Dr. Vince Kokich Jr, an orthodontist, discusses tissue phenotype impact on tooth movement, surgical orthodontic interventions, TADS benefits over implants, and the importance of collaboration in orthodontic cases. Emphasizes tailored treatment planning, historical shifts in orthodontic approaches, and staying within one's expertise in dentistry.
Building good relationships with periodontists is crucial for cases where tissue phenotype affects tooth movement.
Intruding teeth with clear aligners, especially for wear cases, remains challenging despite advancements.
Surgically facilitated orthodontics (SFOT) offers enhanced treatment options by augmenting bone support and tissue grafting.
Deep dives
Predicting Tooth Movement with Tissue Phenotype
The speaker discusses the significance of tissue phenotype in influencing tooth movement and treatment planning, emphasizing the importance of having a good relationship with a periodontist for cases where thin phenotype might affect tooth movement. Collaboration with a periodontist for bone augmentation and soft tissue grafting can provide more flexibility in treatment options.
Intrusion Challenges with Clear Aligners
The podcast highlights the difficulty of intruding teeth using clear aligners, noting that while clear aligner systems have improved, certain complex movements, like intrusion, remain challenging to predict. Intrusion of teeth, especially for wear cases, presents a significant challenge even with auxiliary mechanics like TADS.
Surgically Facilitated Orthodontics for Treatment Flexibility
The episode explores the concept of surgically facilitated orthodontics (SFOT) as a method to augment bone and support tooth movement, offering increased treatment options. SFOT allows for bone augmentation and tissue grafting, enhancing the predictability and flexibility of orthodontic treatment, especially in cases where additional bone support is needed.
Impacted Canine Management for Effective Eruption
The podcast delves into managing impacted canines and emphasizes the importance of proper exposure techniques by a skilled surgeon to facilitate effective eruption. Through meticulous tooth exposure and use of appropriate appliances like 'mouse traps,' impacted canines can be successfully brought into the arch, particularly when treatments are initiated at a younger age.
Navigating Appliance Selection and Mandibular Growth with Precision
The discussion points out the challenges and misconceptions surrounding appliance selection for mandibular growth in orthodontic treatments. The speaker underlines the importance of precise appliance choices, particularly for cases involving complex movements and interdisciplinary considerations. The hierarchy of difficulty in clear liner treatments is also explored to guide practitioners in selecting appropriate cases for clear aligners.
Final Remarks on Professional Development and Educational Resources
The episode concludes with a reflection on continuous professional development and the announcement of an upcoming educational website, cokeacheducation.com. The website is designed to provide visual educational resources and materials to enhance learning and understanding, aiming for an active release by April 1st.
Dr. Kokich Jr. received his dental degree from Tufts University School of Dental Medicine in 1996 and completed a general practice residency at the University of Washington Medical Center in 1997. He remained at the University of Washington for his orthodontic training where he obtained his Masters in Orthodontics in 1999. Since then he has remained on faculty in the Department of Orthodontics as an Affiliate Assistant Professor while maintaining a private practice in Tacoma, Washington. He has received the Charles L. Pincus Research Award for Clinical Research from the American Academy of Esthetic Dentistry and his current research and publications are primarily involved with esthetic, interdisciplinary dentistry. He is a diplomate of the American Board of Orthodontists and a member of both the Angle Society and the American Academy of Esthetic Dentistry. He has written or co-written four book chapters as well as numerous scientific and review articles. Dr. Kokich Jr. has given over 240 lectures nationally and internationally on interdisciplinary dentistry and dental esthetics emphasizing comprehensive treatment planning and the importance of properly sequencing orthodontic, periodontal, and restorative treatment.
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