CAO Bulletin - Winter 2016

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

Bulletin Winter 2016

In this Issue…

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Message from the President Message from the Outgoing President Highlights of the 68th Annual Scientific Session

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Committee Reports

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Student Posterboards

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Component Society Reports

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Dues Assessment for 2017-18: Reading Your Renewal Notice In Memoriam: Dr. Bernard Hemrend

Canadian Association of Orthodontists Association canadienne des orthodontistes 2800 14th Avenue, Suite 210 Markham, Ontario L3R 0E4 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

2016/2017 Board of Directors OFFICERS President President Elect Past President 1st Vice President 2nd Vice President Secretary/Treasurer

Dr. Robert D. Kinniburgh Dr. Rick Odegaard Dr. Jean-Marc Retrouvey Dr. Sheila Smith Dr. Michael Wagner Dr. Michael Patrician

REGIONAL DIRECTORS British Columbia Alberta Saskatchewan Manitoba Ontario Quebec Atlantic

Dr. Gerald Philippson Dr. C. Todd Lee-Knight Dr. Brian Phee Dr. Susan Tsang Dr. J. Eric Selnes Dr. Giovanni (John) Scalia Dr. Stuart A. Matheson

COMMITTEES President CFAO CAO/CDSA Liaison Insurance Committee

Dr. Stephen Roth Dr. Michael Wagner Dr. Mike Wagner Dr. Don Johnston

Membership Committee

Dr. Todd Lee-Knight

Sponsorship Chair

Dr. Michael W. Patrician

WFO - Country Rep

Dr. Robert D. Kinniburgh

WFO - Member-at-Large Conference Advisory Committee Chair Conference Scientific Content Subcomittee Chair New & Younger Members Rep CAO/AAO Liaison Planning & Priorities Communications Nominations Canadian Orthodontic Educators RCDC Liaison

Dr. Michael Patrician Dr. Howard Steiman Dr. Howard Steiman Dr. James Posluns Dr. Rick Odegaard Dr. Robert D. Kinniburgh Dr. J. Eric Selnes Dr. Jean-Marc Retrouvey Dr. James Posluns Dr. Tarek El-Bialy

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

Message from the President Dr. Robert D. Kinniburgh Email: drbob@ncortho.ca

It is a great pleasure to serve the Canadian orthodontic community along with all of our CAO board members. I would like to thank Dr. Jean-Marc Retrouvey, all of the board, and the team at Association Concepts for their high level of collaboration and intention in moving the CAO forward over the last year.

The CAO has enjoyed an extremely productive start to our year following a fabulous turnout at the Charelottetown 2016 AGM and Annual Scientific Session. With the sun setting to the west and a simultaneous full moon rising in the east on Cavendish Beach at the Saturday evening Lobsterfest, it will be challenging for our organizing committee’s to top this year’s event. Despite this, I am sure our next meeting in Toronto 2017 will introduce our organization to many leading edge speakers and even more fantastic social outings.

Strengthening Member Relations The CAO board has identified membership services, membership retention and new members as a top priority. Initiatives to engage new and younger members have been undertaken in order to ensure a smooth transition into practice and to aid in creating value for this important group. They are our future. In addition, the digital world is upon us. The work of Drs. Mike Wagner and Don Johnston on our Insurance Committee has proven fruitful as the CAO continues to work toward the integration of CDANet into orthodontic practice. The possibility of digital submission of orthodontic preauthorizations and claims is on the horizon. This project will be a tremendous valueadded service to the members and to the patients we serve. Further webinars are also planned to help meet the continuing education needs of the membership and to promote the highest standard of orthodontic education that enhances quality of care.

Communications In meeting with our members at large, there has been a call for the CAO to become more vocal in the representation of orthodontic care by orthodontic specialists to the public. With the increase in delivery of orthodontic services by the general dental community and with the potential for direct to consumer product delivery that has infiltrated communities in the USA, the CAO is taking action. Under the guidance of Sheila Smith, the CAO has answered this concern in the past, and will continue to do so through the CAP program that utilizes AAO materials. A CAO Communication/Marketing Task Force has been created in order to have a new and fresh Canadian focused message with a digital presence to represent our profession to the public and to add further value to CAO membership. I do believe that with continued persistence, the CAO will reach its goal of being recognized as the unique providers of orthodontic care in Canada.

Outreach The CAO continues to be the voice of our specialty on the national scale. Through our relations with CDSA, advocacy continues on maintaining the Hick’s agreement.

Furthermore, the CDA continues to look to the CDSA for input on relevant matters

as they arise. Stephen Roth has done a tremendous job in the launch of Smiles4Canada nationwide. This program is a great opportunity to become involved in the community and to give back to the profession that has given us so much.

Without your membership and involvement, none of these initiatives would be possible. Thank you for your continued support of the CAO and please encourage your colleagues to join so that collectively we ensure opportunities for the highest level of quality orthodontics for the families that we serve.

Message de le président J’ai été très heureux de servir la communauté canadienne des spécialistes en orthodontie, tout comme tous les membres du conseil d'administration de l’ACO. J'aimerais remercier le Dr Jean-Marc Retrouvey, l’ensemble du conseil d'administration, ainsi que l’équipe de l’Association Concepts pour leur collaboration soutenue et leur appui au développement de l’ACO durant l’année qui se termine.

L’ACO a pris un départ extrêmement productif cette année, suite à la remarquable participation de nos membres à l’Assemblée générale annuelle 2016 et à la Réunion scientifique annuelle, toutes deux tenues à Charlottetown. Notre comité organisateur devra se surpasser pour supplanter le Lobsterfest du samedi soir, sur la plage Cavendish, entre le soleil couchant à l’ouest et une pleine lune s’élevant à l’est.

Cela dit, je suis persuadé que notre prochaine rencontre, à Toronto en 2017, permettra de faire connaître notre association à plusieurs conférenciers de haut calibre, tous à la fine pointe de leurs spécialités respectives, et de prendre part à des activités sociales des plus intéressantes.

Renforcement des relations entre les membres Le conseil d'administration de l’ACO a fait de l’adhésion de nouveaux orthodontistes, de la fidélisation des membres actuels et de l’offre de services ses priorités absolues. Des initiatives visant à recruter de nouveaux membres et des membres plus jeunes ont été prises, afin d’assurer une transition harmonieuse de la pratique et de contribuer à créer une valeur ajoutée pour cet important groupe de membres. Ils représentent notre avenir. Ajoutons que le monde numérique est à nos portes. Le travail de Mike Wagner et de Don Johnston de notre comité des assurances a porté ses fruits, alors que nous poursuivons l’intégration de CDANet à la pratique de l’orthodontie. Le dépôt numérique des préautorisations et des demandes de remboursement de soins orthodontiques se profile à l’horizon. Il s’agira là d’un service à valeur ajoutée formidable pour nos membres et pour les patients que nous servons. De plus, de nouveaux webinaires sont prévus pour aider à combler les besoins de formation continue de nos membres et à promouvoir les normes les plus élevées qui soient en matière de formation professionnelle et de qualité de soins en orthodontie.

Passing the Gavel

Communications Au cours de nos rencontres quotidiennes avec nos membres, nous avons constaté la volonté que l’ACO prenne davantage la parole pour appuyer publiquement la prestation de soins orthodontiques par des spécialistes du domaine. Compte tenu de l’augmentation des services orthodontiques offerts par divers intervenants en soins dentaires, et de la possibilité de l’offre directe de produits s'immisçant actuellement dans certaines communautés aux États-Unis, l’ACO se doit de prendre les mesures appropriées. L'ACO a déjà réagi à cette préoccupation auparavant, et elle maintiendra le Programme de sensibilisation des consommateurs (CAP), en mettant à contribution le matériel de l’AAO, sous l’orientation de Sheila Smith. Afin d’ajouter du poids à cette initiative, l'ACO a créé un groupe de travail composé de spécialistes en communication et en marketing. Leur mandat est de formuler un nouveau message plus dynamique et actuel, s'adressant spécifiquement aux Canadiens et diffusé par voie numérique, pour représenter notre profession auprès du public et ajouter de la valeur à l’appartenance à l’ACO. Je crois que la persévérance permettra à l’ACO d’atteindre son objectif: la reconnaissance de nos membres à titre d'uniques fournisseurs de soins orthodontiques au Canada.

Rayonnement L’ACO continue de se faire la porte-parole de notre spécialité à l’échelle nationale. C’est ainsi que, par l’entremise des relations entretenues avec l'Association canadienne des spécialités dentaires (ACSD), nous prônons toujours le maintien de l’Entente Hick. De plus, l’Association dentaire canadienne continue de se tourner vers la ACSD pour obtenir de l’information sur les enjeux importants qui se posent. Stephen Roth a accompli un travail remarquable à l’appui du lancement de Smiles4Canada partout au pays. Ce programme offre une excellente occasion de s’investir dans la communauté et de manifester concrètement de la reconnaissance à l’endroit d’une profession qui nous a tant donné.

Sans votre appartenance et votre participation, aucune de ces initiatives n’est possible et je vous remercie de votre soutien indéfectible à l’ACO. Je vous prie d’encourager vos consœurs et vos confrères à adhérer à l’ACO, de sorte que nous puissions collectivement créer l’offre de soins orthodontiques les meilleurs qui soient aux familles que nous desservons.

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Message from the Outgoing President Dr. Jean-Marc Retrouvey Email: Jean-marc.retrouvey@mcgill.ca

When I joined the CAO Board a few years ago, I expected to fulfill my three-year term as provincial representative until someone else from Quebec volunteered. I ended up doing two terms and then was asked to go up the line. I was a bit taken aback as diplomacy is not my main strength and I felt that someone with more social graces would do a better job. Regardless, I accepted the challenge and am immensely grateful for it as I met and befriended many great and dedicated people over the past seven years. The CAO Board meetings have taught me many valuable lessons and allowed me to better understand and to appreciate the intricacies of our professional organization.

Small hint here, get involved in the CAO, it is a great experience and you will enjoy serving your professional organization.

The Board of Directors has been busy this year with projects to make the CAO the ‘go-to’ place, not just for Canadian Orthodontists, but also for present and future patients. The goal is to become the ‘Voice of Orthodontics’ in Canada. Additionally, my focus as President was to develop a closer relationship with the provincial organizations to enhance collaboration, to pool resources, and to inform the public that orthodontists are the best option when considering orthodontic treatment.

The relationship between the dentist and the dental specialist is becoming more complex and not as cordial as it once was.

False and misleading advertising and changes in referral patterns are damaging the once professional relationship. Orthodontists, particularly those new to the profession are experiencing changes in the way patients are referred and the distribution of duties orthodontists once had with the general practitioner is fading fast. More and more orthodontists are of the opinion that the profession needs to educate the public about orthodontic services and inform as to why they should see a specialist for all their orthodontic needs.

The CAO, in lieu of engaging in an aggressive or a negative advertising campaign has opted instead to become the online resource of information and promotion of their members through public information. The objective is to better inform the public of the roles and the services of the CAO, to enhance visibility in the Canadian market and to complement the ongoing AAO-CAP program. It is expected that the newly created Communications Task Force will work with a professional marketing agency to create the most effective communication

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program for the Canadian public. A potential avenue The partnership between the CAO and the provincial organizations may need strengthening to streamline the message and to avoid duplication and dispersion of the message.

I attended several provincial meetings this year and continue to develop a positive relationship with the national organization through meeting as many members of the CAO as possible.

Marketing, insurance and the match program of the AAO were the most frequently discussed topics. These valuable visits permitted me as president to meet and to exchange with members and with the executive of our provincial organisations.

The CAO continues to work with the insurance companies and continues to make progress in creating a unique alpha-numeric code that describes ‘orthodontics performed by a CAO orthodontist’ that will provide members a significant advantage in predetermination and in the simplification of paperwork. The code also provides unique credentials to CAO orthodontists, the only one with access to this code. For more information, please refer to the Insurance Committee’s report found in this edition.

Dr. Stephen Roth and the CFAO have been working hard on the Smiles 4 Canada project and the hope is that many orthodontists will participate to make this initiative a nationwide success in the near future.

Encouraging younger orthodontic colleagues to join the CAO is a challenging task. These members are solicited to join many organizations and by necessity, are selective with respect to those they join, limiting their selection to those associations that provide the most benefit. The CAO must demonstrate to those considering membership its value as an organization that has the interest of its young members at heart. The New and Younger Members Committee has been expanded and our new Quebec representative is a recent graduate. I am certain that the Board will benefit from his insight on how to create a lasting relationship with our newer orthodontists.

I thank the Board and Association Concepts, for all the hard work and the dedication they show to the CAO. I particularly want to thank the membership both young and past-young for their continued support of the CAO. This year has been a tremendous experience for me and I appreciate all the productive interaction I had with members throughout the year.

Watch out for Dr. Retrouvey on the high seas.

Message de la president sortant Lorsque je me suis joint au conseil d’administration de l’association canadienne des orthodontistes, je m’attendais à remplir mon terme de trois jusqu’au moment ou un remplaçant soit nommé. J’ai finalement servi deux mandats et ai été mis en nomination comme deuxième vice président, ce qui m’a amené à la présidence en 2015. Cette nomination m’a quelque peu surpris car la diplomatie et les grâces sociales ne font pas partie intégrante de ma personnalité. J’ai toutefois accepté cette nomination et je suis très reconnaissant au comité de nomination car j’ai beaucoup apprécié mon expérience durant ces sept années et me suis fait beaucoup d’amis tous totalement dédiées à notre profession.

Les réunions du comité d’administration de l’AOC m’on beaucoup appris et m’ont permis de mieux apprécier la complexité de notre organisation professionnelle. Un petit clin d’œil à nos membres : impliquez vous dans l’AOC, c’est une expérience enrichissante de servir cette organisation et votre profession.

Le conseil d’administration a été très occupé cette année pour placer l’AOC en première ligne comme outil de référence pour les orthodontistes canadiens mais aussi pour leurs patients, présents et futurs. Notre but premier est de devenir la ‘’ voix de l’orthodontie’’ au Canada. Un autre but fixé durant ma présidence fut de rapprocher l’AOC des organisations provinciales pour augmenter la collaboration, mettre nos ressources plus en commun et mieux informer le public que les orthodontistes représentent leur meilleure option pour tous leurs besoins orthodontiques.

La relation privilégiée entre dentiste généralistes et orthodontiste s’est dégradée durant les dernières années. De la publicité quelquefois mensongère et malintentionnée associée à des changements dans la façon de référer les patients a ternie une relation autrefois très professionnelle. Les orthodontistes, en particulier nos plus jeunes membres sont soumis à des changements majeurs dans le processus de référence de patients ayant besoin de traitements orthodontiques. La définition du rôle du spécialiste et du dentiste généraliste est en train de changer rapidement. De plus en plus d’orthodontistes sont d’avis qu ‘il est maintenant primordial de s’adresser au public directement au sujet des services orthodontiques disponible et de l’importance de se fier à un spécialiste pour leurs besoins orthodontiques.

L’AOC, ne voulant pas s’engager dans une campagne de publicité négative a opté pour une approche qui lui pemettra de devenir la ressource digitale principale d’information pour ses membres et le public en général. Les objectifs de cette campagne sont de développer un contenu informatif de qualité pour le public, d’augmenter la visibilité de nos membres dans le marché canadien, et de complémenter la campagne de pub-

licité de l’association américaine des orthodontistes. Nous anticipons que le nouveau comité de communications travaillera en collaboration étroite avec une compagnie de marketing reconnue afin de créer le programme de communication le plus efficace possible pour le public canadien.

Une collaboration plus étroite entre l’AOC et les organisations provinciales pourrait être envisagée afin de mieux cibler le message au public et éviter sa duplication.

J’ai assisté en temps que président à plusieurs réunions d’association afin d’augmenter la collaboration et de rencontrer le plus de membres de l’AOC. La mise en marché, les assurances et le programme de l’AAO destinées aux associations provinciales furent les sujets le plus souvent discutés. Ces visites furent bénéfiques et me permirent à titre de président d’échanger avec nos membres et l’exécutif des associations provinciales.

L’AOC continue de travailler étroitement avec les compagnies d’assurances. Des progrès significatifs ont été accomplis en vue de l’obtention d’un code alpha numérique unique décrivant le‘’Service orthodontique rendu par un orthodontiste membre de l’AOC’’. Ce procédé va simplifier grandement le processus de prédétermination et résultera en une simplification du processus administratif. Cette appellation alphanumérique unique renforcera les qualifications d’un orthodontiste membre de l’AOC qui seront les seuls à avoir accès à ce code. Pour de plus amples informations, veuillez consulter le rapport du comité d’assurances que vous trouverez dans ce document.

Dr Stephen Roth et le CFAO ont travaillé avec acharnement sur le projet ‘’sourires Canada’’ et nous espérons que le plus d’orthodontistes possibles y participeront afin de rendre cette initiative disponible à travers tout le Canada.

Encourager nos jeunes collègues à joindre l’AOC se révèle être une tache ardue. Ces jeunes orthodonitstes sont sollicités par de multiples organisations, deviennent très sélectifs dans leurs affiliations et joignent les organisations qui leur apportent le maximum de bénéfices. L’AOC doit démontrer l’importance à tous nos futurs membres et surtout aux jeunes orthodontistes qu’elle a leur intérêt à cœur. Le comité des jeunes membres a été remanié et notre nouveau représentent du Québec est un nouveau gradué. Je suis certain que le comité d’administration bénéficiera de son expérience et pourra bâtir des liens durables avec nos orthodontistes récemment gradués.

Je remercie le conseil et Association Concepts pour leur dévouement et travail acharné au sein de l’AOC. Je tiens à remercier particulièrement les membres jeunes et moins jeunes pour leur support de l’AOC. Cette année fut très enrichissante et j’ai apprécié toutes le interactions personnelles que j’ai eu l’occasion de faire avec tous nos membres.

Encore une fois merci….

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This way to all the CAO fun!

Highlights of the 2016 An

Great discussions at the Round Tables!

Thursday night “Suds by the Sea”

The CAO Past Presidents

Our cyclists take over PEI.

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A day spent kayaking the wild rivers of PEI.

nnual Scientific Session!

Dr. Hugh De Clerck, McIntyre Lecturer (and son?)

33 years of attending CAO meetings for Dr. Murray Deller

Golf Tournament Winners!

Would the real Anne of Green Gables please stand up?

CAO staff take a break.

A fond farewell and thank you to Diane Gaunt

Thank you Past President Dr. Helene Grubisa

Mixing business and fun on the trade show floor!

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CAO

Beach Bash

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THANK YOU TO OUR 2016 CAO ANNUAL SCIENTIFIC SESSION SPONSORS

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Committee Reports

Treasurer’s Report Dr. Michael Patrician Treasurer Email: drpatrician@bellnet.ca As of June 30,2016 the general operations of the CAO had generated net income of $251,959.74. The Scientific Session had generated net income of $247,044.71.

The net combined net revenue of the CAO as of June 30, 2016 was $499,004.45. The total member's equity was $1,066,347.73 and the total current assets stand at $1,113,686.37.

At the 2016 Annual General Meeting, the membership approved the addition of an assessment of $200.00 (plus GST/HST) to the membership dues for both 2017 and 2018.

The total dues for 2017 including the assessment is $855.00 (plus GST/HST).

To date, the general operations are proceeding according to plan. Upgrades to the CAO Website continue and will be tied to the needs of the Communications Committee.

Insurance Report Drs. Mike Wagner & Don Johnston Co-Chairs, Insurance Committee

has become contentious as the extraction of teeth generally falls outside the scope of orthodontic practice. The committee is investigating the reasoning behind such claims and advocating on behalf of the specialty.

CAO/AAO Report Dr. Rick Odegaard CAO/AAO Liaison Email: dr.odegaard@shawcable.com The annual CAO/AAO Liaison meeting took place May 1, 2016, during the AAO Annual Scientific Session in Orlando. The Canadian Board members in attendance included Drs. Jean Marc Retrouvey, Sheila Smith, Eric Selnes and Rick Odegaard.

The media focus for the AAO CAP will be 65 percent digital, and 35 percent cable media. With the cable component, the shift will be from buying specific networks to buying programming with the aim of targeting specific demographics. Digital messaging will be via Spotify, YouTube, Facebook and Instagram. Digital cost is lower by about 40 percent relative to cable but cable still represents significant viewership. The messaging demographic has changed this year and is being extended to include children in the promotional materials. Next year, the plan is to increase exposure to the teenage audience. The AAO will now fund the translation of materials into French and Spanish.

Email: insuranceenquiries@cao-aco.org The Insurance Committee continues to move forward with electronic predetermination.

The application for alphanumeric code approval to categorize orthodontic treatment provided by an orthodontic specialist has been submitted to the NCLS team. Once the application is approved, the CAO membership will potentially be able to submit predeterminations electronically to insurance companies. Monthly payment processing is the next target in assisting the membership to provide improved convenience to patients.

Current bylaws of the AAO require that orthodontists must have graduated from an accredited American or Canadian program to qualify for active membership. Internationally trained orthodontists who have completed advanced training in Canada, have passed the RCDC and are licensed orthodontic specialists in Canada do not qualify for membership. Further, because they are Canadian residents, they are unable to join as international members. At present, there is no category that permits them to join the AAO. In order to rectify this predicament, an amendment to the AAO bylaws is required. Dr. Ron Wolk will take this issue to the AAO and will work to make the necessary amendments. This accommodation will not occur until next year at best.

The Insurance Committee has tabled questions and predicaments related to insurance providers to categorize tooth extraction as part of the orthodontic treatment plan. This initiative

The AAO is receptive to the promotion of the Smiles 4 Canada program and plans to integrate the Canadian program into their promotion of the DOS (Donated Orthodontic Services). Dr.

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Committee Reports Myron Guymon with the AAO Council on Communications will contact Dr. Stephen Roth to discuss how this can best be coordinated and promoted.

AAO Presdent Dr. Dewayne McCamish, attended the CAO Scientific Session in Charlottetown. He addressed the CAO Board at the meeting on September 14 and the membership at the CAO Annual General Meeting on September 17.

The next AAO annual scientific session is in San Diego, CA April 21 to 25, 2017.

The CAO has set up a Communications Committee and Task Force to develop a Canadian Consumer Awareness message and to improve communications with both the public and CAO members through digital media. The messages from both the AAO/CAO CAP and the Communications Committee will complement and enhance each other.

CFAO Report Dr. Stephen Roth CFAO President Email: stephenfroth@mac.com

CAP Report Dr. Sheila Smith Email: stuart.smith4@sympatico.ca The Consumer Awareness Program (CAP) is currently running television spots during special events. High profile entertainment and sports events were selected including the Red Carpet Award Shows, Olympic Primetime and the NHL playoffs.

There are no longer commercials airing on the “W” network.

The online presence on cbc.ca, Pandora, Hulu, Google, Yahoo and other digital Rogers programming has been increased. A homepage takeover of cbc.ca and src.ca took place on Wednesday November 9, 2016, immediately followed the US election. The CAP plan included the pairing a smile contest and selfies with Hello! Canada and LouLou during the Red Carpet at TIFF. The CAO logo was prominently displayed.

Many thanks to Drs. Jean Marc Retrouvey, John Scalia and Helene Grubisa for working with a French translator in Quebec to translate the digital and television spots for French television and src.ca.

“Smiles4Canada” - The Smiles4Canada National Organizing Committee is pleased to announce the expansion of this program.

The program is now accepting applications from B.C., the Prairies and Ontario. The Regional Directors are Drs. Jeff Stewart, Sunny Leong and Gordie Organ respectively. Each region has a Regional Committee in place and the committees are eagerly awaiting applicants. Notification will be sent to the various stakeholders across the country and the program will be promoted on local radio programs and television news casts. The pilot program in Atlantic Canada has gotten off to a great start. It has allowed for the refinement of forms, policies and protocols. A great deal of positive feedback about the program has been received from orthodontists and from members of the general public. This program will significantly benefit the profession and the participating orthodontists, by providing a life changing service to those fortunate enough to receive treatment through the program. Full details about the program can be found on our website: smiles4canada.ca. Volunteers are being sought from Quebec to help launch the program in “la belle province” in the near future.

The CAP will run from September 2016 through May 2017.

The budget is $399,918.00 CAN. The plan utilizes 74 percent of the funds to purchase digital media and 26 percent to purchase airtime on television nationwide.

CFAO Silent Auction - The CFAO Silent Auction was held at the Annual Scientific Session in Charlottetown. Thank you to the provincial associations and to the individuals who donated items this year. Thanks to your generosity we were able to raise $5,695.00 for the Foundation.

The provincial associations of British Columbia, Alberta, Ontario and Quebec have initiated consumer awareness programs that are funded by the Fund Matching Program initiated by the AAO. These programs utilize CAP materials developed by the AAO and most are digitally based.

Golf Tournament - The CFAO appreciates the sponsorship and the assistance of Cerum Ortho Organizers in helping to organize the golf tournament at the Links at Crowbush Cove. This was the final year of the golf tournament. Cerum Ortho’s dedication to the tournament over the last 20 years has been highly valued by all who participated. The CFAO looks forward to

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Committee Reports Cerum Ortho’s continued support going forward. Keep an eye open for the exciting new events planned for the Annual Scientific Session in Toronto, 2017.

New and Younger Members Report

CFAO Treasurer Report

Dr. James Posluns New and Younger Members Representative

As of June 30, 2016, the net revenue for the CFAO was $10,690.02 and the total current assets were $356,535.04.

Total members’ equity is $226,015.04. The 2016 disbursements from the Foundation have not been completed. The disbursement quotient for 2016 is $10,364.17.

The disbursement quotient amount for 2015 was $9,801.95.

Going forward the CFAO appears to be maintaining the status quo. Because of the not-for-profit legislation regulations, the CFAO Board of Directors is considering an appropriate future economic plan.

GST/HST Report Dr. Michael Patrician Treasurer Email: drpatrician@bellnet.ca There have been no new communications with CRA regarding the ITC system and GST/HST in Canada. A communiqué jointly written by the CAO and CRA was sent to the membership February 2, 2016 to inform members of the points of interest encountered by CRA during audits of orthodontic offices.

A request was received from the Ontario Association of Orthodontists (OAO) for more information about the ITC system.

A report was provided to the OAO at its Annual General Meeting in Niagara-on-the-Lake, May 28, 2016.

Email: james.posluns@utoronto.ca The CAO attended GORP in 2016. Responses from those who dropped by the table ranged from “Canada? Where is it?”

To: “Canada! OMG. I love Canada. Maybe I should move there.

After the election of course!”

The booth looked sharp and was well-attended. Thank you to Alison for the T-Shirts, coffee cups, pens and other various and sundry iterations of CAO swag. Sincerest apologies for disrespecting the flag by using it as a table cloth, but no one seemed to notice.

Insightful questions were asked….some even by the residents.

A list of Canadians in American programs was compiled and follow-up has been initiated. All in all, they seemed happy to see us.

The NYM Luncheon speaker for 2016 was Mr. Marco Dolfi who spoke on his experiences as a lawyer involved with corporate dentistry. This event will be well attended by both the young and the young-at-heart. Plans are already in the works for the 2017 event in Toronto.

Engagement with this group is always a work in progress. Efforts continue to be made in this area. An electronic newsletter geared to the newer members was sent out in late August. Regular updates will be sent to the NYM group as the need arises.

GORP participants show off their shirts.

CAO booth at GORP 2016

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Committee Reports RCDC Report

CDSA Report

Dr. Tom McIntyre Orthodontic Councillor, CAO/RCDC Liaison

Dr. Bob Kinniburgh

It has been my pleasure to serve as the RCDC orthodontic councillor/CAO liaison.

The CDSA/CDA Annual General Meeting was held in Ottawa, Ontario from April 14 to 16, 2016.

I welcome Dr. Tarek El-Bialy as the incoming representative. The annual meeting of the RCDC took place in Montreal on Saturday September 24, 2016.

Components I and II of the annual spring fellowship exams took place under the direction of Dr. Lesley Williams as Chief Examiner. As reported by Dr. Williams, 48 candidates challenged Component I (written) examination with 42 successful for a pass rate of 87.5 percent. Component II (oral and case analysis) had 54 candidates with 42 successful for a pass rate of 81.5 percent.

I formally acknowledge the contribution of Dr. Williams in particular as well as her team of examiners. They are a dedicated group of professionals that give of their personal time to create and administer the fellowship exams. I welcome Dr. Susan Eslambolchi as the new Chief Examiner.

As this is my last report as the RCDC/CAO Liaison, I would like to thank my colleagues both at the CAO and the RCDC for their dedication to our profession.

Communications Report Dr. Daniel Pollit Communications Chair Email: dpollit@rogers.com The Communications Committee is seeking a public relations/marketing firm to improve how the CAO presents to the public. Until recommendations on how to proceed have been made, expenditures are minimal. This fall, we are repeating the successful, Show Us Your Selfie Smile Campaign.

Email: drbob@ncortho.ca

The respect of privacy and security is a challenging issue in the exchange of patient records for all specialties. The CDA continues to redevelop their e-referral program rebranded as “Secure-Send”. It is currently in the beta testing phase.

The CDSA Student Travel Award is now online and is set to receive applications. The first recipient was announced in September 2016.

CDA’s financial support of the CDSA at the AGM is currently under review. Although continued support is likely, the provincial corporate members of the CDA are continually pressing for cost-cutting measures.

The CDA Environmental Scan identified 10 mega trends in dentistry. Some of the significant trends include negotiations with benefit carriers, the evolution of alternative dental care delivery models and a decrease in middle class care. The important trends identified include the integration of internationally trained dentists, the perception of increased commercialization, and the expansion of alternative providers. The emerging trends include changing care for seniors, the rise of the empowered consumer, the shift away from fee-for-service payments and the ongoing changes in the educational competencies.

The priority projects of the CDA for 2016/2017 encompass claims transmission, insurance audits, Secure Send (particularly the integration into practice management software), sugar reduction, and the Smiles for Life campaign.

A Pan-Pacific partnership commenced in 2016. Countries participating in this agreement represent 40 percent of global economic output. The Government of Canada is in discussions regarding eight other potential trade agreements. It is perceived that these agreements will ultimately result in the “Uberization” of all professional services. These agreements will be a continued challenge for the DRA’s as the government is of the general opinion that portability of the professions is a high priority in the interest of improving access to care for the consumer.

The date of next CDA/CDSA Annual General Meeting is April 20 to 22, 2017.

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Committee Reports WFO Liaison Report Dr. Amanda Maplethorp WFO Executive Committee Email: a_maple@shaw.ca The WFO is currently accepting applications for Editor for the Journal of the World Federation of Orthodontists. See the website wfo.org for more information.

statements, an abstract illustrating personal work and research suitable for poster display at the 8th IOC, 35 delegates received Educational Grants which meant that their travel, accommodation and congress fees could be covered enabling them to attend — an experience it is hoped provided a lasting legacy to the developing world being represented. A WFO selection committee has chosen a number of these posters to place on the website http://www.wfo.org/about-wfo/programs/educational-grantposters/ to high-light the work being done around the world.

Representing Canada, Robert Kinniburgh is invited to attend the WFO Affiliate President’s Breakfast Meeting in San Diego in May at the AAO Annual Scientific Session.

The next International Orthodontic Congress (IOC) meeting will be in Yokohama in 2020 and will mark the 25th anniversary of the WFO. This will be a great meeting following in the footsteps of Paris in 2005, Sydney in 2010 and London in 2015. Anyone who has attended any of these meetings can attest to the fact they are well worth it. To join the WFO costs only $40 US a year or the bargain of $184 US for 5 years. As well as reduced rates for the IOC meeting, membership provides you a world class journal and supports orthodontics and orthodontists around the world.

In keeping with the purpose of the World Federation of Orthodontists to advance the art and science of orthodontics throughout the world, the British Orthodontic Society decided it wanted to bring to the 8th IOC in London exceptional orthodontists from around the world that normally would not be able to attend. Following a competitive application process requiring personal

CAO Helpline Dr. Howard Steiman Chair, Helpline Task Force [Email: straightsmile@sympatico.ca]

The Helpline has received numerous telephone calls since the last report and kudos go out to the intake person at Association Concepts (aka Alison) who spearheads these complaints and questions. Fortunately, not one of those calls or e-mails required activation of the Helpline committee.

A big thank you goes out to all our Helpline rep representatives across the country as they patiently await their opportunity to deal with patients and/or parents who have disputes concerning our members.

Please find a breakdown of calls from each provincial area since the last report.

Province

Calls (this period) Calls (last period)

Atlantic

2

2

Quebec

3

6

Ontario

8

5**

Manitoba

1

0

Saskatchewan

1

0

Alberta

8

2

BC

1

3

TOTAL

24

18

**was a member asking for help

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CAO Bulletin • WINTER 2016

Student Posterboards Abstracts from the 2016 CAO Annual Scientific Session – Part 1 of 2 part series

University of British Columbia ANALYSIS OF SOFT PALATE MORPHOGENESIS SUPPORTS REGIONAL REGULATION OF FUSION Authors: Dool CJ*, Danescu A, Mattson M, Diewert VM, Richman JM Life Sciences Institute, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada OBJECTIVES: In humans, hard palate development occurs between 7-12 weeks post conception with the fusion of the epithelial lined maxillary prominences creating a midline epithelial seam. The failure of fusion or seam removal in hard palate leads to cleft palate or cyst formation. The mechanism of soft palate formation is less well defined. Evidence exists supporting both fusion and the alternative mechanism of merging. The aim of this study is to densely sample the late embryonic-early fetal period between 54-84 days post-conception to determine the mechanism and timing of soft palate closure.

METHODS: 28 human specimens aged 54-74 days postconception were serially sectioned and analyzed histologically for soft palate development. Nine unsectioned human specimens aged 64-84 days post-conception underwent MRI scanning and qualitative analysis of 3-dimensional shape

changes during palatal development using a 3D-slicer program.

RESULTS: We confirm the presence of a seam extending throughout the soft palates in 57-day specimens suggesting fusion. Cytokeratin antibody staining confirmed the epithelial character of the cells in the midline seam. The seam is rapidly degraded and exists only in the posterior soft palate by 64 days. In contrast, we show the remnants of the seam exist in the hard palate from the time of initial fusion and remain during and after soft palate seam degradation up to 84 days. Our data shows that the soft palate follows a developmentally more rapid fusion compared to the hard palate.

CONCLUSIONS: Soft palate development occurs similar to the hard palate with the formation and removal of an epithelial seam with resulting fusion albeit faster than in the hard palate.

This differential timing of development of the hard and soft palate suggests that the two regions of the palate have their own internal clocks regulating seam removal.

Acknowledgements: Supported by Faculty of Dentistry research funds to JMR.

University of Alberta POSTERIOR CRANIAL BASE TIME-RELATED CHANGES: A SYSTEMATIC REVIEW Authors: Kris Currie, Humam Saltaji, Dena Sawchuk, Heesoo Oh, Manuel Lagravere, Carlos Flores-Mir. OBJECTIVES: The goal of this systematic review is to provide a synthesis of the published studies evaluating the growth and development of the posterior cranial base.

MATERIALS AND METHODS: The search was performed on Medline, Embase, PubMed, and All EBM Reviews electronic databases. In addition, reference lists of the included studies were hand-searched. Articles were considered if they specifically analyzed posterior cranial-base growth. Study selection, Continued…

LACOR presenter Dr. Carly Dool

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CFAO Graduate Student Posterboards data extraction, and risk of bias assessment were completed in duplicate. A meta-analysis was not justified.

RESULTS: 23 published studies were selected: 5 cross-sectional and 18 longitudinal studies. Articles were published between 1955 and 2015 and were all in English. The sample sizes varied between 20 and 243 subjects and consisted of craniofacial measurements from either living or deceased human skulls. Validity of the measurements was not determined in any of the studies. All but five reported some form of reliability assessment. All the articles included multiple time points within the same population or data from multiple age groups. Growth of the posterior cranial base is generally agreed to be from spheno-occipital synchondrosis. Basion displaces downward and backward and Sella Turcica moves downward and backward during craniofacial growth. Timing of cessation of posterior cranial base growth is not conclusive due to limited evidence.

CONCLUSION: Current evidence suggests that the posterior cranial base is not stable as its dimensions change throughout facial growth and minor dimensional changes observed even in late adulthood.

University of Alberta MRI ALONE VERSUS MRI-CBCT REGISTERED IMAGES TO EVALUATE TEMPOROMANDIBULAR JOINT INTERNAL DERANGEMENT Authors: Al-Saleh M.A.Q.*, Alsufyani N., Lagravere M., Lai H., Major P. Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta.

slope of the articular eminence.

RESULTS: The intra-examiner consistency in MRI alone (examiner 1 = ICC 0.85[0.74-0.92]; examiner 2 = ICC 0.91[0.84-0.95]) was lower than the MRI-CBCT registered images (examiner 1 = ICC 0.95 [0.91-0.97]; examiner 2 = ICC 0.97 [0.96-0.99]). The inter-examiner consistency of evaluating the internal derangement in MRI alone (ICC = 0.52 [0.18-0.73] at T1; 0.71 [0.45-0.84] at T2) was lower than the MRI-CBCT registered images (ICC= 0.97 [0.95-0.98] at T1; 0.98 [0.96-0.99] at T2).

CONCLUSIONS: The MRI-CBCT registered images improved the intra- and inter-examiner consistency to evaluate the internal derangement of TMJ.

University of Alberta ORTHODONTIC CEPHALOMETRIC ANALYSIS IN THREEDIMENSIONS: A SYSTEMATIC REVIEW Author: Sam AJ, Lagravere MO, Oh HS, Heo G, Flores-Mir C ABSTRACT: Conventional two-dimensional (2D) cephalometric radiography is an integral part of the accuracy of orthodontic patient diagnosis and treatment planning. Although one must be mindful of its limitations as it is indeed a 2D representation of a vaster three-dimensional (3D) object. Issues with projection errors, landmark identification, and measurement inaccuracies impose significant limitations of data–and may now be overcome with the advent of cone-beam computed tomography (CBCT). A systematic review of the accuracy and reliability of different 3D cephalometric landmarks in

PURPOSE: To evaluate the effect of the MRI-CBCT image registration on improving the inter- and intra-examiner consistency when evaluating temporomandibular joint (TMJ) internal derangement compared to MRI alone.

METHODS: MRI and CBCT images of 25 patients (50 TMJs) were obtained and co-registered using mutual-information rigid image registration via Mirada XD software (Mirada Medical, Oxford, UK). Two experienced radiologists independently and blindly evaluated two types of images (MRI alone and MRI-CBCT registered images) at 2 times (T1 & T2 for TMJ internal derangement based on sagittal and coronal articular disc position in relation to the head of condyle and posterior

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CAO Bulletin • WINTER 2016

LACOR preseenter Dr. Mohamed Al Saleh

CFAO Graduate Student Posterboards CBCT imaging was conducted. Electronic database searches were administered until May 2016 using PubMed, MEDLINE via OvidSP, EBMR and EMBASE via OvidSP, Scopus, and Web of Science. Google Scholar was used as an adjunctive search tool to discover other scholary sources that may exist.

Twenty-seven articles were selected and reviewed representative of CBCT scans of human subjects from pre-existing data sets and those of dry human skulls. Majority of studies have methodological limitations and are of moderate quality. Due to the heterogeneity of included studies, key data of each could not be combined and reported independently. Overall, bilateral and midsagittal plane structures, with exception of gnathion, demonstrate the highest accuracy and reliability in 3D. Cephalometric landmarks with lowest reliability are subspinale, bilateral lingula, and those marked on the condyle. A minimum number of dental landmarks were reported on, with left upper molar point demonstrating clinical reliability in both multiplanar reconstructions and 3D reconstructions. More research is required to discern applicability of 2D cephalometric landmarks when evaluating 3D cranio-facial complexes.

ity in children did not find a significant association/correlation between CBL and OSA. The risk of bias assessment ranged from 1-6 of a potential 9 in the selected studies.

CONCLUSIONS: The existing literature on the association of CBL and pediatric OSA have moderate-high RoB. Low sample size, limitations of 2-D imaging, and limited number of studies prevent us from establishing a positive association between pediatric OSA and CBL. More studies, preferably using 3-D imaging, are required to evaluate a potential association, which could be potentially used for early diagnosis and prevention of OSA consequences.

University of Manitoba PATIENT COMPLIANCE AND PAIN PERCEPTION USING LOWINTENSITY PULSED ULTRASOUND (LIPUS) TO ACCELERATE TOOTH MOVEMENT Authors: Robert Drummond*, Tim Dumore and William Wiltshire

University of Alberta CRANIAL BASE LENGTH IN PEDIATRIC POPULATIONS WITH OBSTRUCTIVE SLEEP APNEA: A SYSTEMATIC REVIEW Authors: Abtahi, S., Phuong, A., Flores-Mir, C., Faculty of Medicine and Dentistry, University of Alberta OBJECTIVE: To review the existing literature on the relationship between the cranial base length (CBL) and obstructive sleep apnea (OSA) in children.

METHODS: Cross-sectional studies that evaluated the association between CBL and pediatric OSA were included.

Searches of literature up to May 2016 were carried out using Ovid MEDLINE, EMBASE, and Science Citation Index. A modified NIH Quality Assessment Tool was used to assess risk of bias (RoB) among the finally selected studies.

RESULTS: Only 4 articles were finally selected that evaluated CBL in a pediatric population with a diagnosis of OSA through nocturnal polysomnography (PSG). All four studies used cephalometric landmarks to measure the CBL. Two of the studies (n=57 - added) comparing groups of healthy vs. OSA diagnosed children showed significant and "probably" significant shorter CBL in children affected with OSA. Another study (n=15) that looked at OSA affected vs. healthy children and one (n=56) that looked at correlation of CBL with OSA sever-

INTRODUCTION: SmileSonica Inc. is a Canadian medical device company which produces the Aevo System™ to enhance or accelerate orthodontic tooth movement via therapeutic ultrasound (LIPUS). When used for one 20-minute period per day as a complement to braces, the Aevo System enhances osteoblast and osteoclast activity resulting in accelerated alveolar bone remodeling and, therefore, faster orthodontic tooth movement and reduction in root resorption.

PURPOSE: To clinically assess patient compliance and pain perception with the Aevo System.

SUBJECTS AND METHODS: Eight subjects (12 to 23 y.o.) from a university-based (4) and private orthodontic office site (4) with full fixed braces and 1st premolar extractions, used the Aevo System on a requested daily basis for 20 minutes, until extraction space closure was accomplished employing a splitmouth design. Compliance was ascertained from the Aevo System in-clinic software and a pain perception questionnaire was completed by the subjects.

RESULTS: Preliminary data are presented in this research report. Patient compliance varied from 38.8% - 99.3%. On average patients from the private office were more compliant (74.8%) than university-based patients (54.3%). On a pain perception scale from 1 to 10 (1= no pain and 10 = extreme Continued…

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CFAO Graduate Student Posterboards pain), 7 of 8 patients recorded a score of 1, and 1 patient, a score of 3, which was also the only patient with a pain score in the control group.

Generally, from the five multi-site study across Canada, results show that the Aevo System provides a statistically significant increase in tooth movement rate (p<0.05), with an average percentage increase of 29.0% in tooth movement, compared to the control. It was also shown that the Aevo System had a statistically significant decrease in root resorption rate (p<0.05), with the control having a root resorption rate on average 220.8% higher than Aevo System. Finally, there was no increase in adverse events or pain reported for the Aevo System as compared to the control (p< 0.05).

CONCLUSIONS: There exists a wide range in patient compliance in system usage. Patients do not perceive any increase in pain when using this device. Tooth movement is accelerated.

University of Manitoba LEACHING OF BISPHENOL-A FROM INTRA-ORAL AND ORTHODONTIC MATERIALS Authors: Kotyk, M.W., Sharma, R., Wiltshire, W.A. OBJECTIVE: To simulate intense mechanical and thermal conditions that may occur intra-orally in order to investigate whether these conditions could cause bisphenol-A (BPA) to leach from routinely employed orthodontic and intra-oral materials.

MATERIALS AND METHODS: Samples of intra-oral materials including pacifiers, mouth guards, elastomeric ligatures, and polycarbonate brackets were subjected to simulated abrasion,

immersion in artificial saliva, thermal shock via temperature cycling, and simulated intraoral exposure. Sample aliquots were collected for up to 2 weeks after artificial saliva immersion, derivatized, then analyzed for BPA by gas chromatography/mass spectroscopy. BPA concentrations were quantified by calculating the relative response factors based on the area of the internal standard diacetylated BPA-d14 or by using a standard calibration curve created by a serial dilution of a BPA water solution. BPA leaching data was analyzed by descriptive statistics.

RESULTS: Quantifiable amounts of leached BPA were observed from 3 of 25 materials tested: a Gerber silicone baby bottle nipple (20 µg), a Bioacryl thermoformed retainer (3038 µg depending on the mass of the retainer) and Transbond XT orthodontic adhesive (2 µg). BPA leaching was only observed after 3 days of artificial saliva immersion with no additional leaching thereafter.

CONCLUSIONS: Although many parts of the world have banned the use of BPA in baby bottles, BPA content may still be present in some silicone baby bottle nipples. While the leached BPA from this investigation was below the United States Environmental Protection Agency reference dose, it was greater than the tolerable daily intake established by the European Food Safety Authority for the Gerber nipple and the thermoformed Bioacryl retainer. Due to the existing high level of BPA exposure in children, and its potential association with adverse health effects, BPA exposure should ideally be minimized.

Whenever possible, BPA-free baby bottles and nipples are recommended. Methods to reduce BPA leaching from the orthodontic products investigated may include: soaking retainers in hot water prior to delivery, ensuring that the adhesive is fully cured, having the patient rinse after bonding, and/or using an orthodontic adhesive that does not contain a BPA derivative.

University of Manitoba PULPAL STATUS OF ECTOPIC MAXILLARY CANINES AFTER ORTHODONTIC TREATMENT Author:

Alvaro W. R. Salles, Robert Drummond, Eraldo Batista Junior, Rodrigo S. Cunha, Fabio Pinheiro

INTRODUCTION: Pulpal necrosis is one of the adverse effects associated with orthodontically treated ectopic maxillary canines. Information correlating the pulpal reactions and orthodontic movement is scarce.

LACOR presenter Matthew Kotyk

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CAO Bulletin • WINTER 2016

Objective: To evaluate the influence of the initial position of ec-

CFAO Graduate Student Posterboards topic canines on the pulpal status following orthodontic treatment.

Sample: The sample was comprised of 20 patients (13 females and 7 males) with a mean age of 21.7 years.

Methods: Forty maxillary canines were divided into two groups: ectopic and non-ectopic (control). All participants were asked to revisit the University of Manitoba orthodontic clinic after completion of treatment to undergo a pulpal vitality test in order to evaluate the vitality of their canines. The pulpal evaluation included thermal, electrical, and percussion tests. Initial panoramic radiographs were used to assess the angle of long axis of the impacted canine and the linear distance to the occlusal plane.

Results: The Mixed-effects Logistic Regression Model showed no statistically significant difference between the ectopic and control canine groups with regard to the pulpal necrosis (p>0.0744). The Kruskal-Wallis Test showed no statistically significant difference when considering the variables to assess the initial position of the canine (p>0.0797, p>0.285). From a clinical standpoint, it seems relevant to report that 12 teeth (46.15%) presented with necrosis of the dental pulp in the ectopic group whereas only 2 teeth (14.29%) had the same diagnosis in the control group.

Conclusion: Pulpal necrosis may be a side effect of orthodontic treatment for ectopic maxillary canines.

University of Toronto LOAD-DEFLECTION CHARACTERISTICS OF GRADED THERMODYNAMIC NICKEL TITANIUM ARCHWIRES Authors: Oguienko O, Simmons S, Whyne C, Suri S BACKGROUND: AgenManufacturers of graded thermodynamic nickel titanium (NiTi) wires claim to deliver differential force levels throughout the arch. No studies evaluating the force delivery characteristics of such wires currently exist. Objective: To evaluate the mechanical properties of graded thermodynamic NiTi wires in bending and compare them with non-graded thermodynamic NiTi wires.

METHODS: Two dimensions (0.016 x 0.022 inch and 0.018 x 0.025 inch) of graded thermodynamic NiTi wires (BioForce, GAC) were divided into anterior, premolar, and posterior sections. Each segment was activated to 3 mm deflection in a

water bath stabilized at 36°C. Following ADA guidelines, 6 samples of each section were used. The superelastic plateau during deactivation was identified on the load-deflection curve and its mean force, length and slope was assessed and compared with the control wires (NeoSentalloy, GAC) of the same dimensions.

RESULTS: Statistically significant differences in mean force levels were found between the anterior, premolar, and posterior sections of graded thermodynamic NiTi wires compared with control wires and the values increased from anterior to posterior sections of the wire.

CONCLUSIONS: Graded thermodynamic NiTi wires deliver different forces in different sections of the same wire. Clinicians can use this knowledge to optimize their use for individual requirements of the malocclusion being treated.

Acknowledgements: Jian Wang, Bertha Rosenstadt start-up funds (SS)

University of Western Ontario AN IN-VITRO COMPARISON OF DIFFERENT PALATAL SITES FOR ORTHODONTIC MINISCREW INSERTION: THE EFFECT OF BONE QUALITY AND QUANTITY ON PRIMARY STABILITY Authors: Christos Papadopoulos*, C Bourassa, YK Hosein, SI Pollmann, K Galil, RN Bohay, DW Holdsworth, A Tassi Division of Graduate Orthodontics, Schulich School of Medicine and Dentistry, Western University INTRODUCTION: The maxillary hard palate is a desirable location for orthodontic miniscrew (OMS) placement. The related anatomy is well known, but little data exists regarding the primary stability of palatal OMSs. Purpose: To assess the quality and quantity of human cadaveric palatal bone at different insertion sites using microCT imaging, and to determine their effect on the primary stability of OMSs. Materials and Methods: One hundred and thirty OMSs (VectorTASTM, 6 mm) were inserted into ten human cadaveric maxillary hard palates and maximal insertion torques (IT) were recorded. MicroCT images were obtained before and after OMS insertion for assessment of bone quality and quantity [bone mineral density (BMD), bone thickness (BT) and length Continued…

WINTER 2016 • CAO Bulletin

19

CFAO Graduate Student Posterboards

of screw engagement (LSE)]. Statistical analyses were carried out to assess differences in BMD, BT, LSE and IT at the different insertion sites, as well as correlations between IT and measurements of BMD, BT and LSE. Perforations into the nasal cavity were recorded.

Results: Significant differences (p < 0.0005) were found among insertion sites for IT, BT, and LSE, but not BMD (p = 0.004). Correlations were found between IT and BMD (rs= 0.42, p < 0.0005); IT and BT (rs = 0.58, p < 0.0005); and IT and LSE (rs = 0.58, p < 0.0005). A high number of OMS perforations into the nasal cavity were recorded posterior to the permanent second premolars.

Conclusions: The primary stability of OMSs is moderately affected by bone quality and quantity. Higher primary stability may be obtained anterior to the second premolars and parasagittally at the level of the permanent first molars. The posterior palate is more susceptible to OMS perforations into the nasal cavity.

Dues Assessment for 2017-18: Reading Your Renewal Notice The original CAO Consumer Awareness Program (CAP) expenditure was planned for a duration of three years. A survey of the CAO membership, completed in 2014 indicated that a yearly dues assessment of up to $350.00 was acceptable to cover this expenditure.

The 2014 and 2015, CAP expenditures were taken from CAO reserves. For 2016, there was an assessment of $200.00 plus HST applied to your membership dues. Based on your membership rate, and in accordance with the CAO membership protocols for dues, the assessment was applied as follows: Active 1/Retired/Life/Honourary

0%

($0)

Active 2/Academic/Life Active

50%

($100)

Active

100%

($200)

That assessment was subject to HST. These fees permitted the CAO to clear the balance of the three-year CAP expenditure by the end of 2016 and to generate funds for a new CAO Canadian Marketing and PR Consumer Development Program. Since momentum has been gained through the CAP over the last three years, the CAO Board of Directors has decided to continue a Canadian-focused program with a strong emphasis on patient/public directed education, branding and website redevelopment. This will help all orthodontic specialists get the message out to the public in a long-term and viable manner. The better the program support, the better the message.

At the 2016 Annual General Meeting in Charlottetown, the CAO Board approved and the general membership voted in favor of this program. For the years 2017 and 2018 there will be a $200.00 assessment plus HST added to the membership dues. Based on your membership rate, and in accordance with the CAO membership protocols for dues, the assessments will be applied as follows:

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

Active 1/Retired/Life/Honourary

0%

($0)

Active 2/Academic/Life Active

50%

($100)

Active

100%

($200)

This assessment is subject to HST. We thank you for your continued support of the CAO and its programs.

Sincerely, CAO Board of Directors.

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CAO Bulletin â&#x20AC;˘ WINTER 2016

I N M EMORIAM

Downtown Toronto – Orthodontist Wanted!!

Orthodontist wanted to cost-share at downtown Yonge Street office. Office is four years old and located right at a TTC Line 1 stop.

One or two days per week to start, possibly leading to takeover of practice and lease.

Dr. Bernard Hemrend On October 1, 2016, the Graduate Orthodontic Program at the Faculty of Dentistry, University of Toronto lost one of its stalwarts, Dr. Bernard Hemrend.

Dr. Hemrend was born in Windsor Ontario, ultimately working his way to graduate with a dental degree in 1947. He completed his orthodontic training at U of T in 1953, under Dr. Robert Moyers. Bernie put the research program on the map when he received the Milo Hellman Award from the AAO that same year.

Up until the mid-60’s Dr. Hemrend practiced full-time in mid-town Toronto. Bernie joined the Faculty part-time in 1965 and by 1968 he was full-time under the direction of Dr. Donald Woodside. In addition to giving seminars on growth and development, Dr. Hemrend’s clinical teaching partners included Dr. Harvey Jenkins and Dr. Bill Wilson.

Bernie was a man of many interests outside of orthodontics that included painting, cooking, music and competitive tennis. Always up for chat, Bernie was a regular attendee at orthodontic meetings where he was distinctive in his comfy sweater and his ability to connect with everyone in the room.

The loss of Dr. Hemrend, coupled with the recent losses of Drs. Woodside and Dale reminds us all how much these individuals contributed to orthodontics in Ontario and beyond. As a profession, we are all the beneficiaries of their collective wisdom, insight and dedication.

Email: YCorthodragon@gmail.com

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) - 902-4688215 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

WINTER 2016 • CAO Bulletin

21

Component Society Reports

British Columbia

Alberta

Dr. Jay Philippson

Dr. Todd Lee-Knight

Email: jayp@shaw.ca

Email: todd@drlee-knight.com

The BCSO Annual General Meeting was held in Vancouver at the UBC Golf Club on June 10, 2016. The educational component was provided by Nicola Wealth Management and provided information pertinent to investors of all ages on how to minimise tax exposure through incorporated companies.

There was agreement to continue the CAP programme until 2018 with a yearly levy of $300.00 (reduced from $600.00) and for the BCSO to take advantage of the matching funds from the AAO. There was controversy regarding the slate of candidates for the elected positions with the College of Dental Surgeons of BC. The BCSO Board will consider having candidates come and discuss their platform at future meetings and to possibly engage the BC Specialists Society to ensure that the candidates understand the concerns of specialists of BC. Congratulations to Dr. Amanda Maplethorp who is the Vice President of the WFO for the next five years. Dr. Ed Yen spoke at length about the UBC graduate programme and about the elimination of the undergraduate orthodontic clinic.

Undergraduates will partake in screening clinics with the grad students to provide the students with the tools to triage and to create a solid baseline for referral. Two prolific researchers and UBC Dentistry mainstays, are reducing their commitment to the university. Dr. Alan Lowe is retiring and Dr. Virginia Diewert is reducing her time to 75 percent at the conclusion of this academic year.

Dr. Todd Moore is the incoming President of the BCSO, with Dr. Will Chow assuming the role of Past President. Dr. Lucien Bellamy is the Vice President and Dr. Fred Cheung is coming in as the new Secretary Treasurer. Future meetings are, March 9, 2017, (in conjunction with the Pacific Dental Conference) and June 9, 2017 (the AGM and golf tournament).

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CAO Bulletin â&#x20AC;˘ WINTER 2016

The Alberta Society of Orthodontists will be holding its Annual Scientific Session and Meeting on Friday April 7 and Saturday April 8, 2017 at the RimRock Resort in Banff, Alberta. This yearâ&#x20AC;&#x2122;s meeting format will feature multiple speakers centered around the general topic of accelerated orthodontics. Dr. Sonia Palleck will represent Acceladent, Dr. Thomas Shipley will discuss the Propel system and Dr. German Ramirez will address Myofunctional Treatment and its related issues. The plan is to round out the meeting with a discussion as to how each of the above adjuncts can contribute to the enhancement of clear aligner therapy.

The ASO membership will continue its support of the CAO Consumer Awareness Program by committing additional funds to supplement the national campaign within the province of Alberta.

The ASO Executive continued its support of the CFAO (by donating a weekend stay for two in Banff) at the silent auction fundraiser in Charlottetown.

Saskatchewan Dr. Mike Wagner Email: wagner.orthodontics@gmail.com I am proud to report Saskatchewan will be receiving more help on the orthodontic representative front. As my three-year term as provincial representative comes to an end, younger blood steps in to continue the role. Dr. Brian Phee has accepted the new position of president of the Saskatchewan Society of Orthodontists and the Provincial Director role to the CAO. I look forward to working with Brian to solidify the last provincial agenda by carrying through with the provincial plan for public awareness, provincial unity and professional collegiality.

Component Society Reports Cont’d The provincial meeting will be in coordination with Dentsply/ GAC this term.

Thanks to my colleagues for the past three years who permitted me to represent our province at the national level. It has been an enlightening experience and I look forward to the bright future that is ahead.

Manitoba Dr. Susan Tsang Email: drtsang@winnipegorthogroup.com The spring Manitoba Orthodontic Society (MOS) dinner meeting was held on May 5, 2016. The fall MOS meeting was held on October 7, 2016 at the Delta Hotel in conjunction with a continuing education lecture given by Dr. Patrice Pellerin, sponsored by 3M Oral Care.

At the fall MOS meeting, Dr. Robert (Bobby) Ward commenced his term as the MOS President. Dr. Conny Athanasopulous has stepped down after 12 years in the position and sincerest thanks go out for his many years of dedicated service.

Incidences of misrepresentation to the public by general dental colleagues about their qualification in providing orthodontic care was brought to the attention of the registrar of the Manitoba dental regulatory body to request action on this issue. The MDA has indicated that they will not be taking action at this time on this issue.

Ontario Dr. J. Eric Selnes Email: str8smiles@sympatico.ca The 2nd Biannual OAO Scientific Meeting was held in Niagara-on-the-Lake May 27 to 29, 2016 and was a huge success.

The meeting included 30 sponsor and exhibiting companies, 98 registered doctors and 217 attendees over three days. Dr. Jean-Marc Retrouvey was in attendance on behalf of the CAO. “SearchKings” has been retained to assist with the CAP and will use materials provided by the AAO/CAO campaign. The

material is targeted to educate the public on the benefits of seeing an orthodontist when considering orthodontics. The material is 100 percent digital. Financing is from OAO reserves and from the AAO matching program equaling up to $70,000 USD over a three- year period. The OAO, acting as a non-profit organization, has applied for and has received $10,000 per month of free Google ad-words through “Tech Soup”. The OAO home page ‘Find a Doctor’ search has been updated with a website update to follow.

The OAO will continue to work with SearchKings on the Google key word ad campaign working with materials and key word searches from Athorn Clark. In the last 3 months, with the help of SearchKings & Google Canada, the OAO has driven over 6,000 new visitors to its member website, www.oao.on.ca. This figure translates to a massive 543 percent increase over the previous three months (6032 vs. 938 hits).

The number of people who engage with the website by using the Find an Orthodontist tool is now being tracked. Of the 5100 or so new visitors, 725 (approximately 13 percent) have used the Find an Orthodontist tool to search the member database. This number is an excellent start since these visitors have never been to the website, and have likely never heard of the OAO. These new visitors are being driven directly to members’ practices, as well as being educated about the value of seeing an orthodontic specialist via the updated web content.

In future, it is anticipated that it will be possible to track not only the users who use the doctor locator tool, but also those who schedule appointments.

The OAO website is being reviewed and updated. Similar to the CAO initiative, the OAO is running AAO advertisements on the net in an effort to steer the public to the OAO webpage.

The OAO is also starting to develop new public and member Facebook pages.

The slate of the board of directors for 2016 – 2017 for Ontario was presented with a call to nominations to all OAO members.

A committee was made up of five past presidents to review the nominations received based on the bylaw revisions of 2015. The nominations committee decided on seven directors, an increase from the previous four directors. Congratulations to our 2016/2017 Board of Directors, Dr. John Bozek, President, Dr. Mitch Miller, Vice President, Dr. Lui Redigonda, Past President and to Directors Drs. Shervin Abbaszadeh, Emel Arat, Kent Floreani and Pourang Rahimi.

The current OAO membership stands at approximately 300 representing a small decline in active membership, due in part Continued…

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Component Society Reports Cont’d to the conversion of a number of active memberships to retired memberships.

Over the past year a few informal complaints were made, in addition to a formal complaint brought by the OAO Executive to the RCDSO. The complaint involved a general dentist who advertised on his website that he was an orthodontist. The RCDSO informed the general dentist and it is now in the hands of an investigator. The OAO will continue to file formal complaints to the RCSDO on behalf of the membership when warranted.

Dr. Louann Visconti (a CAO member orthodontist) will be president of the Ontario Dental Association. This installation is a rarity and is an event to be celebrated.

Quebec Dr. Giovanni (John) Scalia Email: johnny.scalia@gmail.ca At the annual provincial dental conference, Journées dentaires internationales du Québec (JDIQ), members of the Quebec Association of Orthodontists united. During the meeting, members learned from Dr. Antonio Secci, who discussed leveraging clinical advancements in treatment mechanics, and from Dr. Ryan Tamburrino who discussed using CCO treatment designed to objectify diagnosis and eliminate guessing.

The CAO Board would like to thank Dr. Claudia Giambattistini for her efforts as president of the QAO for 2015-2016, and would like to congratulate Dr. Louis Roy for his appointment as president for 2016-2017.

At the General Assembly, members of the Quebec Association of Orthodontists voted in favour of an increase in our annual membership dues for 2016-2017, in order to obtain the necessary funds for the AAO Match Program. According to the AAO Match program, with a clearly defined marketing proposal, the AAO matches the provincial body’s financial investment towards the marketing campaign. Currently, board members of the QAO have interviewed several marketing firms to analyze their proposals in order to proceed with the program. The public relations firm Bunka has been selected to produce the media campaign. The AAO has recently approved Quebec’s AAO Match Program.

The QAO has delegated Dr. Jean-Marc Dumoulin as representative to the Federation of Dental Specialists of Quebec

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for a public awareness program to promote treatment by dental specialists. Our members were invited to participate in the first conference uniting dental specialists of Quebec from November 17 to 19, 2016.

Information and subscription: www.associationdesorthodontistes.com

Rapport de la province de Québec En mai dernier a eu lieu notre rencontre scientifique combinée avec l'AGA de l'AOQ, dans le cadre des «Journées Dentaires Internationales du Québec»(JDIQ).

Nous avons eu le plaisir de recevoir les Dr Antonio Secci et Dr Ryan Tamburrino qui nous ont présenté deux conférences 1) Tirer profit de l’ensemble des innovations dans l’exécution des mécaniques orthodontiques et 2) Méthodologie CCO: Constance et rigueur pour un diagnostic précis et un plan de traitement sans faille.

Le Conseil exécutif de l’AOQ aimerait féliciter Dr Louis Roy pour sa nomination comme Président de l’AOQ pour 20162017 et sincèrement remercier Dre Claudia Giambattistini pour son excellent travail et son exceptionnelle contribution comme Présidente de l’AOQ pour 2015-2016, ainsi que pour les 6 dernières années auprès de l'exécutif.

Lors de l'AGA, les membres de l’AOQ ont voté en faveur d’une augmentation de la cotisation pour l’année 2016-2017 afin d'amasser les fonds nécessaires pour participer au programme CAP. Ce dernier vise à redistribuer aux membres Canadiens de l'AAO de la province de Québec leur quote-part afin d'investir dans une campagne de publicité et d'information grand public à condition de contribuer à part égale. La firme de relations publiques Bunka a été choisie pour générer la campagne médiatique au Québec. La AAO a récemment approuvé le programme CAP du Québec et les fonds sont dès maintenant disponibles pour réaliser ce projet.

L’AOQ a nommé Dr Jean-Marc Dumoulin comme représentant au sein du comité de publicité et relations publiques de la Fédération des dentistes spécialistes du Québec (FDSQ).

Nos membres sont invités à participer en grand nombre au premier congrès regroupant l'ensemble des dentistes spécialistes du Québec du 17 au 19 novembre 2016 : 10 SPÉCIALITÉS, UN AVENIR ENSEMBLE . Bienvenue à tous!

Informations et inscriptions: www.associationdesorthodontistes.com

Component Society Reports Cont’d

Atlantic Report Dr. Don Johnston Email: johnston.donald@gmail.com The Atlantic Orthodontic Association met on April 15, 2016, at the Westin Nova Scotian in Halifax. The meeting was held in conjunction with a continuing education session, featuring Dr. Bill Kottemann, sponsored by Invisalign.

There were no major issues brought forward at the meeting and the Executive was pleased to announce that the AOA incorporation as a not-for-profit corporation was completed.

The AOA was honoured to have Dr. Jean Marc Retrouvey, president of the CAO, attend the AGM to present on the accomplishments of the CAO over the past year. His outline of the CAO’s current goals was well received.

This meeting also marked the installation of the next directors of the AOA with Dr. Stuart Matheson as President, Dr. Avi Goldberg as Vice-President and Dr. Matt MacLeod as Secretary/Treasurer.

One evening there was a murder in the home of a married couple, their son and their daughter. One of these four people murdered one of the others. One of the members of the family witnessed the crime. The other one helped the murderer.

These are the things we know for sure: 1. The witness and the one who helped the murderer were not of the same sex.

2. The oldest person and the witness were not of the same sex.

3. The youngest person and the victim were not of the same sex.

4. The one who helped the murderer was older than the victim.

5. The father was the oldest member of the family.

6. The murderer was not the youngest member of the family.

Who was the murderer?

Webinar Update Dr. Gerry Zeit The spring, 2016 Webinar was presented on Thursday, April 26, at 8:00 ET. The speaker was Dr. Thomas Shipley and the title of the presentation was “Increasing Predictability and Acceleration with Micro-osseoperforation”.

The presentation was co-sponsored by Propel Orthodontics. Propel was kindly able to cover the costs for the speaker.

Our Fall Webinar was held November 24, 2016 with the topic being “TMJ Disorders - A Physiotherapist's Perspective” presented by Lianne Chan, BScPT, MClScPT, Dip. Manip., FCAMPT, CAFCI, Registered Physiotherapist.

– Answer on page 27 –

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.

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From the Editor

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

Trumped-up, Trickle-down Orthodontic Policies “I will build a great wall - and nobody builds walls better than me, believe me – and I’ll build them very inexpensively. I will build a great, great wall on our southern border and will make Mexico pay for that wall. Mark my words.”

the beck and call of corporate America.

No surprise; that’s what happens when one spends one’s life in public office.

Some people don’t like that. Some people don’t like her.

Donald J. Trump. 2016.

So what if she’s not liked. She’s smart.

She’s qualified. She had three years of advanced training in her specialty, making her an expert in her field and the one to see if you are considering world domination. You know where I am going with this; there are striking similarities between the 2016 US election and what is going on these days in our beloved specialty of orthodontics.

Pity the poor Americans. They are faced with an uncertain future. I am certain that the leaders of this once great nation, all the way back to Barak Obama, have a churning in their stomachs that even Pepto-Bismol cannot touch.

Donald Trump as president. It’s not to be believed. Even his own party can’t fathom it. The sad truth is that the resultant turmoil isn’t unique to the US. Boris Johnson, Rodrigo Duterte, and closer to home our own beloved cracksmoking, fun-loving, frat-boy of a mayor, the late Rob Ford, are all polarizing figures. They are all men of questionable character who ascended a magic escalator of power built upon a foundation of anger, frustration and dare I say it, public gullibility. America isn’t blazing any new trails here; it’s simply falling in step with the rest of the world.

On the other side, the real deal was Hilary Clinton. What seemed to be lost, or simply could not be heard over The Donald’s booming voice, is that, by the time you read this, America came this close to electing its first female president. To use his words, “This is HUGE!” But Hilary polarized as well. She represented the status quo, the career politician at

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By and large, the profession seems to adhere to the Democratic approach. Don’t orthodontists spend a lot of time and a lot of money trying to convince a public that will believe anything that they are the most qualified to do the job? That they are the most prepared to treat any given malocclusion and that the stability (pun

intended!) of the free world, (or at least those with unappreciated overbites) depends on orthodontists continuing to do what orthodontists are trained to do.

But like free world, orthodontists are threatened by forces from within. Donald Trump has a problem with immigrants, immigration, and the core values on which his own country was founded.

He’s afraid, and he wants everyone around him to feel the same. Trump’s answer; hurl insults, build a wall and send a bill. Now think about if we, as a profession, treated the internationallytrained specialist the same way. It would blow up in our faces. It’s been tough, but the profession has adapted. The onus is on the applicant to prove he or she is comparable in knowledge and in skill to those trained at home, and then he or she is good to go. That’s not fear-mongering, that’s good practice. Welcome to the 21st century Donald.

The big unknown here is whether or not orthodontics is at risk of being Trumped just like America. Akin to politics, the profession of orthodontics is a people profession; the majority of the orthodontist’s time is spent in an effort make folks happy be it patients, family members and/or the referring dentists, to say nothing of staff, the bank or even oneself.

With all of these stakeholders so actively involved, it goes without saying that at any given time, someone is going to stand up and say “Enough. Things have to change. Trust in me. I’m just the man/woman to make it happen. It’s all

From the Editor Cont’d. their fault. Let’s get rid of X!!” X being whatever it is that one feels is preventing one from getting one’s due. Think parents in the waiting room. Think general dentists practicing orthodontics. Think internationally- trained specialists seeking a better life. Think the various organizations entrusted to oversee it all.

Trump isn’t going to save America. Only America can save America. The ripples of discord that started south of the border grew into waves that swept an unqualified, undisciplined and unprecedented man into power. Obviously orthodontics isn’t world politics but ripples are ripples. I’ve heard, felt and seen them. Let’s all be smart and learn from what happened this November past. It cannot end well for America. Let’s not let it happen to us.

Holiday Greetings!

On behalf of everyone at the CAO office, we wish all of our members a Wonderful Holiday Season and a Healthy and Successful 2017!

Kindly note that the CAO offices will be closed from 2:00 pm on December 22nd and will re-open on January 2nd at 9:00 am.

Pity the poor orthodontists. They are faced with an uncertain future.

Jimmy P

2017 April 22-25 . . . . . . . . . AAO Annual Scientific Session, San Diego, CA

Of the three possibilities: The first is impossible (from (3) – the youngest person and the victim were of different sexes); the third is also impossible (from (1) – the witness and the helper were of different sexes). Therefore, only the second possibility holds – and the mother was the murderess.

UPCOMING ORTHODONTIC MEETINGS

From http://www.fitbrains.com/blog/friday-fun-brain-teasers/

Canadian Association of Orthodontists

September 14-16 . . . CAO Annual Scientific Session, Toronto, ON

May 4-8 . . . . . . . . . . . . AAO Annual Scientific Session, Washington, DC September 6-8 . . . . . CAO Annual Scientific Session, Vancouver, BC September 13-16 . . GLAO Annual Meeting, Toronto, ON September 21-22 . . MSO Annual Meeting, Bloomington, IN October 14-18 . . . . . PCSO Annual Meeting, Monterey, CA November 1-4 . . . . . NESO Annual Meeting, TBD

2019 May 3-7 . . . . . . . . . . . . AAO Annual Scientific Session, Los Angeles, CA September 17-21 . . . CAO Annual Scientific Session, Fredericton, N B

Puzzle Answer from page 25

2018

We know from (3) that the youngest person was not the victim, from (4) that the youngest person was not the helper and from (6) that the youngest person was not the killer. The youngest person can only have been the witness therefore. If you make up a chart there are now three possible combinations:

November 9-12 . . . . NESO Annual Meeting, Boston MA

Oldest person (father) HHM Next to oldest (mother) VMH Next to youngest (son) MVV Youngest (daughter) WWW (H= Helper, V = Victim, M = Murderer, W= Witness)

October 11-15 . . . . . PCSCO Annual Meeting, Reno, NV

We can work out from (5) that the father was the oldest, and from (2) that the youngest person must have been the daughter. Therefore, the next to youngest must have been the son and the next to the oldest, the mother.

September 14-17 . . MSO GLAO Annual Meeting, New Orleans, LA

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