JDO Vol. 76
Editorial
Chris H. Chang
Why YouTube for Orthodontic Learning Videos?
Upon my return to Taiwan after 10 years of orthodontic learning, I embarked on another learning journey, namely guitar! I had enrolled with Maestro Paco Wu, a fellow golfer and a dear friend, when I can across a talented young Korean player on a then innovative platform called YouTube. On his channel, I could find all the musical pieces that I had ever wanted to learn, with detailed, broken-down instructions. I thought that was a brilliant idea and introduced this concept to my guitar teacher. My suggestion was prompt discarded by Maestro Paco, which back then made perfect sense, as no one really knew what YouTube was, and learning from it seemed foreign and most unconventional…
Site Selection for Mandibular Buccal Shelf (MBS) and Infra-Zygomatic Crest (IZC) Bone Screws
Lily Y. Chen, Chris H. Chang, W. Eugene Roberts
Multiple studies indicate primary stability of TAD is the critical factor for clinical success.
Primary stability has a positive relationship to cortical bone thickness and density. At least 1 mm of buccal cortical bone thickness is necessary to achieve primary stability.
To facilitate oral hygiene and prevent soft tissue irritation, Chang et al. recommended 5 mm distance between screw head and soft tissue surface. With the 5 mm soft tissue clearance, screws can be positioned in either attached gingiva or movable mucosa. There is no statistical significance affecting screw success rate between these two types of tissue. (J Digital Orthod 2025;76:4-8)
Class II Division 2 Malocclusion with Severe Deep Bite, Unilateral Posterior Scissors Bite, and Missing Lower First Molar in an Adult Treated with Miniscrews and Bite Turbos
Huang-Ting Lee, Jia-Hong Lin, Chris H. Chang, W. Eugene Roberts
A 27-year-old female with Class II division 2 malocclusion, severe deepbite, right posterior scissors bite, and a missing right mandibular first molar presented for orthodontic consultation. After 49 months of treatment, intrusion of the incisors in both arches and maxillary whole arch distalization were successfully achieved with anchorage provided by temporary skeletal anchorage devices (TSADs), including an incisal screw and bilateral infra-zygomatic crest (IZC) screws. The left mandibular first molar was extracted due to poor prognosis, and then the symmetric lower first molar spaces were close with bilateral L-shaped Class II elastics and power chains. Anterior bite turbos, anterior root torquing (ART) springs, and pre-torqued archwires were used to correct the deep bite and increase the inclination of maxillary incisors. An ideal dentofacial result was achieved in a minimally invasive manner. (J Digital Orthod 2024;76:16-33)
Key words: Class II division 2, deep bite, unilateral scissors crossbite, miniscrews, bite turbos, whole arch distalization, molar extraction space closure, anterior root torquing spring
Download Article
Transposed Maxillary Canine Impactions with Gingival Recession Treated with the Vertical Incision Subperiosteal Tunnel Access (VISTA) Technique and Infrazygomatic Crests (IZC) Screws
Chris H. Chang, Lily Y. Chen, Jenny Y. Chang, W. Eugene Roberts
Introduction: A 10-year 6-month-old girl presented with impacted and transposed maxillary canines.
Diagnosis: The patient was skeletal Class I (SNA 84 ̊; SNB 81 ̊; ANB 3 ̊) with bilateral Class I molar relationships. Both maxillary deciduous canines (URc and ULc) were present. Maxillary right canine was incompletely transposed while maxillary left canine was completely transposed. The Discrepancy Index (DI) was 9.
Treatment: The impacted and transposed canines were treated using the vertical incision subperiosteal tunnel access (VISTA) technique and custom 3D lever arms anchored by an OrthoBoneScrew® (OBS) inserted in the infrazygomatic crest (IZC).
Discussion: After 40 months of active treatment, both the incomplete (UR3) and complete (UL3) transposed impacted canines were successfully aligned into the arch. Although gingival recession on both maxillary canines was observed after the eruption, they were treated with the VISTA technique to recover the gingiva. The Cast-Radiograph Evaluation (CRE) was 4, and the dental esthetic (Pink & White) score was 4.
Conclusion: The VISTA surgical exposure is a unique approach for submucosal movement of the impactions. Skeletal anchorage using OBS with a 3D lever arm provides an independent force system for retracting both impactions. (Reprinted with permission from Perio Clínica 2024;28:46-66; J Digital Orthod 2025;76:38-60)
Key words: Impacted maxillary canine, infrazygomatic crest miniscrews, bone screw anchorage, vertical incision subperiosteal tunnel access (VISTA), 3D lever-arm, root resorption, gingival recession.
Download Article
My Journey of Orthodontic Education
Dr. Nawal J. Almutawa
Embarking on a journey of orthodontics has been a transformative experience, marked by a series of milestones that have shaped my career and passion for dental care.
From my initial focus on Prosthodontics to becoming a dedicated orthodontist, my path has been driven by a desire to create beautiful smiles and enhance patients’ quality of life. Each phase of my education has been pivotal, leading to profound shifts in my understanding and approach to orthodontics. The journey began with a foundational passion for dentistry, where I initially found joy in restoring teeth through prosthodontics as a specialized prosthodontists with a PhD from Tokyo Medical and Dental University in Japan…