NEWS & TRENDS IN ORTHODONTICS
1, 2008 VOLUME 9
2 mm Bone Screw vs. M I A
Dr. John Jin-Jong Lin
Consultant,
News and Trends in Orthodontics
I would like to express my sincere gratitude to Dr.
Kyung’s comments1 on my article about MIA in News &
Trends in Orthodontics2. However, my concern is that Dr.
Kyung might have misunderstood my comments about MIA
(Micro-Implant Anchorage) due to incomplete translation. So I
‘d like to further explain my points of view and clarify some
misunderstandings about MIA.
I respect and appreciate the wonderful MIA group led by Dr.
Sung, Dr. Kyung, Dr. Bae and Dr. Park very much. They are
some of my best international orthodontic colleagues.
I have learnt so much from Dr. Kyung’s group’s lecture in
Taiwan years ago, when I was the president of Taiwan Associa-
tion of Orthodontists. Due to their great leading contribution to
22y9m: Two 2 mm x 14 mm bone-screws were placed over the buccal
shelf.
22y10m!23y!23y1m!23y4m: The whole lower arch was distalized
by the buccal shelf bone screws.
22y5m!23y11m: The Class III malocclusion has been corrected by
distalization of the whole lower arch.
22y9m
News & Trends in Orthodontics is an experience sharing magazine, rather than a scientic journal.
You can download it at http://orthobonescrew.com.
JAN.
TADs, it encouraged and stimulated the development of TADs
in Taiwan. Through the collective effort of James Cheng-Yi
Lin, Eric Liou, Johnny Joung-Lin Liao, Ming-Guay Tseng,
Zeng-Yang Hwang, and Hwai-Nan Chang’s efforts, now we
have our own bone screw system in Taiwan.
I observed Dentos from the beginning, and now they have
become a well developed micro-implant company. AbsoAn-
chor products are selling in over 60 countries (Congratula-
tions!). There is no doubt that their products are among the
most popular TAD products in the world, and have contributed
to TADs’ worldwide poplularity. Their book is the first well-
documented TADs reference book. The orthodontic world
should pay the highest respect to the invaluable contribution
made by Dr. Kyung’s group.
Before proceeding to discussion regarding 2 mm bone screw
and MIA, I’d like to present two of the most common applica-
tions of 2 mm bone screw in my practice.
Pre-treatment Post-treatment
22y9m 22y9m 22y9m
23y11m
1
 NEWS & TRENDS IN ORTHODONTICS
2 mm Bone Screw vs. M I A
17y5m: Two 2 mm x 12 mm bone screws placed over infrazy-
gomatic crest region.
17y5m!17y11m!18y2m!18y6m: The whole maxillary denti-
tion distalized by the bone screws.
This case was treated by distalization only. The nonextraction
Tx. gets the extraction-like appearance. (The author prefers to
call this kind of treatment:“ Extraction like Nonextraction
Treatment.” )
18y7m
2 !http://orthobonescrew.com
JAN. 1, 2008 VOLUME 9
Below is a summary of my views on what constitutes ideal
TADs and MIA.
(1) Size of TADs
Dr. Kyung is right that the sizes of products range from 1.2
to 2.7mm. However, the most popular size for pre-drilling and
inter-radicular placement of TADs as instructed in their manual
is 1.3 mm in diameter and 7 mm in length. Their tapered tip is
only 1.2 mm in diameter.
My point is that 1.3 mm is too thin and therefore sometimes
has a risk of fracturing (Fig. 1). The earlier version of the pure
titanium microscrew fractures a lot. The later version of tita-
nium alloy reduces the fracture rate, but sometimes it still
Fig. 1: In this case, the micro-implant was fractured at inser-
tion. It took considerable effort to remove the micro-implant.
Note the obvious scratches from the pliers at the fractured end
of the screw. (Courtesy of Dr. Shou-Hsin Kuang)
Fig. 2: A case of damage to the root with micro-implant.
Whenever placing the screws between roots, there is a risk of
either root damage or screw fracturing.
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

2 mm Bone Screw vs. M I A

1. Chronic abscess around the mesial side of the lower 1. For the smaller core diameter screw the PTV (peak
first molar, after debonding. torque value) is very low, it means the smaller the

2. Apical film showed fragments of micro-implant over
mesial root.
3. A concavity on the mesial root on the lower first mo-
lar.
4. The screw tip fragment was removed.
(Courtesy of Dr. Johnny Joung-Lin Liao)
diameter, the easier it is to be fractured.
2. The same 1.2 mm core diameter, titanium alloy
(Orus) is much stronger than pure titanium
(TOMAS).
3. The OrthoImplant has the thickest core diameter in
the study and the highest PTV.

breaks due to its tiny diameter. In addition, the inter-radicular
placement often causes damage to the root surface (Fig. 2).
(2) Fracture of bone screws vs. their diameter
Jolley et al’s recent JCO article3 compares 5 kinds of bone
4. The 2 mm x 12 mm stainless steel has not been
studied, but because of its 1.3 mm core diameter
and the strength of stainless steel it has never had
a fracture reported in clinical use.
5. The A1-screw data was added by the author.

screws examining the peak torque value at fracture. The result

shows that as the core diameter decreases, the lower the value less steel bone screws, due to its large 2.0 mm diameter and

gets. It takes only 23.26 NCM to fracture a 1 mm core diame- good ductility, no fracture has ever been reported (Table 1).

ter screw, but takes up to 78.24 NCM to fracture a 1.5 mm core

diameter screw. Although there is no data yet for Bioray stain- Miyawaki’s study4 suggests bone screws larger than 1.5 mm
in diameter are safer.
Table 1 In Kravitz and Kusnoto’s5 recent review of risks and compli-
cations of orthodontic bone screws, they recommend a mini-
Peak Torque Value at Fracture (NCM)
mum diameter of 1.6 mm for self-drilling bone screws that are
LO- Dual- placed in dense cortical bone.
Ortho A1
MAS Top TOMAS Orlus Implant Screw
Quattro Melsen6 emphasizes that even though a small diameter
Frac- Yes Yes Yes Yes No No
ture
Not
Mean 23.26 29.72 32.44 58.33 78.24
available
Diame- 1.5 mm 1.6 mm 1.6 mm 1.6 mm 1.8 mm 2.0 mm
ter
Core 1 mm 1 mm 1.2 mm 1.2 mm 1.5 mm 1.3 mm
Length 7 mm 6 mm 8 mm 7 mm 6 mm 12 mm

Materi- Ti6AI4VTi6AI4V PureTi Ti6AI4V Ti6AI4V SS

als

Mondeal Dentau- Ortholu- Fig. 3: The larger the screw diameter, the smaller the relative
Com- Jeil Imtec Bioray stress. Compared to the 2 mm screw, the 1 mm screw has a
Ger- rum tion
pany many
Korea
Germany Korea
America Taiwan much higher relative stress rate. Therefore, it will fracture
much more easily.

3
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

2 mm Bone Screw vs. M I A

(1~1.4 mm) facilitates placement between roots, this small
diameter bone screw7 reduces its mechanical properties. In
Aarhus anchorage system, only two diameters 1.5 mm and 2.0
mm are available. (Fig. 3)

(3) Reports of fracture of MIA

Dr. Kyung states “ ... However due to changing the material
from the pure titanium to titanium alloy since 2003, fracturing
is very rare. Also we have never broken the small titanium al-
loy microimplants over the last 6 years, even when we placed
the 1.2~1.4 mm diameter microimplants without drilling on Fig. 4: This fractured screw remover from Biomaterials Korea,
95% of maxilla and 90% of mandible... ”. is very convenient for removing small size broken micro-
I admire that Dr. Kyung’s group have never broken the small implants or mini-screws.

microimplant over the past 6 years. My own experience and

cases reported by other practitioners indicate otherwise. Please
refer to Figure 1 and 2 for two examples. Even though the frac-
ture rate may not be very high, the risk is still there. When a
fracture happens, it’s a very frustrating experience.
Due to the MIA system’s emphasis on inter-radicular place-
ment, sometimes it can cause damage to the root as in Figure 2.
In a clinical study using microimplants, Chen et al8 reported
only two microimplants (one 1.2 mm x 6 mm, one 1.2 mm x 8
mm) fractured during insertion, out of some 59 microimplant
placements. The fracture rate was 3.39%.
In an animal study using microimplants, Buchter et al9 found
that 6 microimplants (1.1 mm x 10 mm) fractured during inser-
tion out of some 102 microimplant placements. The fracture
rate was 5.88%.
According to Dr. Kuang and Dr. Wu’s study of fracture rates
of MIA at the Veteran’s General Hospital, there were only 6
micro-implant fractures out of a total of 339 micro-implant
placements; the fracture rate was only 1.77%. If there were
only concerns over fracture, MIA might have been an accept-
able choice. In practice it often causes abscesses as shown in
figure 2. Additionally it can also interfere with tooth move-
ment.
When a fractured screw occurs, there is a very well designed
fractured screw remover from Biomaterials Korea
(http://www.biomk.com, Tel: +82-2-2025-0720) (Fig. 4).
Of course, the best solution is to use a larger diameter
screw to prevent any fractures.
(4) Disadvantages of pilot drilling
1. More facilities are required, such as low speed engine.
2. Overheating: If not irrigated with copious amounts of wa-
ter, overheating may result in bone necrosis and mini-
implant failure.
3. Overenlarge: If the drill is not held steady enough, overen-
larging may happen, and the loosening of the mini-implant
will result.
4. Fracture of a drill: If the drill is over used, or is of poor
quality, it may break.
5. Reduced stability: Kim et al’s study11 showed drill free
mini-implants have better stability than the pre-drilling
mini-implants.
If we can use a self-drilling mini-implant without fractures,
it will not only save a lot of time but also will have satisfactory
primary stability of TADs.
(5) Distalization of the whole dentition
In Dr. Kyung’s article it reads“ ... However, small diameter
of microimplants placed in the molar area is strong enough to
move the whole mandibular dentition as well as the whole

4 !http://www.newtonsa.com.tw
 NEWS & TRENDS IN ORTHODONTICS
2 mm Bone Screw vs. M I A
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 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

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時 間：97年元旦 7：00 am
組 數：球賽限 40 組（恕不接受現場報名）
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開幕酒會：12：25 pm，新竹市建中一路25號 （交大華廈2F：金牛頓藝術股份有限公司）
諮詢專線：03-5749567-10 吳小姐
上網查詢：www.beethoven-teeth.com.tw
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6 !www.beethoven-teeth.com.tw
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

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 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

3D Control of An Ectopic Tooth

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8 !http://orthobonescrew.com
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

3D Control of An Ectopic Tooth

!"#$ &$'()*
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2 %

9
 NEWS & TRENDS IN ORTHODONTICS
Sandra Diver on Damon Then and Now
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10 !http://www.newtonsa.com.tw
JAN. 1, 2008 VOLUME 9
/;%(8';!A(*#T!$*0!$11!/;#!28&6! /)6&!4#%#!1#.#1! R&(!/((/;! /)66)*'!
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4 months
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

Learning from the Master

!"#$%&'()*+,!"-!(,&!.-!&/-!0(+!,&-"(&1("%&"(2(/!01(&!*&+(3&!(2.+*$4 &&&&U.(+&C&70",!&,-3&!.(&(10'(+2(&/"*10+5&&9"8&9-)*+W,&2$-0),D&
*5%&-+'&.*3&0!&30$$&6(+(70!&!.()&'#"0+5&!"(-!)(+!&-+'&&0+&!.(&$*+5& /$#,&$*+5("&!(")&"(!(+!0*+& "(,#$!,MC&N+(3& 7*"&!.(&70",!& !0)(&0+&)%&
!(")8 $07(4&C&3-,&/-"!020/-!0+5&0+&-&$-"5(&,$02(&*7&*"!.*'*+!02&.0,!*"%8&C!&0,&
9#"0+5&:;;<& *1("&=;;;& 9*2!*",&3*"$'& 30'(&-!!(+'('&(>!(+,01(& !.(&)*,!&(>20!0+5&!0)(&*7&)%&2-"(("&!*&'-!(M-+'&C&-)&5"-!(7#$&7*"&
7*"#),& -+'&,()0+-",& ?@AB&!*&$(-"+&.*3&!*& -2.0(1(& !.(&9-)*+& !.(&2.-+2(&!*&/-"!020/-!(&*+&(1("%&$(1($8
,%,!()&"(,#$!,8&B.0,&-$*+(&0,& *"!.*'*+!02&.0,!*"%&4444&+(1("&6(7*"(&
.-1(&,*&)-+%&5-!.("('&!*&$(-"+&-6*#!&*+(&/.0$*,*/.%&*7&!"(-!)(+!8&
C&&2*+5"-!#$-!(&!.(,(&9*2!*",&D&6(2-#,(&!*&)(D&!.(%&.-1(&2*))0!!('&
!*&2.-+5(&7*"&!.(&6(+(70!&*7&!.(&/-!0(+!D&"(5-"'$(,,&*7&.*3&'07702#$!&&
!.-!&2.-+5(&0,&7*"&!.()D&-+'& !.(%&-"(&'(!(")0+('&!*&)*1(&7*"3-"'&
Reshaping before bonding
!*&-&+(3&("-&*7&E"!.*'*+!02,8
&&&&F*3&7"02!0*+D&$*3& 7*"2(&E"!.*'*+!02,&0,&+*3& *+(&*7&!.(&)*,!& I think the first protocol prior to the initial
bonding is reshaping the teeth, particularly from
(>!(+,01($%&'*2#)(+!('&*"!.*'*+!02&/.0$*,*/.0(,&&!*& '-!(8& G*"(&
cuspid to cuspid, with a high speed handpiece
0+!("(,!0+5& 7*"&)(&!*&*6,("1(D&0,& !.-!&!.(&(+*")*#,&&6*'%&*7&2$0+04
and diamond bur. It is much easier to place the
2-$& &(10'(+2(&7*"&!.(&9-)*+& ,%,!()&.-,&*7!(+&6((+&05+*"('D&'0,4
brackets more accurately after this macro reshap-
)0,,('&6%&!.(&#,(&*7&HIJK9EBHF& -,&-&/(L*"-!01(&!(")M%(!&M
ing. After this reshaping I polish with a white
2$0+02-$& "(,#$!,&-"(&3.-!&!.(&/"*7(,,0*+& ,((,& -+'&)(-,#"(,& (1("%& shofu stone and a brown rubber point. This takes
'-%D&-$$&'-%8&C!&0,&7-,20+-!0+5&!*&)(&-$,*D&!.-!& )-+%&C&!-$N&!*&O#*!(& very little time if the doctor has a plan prior to
,20(+!0702&(10'(+2(&!*& ,#//*"!&-&,!-+2(&*+&"()-0+0+5&30!.& PQJD& sitting down with the patient.
.05.("&7*"2(&E"!.*'*+!02,& (!2M%(!& !.(&6*'%& *7&(10'(+2(&-5-0+,!&
,#2.&7*"2(&0,&05+*"('&6%&!.()8&C+!("(,!0+5&'(6-!(,&0+'(('8
&&&&C+&-''0!0*+D&9"8&9-)*+D&9"8&Q0!!,&-+'&*!.(",&.-1(&,*&)-+%&!(+&
%(-"&*$'& 2-,(,&!.-!&-"(&,!-6$(&6(%*+'& 6($0(7&R3(&2-+&+*3& !"#$%&
,-%& !.(,(& "(,#$!,& 30$$& $-,!8&9-)*+& 0,& 3*"$'30'(&-+'& -//$0(,& !*&
(1("%&)-$*22$#,0*+&R&!.(&!.*#,-+',&*7&*"!.*'*+!0,!,&-"*#+'&!.(&
3*"$'&&#,0+5&9-)*+&,%,!()&-!!(,!&!*&!.(&7-2!&!.-!& !.(,(&"(,#$!,&-"(&
-!!-0+-6$(&7*"&HFF& *"!.*'*+!0,!,& 30$$0+5& !*& )-N(&!.(& 2.-+4
5(MIEB&?@AB&H&KSEAJI&TJU&KHAJAVVV&&&

Dr. Thomas R. Pitts

11
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

Stunning Changes of Arch Width and Smile

#$% #'$()* +,-,.,/ ##0 12(-345 Case 1!severe crowding and anterior crossbite, non-extraction
6$',/ 7,8(9:$;(,

M !"#$%&''()("*$ '&+(%$,)*-,%,"*&.$/#/*(0/$ -!1($

2(("$ %(1(3,4(%$ ,1()$*-($#(!)/5$ 6,)$ 0,/*$ ,'$ 0#$ 78$
#(!)/$&"$4)!.*&.(9$:$;/(%$1!)&!*&,"/$,'$*-($/*!"%!)%$*<&"$
2)!.=(*$ /#/*(05$>,<9$ !'*()$(+4()&(".&"?$ *-($*)(0("@
%,;/$2("('&*/$,'$*-($A!0,"$B#/*(0$&"$ 0#$4)!.*&.($',)$
Case 2 !anterior open bite with tongue-thrust, non-extraction
,1()$*("$#(!)/9$:$-!1($0!%($*-($',33,<&"?$.,".3;/&,"/C
D5 E-($A!0,"$B#/*(0$%(3&1()/$.,"/&/*("*3#$(+.(33("*$
.3&"&.!3$)(/;3*/5
F5 E-($A!0,"$ B#/*(0$-!/$ &".)(!/(%$*-($(''&.&(".#9$
(''(.*&1("(//$!"%$.,0',)*$,'$,)*-,%,"*&.$*)(!*0("*5$
75 E)(!*0("*$*&0(/$-!1($%(.)(!/(%$,"$ !1()!?($2#$/&+$
0,"*-/9$!"%$ &"&*&!3$ 3(1(3&"?$ ,'$*-($!).-(/$,..;)/$ Case 3!Class III with severe crowding and anterior crossbite,
<&*-$(+.(4*&,"!3$/4((%$!"%$.,0',)*5$ non-extraction
G5 E)(!*0("*$ (''&.&(".&(/$.,02&"(%$<&*-$*-($.,"1("@
&(".($,'$*("@<((=$!44,&"*0("*$ &"*()1!3/$ !"%$ )(@
%;.(%$"((%$ ',)$(+*)!.*&,"$*-()!4#$/()1(/$*,$ ,1()@
.,0($,2/*!.3(/$',)$4!*&("*/$*,$*)!1(3$3,"?$%&/*!".(/$
*,$)(.(&1($*-($2("('&*/$,'$*-($A!0,"$B#/*(0$'),0$
0#$4)!.*&.(5$
H5 E-($A!0,"$B#/*(0$-!/$ !3/,$0!%($/*!''$*)!&"&"?$
(!/&()$ !"%$ -!/$ )(%;.(%$ *-($ ";02()$ ,'$&"@%(4*-$
/=&33/$*-!*$(043,#((/$"((%$*,$/;..((%$.3&"&.!33#5$ Case 4:!narrow upper arch
85 I/($,'$*-($A!0,"$B#/*(0$-!/$%)!0!*&.!33#$)(%;.(%$
*-($";02()$,'$4!*&("*/$ <($/(($(!.-$ %!#$<&*-,;*$
)(%;.&"?$J;!3&*#9$4),%;.*&1&*#$,)$4),'&*!2&3&*#5$
K5 L)(.&/&,"$2)!.=(*$43!.(0("*$&/$(+*)(0(3#$&04,)*!"*$
<&*-$*-($A!0,"$/#/*(05$$

Case 5!narrow upper arch, Class II malocclusion

!" !...%<''43:=';>4''43%):?%4.
 NEWS & TRENDS IN ORTHODONTICS
Stunning Changes of Arch Width and Smile
!" #$%&'&()&*+,*+%&*-./,(* 012+&/*+'&.+/&(+* 3',+,4
),52*/.6&2* +'&.+/&(+*/,'&*&77&)+89&*.($* 3'&$8)+4
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2&&(*8(*,9&'*+&(*1&.'2*,7*=2&*,7*+%&*-./,(*012+&/"*
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/.'6.:5&*8/3',9&/&(+2*8(*+%&*&2+%&+8)2*,7*3.+8&(+2?*
2/85&2"*@(* .$$8+8,(*+,* +%&*&77&)+*,7*2+'.8>%+&(8(>* +%&*
+&&+%*.($*&2+.:582%8(>* .(*&A)&55&(+*,))5=28,(B*+%&'&*.'&*
+%&*.$$8+8,(.5* :&(&78+2* ,7*)'&.+8(>* :&.=+87=5B*<8$&*
Case 6!narrow arch, dark buccal corridors
Cases 7!beautiful smile arc
Case 8!broad smile
JAN. 1, 2008 VOLUME 9
2/85&2B*.($*'&$=)&$*:=)).5* ),''8$,'2B*<8+%,=+*=28(>*.(1* 7,'/*,7*'.38$*3.5.+.5*
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7,'*/,2+*).2&2*8(*,='*3'.)+8)&*82*.2*7,55,<2E
F" "GFH*,'*"GFI*),33&'*(8+8
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H" ;.6&*3.(,'./8)*'.$8,>'.3%*.($*'&3,28+8,(*:'.)6&+2*.2*(&)&22.'1
I" "GFM*A*"GJK*,'*"GF!*A*"GJK*),33&'*(8+8
K" @7*(&)&22.'1B*"GFNK*A*"GJK*,'*"GFO*A*"GJK*;P#
M" "GFO*A*"GJK*2+.8(5&22*2+&&5
****#$$8+8,(.5* +&)%(8C=&2*+,*&(%.()&*+'&.+/&(+*'&2=5+2*.($* &77&)+89&(&22*8(4
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****L&+&(+8,(*82*.)),/3582%&$*+%',=>%*=2&*,7*R.<5&1* '&+.8(&'2B* 78A&$*=33&'*
5.+&'.5*+,*5.+&'.5* .($* 5,<&'*)=238$*+,*)=238$* '&+.8(&'2B*)5&.'*9.)==/*7,'/&$*
'&+.8(&'2B*.($*,(*2,/&*,)).28,(2*8()5=$&*=2&*,7*+%&*-./,(*2358(+"*;%&*23&4
)878)*+13&*,7*'&+.8(&'* =2&$* 82* $&3&($&(+*,(*+%&*'&C=8'&/&(+2* ,7* &.)%* ).2&"*
S,(>*+&'/*3,2+4+'&.+/&(+*2+.:858+1*.33&.'2*+,*:&*&A)&55&(+"*@(* ,(&*,7*,='*2+=$4
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J" ;%&*3'&4+'&.+/&(+*/.A855.'1*.')%*3&'8/&+&'*<.2*/.8(+.8(&$
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13
NEWS & TRENDS IN ORTHODONTICS ./N. 1, 2008 VOLUME :
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

How Do You Close A 13 mm Molar Space?

*0"!+("'$&)32+(*3)7*!*)3"'..)"#*)3+,*8)F)G8GEH)0)G8GAI?'&) 3"+'&.*33)
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Drs. Chris HN Chang, Yi Lung Tsai, Chin Huang Tseng 32+(*3)(.$3*%) 43'&/) +)3.'%'&/),*(#+&'3,8);$) $4!)34!2!'3*<) "#*)
Beethoven Orthodontic Center, Hsinchu, Taiwan
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,+6)'&) 3$,*)7+63) 5*) +) ($,2!$,'3*8) 9!+5*!) 3"+"*%)"#+") 32+(*)
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,'/#")5*&*1'")1!$,)"#*)*0"!+("'$&)$1)>4*3"'$&+5.*),$.+!3)'&3"*+%)$1))
"#*)*0"!+("'$&) $1) #*+."#6) 2!*,$.+!3) 5*(+43*) $1)"#*) %$45"14.)
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Pretreatment
"$) (.$3*) "#*) 32+(*)5*"7**&) ,'33'&/) $!) *0"!+("*%) ,$.+!38) @*)
2!*3*&")+)(+3*)7#$)7+3)"!*+"*%)7'"#)+)3',2.*)+&%) *11'('*&"),*"#$%)
"$)(.$3*)"#*)32+(*3)7'"#$4")($,2.*0)7'!*)5*&%'&/8
))));#'3)1*,+.*)2+"'*&"<)AA)6*+!3) $1)+/*<)#+%)+)B.+33)::)5',+0'..+!6)
2!$"!43'$&) 7'"#),'.%)(!$7%'&/<)"#*),+&%'54.+!)!'/#")+&%) .*1") 1'!3")
,$.+!3) #+%) *&%$%$&"'() 2!$5.*,3) +&%) 1$4!) C!%) ,$.+!3) 7*!*)
After extraction
4&*!42"*%8)D+0'..+!6).*1")+&%) !'/#")E3")2!*,$.+!3) +&%) ,+&%'54.+!)
E3") ,$.+!3) 7*!*)*0"!+("*%)5*(+43*)$1)5',+0'..+!6)2!$"!43'$&)+&%)
.$&/?"*!,)2$$!)2!$/&$3'3) $1),+&%'54.+!)1'!3"),$.+!38)B.$3'&/) $1)
"#*)*0"!+("'$&) 32+(*3) 7$4.%) 3*!-*)"$) !*%4(*) "#*)5',+0'..+!6)
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))))F1"*!)'&'"'+.) .*-*.'&/) +&%)+.'/&,*&"<)7*)1$4&%)"#+"),+0'..+!6)
8 months
*0"!+("'$&) 32+(*3) 7*!*) %','&'3#*%) +) .'"".*)54") ,+&%'54.+!)

14 !http://orthobonescrew.com
 NEWS & TRENDS IN ORTHODONTICS
Dr. Roberts Talks about Molar Spaces Closure
Mechanics used in this case
After extraction
8 months since space closing
!!!!"#$!%&'(')*! +,-./)'%+!01$2%!1)! 34356! 7! 34389:')! %;/')&,%%!
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JAN. 1, 2008 VOLUME 9
%/+,!/$-.4!@1+,!-1++1)!$,/%1)%!/$,!,(,);#&1#%!$'(*,!0'(;.!/)(!
.,'*.;E! $11;! 0'(;.! /)(! $11;! %#$?/-,! 1?! ;.,! ;,,;.E! 1--&#%/&!
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/$-.0'$,%!+/A! ('%;#$B! ;.,!');,$/-;'1)!1?!;$/)%,=;/&! ?'B,$%E!0,!/&%1!
?1#)(! ;.,! %/+,!,??,-;! B,;0,,)! +/7'&&/$A! 5%;! /)(! 8)(! +1&/$%4!
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/)!/(>,$%,!,??,-;!1)!;11;.!+1>,+,);!')!;.'%!-/%,Q!
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W. Eugene Roberts, DDS, PhD.
Department of Oral Facial Development,
Indiana University School of Dentistry, Indianapolis
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15
 NEWS & TRENDS IN ORTHODONTICS JAN 1, 2008 VOLUME 9

Learning from the Master

Dr. Chris HN Chang, Dr. Yu Lin Hsu, Dr. Thomas R. Pitts

Beethoven Orthodontic Center, Hsinchu, Taiwan

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("7"0$1&<"/&5.)%*(&*.&(+$0"&?)*+&.'0&0"$2"0(H 5 6

16 !http://www.newtonsa.com.tw
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

Learning from the Master

!" #$%&'()*+*(,&(-&./012%+)3&4/012%+)&0/%&'()*+*(,%5&,%0/&+$%&
A Wonderful Interlude which Changed My Life
6*,6*70&89*6"&!:"&;/"&#(<&=*++)&.%>*%7%)&0&.%++%/&+(/?@%&1(,+/(>&
The First Contact with “Braces”
0,5&)<*>%&0/1&10,&.%&01$*%7%5&A$%,&./012%+)&0/%&'>01%5&
1>()%/&+(&+$%&1%,+%/&(-&/%)*)+0,1%"
I was an exchange student in the
B" 4/012%+&)%>%1+*(,&-(/&*,1*)(/)3&C!&0,5&CB&0/%&.(+$&+$%&)+0,D
US last year. By chance, I met Dr.
50/5&+E'%&.@+&0/%&'>01%5&@')*5%&5(A,&A$*>%&$%&@)%5&DF!>(A&
Tom Pitts there and he used the
+(/?@%&./012%+&(,&+$%&>(A%/&0,5&>(A%/&1%,+/0>&*,1*)(/)"&G*)&
braces to change my life. I look
/0+*(,0>%&A0)&+$0+&+$*)&,(,D%H+/01+*(,&10)%&10,&(.+0*,&0&.%++%/&
much different than I used to. I
'/(-*>%&A*+$&>%))&'/(,(@,1%5&'/(+/@)*(,&89*6"&B:"
have a great big smile now! Also,
I" 9*,*)$&.%,5*,63&$%&'%/-(/<%5&-*,*)$&.%,5*,6&@)*,6&0,&*,D(@+& Michael Ho
to my amazement, it didn’t hurt at
.%,5&(,&.(+$&@''%/&0,5&>(A%/&1%,+/0>&*,1*)(/)"&J+&*)&)+*>>&'()D all!! That’s totally different from what my friends
)*.>%&+(&0''>E&<(5%/0+%&)*<'>%&.%,5*,6&+(&01$*%7%&0&.%++%/& told me. I didn’t feel any pain with braces on my
-*,*)$&%7%,&A*+$&0&)+/0*6$+&A*/%&)E)+%<&89*6"&IKL:"&& teeth, and I have learnt to clean my teeth much
L" C)%&(-&%>0)+*1)3&C)%&%>0)+*1)&+(&*<'/(7%&*,+%/1@)'0+*(,&0+&+$%& carefully. When I came back to Taiwan, I found
-*,*)$&)+06%&89*6"&MKF:" Dr. Chang who Dr. Pitts strongly recommended. In
Beethoven Orthodontic Center, I find nothing dif-
&&&&J,&1(,)@>+0+*(,&A*+$&;/"&#(<&=*++)&/%60/5*,6&+$%&'0+*%,+N)&
ferent from Dr. Pitts’ Clinic in the US; they have
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the newest instruments, well-trained doctors and
)+%%>)&)(&+$0+&A*+$&+$%&5%+(/?@*,6&(-&+$%&0,+%/*(/)P&+$%&>*'&.@<'%/&
great services! The only differences are the decor
%--%1+&1(@>5&.%&-@>>E&%H'/%))%5"&J,&055*+*(,P&$%&/%1(<<%,5%5&)>%,D
and that the people speak Chinese! I feel great go-
5%/*S*,6&+$%&1(,+01+)&(-&+$%&>(A%/&0,+%/*(/)&-(/&+((+$&)*S%"
ing to Beethoven Orthodontic Center not only be-
cause of the great doctors but also the marvelous
&&&&#$*)&10)%&'/(7*5%)&(@/&1>*,*1&A*+$&0&6/%0+&(''(/+@,*+E&+(&(.)%/7%&
treatment they gave me! These braces have totally
@'&1>()%&+$%&%H1%>>%,+&A(/2&(-&+$%&<0)+%/&(-&+$%&;0<(,&)E)+%<"&J,&
given me a whole new life!! It’s not only about
055*+*(,P&*+&'/(7%)&+$0+&(,1%&+$%&'/(+(1(>)&0/%&7*6(/(@)>E&-(>>(A%5P&
braces; it’s about your health!! Give my sincerest
0&10)%&)+0/+%5&*,&+$%&CT&10,&%0)*>E&.%&-*,*)$%5&%>)%D
gratitude to Dr. Pitts, Dr. Chang and the
A$%/%&A*+$(@+&1(<'/(<*)*,6&+/%0+<%,+&?@0>*+E"
Beethoven Orthodontic Center!

17
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

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18 ,www.beethoven-teeth.com.tw
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

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19
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20 !http://orthobonescrew.com
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

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21
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

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22 Ihttp://www.newtonsa.com.tw
NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

2008 Damon in-office course

!"!#$%&'!()*+!,!-./0!/1122345!6789:;<=-.10!53>41.4!?@A 23
 NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

From the Publisher: From Good to Great NTO contributors

Chris Hwai-Nan Chang, DDS, Ph.D TU&%V!WXU$!$%!&#YZ$[

I WAS CRAZY ABOUT the lingual appliance and RPE for many years. As a matter
of fact, RPE was the topic of my Ph.D. studies. Three years ago, I met an amazing woman, Ms.
Sandra Diver, in Dr. John Lin’s office. She was trying very hard to convince us there were better
ways to treat patients than the popular RPE. Her passionate speech surprised me a lot. When I
returned to my office that afternoon, I decided to make a thorough study of my cases. My curios-
ity has driven me to investigate the difference between arch development and suture expansion
as Sandra mentioned in her lecture. This shift has marked one of the most creative periods of my
orthodontic learning. Dr. Chris HN Chang,!Publisher
Dr. Johnny JL Liao, Consultant
Through studying my own mistakes, I find out that the more I learn, the more I realize how Dr. John JJ Lin, Consultant
much I don’t know. With the invention of multimedia tools, it has been easier to learn from ones’
!"#$%&'
own records. You can easily look through all your cases, and compare the treatment outcomes.
TU&%V!WXU$!$%!&#YZ$[
My new secret weapon is, an Apple software, Keynote. I’ve learned so much about the Damon
effect and the value of bone screw anchorage by using Keynote. Keynote, the Damon system
and bone screws have become three wonderful toys for my orthodontic practice and learning.

If there’s one thing I hope you get from this issue, it’s an attitude about learning. Learning
should not be a challenge, a grim obligation, or a way of filling up time. Learning is man’s
greatest invention, a way to make improvements, and one of the most fulfilling pleasures that
life has to offer. I encourage you all to consider every treatment procedure as an opportunity for Dr. Yu Lin Hsu (Editor-in-Chief)
learning. Regardless of your ability as an orthodontist, remember: Rachel O’Brien
1. If you think you’re not good at it, you can be.
Tzu Han Huang
2. If you think you are good at it, you can be better.
Ed Chen

Keep learning and don’t settle for less! Let’s con-

tinue on this journey of going from good to great.

Chris Hwai-nan Chang

NEWS & TRENDS IN ORTHODONTICS JAN. 1, 2008 VOLUME 9

News & Trends in Orthodontics OCT 1, 2007 VOlume 8

全齒列遠心移位之極限？
! !"#$%&'$()*+,+&+$-./0123456789:
;<=>?@ABCDEFGH2IJKL?MNOP ! " # $ %
2 mm Bone Screw vs. M I A
17y5m: Two 2 mm x 12 mm bone screws placed over infrazy-
gomatic crest region.

17y5m!17y11m!18y2m!18y6m: The whole maxillary denti-

tion distalized by the bone screws.
This case was treated by distalization only. The nonextraction
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Q78RSTUVWX/9YZ[\]ABCEFGH Dr. John Jin-Jong Lin Tx. gets the extraction-like appearance. (The author prefers to
自從聽聞張慧男醫師要到“下 Consultant, News and Trends in call this kind of treatment:“ Extraction like Nonextraction

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港“出巡教授矯正課後，就迫不及待
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地想要知道是否 Damon 真如此神
€$•‚/ƒL„…2†6‡$ˆ$‰‰$Š‹Œ&•Ž•Œ$•$€$‰‰$Š‹Œ&‘Œ•$ 效，能讓這麼多矯正醫師為之傾心？
/’“yz$jk+ll$mm$”•{ I
Keynote 又是什麼碗糕？我學的會 would like to begin by expressing my sincere gratitude
! _`r–—˜hi /U“$jk+ll$mm$™8\]ABCE to Dr. Kyung’s comments
嗎？結果 11 堂課下來，對於 Keynote1 on my article about MIA in News &
FGHštuvwƒ› /œQ•œžŸ 2¡¢s£¤ 在演講上的表現，只能用生動活潑、
Trends in Orthodontics2.However, my concern is that Dr.

p¥¦rstuvw ƒ›2§efABCEFGH¨ 歎為觀止來形容。課程毫無冷場，都

Kyung might have misunderstood my comments about MIA
忘記了要打瞌睡。最神奇的是連(Micro-Implant Anchorage) due to incomplete translation. So I
©sª«"2¬@t -®¯\]°p±²Bvw2œž
Power Point 都 would like to further explain my points of view and clarify

>-?@A-BCD-*E
³´/µ2abABC EFGH{¶·´¸/¹2º»¼ 不曾摸過的 some misunderstandings about MIA.
L$Š‹Œ&‘Œ•$½¾¼¿pLp•‚/ABCEFÀÁ^2Š‹Œ&•Ž•Œ$•$Š‹Œ&‘Œ•$ 我，居然在短 I respect and appreciate the wonderful MIA group led by Dr.
ÃÄű2”•½K·$jk+ll$m{ 短的兩個星期
Sung, Dr. Kyung, Dr. Bae and Dr. Park very much. They are
! Æ?Ç$Š‹Œ&‘Œ•$»cȹɵÊ˵̽Ç$Š‹Œ&‘Œ•$űÈc4Í 就會使用 Key-
some of my best international orthodontic colleagues.
Î{g9Y•\]°pc²BnoÏKFÐ>K/ ÑÒ2¦ note ，而且還
I have learnt so much from Dr. Kyung’s group’s lecture in
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Taiwan years ago, when I was the president of Taiwan Associa-
告。這份成就感就是來自於一台
ÙsÚs@Û\°pc²BnoÏ\/KFÐÜ tion of Orthodontists. Due to their great leading contribution to
Apple 電腦和一套簡單易學的 Keynote
Ý2rÞß@\]ABCDEFGH{àá\ ]A TADs, it encouraged and stimulated the development of TADs
軟體。各位同好們，趕快將您收集好

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stuvw/ùú{!!!!!!!!!!!!!!!!!!"#!$%!&'()*+,-./0
F-GH,-ICJ-KL
é2 in Taiwan. Through the collective effort of James Cheng-Yi
的資料及照的漂漂亮亮的照片存進
/P Apple 裡吧！讓Lin, Eric 為您編排一
Keynote Liou, Johnny Joung-Lin Liao, Ming-Guay Tseng,
段精彩的 Case Zeng-Yang
Show。您將會有一份 Hwang, and Hwai-Nan Chang’s efforts, now we
意外的喜悅!! have our own bone screw system in Taiwan.
I observed Dentos from the beginning, and now they have
!!!!!!!123!$%!45678$9:
become a well developed micro-implant company. AbsoAn-
chor products are selling in over 60 countries (Congratula-
tions!). There is no doubt that their products are among the

M-NOP1QRS8
most popular TAD products in the world, and have contributed
to TADs’ worldwide poplularity. Their book is the first well-
documented TADs reference book. The orthodontic world
should pay the highest respect to the invaluable contribution
made by Dr. Kyung’s group.
Before proceeding to discussion regarding 2 mm bone screw
and MIA, I’d like to present two of the most common applica-
tions of 2 mm bone screw in my practice.

29y5m 30y6m
News & Trends in Orthodontics is an experience sharing
magazine, rather than a scientic journal. You can download it at http://orthobonescrew.com. 1
1

!"#www.beethoven-teeth.com.tw TEL#(03) 5749567

24
$% E-mail#beeth.oven@msa.hinet.net FAX#(03) 5479476