In this Issue

From the CEO How to get started with the MRC Systems.		Guest Writer Establishing Nasal Breathing. By Dr John Flutter.
Scientifically Speaking Your questions answered.		Events and Education Our upcoming training events listed.
MRC Global Frequently Asked Questions.

From the CEO

Hello [firstname],

With the MRC Systems, you can be on your way to increasing the number of patients you treat successfully. Profit from your experience with early treatment, habit correction, cosmetic alignment and TMJ treatment by following these simple steps:

STEP 1: Spend 5 minutes watching each of the the instructional videos from the MRC Complete Systems CD-ROM. (TRAINER System™, MYOBRACE System™ and TMJ System™). If you have broadband internet, you can also view these from our website. It is important to find a time when you can give 100% attention to the subject, as there is vital information condensed into each of these videos. It takes only 5 minutes for each subject.

STEP 2: Identify the potential uses in your practice. After watching the video you will recognise the potentialities of the MRC Systems. They are easy to implement and now it is up to you to choose patients in your practice who already have a need for this treatment. Most growing children have developing malocclusion and poor facial growth. Choose 2-3 for the TRAINER System™. The appliance selection can be done based on:

• The malocclusion (mild is recommended to start with) or
• According to the patients age (the earlier the better with the T4K™ during mixed dentition).

See our Age Selection Chart for guidance.

STEP 3: Read the T4K™ manual of procedures to obtain an overview of the different applications of the TRAINERS - use right column as a subject guide. Download the manual, check the T4K™ Clinical Applications from the website or watch the MRC Complete Systems CD-ROM for more detailed information on the entire system.

STEP 4: Select the best case to start with the TRAINER System™. It is best to initially start with mild cases and motivated patients and parents. Start with the T4K™ if a child is in the mixed dentition stage with signs of a developing malocclusion. Case criteria: Mild crowding, open bite, poor mouth posture, tongue thrust swallow narrow maxilla.

STEP 5: Gain more patients by showing each patient information from the CD-ROM, DVD or brochure in your waiting room. This will introduce the concept to many interested parents. Remember to tell the parents that the treatment goal is NOT to eliminate the malocclusion (although this is possible in some cases), but to decrease its severity, improve facial growth, decrease the need for extractions, and to improve the stability of any future orthodontic treatment. If used as directed you will obtain routine success. Many orthodontic problems can be eliminated with an early start with the T4K™.

More information.

Regards,
Dr Chris Farrell BDS (Syd Uni)
CEO and Founder

Scientifically Speaking

"Is there scientific evidence in the literature supporting and demonstrating the modus operandi and effect produced by the TRAINER? What about the MYOBRACE®?"

The effect produced by the TRAINER is similar to other functional appliances designed to stimulate mandibular growth (Bionator, monoblock, twin-block, etc). These appliances force the mandible into an edge to edge bite. Thus, while the appliance is worn, it produces a stretching of the lateral pterigoid muscle. Once the appliance is taken out of the mouth, the lateral pterigoid enters in hyper-contractile movements, which makes the condyle move forward and backward for a certain time. This was explained by Petrovic and Stutzman (1994, 1990). These little movements of the condyle are not noted by patients, who generally interpret this as a discomfort to achieve a proper occlusion immediately after he takes out the appliance. Such movements of the condyle stretch the retrodiscal pad (known as Zenckel’s zone), where the blood vessels release nutrients and growth factors into the condyle, producing the mandibular growth that we know is created by these appliances.

In the case of the TRAINER, mandibular relocation has been scientifically demonstrated by an increase of the SNB angle (Usumez, 2004). An advantage of the TRAINER is that they relocate the mandible, and stimulate transversal development. We have just finished a research evaluating the effect of the TRAINER for Kids™ (T4K™) on the dimensions of the dental arches. For this, 60 kids treated only with the T4K™ for one year were involved in the study. Our results showed that there was a significant increase in inter-canine, inter-premolar and inter-molar distances. Furthermore, overjet and overbite were improved in all patients treated with this functional appliance. This effect is produced by the relocation of the tongue produced by the flag incorporated into the T4K™, and also the effect of the external flange on the muscles of the cheeks and lips, which produces an effect like that observed in patients treated with the Functional Regulator (Frankel). This study has been submitted to be published in an ortho journal.

In addition, the efficiency of the T4K™ was also evaluated on these patients. We are now able to say that the TRAINER produces a significant increase, up to 4 mm in a year, in the transversal dimensions of the dental arches. In addition, the TRAINER™ corrects sagittal and vertical problems (deep and open bites) in 80% of the cases. This data supports the success achieved with this functional appliance (Quadrelli, 2002) and is also applicable to the MYOBRACE®.

The modus operandi of the MYOBRACE® is the same as the TRAINER. However, it has an extra advantage. It guides the teeth to achieve correct positioning, and so, producing that effect of the brackets. With the TRAINER dentists may achieve success treating sagittal and vertical problems, and at the same time, to stimulate transversal development, and thus, to avoid extractions. However, if you need to stimulate higher transversal development (4 mm or more) you should combine the TRAINER with the BENT WIRE System™ (BWS™).

Summarizing, the TRAINER produces a relocation of the mandible, demonstrated by Usumez (2003), in a similar way as the Bionator and other functional appliances do. In addition, the TRAINER stimulates transversal development of the dental arches, demonstrated by Ramirez-YaÀez (2005), in a similar way as the Frankel. Therefore, the Usumez paper published in the Angle Orthodontist (2004) and my study (2005), as well as all the literature published about other functional appliances extensively explain the modus operandi of the TRAINER and may support and show our customers and the institutions that there is enough scientific basis to use this functional appliances.

Research References

Best regards,
Dr. German O. Ramirez-Yañez
Scientific Researcher for MRC

MRC Global - A World Perspective

More FAQ

Regards,
Damien O'Brien
MRC Global Sales & Training Executive

Establishing Nasal Breathing

Over the years I have noticed an increasing tendency for children to show evidence of chronic or habitual mouth breathing. This has a negative effect not only on the development of the jaws the shape of the developing cranium and the occlusion but also on the general health of the child.

When I see a child for the first time seeking orthodontic treatment the first thing I assess is the breathing pattern. Children who are chronic mouth breathers will all hyperventilate. In normal nasal breathing the child will inhale/exhale about every six seconds. Children who are chronic mouth-breathers will inhale/exhale about every three seconds. It is often possible to note this by looking at the rise and fall of the shoulders in time with the breathing.

When I see the shoulders and chest moving during relaxed breathing I see it as a clear indication that all is not well. Breathing should always be controlled from the diaphragm with no visible outward signs of the breathing.

In addition, breathing should be silent. So when I can hear the child breathe it is a strong indication the breathing is dysfunctional.

Children who are chronic mouth breathers as a result of an allergic rhinitis will only manage to breathe through the nose if it is possible identify and eliminate the allergens. Allergens may be airborne and inhaled or food allergies that are consumed.

For the children who do not display allergic rhinitis then establishing nasal breathing is often a matter of breaking the mouth-breathing pattern. Sometimes is is necessary to reduce the hyperventilation in these children before the pattern can be changed.

View full article.

Regards,
Dr John Flutter
BDS (London) Dental Surgeon.

Share Your Advice

Patient Compliance is an important subject when it comes to successful treatment with the TRAINER System™. In Issue 4, Dr German Ramirez wrote an article on Patient Compliance, which was discussed further in Issue 3 of his MRC Newsletter.

This month, we are extending an invitation for you to step forward and share your advice and methods with readers on how to achieve Patient Compliance.

We ask that submissions remain between 500 to 1000 words and be sent via email along with any supporting material to the eNewsletter Editor.

Your feedback is appreciated. If you have any views or responses please contact us with any feedback or ideas you have to improve this new service.

Testimonial

"The TRAINER is enjoying great popularity in my clinic.

Thanks to the TRAINER, I've gained more than 570 (pre-)orthodontic patients since I first started using the appliance in July 2001.

It is my great joy and honour to see my patients (children) grow bright and charming without using braces or other orthodontic appliances.

If used properly, the TRAINER almost never fails to prove successful."

Dr Masashi FUKUOKA
Arte Dental Clinic, Japan

Patient Information Binder

The 3 page Patient Information Binder is an effective resource for every practice. Order through your local representative.

Contact Us

MRC's Events Gallery is continually growing as we attend events all over the world informing professionals about the importance of MYOFUNCTIONAL RESEARCH.

Events Gallery

Have you seen the MYOBRACE® website?

Myobrace.com is a new, informative website about the MYOBRACE® and all it's features.

Visit www.myobrace.com

eNewsletter Credits:

Published by:
Myofunctional Research Co. (MRC)

MRC CEO & Founder:
Dr Chris Farrell (BDS Sydney)

Editor: Jill Steptoe
Webmaster: Aaron Young