repeated measures Friedman test for RDC/TMD data, analysis of variance for EMG variables, and chi-squared test for scorings will be used with the significance level set at 5%. Inter-rater and intra-rater reliability tests (Kappa) will also be performed. RESULTS/DISCUSSION/CONCLUSION: All preliminary results will be conducted by the time and presented at the 66th Annual CAO Scientific Session.

University of Montreal COMPARAISON DE LA PERCEPTION DE LA DOULEUR ENTRE LE TRAITEMENT ORTHODONTIQUE AVEC INVISALIGN® ET LE TRAITEMENT AVEC DES BOITIERS FIXES.

nique et les boîtiers fixes sur une longue période. OBJECTIF : L’objectif de la présente étude est de comparer la douleur ressentie par les patients qui suivent un traitement orthodontique avec coquilles correctrices Invisalign avec celle des patients qui suivent un traitement orthodontique conventionnel avec des boîtiers fixes. MATÉRIELS ET MÉTHODES : l’étude sera effectuée sur 40 patients. Les deux sous-groupes seront Invisalign® (n=20) et boitiers (n=20). Le groupe avec boîtiers sera un des 2 groupes de l’étude du Dr Labbé effectuée en 2011 qui comparait la perception de la douleur durant le traitement orthodontique avec boitiers auto-ligaturants passifs et actifs. À l’aide d’un questionnaire de 7 questions incluant une EVA, l’étude évaluera l’ampleur, la durée et la localisation de la douleur pendant l’utilisation des coquilles correctrices Invisalign® sur une période de 6 mois : 4 phases évaluées aux 6 semaines comprenant chacune 6 temps ((T0) : pour s’assurer de l’absence de douleur avant le début du traitement à (T6) : 2 semaines après la mise en bouche de la coquille). L’analyse statistique comprendra l’utilisation des statistiques descriptives, un test ANOVA pour les valeurs de douleur à des temps différents avec un niveau de signification fixé à 5%. Le coefficient d'objectivité et des tests de fiabilité intra-évaluateur (Kappa) seront également effectués. RÉSULTATS/DISCUSSION/CONCLUSION : des résultats préliminaires seront recueillis et analysés pour être présentés à la 66e session scientifique annuelle de la CAO.

Authors: C Masi-Damois*, H El-Khatib, A Montpetit, P Rompré. INTRODUCTION : L’inconfort causé par les appareils orthodontiques peut significativement affecter la coopération des patients dans leur traitement. La douleur, ainsi que la détérioration de la fonction (mastication, élocution) sont reconnus comme les déterminants majeurs de la coopération du patient traités par appareils amovibles. Invisalign se positionne comme une alternative esthétique aux multiples inconforts observés lors des traitements fixes avec boitiers A ce jour, peu d’études ont cherché à comparer la douleur (quantitativement et qualitativement) perçue entre cette tech-

CAO Bulletin • FALL 2014

Poster Presenter: Dr. Claire Masi-Damois

Component Society Reports

British Columbia Dr. Rick Odegaard

its support of the CFAO by donating a weekend stay for two in Banff to the silent auction fundraiser in Montreal.

Email: dr.odegaard@shawcable.com Jay Philippson has been elected as the BC representative to the CAO Board starting in September 2014. Todd Moore has been elected the BCSO secretary, Will Chow as the vice president and Charity Siu as the president. The College of Dental Surgeons of BC has established a task force to review bylaws and ethics as they pertain to corporate ownership of dental practices. The BCSO website has been upgraded with a public directory including a dedicated webpage for each BCSO member including a brief biography, links to the practice’s social media profiles and a Google Map locator for the office. The website will also feature two BCSO members per week and can be viewed through the BCSO Facebook, Twitter and Linkedin pages.

Alberta Dr. Todd Lee-Knight Email: todd@drlee-knight.com The Alberta Society of Orthodontists (ASO) will be holding its Annual Scientific Session and Meeting on Friday April 10 and Saturday April 11, 2015 at the RimRock Hotel in Banff. The ASO is proud to present as the guest speaker James Mah, an alumnus of the University of Alberta Graduate Orthodontic Program. Dr. Mah’s research focuses on 3-Dimensional imaging and modeling for the purposes of diagnosis, treatment planning and therapeutics as well as anthropology and forensics. This will be a particularly timely topic for the ASO as the Alberta Dental Association & College is currently in the process of developing CBCT standards, educational programs, and certification processes. The ASO has once again agreed to continue its support of the CAO Consumer Awareness Program by committing additional funding to supplement the national campaign within the province of Alberta. The ASO Executive is also continuing

Saskatchewan Dr. Mike Wagner Email: image.orthodontics@gmail.com The Saskatchewan Society of Orthodontists Annual General Meeting was held October 24, 2014 and featured Mo Razavi who presented on the latest advances in temporary anchorage devices, Class II correction, and digital adjuncts to augment practice efficiency. The SSO would like to thank 3M Unitek for their partnership in conjunction with our scientific session. Progress continues as independent assistant education is being entertained by post-secondary educational institutions in Saskatchewan. Website development continues as we enter the new 2014-2015 term of the SSO. The SSO will continue to work within the confines of our local governing body to ensure its maximum participation with the Consumer Awareness Campaign. Additional funding for the CAP on a provincial level is not possible at this time but will remain part of our discussions as the new year begins.

Manitoba Dr. Susan Tsang Email: s_tsang2@hotmail.com The spring Manitoba Orthodontic Society (MOS) dinner meeting was held on May 8, 2014. A survey of the MOS membership indicated that a majority of members supported a consumer awareness program promoting orthodontic specialists. Additional funds will not be assessed by the MOS at this time to augment the campaign. The Manitoba chapter of “Smiles for Life” is accepting applications to be considered for pro-bono treatment. Information Continued… FALL 2014 • CAO Bulletin

Component Society Reports Cont’d on receiving application materials can be found on the MOS website mbbraces.com.

Quebec

The fall MOS meeting will take place on November 21, 2014, in conjunction with a continuing education lecture by Invisalign.

Email: lacedge@videotron.ca

Ontario Dr. Sheila Smith

Dr. Sonya Lacoursière The ODQ Annual General Meeting was held during “Les Journées dentaires internationales du Québec” on May 26, 2014, at le Palais des Congrès de Montréal. Dr. Carrière (Barcelona, Spain) presented an excellent conference on correction of Class II cases with the “Carrière Distalizer”. Thank you to the future president of the CAO, Hélène Grubisa, for taking the time in her busy schedule to address the QAO members “all in French” during our AGM.

Email: stuart.smith4@sympatico.ca The Ontario Association of Orthodontists held its first combined scientific/business meeting on June 6 to 8, 2014 at the Queen’s Landing Hotel in Niagara-on-theLake, Ontario. The meeting drew rave reviews from the membership and from the sponsors. The OAO Executive has yet to determine the schedule of similar meetings in the future. In Ontario, it is mandatory for every worker or employer to complete OSHA certification. Every office must comply with the necessary safety regulations that vary depending on the size of the office. The Ministry of Labour has permitted employees in dental offices to unionize and a large oral surgery office in the western Greater Toronto Area is the first to do so. The Royal College of Dental Surgeons of Ontario was successful in its bid to permit dentists to treat their partners. Bill 70 passed in the Ontario legislature has prohibited dentists from treating their partners even in emergency circumstances.

The QAO’s new executive board members for 2014-2015 are Martin Rousseau, president, Claudia Giambattistini, president elect, Louis Roy, treasurer, Jean-Marc Dumoulin, secretary, Madelaine Shildkraut, archivist, Broula Jamal, member-at-large and Florence Morrisson, past president. On October 17, 2014, Mrs. Charlene White presented to doctors and staff on “Orthodontic consulting & management”. Dr. Patrice Pellerin from Lachine and Dr. Charles Rodrigue from Quebec will visit us on November 21, 2014. Their conference will be given in French on topics to be determined. On March 20, 2015, the conference for “la Journée Paul-Geoffrion” will be given by Dr. Jeanne-Nicole Faille from Montreal. The next AGM will be held on May 25, 2015. Dr. Elie Callabe (Paris, France) will give a lecture in French on “Le propulseur mandibulaire universel”.

Rapport de la province de Québec The 2014-15 Executive of the OAO is comprised of Drew Smith, president, Lui Redigonda, vice president, John Bozek, secretary treasurer and Anthony Mair, past president. The next General Meeting is scheduled for November 6, 2014.

= person

*erso*

= speaker

*p*a*e*

= mat

ma*

= zoo

**o

= queue

**eue

= fever

*e*er

***igent *ur* *a*

= diligent = jury = wax

*ouse ***k*am*on

= house = backgammon

Puzzle Answer from page 31:

CAO Bulletin • FALL 2014

L’Assemblée générale (AG) de l’Ordre des dentistes du Québec (ODQ) a eu lieu le 26 mai dernier, à l’occasion des Journées dentaires internationales du Québec, au Palais des Congrès de Montréal. Le Dr Carrière (de Barcelone, en Espagne) a prononcé une excellente conférence sur la correction des cas de catégorie II au moyen du Distalizer Carrière. Je remercie la future présidente de l’ACO, Hélène Grubisa, qui a réservé une période dans son horaire fort chargé pour s’adresser aux membres de l’Association des orthodontistes du Québec (AOQ) en français à l’occasion de notre assemblée générale annuelle. Les nouveaux membres du conseil de direction de l’AOQ pour l’année 2014-2015 sont Martin Rousseau, président, Claudia Giambattistini, présidente désignée, Louis Roy, trésorier, Jean-Marc Dumoulin, secrétaire, Madelaine Shildkraut, archiviste, Broula

Component Society Reports Cont’d Jamal, membre à titre particulier, et Florence Morrisson, ancienne présidente. Le 17 octobre 2014, Mme Charlene White, en présence de médecins et de membres du personnel, a prononcé une conférence intitulée La consultation et la gestion orthodontiques. Le Dr Patrice Pellerin, de Lachine, et le Dr Charles Rodrigue, de Québec, nous rendront visite le 21 novembre 2014. Leur conférence, prononcée en français, portera sur des sujets qui restent à déterminer. Le 20 mars 2015, la Dre Jeanne-Nicole Faille, de Montréal, prononcera la conférence donnée à l’occasion de la Journée Paul-Geoffrion. La prochaine AG aura lieu le 25 mai 2015. Le Dr Elie Callabe (de Paris, en France) donnera un cours en français intitulé Le propulseur mandibulaire universel.

Atlantic Report Dr. Don Johnston Email: info@taortho.ca

The Atlantic Orthodontic Association has not met since the Annual General Meeting in June 2013. A meeting was planned for June 2014 but was cancelled due to lack of participation. The meeting is to be rescheduled for the fall of 2014, with a date yet to be determined. Currently, the AOA is working with the CAO to amend the existing bylaws to conform to the newly enacted CAO bylaws.

I N M EMORIAM Dr. Gunnar Lie

CFAO Donations Since Spring 2014 CAO In honour of Scientific Session Round Table Presenters: Dr. Tarek El-Bialy Dr. Carlos Flores Mir Ms. Deana Ghesquiere Dr. Bart Iwasiuk Dr. Bruce Oliver Dr. Stephen Roth Dr. Stan Waese CAO In honour of Scientific Session Speakers: Dr. Sylvain Chamberland Dr. Reginald Goodday Dr. Duncan Ward Higgins Dr. Robert Miller Dr. Mohammad Razavi General Dr. Wil Hergot

Gunnar Lie passed way September 16, 2014, one month short of his 91st birthday. Dr. Lie was born in Norway, but left when Germany invaded during World War II. He trained with the Norwegian Air Force based in Toronto and Muskoka. Gunnar met and married Mary in Canada, then returned to Norway after the war to finish his high school education. Gunnar and Mary eventually returned to Canada where Gunnar obtained his dental and his orthodontic degrees. Dr. Lie was a private practitioner, taught part-time in the department of orthodontics at the Faculty of Dentistry, University of Toronto and served on the Board of Governors of the Ontario Dental Association. Dr. Lie is survived by Mary, his wife of 69 years, his daughter Kari, his grandsons Matthew and Nicholas and greatgranddaughter Freya.

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 authors, 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.

FALL 2014 • CAO Bulletin

From the Editor

Dr. James Posluns [Email: james.posluns@utoronto.ca]

Desperate Times Call for Desperate Measures Two cannibals were eating a clown. One cannibal turned to the other and asked, “Does this taste as funny to you?” (LSK, circa 1996)

This summer past, as I scanned with interest the newspaper articles on the discovery of the ship associated with Franklin Expedition, I wondered why this particular discovery was such a big deal. So big that it was announced by the Prime Minister in the House of Commons to a rousing ovation no less. Some would answer that it’s the history behind the find; it was the famed Northwest Passage after all. How exciting, how elemental, how very Canadian! Others might say it represents a marine disaster that is beyond compare, but let’s be honest it’s no Titanic, Empress of Ireland or Edmund Fitzgerald. Nope, by my way of thinking, the attraction to the discovery of the HMS Erebus wasn’t the vessel itself, it was the macabre documented connection to (dare I say it) cannibalism. Cannibals and cannibalism have been around a long time. A quick check of Wikipedia tells of history dating back to almost the dawn of man. But the crew of the Erebus consisted of brave, upstanding British gentlemen raised in the epicenter of civilization. Gentlemen don’t feast on gentlemen, ever. Never ever. Never, ever, ever. Well, maybe they do, if the conditions are right. Des-

CAO Bulletin • FALL 2014

perate times call for desperate measures, and I can’t think of anything more desperate than being stuck in the ice, in an old leaky boat with a bunch of scurvyravaged dudes who haven’t eaten in weeks.

Like the members of the Franklin Expedition, we orthodontists like to think we are a civilized lot. But as our competition grows and our patient base shrinks, something sinister lying just below the surface is beginning to emerge to which we don’t like to admit. We are starting to turn on ourselves. Someone just lit the fire, because that’s water I hear a-boiling! I can recall with clarity from my residency days being instructed on the dangers of criticizing the work of a colleague; all one sees is a snapshot in time and that ultimately whatever one says will haunt oneself for the rest of one’s practicing life. Anything one utters in the presence of an unhappy patient during any sort of second opinion will be used as fodder to skewer an unsuspecting practitioner who has no knowledge of the conversation at

hand. And if it’s you doing the skewering, one can be sure as sugar, there’s someone not too far away doing the same right back at you, Kiddo. I’m not suggesting that orthodontists are beyond reproach. There are times when the facts need to be told. But I’m pretty sure that each and every one of us has cases that aren’t representative of our best work for whatever the reason, be it growth, anatomy or that pesky, unrelenting demon known as patient compliance. It’s gone beyond verbal sparring. Letters have been written encouraging patients to seek action against their previous orthodontists. Relapse has been misconstrued as malpractice. Even retired orthodontists aren’t safe; one is only as good as one’s latest success. Patients, empowered by their newfound knowledge and friendly neighbourhood solicitor will think nothing of hauling you off the beach and making you answer for your actions, if you are still with-it enough to recall. If you think it all stops when you are dead, think again. The most heinous of situations has got to be actions against the estates of orthodontists. It happens, and it’s particularly nasty when there is an orthodontist at the other end fanning the flame. Are things that bad? Are we stuck in the ice with no heat, no light and a pantry full of nothing but crumbs? Hopefully not, Continued…

From the Editor Cont’d. Canadian Association of Orthodontists but we need to be careful. Practice is hard enough these days. By supporting one another, our field becomes stronger. We appear more cohesive, more organized and more professional in the eyes of the public and that, in combination with the everimproving Consumer Awareness Program, can only benefit us all in the long run. So pity the members of the Franklin Expedition. They were cold, they were tired and they were really, really hungry. They did what they needed to do to survive and they died in spite of it. Fortunately, we aren’t navigating such unfamiliar waters and we’ve all got enough to eat. So let’s stop looking at one another and wondering how they would look stuffed like a Thanksgiving Day turkey. Because that’s not a good thing. Any way that it’s sliced.

UPCOMING ORTHODONTIC MEETINGS 2015 May 15-19 . . . . . .AAO Annual Session, San Francisco, CA Sept 10-13 . . . . .NESO Annual Session, Providence, RI Sept 17-19 . . . . .CAO Annual Scientific Session, Victoria, BC Sept 27-30 . . . . .International Orthodontic Congress, London, UK October 8-10 . . .MSO Annual Session, Rochester, MN

Straight Shooters

Here’s hoping next winter is nothing like the last! Jimmy P

September 27-30th 2015 The WFO is active on behalf of orthodontists around the world, working with over 100 orthodontic organizations through networking, opening lines of communication and providing resources. One year from now, London England will be the host of one of the most interesting orthodontic meetings of the year. Since the IOC meetings only happen once every five years, they are unique – with exceptional scientific sessions, fabulous exhibits and the city itself, full of opportunities for social events- not just with the convention – but everywhere (including theatre, rugby games, and more.) The meeting takes place in London’s premier conference venue, ExCeL, which is located in an area of the city that has undergone a renaissance as a result of the Summer Olympics in 2012 including a brand new transport system that whisks attendees into central London in mere minutes. Visit http://wfo2015london.org to learn more about the 8th IOC.

Why did the circus performer get braces? He worked the “high –wire”.

What do policemen like best about braces? The doughnuts.

During a recent consultation, a patient was told that he had a mandibular asymmetry. When the patient asked what was wrong with his bite, the orthodontist replied,

“ I’m sorry. I can’t [sic] tell you.”

Complete these common words by using all of the letters A to Z, each exactly once. *e*er

***k*am*on

**o

*a*

*ouse

**eue ma*

*p*a*e* *erso*

*ur*

***igent (source: brainbashers.com)

– Answer on page 28 –

FALL 2014 • CAO Bulletin