GAP Australasian Dentist Sept Oct 2020

Category 38 Australasian Dentist O rthodontic treatment in adults is very different than that for adolescents. A significant number of finished ortho cases are in truth, not finished in the eyes of the patient. Patients that have undergone oftentimes lengthy orthodontic treatments are typically motivated by dental health and aesthetics. It simply doesn’t make sense to these patients to be in treatment for so long and make personal sacrifices to journey through orthodontic therapy, to then turn around and “finish” by covering the teeth with porcelain laminates – especially if the laminates will require, in their words, “grinding my teeth down to nubs”. While this may be an overstatement of the reduction of a tooth, most rational patients will choose an additive, rather than subtractive restorative approach. Is this a widespread problem? The prevalence of adult orthodontics has risen approximately 40 per cent since 1996, 1 and at least 40 per cent of adult orthodontics results in black triangles. 1, 2 Many of those patients view black triangles as a bigger problem than crowded teeth and sometimes report that they wish they had not embarked on the orthodontic treatment and want to turn back the clock. Most of these unhappy post-orthodontic outcomes resulted from lack of informed consent regarding the possibility of Black Triangles and also incomplete treatment plans combined with inexperienced general dentists dabbling in orthodontics. Why is Canada leading the world in the percentage of dentists performing the Bioclear Method? Clinical Research Dental was the first Bioclear dealer outside of the USA and has shown a strong commitment by creating a plethora of Bioclear courses in Canada over the past 11 years. With this powerful commitment to education and hands-on training, it is not surprising that Canada leads the way. Recently, dental schools such as Université de Montréal and McGill University are incorporating some or all of the Bioclear Method into their curriculum which embraces modern, non-GV Black, infinity edge style cavity preparations restored with injection molded composite resins. The GPR program at University of Alberta was the first program in Canada to adopt the Bioclear Method. The functional and esthetic impairment resultant unfamiliar negative space Negative space is the space surrounding and defining the boundaries of positive space occupied by an object. 3 The human visual system is more sensitive to contrast than absolute luminance. The human eye sees contrast between black and white more readily than soft-colour contrasts. As a result, our visual focus on an area or object is enhanced when surrounded by the stark contrast of negative space. Dentists often fixate on the colour or colours of the tooth. Our patients fixate on the shape and any darkness around that shape. Unfamiliar negative space is darkness where it doesn’t belong. To a patient’s eyes it looks like decay and disease, even in the tiniest of black triangles. The patient highlighted (Fig. 1) in this article lives in Texas and contacted my west coast (Tacoma USA) office after being disappointedat her post-orthodontic result. While better than before the orthodontic treatment, the patient felt like the result was far from ideal. She researched the internet options for treatment of Black Triangles and discovered the Bioclear Method and our Bioclear Clinic. She and her family flew for two days of treatment. She returns annually for prophylaxis which affords us the opportunity for annual follow up photographs (Figs 1-8). Here are a few comments from the patient, Bridgette: “Being a nurse, I research everything and was becoming very worried that I would never find a solution! I hated the black spaces between my lower teeth but was repeatedly told that there was nothing that anyone could do. I am a person that laughs all the time and the spaces were becoming noticeable. Now that the Bioclear treatment is finished the teeth feel perfect! They feel like natural teeth but smoother.” The author has treated hundreds of Black Triangles from several countries including Canada and several states in the USA. Patients are aggressively seeking Bioclear treatment for Black Triangles along with other aesthetic dilemmas. Today there are 102 Certified Bioclear providers in Canada that have travelled for intensive hands on training at the Bioclear Learning Center in Tacoma. In addition, there are approximately 2,000 Canadian clinicians that have taken a Bioclear course at a CRD sponsored event. This makes Canada, according to internal research at Bioclear, the leading country per capita in the world performing Injection molding composite dentistry with the Bioclear Method. Injection molding with the Bioclear Method today Injection molding is made exponentially easier with heated composite. The Treating the dreaded black triangle with the Bioclear Method: A 4-year follow up clinical By Dr David Clark, DDS Figure 1. The smile photograph alone does not realistically display the human dentition. When a patient talks, yawns, laughs or any of a myriad of activities, the black triangles suddenly appear. David Clark