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	UK Register of Expert Witnesses

Top UK Register of Expert... Straumann Orthosystem

Now in preparation for its 12th year, the UK Register of Expert Witnesses is a `live' database of experienced expert witnesses. It currently holds the details of more than 3000 vetted individuals, whose fields of expertise range from accountancy to yacht building, anaesthesia to zoology and acupuncture to zinc—the subject index runs to no fewer than 17,000 entries!

The database is available in three formats: as a book (distributed free of charge to the top 3000 UK solicitor firms), as Windows-compatible software and now on-line.

Readers of the British Journal of Orthodontics who wish to make known their availability as expert witnesses to wider circle of the legal profession should contact Kate Porter at J. S. Publications, P.O. Box 505, Newmarket, Suffolk CB8 7TF (tel 01638 561590; fax 01638 560924).

	Straumann Orthosystem

Top UK Register of Expert... Straumann Orthosystem

 
Anchorage has always been one of the perennial challenges of Orthodontics. Following the concerns raised over the safety of headgear and the ongoing problem of patient compliance, a number of ingenious alternative treatment approaches have been suggested to gain additional anchorage or distal movement in the upper arch. However, it would seem that the old adage, that you never get something for nothing, still holds true. yet the use of implants would appear to offer a possible solution.

The Straumann Orthosystem is a relatively new endosseous orthodontic implant designed to provide Orthodontic anchorage. Two sub-systems are available: the Ortho implant for temporary insertion in the median palate or retromolar region, and the bonding base for use with `regular' permanently anchored implants.

The Ortho implants are solid screws constructed of pure titanium and surface-treated using a two-stage process involving grit-blasting then acid-etching to increase the surface area of the endosseous section. The implants are 3.3 mm in diameter, and are available in 4- and 6-mm lengths. The manufacturers suggest that this design can be used in the median palatal section of the palate or the retromolar region in the mandible. However, careful pre-operative assessment is required to ensure that adequate depth of bone exists prior to placement.

Following insertion using the Straumann kit, an Ortho healing cap is placed and a healing phase of approximately 12 weeks allowed before the implant can be loaded. An impression cap is provided to be used during impression taking which acts as a transfer coping. When a palatal implant is used, a palatal arch is then constructed in the laboratory and attached to the implant via an Ortho clamping cap and to the anchor teeth by means of a lingual pad which is applied using the acid-etch technique. Bands can be used on the anchor teeth, but as undesirable torquing forces can result, the acid-etch method is advised. The position of the implant is limited by the available palatal bone, therefore, geometry may dictate utilization of one premolar tooth in each maxillary quadrant as the anchor tooth to which the palatal arch is attached.

At the end of treatment the implant is removed using an explanation drill transmucosally and, if necessary, a dressing placed until the wound heals.

While this system may have advantages, these need to be offset against the two operative procedures required and the increased costs. The risks and morbidity of this approach are undoubtedly greater than those of headgear use, and for the present will probably limit the use of this technique to patients with severe hypodontia, or loss of tooth and supporting structures due to trauma or pathology.

The Octasystem has been developed by Straumann for use with permanently anchored implants in the line of the arch. The Octasystem incorporates a bonding base with a special 24-facet internal profile that allows the base to be placed in the desired position. Two different heights of the bonding base are available to accommodate variations in the distance between the implant shoulder and the mucosa. The desired bracket is then attached to the bonding base and appliance treatment carried out. This system has the advantage that crown placement can be deferred until Orthodontic treatment is complete.

Costs and further details, including reprints of clinical trials involving the Orthosystem and Octasystem, are available from Straumann Limited, 2 Falmer Court, London Road, Uckfield, East Sussex, TN22 1HN. Tel:01825 760686. Fax: 01825 760696.

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