2021 Conference Programme

Anterior openbite is challenging to correct, and even more challenging to retain. Many studies have been conducted on the etiology, treatment and retention of these patients. Dr. Huang will review the literature on openbite treatment in three age groups - mixed dentition, permanent dentition adolescents, and adults. He will focus on systematic reviews and meta-analyses, where available, as they represent the best evidence we have. However, much of our evidence on anterior openbite is from observational studies, and better evidence is necessary to improve our understanding of this malocclusion.

Dr. Huang will also review some of his findings from a recently conducted National Network study focusing on adult anterior openbite patients. The study assessed the recommendations of practitioners, the acceptance by patients, the end-of-treatment results, and the stability one year later. Importantly, it included patients treated with two new modalities - temporary anchorage devices, as well as clear aligners.

Learning Objectives:

• The attendee will understand some common strategies employed for anterior openbite patients in various age groups
• The attendee will be exposed to the systematic reviews and meta-analyses that deal with anterior openbite, and appreciate the limitations of the existing literature
• The attendee will learn about factors associated with treatment success in adult anterior openbite patients

Common anterior open bite corrections include extractions and a variety of appliances, such as, high-pull headgear, bite blocks, and elastics. In more severe cases, orthognathic surgery is required to correct the skeletal malocclusion. While surgery proves to be a reliable treatment option, many patients reject it for the prohibitive cost, pain and long recovery time. Recently, buccal shelf screws have allowed orthodontists to treat some of these patients without orthognathic surgery through intrusion of the posterior maxillary molars. They provide a treatment alternative for mild-to-moderate open bite cases without other skeletal contributing factors. This lecture will demonstrate how to properly identify and eliminate the etiology of anterior open bite and create effective strategies to correct it with TADs and extractions.

Learning objectives:

• After this lecture, you will be able to accurately diagnose different types of open bite malocclusions.
• After this lecture you will be able to successfully identify possible etiological factors of different open bite malocclusions.
• After this lecture you will be able to manage open bite malocclusion based on different etiological factors and patient preference.

The demand for minimally invasive solutions led to the development of appliances that combine effectiveness in correcting dental positions with comfort and aesthetics features. Despite the widespread use of orthodontic therapy with clear aligners, their level of efficiency is still controversial. However, the reliability of CAT has increased due to the implementation of the thermoplastic biomaterials and a better understanding of biomechanics applied in combination with the exponential number of biomedical studies.

Systematic reviews on the predictability of orthodontic movements of teeth with aligners showed that bodily movements, in the sagittal and vertical planes are unpredictable.

One of the reasons why the effectiveness of aligners is still under discussion could be the force transmission mechanism. In the traditional system, the orthodontic movement is the result of the interactions of metal wires and brackets to the tooth; conversely, in the aligners system, the forces and moments are generated by the difference between the shape of aligners and the teeth. In addition, the resolution of complex movements demands the use of attachments. The application of engineering knowledge in dentistry with the use of computational techniques has helped to understand oral biomechanics aspects. The finite element method (FEM) is a numerical technique used to perform finite element analysis (FEA) of any given physical phenomenon and is widely accepted for medical purposes. The aim of the lecture is to provide some clinical tips, on the basis of FEAs, in order to increase the predictability of some orthodontic tooth movement with aligners.

This session will cover new frontiers and perspectives in the treatment of skeletal III malocclusions in adults and young adults. Around 60 % of Dr Huan Carlos Perez Varela's patients are adults and a significant percentage of them have skeletal III malocclusions. In this conference Dr Juan Carlos Perez Varela will present cases with different treatment alternatives including a new protocol with local anesthesia and sedation using 3D technology.

Learning Objectives:

• After this lecture, you will be able to perform an adequate diagnosis of maxillary skeletal hypoplasia in adults and young adults.
• After this lecture, you will be able to know how to use 3D technology to develop customized appliances.

Smile aesthetics is considered as the main objective to fulfill during our orthodontic treatment. In handling our patient’s problem list, we ask frequently ourselves: • Do we have to consider the incisor position ONLY in the sagittal plane or more and more in the vertical? • Should we have to apply a SYSTEMIZED treatment approach or must we INDIVIDUALIZE our treatment planning?

Our orthodontic philosophy has to consider the initial vertical position of upper and lower incisors at rest and during smiling in order to set up individualized treatment objectives and to attain the best final aesthetic result. Therefore, we have to apply individualized mechanics depending on facial growth pattern, occlusal plane inclination and smile line position.

Learning Objectives:

• Establish an individualized diagnosis based on the different components of the face.
• Set-up an appropriate treatment planning according to smile aesthetics need.
• Apply individualized mechanics depending on facial growth pattern, occlusal plane inclination and smile line position.

Orthodontic practice is changing rapidly. New developments, including improvements in skeletal anchorage and aligner therapy, seemingly pull orthodontists in opposite directions as many patients demand faster treatment, better results, and all accomplished without tooth extractions or surgery. How do traditional treatment strategies and mechanics fit into the changing orthodontic practice of today and how have patient expectations regarding their treatment experience and outcome changed? This lecture will discuss the indications for adopting new orthodontic techniques and approaches to treatment for accomplishing goals that cannot be reached using conventional means. Conventional mechanics require the clinician to predict the wanted and unwanted side effects of appliance activations. Recent research on new methods for making orthodontic outcomes more predictable and reliable while reducing or eliminating unwanted side effects will be presented. Overall, biomechanical knowledge and creativity in appliance design are important tools that can be used dependably by orthodontists to accomplish dramatic changes for patients primarily using traditional mechanics and appliances, sometimes in conjunction with new techniques as indicated.

Learning Objectives:

• To recognize that patients desire high quality outcomes and that this goal can be achieved with a variety of treatment strategies, techniques, and appliances.
• To become familiar with current research trends in procedures to make orthodontic treatment more effective and predictable.
• To know the indications for applying creative strategies using traditional mechanics to achieve desired outcomes efficiently by taking advantage of desirable side effects and avoiding unwanted side effects.

The fundamental principles of biomechanics are presented. The application of these principles in clear aligner treatment with the Invisalign System are described. The difference between a “force driven” aligner system and a “displacement driven” aligner system is explained. The presentation describes the SmartForce features, SmartTrack material, and SmartStage technology that work in unison to control tooth movements with the Invisalign aligner. The principles incorporated in the latest innovation, Invisalign G8, are presented.

Learning Objectives:

• How biomechanics is being used to control tooth movement with an Invisalign aligner.
• The attendees will understand the “equivalent stainless steel wire” of the aligner stiffness.
• Attendees will learn the importance of using a force driven aligner for treatment.

Dr Alex Yusupov and Brent Bankhead, specialist orthodontists from Melbourne Australia and St Louis Missouri USA are coming together virtually; to share their respective digital orthodontic journeys through case presentations and discussion. The focus will be their software platform of choice; that has transformed the way they deliver orthodontic patient care and achieve treatment goals. Dr Yusupov will explain why every patient is planned using the SureSmile technology and discuss the product choice outcomes that allow for planning treatments, surgical and complex multidisciplinary cases and aid with Indirect Bonding. Dr Bankhead will discuss how the SureSmile aligner platform works and is continually developing & evolving for aligner treatments. He will present the features that are unique to the SureSmile aligner software and discuss hybrid & combination treatments. Hybrid manufacturing options will also be covered.

Learning Objectives:

• Key advantages of a 3D planning and treatment platform
• SureSmile enabled pathways for conventional treatments
• SureSmile enabled pathways for aligner and hybrid treatment

In this presentation, Dr Sandra Tai will demonstrate the value of integrating digital technology into the orthodontic practice, and its role in diagnosis, treatment planning and tracking the treatment progress. This will be presented as a cycle of digital workflow integration and illustrated with clinical cases treated with clear aligners.

In my lecture, I will present step by step the virtual planing, printing and clinical Insertion of a 3D metal printed rapid-palatal expansion device. Then, I would like to share also some ideas and possibilities from 3D printed appliance in regards to variability and different aspects for clinical use. In the second part, I want to show you my ideas on how to join 3D metal printed appliances with mini-Implants and TADs (Temporary Anchorage Device).

Learning Objectives:

• How to virtually plan a 3D metal printed orthodontic appliance
• Variabillity and restrictions of 3D metal printed appliances
• Production of 3D metal printed appliances.
• How to combine TADs with a virtual planned 3D metal printed appliance
• Clinical procedure (Insertion and removal in the mouth)

Dr. Mario Chorak will demonstrate his clinical results using today’s progressive, highly efficient technologies and workflow. He will share comprehensive, challenging Class II and Class III malocclusions that can be simplified through Sagittal First protocol, combined with a crystal-clear, silky-smooth next-generation aligner solution, or the proven, passive self-ligation bracket system – delivering precision and predictability.

Dr. Chorak will show how to increase efficiencies and differentiate your practice through minimum touch solutions. His clinical results will challenge your views on the traditional practice workflow, while demonstrating how to create long-term aesthetics results with minimal extractions.

Learning Objectives:

• Demonstrate how to simplify complex and severe Class II and Class III malocclusions
• Describe the mechanics and clinical applications of Motion 3D appliance with clear aligner therapy
• Share how to shorten treatment time and increase predictability with the Sagittal First™ treatment approach combined with a new paradigm in clear aligner therapy or passive self-ligation brackets
• Show the unique advantages and rationale for minimal to no attachments with Reveal, an advanced clear aligner technology
• Demonstrate the Reveal Clear Aligner platform and process for submitting and reviewing cases

‘To save or not to save, that’s the question.’

Teeth impaction is one of the most commonly encountered clinical problems which require meticulous biomechanics for saving them, if not surgically removing them eventually.

Temporary anchorage devices (TADs) have been advocated in providing absolute anchorage for orthodontic treatment predictably. The advantage of TADs usage has significantly improved the prognosis and success rate of saving the heavily impacted teeth.

‘To wait or not to wait, that’s the second question.'

The timing of saving the impacted teeth can be as important as the technique in handling the problems themselves.

This lecture aims at demonstrating the versatility of TADs application in those challenging impacted teeth cases, as well as solving the problems without the use of TADs on different orthodontic systems. Careful case diagnosis, treatment planning and the potential complications will be discussed.

Learning Objectives:

• To understand the therapy of saving impacted teeth on different orthodontic systems
• To recognize the case diagnosis, treatment alternatives, limitations & complications
• To design TADs insertion sites & respective biomechanics in different scenarios

The fast technological and technical progress during the last years has considerably changed the face of orthodontics in terms of diagnosis and treatment planning with a much greater focus on dental and facial aesthetics than in the past. However important a ‘great smile’ is to our patients, we must not forget that function and maintainability of our treatment outcomes should not be sacrificed to bells and whistles and to meeting mere cosmetic demands which are subject to fashion trends and change over time.

Proven treatment principles such as respecting the patient’s individual physiognomy, skeletal relationships, and the bony and soft-tissue envelope of the dentition still hold true today, even if rapid palatal expansion or whole-arch distalization supported by skeletal anchorage, corticotomies coupled with bone and soft tissue grafts, and photobiomodulation for faster and less painful treatment gain more and more momentum - pushing the boundaries of conventional orthodontics.

However appetizing and promising these new-age approaches may be, it is important to understand that a thorough diagnosis based on sound clinical examination and analysis of good quality standard records, a comprehensive differential treatment plan, correct timing, considerate application of simple but efficient mechanics guided by common sense, and a critical review of every single treatment result is still more important than a fancy virtual simulation for achieving the so-called ‘ideal smile’ and the insertion of a high-tech digitally planned and printed appliance as heavily advertised in every media. Instead, careful and selective implementation of the recent advancements in our field, providing complex treatment by a skilled and well-orchestrated interdisciplinary team, and continuous synchronization of the clinician’s experience with the latest evidence based on sound high-quality research is the key to excellence.

Learning Objectives:

• To understand which proven concepts to achieve excellent treatment results on a regular basis are still relevant today
• To learn which recent advancements should be implemented to continuously improve orthodontic treatment results
• To understand that orthodontics is not a stand-alone specialty anymore, but should be considered as an integral part of interdisciplinary patient-centred care

During the pandemic period, there is a gradual transformation in the ecosystem of patient care: The structured treatment setting, the frequency of treatments, or reduced visits without delaying treatment time. With this transformation, the integration of technology enables the digital adaptation. This session will focus on the application of high technology to increase patient care and treatment outcome. Tips for integration into the usual dental workflow, indications of clinical applications, assimilation in tween and teen patients will be discussed in details.

Learning Objectives:

• How to increase clinical efficiency and predictability with technology?
• How to maintain close communication with patients?
• How to efficiently monitor during treatment?

Understanding and managing patient expectations are fundamental aspects of clinical practice, especially in elective treatments such as orthodontics. This presentation will consider how patient expectations develop and the relationship between meeting expectations and achieving optimum patient satisfaction. It will also include what we know from the literature about patient expectations, with respect to both the process and outcomes of orthodontic treatment. The management of realistic and unrealistic expectations will be discussed, highlighting the importance of good communication if this is to be successful.

Learning Objectives:

• How expectations develop and their importance in orthodontics
• The current evidence regarding expectations of both process and outcomes of orthodontic treatment
• The key elements involved in managing realistic and unrealistic expectations

We are standing at the precipice of changing trends in our orthodontic specialty today. The many recent advances in technology like Digital Orthodontics, Artificial Intellignce (AI), Clear Aligners etc and their potentially disruptive effects may change the practice of Orthodontics as we know it. Will the advent of AI and big data analytics coupled with an ever-changing consumerism behaviour signal the demise of the bracket? Is this piece of plastic overtaking a position in which the orthodontist has reigned supreme with his bracket and wire- bending skills? Let this panel of experts give us an insight and perhaps gaze into the crystal ball of our specialty.

1) Explain conceptually how AI algorithms work.
2) Classify AI applications and their scope in orthodontics.
3) Asses clinical scope, performance and risks associated in therapeutics.
4) Propose an outline for audit of AI applications in orthodontics.

The lecture will explain how AI is a set of tools for problem-solving that can assist orthodontists with extra powerful and applied tools to provide better standards of care. AI can assist orthodontists to choose the best way to move a tooth or group of teeth, but AI today completely ignores the existence of oral diseases, does not fully integrate facial analysis in its algorithms, and is unable to consider the impact of functional problems in treatments. The lecture will also deliberate the risks associated with AI application. As AI enters practice, clinicians need to know how law will assign liability for errors that arise from interaction between algorithms and practitioners. These issues are likely to arise sooner rather than later. Responsibility and the varied scope of these applications will also be deliberated.