Top 5 ortho schools?

[pocket aces]

Anyone have any thoughts on what the top 5 clinical ortho programs in the US are?

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[Jediwendell]

Clinical ortho? I can tell you what some good ortho programs are but I am not sure if they would all be known as "top 5".

Houston
Baylor
UNC
VCU
Iowa
Florida
Washington
Oregon

 

[Jaybe]

I would say:

Michigan (Heavy hitting researchers and clinicians, variety of philosophies, incredible facilities, cold weather)

Baylor (variety of philosophies, good facilities, hot weather)

Oklahoma

UIC (tons of patients, lots of foreign accents, not much consistency in philosophy, dungy facilities)

St. Louis (heavy clinically, lighter on research, variety of philosophies, LOTS of residents, Best Facilities I've ever seen)

 

[Firm]

I believe he wanted top 5 clinical programs. I've heard St. Louis is strong clinically among others.

 

[antidentite]

not sure about clinical programs. actually it is all speculative. programs I have heard the most when the topic of top ortho programs come up:

north carolina
illinois
michigan
washington
UCSF

no basis at all for the above list. just the names I usually hear thrown around.

I believe he wanted top 5 clinical programs. I've heard St. Louis is strong clinically among others.

 

[gryffindor]

How do you measure "clinically strong?" I recall at Montefiore, the first years were bragging about having started 100 cases or something absurd like that and it was only October. I didn't bother asking them to define what "start" means, but I guess that kind of a statement could push you up to the clinically strong program category. Or how about a program like Mayo where it is 1 resident per year and you are carrying like 100+ patients by the time you get to third year. Sure sounds like there are a lot of clinical opportunities there compared to St. Louis where they start 30ish cases (according to one of the other threads).

Top names I have heard include UNC, Washington, Connecticut, Michigan... but there is also a lot of big research coming out of those places too.

 

[S Files]

How do you measure "clinically strong?" I recall at Montefiore, the first years were bragging about having started 100 cases or something absurd like that and it was only October. I didn't bother asking them to define what "start" means, but I guess that kind of a statement could push you up to the clinically strong program category. Or how about a program like Mayo where it is 1 resident per year and you are carrying like 100+ patients by the time you get to third year. Sure sounds like there are a lot of clinical opportunities there compared to St. Louis where they start 30ish cases (according to one of the other threads).

Top names I have heard include UNC, Washington, Connecticut, Michigan... but there is also a lot of big research coming out of those places too.

Mayo is a great program, would be my #1 if i got an interview. i gotta say i was impressed by Montefiore, 3rd yrs were saying around 90 pts - plus technologically advanced (all digital, etc) over there. i ranked VCU #1 though - nice clinic, plenty of assistants and support, etc. Washington's got a solid program as well. other places to look out for: Nebraska, Einstein (in Philly) clinically very strong and gives the highest stipend in the country, Michigan, UNC.

 

[Jaybe]

I believe he wanted top 5 clinical programs. I've heard St. Louis is strong clinically among others.

Yeah, some of the stronger clinical programs tend to do research as well.

By the way, someone mentioned Montfiore (sp?) residents doing 100 starts in their first year. . . Plenty of busy clinicians 30 years out in private practice are only doing twice that in a year (200 starts is about 1 new patient start per work day). My point is: As a brand new resident, are you able to learn very much if you are having to start that many cases right away. Sounds like an assembly line.

Thoughts?

 

[Jone]

this is off topic, but i recall someone mentioning a program that did not accept applicants who were fresh out of d-school. i thought it was it Montefiore. or am i imagining things? any idea which program i might be referring to?

 

[indeep]

this is off topic, but i recall someone mentioning a program that did not accept applicants who were fresh out of d-school. i thought it was it Montefiore. or am i imagining things? any idea which program i might be referring to?

I am pretty sure that Loma Linda is that way. I did a week long externship there and they told me that they will be going towards having all 6 residents/year have some sort of experience after D-school (GPR, private practice, etc.) When I interviewed at Montefiore, most of us were still in D-school and many of their current residents came straight from school, so I don't think it is Monte that you are thinking of.

 

[gryffindor]

this is off topic, but i recall someone mentioning a program that did not accept applicants who were fresh out of d-school. i thought it was it Montefiore. or am i imagining things? any idea which program i might be referring to?

St. Barnabas, the other program in the Bronx. Also Albert Einstein. Those 2 programs are definitely sticklers for only interviewing those with experience, but it is stated in their program info. I remember getting a letter from Loma Linda indicating what indeep said, and it would start probably with the class that will start this fall.

 

[pocket aces]

The way I see it....you can learn as much theory as you want, but unless you are actually able to apply it while you are in school you aren't gonna learn a damn thing. Obviously some learning has to happen once you graduate too, but then that's why they call it a dental "practice"...hehe Don't really feel like spending a whole lot of time doing research either!

So I guess the top 5 clinical from what everyone is saying would have to be (in no particular order)...

Washington, UNC, Michigan, Montefiore and one of (St. Louis/Baylor/Connecticut/VCU)

Does this sound right...or are any of the big ones missing?!

Any other comments about the facilities/stipends/tuition fees/profs/crime rates/etc...

 

[indeep]

Mayo is a great program, would be my #1 if i got an interview. i gotta say i was impressed by Montefiore, 3rd yrs were saying around 90 pts - plus technologically advanced (all digital, etc) over there. i ranked VCU #1 though - nice clinic, plenty of assistants and support, etc. Washington's got a solid program as well. other places to look out for: Nebraska, Einstein (in Philly) clinically very strong and gives the highest stipend in the country, Michigan, UNC.

I just have to put in my 2 cents about Michigan. It is a stellar program as far as name and reputation go. They have great faculty, research opportunities and facilities, not to mention their athletics programs and Ann Arbor being one of the coolest cities that I have ever spent time in, but clinically, they seemed a little weird. When I interviewed there, I was so excited, all of the residents are VERY nice and they all said that they start 30-35 cases and 50% are bonded with a zero-zero bracketing system and they are forming all of their own arch forms for those ~15-18 cases. While I understand that this technique can be helpful, I felt that it was overkill to do 50% of your cases this way especially when every resident said that they will not use that approach in private practice. It just seemed a waste to do that many cases that way, to not use the technique again.

The reason I mention this is because I noticed Mich was on several people's top 5 clinical programs list and I just wanted to share my experience. While it is a great program, there are some things to consider about their clinical approach. Plus I am just an over-analysing nerd as you can see that I am on here at 10:30 on a Friday night, instead of tending to my wife who is looking at me sadly right now.

Loma Linda is a strong clinical program starting around 50 cases and having your own assitant and 2 chairs to work out of. The residents are seeing up to ~24 patients in a day. They do a lot of bioprogressive there, which again is a little weird and many residents said that they wouldn't sectionalize in private practice either.

To the OP, I guess it comes down to the fact that most programs vary greatly but you will get a comparable education at any of them.

This is all just my opinion from my limited experience as a lowly 4th year dental student-wanna-be-ortho-resident (soon-to-be, actually). Gotta go, sorry my 2 cents turned into 4.

 

[indeep]

Clinical ortho? I can tell you what some good ortho programs are but I am not sure if they would all be known as "top 5".

Houston
Baylor
UNC
VCU
Iowa
Florida
Washington
Oregon

I would definitely agree with Jedi about Florida (Gators). I put them #1 out of 9 on my MATCH list, because of their clinical program. VERY strong. One thing that stuck out in my mind was the way cases were started. You don't necessarily get a bunch of new starts to bond up in the first 6 months or whatever, rather you get a varieyy of cases throughout your time there. So your first day in the clinic you may debond a finished case, deliver a retainer for intercetive care, do an initial exam, bond a case, do a retie on a case in the finishing stages, etc. You will continue to get new patients throughout your time there, so up until your last few weeks, you may be bonding a new case to hand off to a new resident. This seemed to be good, because I had heard residents at other programs complain that they hadn't bonded a case since the first 6 months of their residency.

Another great thing is that you rotate through the faculty practice once a week or so and treat the faculties' patients. You will see many cases at different stages and learn to quickly evaluate what has gone on, what the current situation is and what to do next, much like coming into a private practice after residency and stepping in mid-way through treatment.

Again just my thoughts as a dental student. Take it for what it is worth.

 

[Billy Gilmore]

Having recently interviewed at a number of the programs being bantered about I felt I would provide my thoughts on how the clinical experience at each school rated based on what I was told by faculty and residents at each interview.

UNC - Baylor - Michigan - Ohio State - Washington - St. Louis

I interviewed at a couple of other schools that were not worth mentioning for the sake of this discussion and this was only the picture I got based on my interview at each school. I would be happy attending any of the schools on that list, except one.

 

[Jaybe]

I also just interviewed at about half the programs on this list. Let me say I would be dubious of a program that equates their clinical experience to the "Number of Starts", per se.

As future specialists, we should look at other aspects of the program, such as the different philosophies of treatment used in a program and how those philosophies are utilized. Is the program structured enough to offer consistency in its usage of different philosophies? I would steer clear of a program that only treats cases with a limited number of philosophies. Likewise, I would steer clear of an absolute "free for all" program that is unstructured. I interviewed at a program where a resident showed me a case where she was trying to distalize molars about 10 mm to correct an atrocious Class 2 case. Even the most rabid opponent of Extractions would have extracted premolars. She had to "shop around" about 8 faculty until she found one that would let her do it. That just seems too loosely structured to provide sufficient consistency.

I would want to know how much time residents spend in Seminar. This is where they can learn from and follow the diagnosis and treatment of their fellow residents' cases. A program that lets you start AND finish more of your OWN cases also lends itself to quality clinical experience since you can really see the results of the mechanics you applied. These types of experience have to be balanced.

Finally, the "clinical quality" of a program is highly correlated to its ability to teach its residents to think. This is the skill that cannot be taught in weekend Holiday Inn CE courses, and it often requires more time away from the patient chair so that the resident can diagnose and treatment plan properly.

With respect to Michigan's usage of "zero-zero" backets, I think it provides an excellent learning opportunity regardless of whether it is used in private practice. The hand skills learned will serve you well in bending preformed arch wires to fit your patients' unique arch forms and in finishing cases treated with any bracket system. But the fact remains, Tweed is tedious. I cannot dispute that.

Moral of the Story, don't rely on statistics about "Number of Starts" to gauge the clinical quality of a program. The easiest part of Orthodontics is the work, that's why many of us chose it! The hardest part is learning to diagnose and treatment plan. Find a program that excels in that arena, and you will serve yourself well.

 

[Billy Gilmore]

Jaybe,

I cannot argue with much of what you stated. However, after reading your post I feel I evaluated these programs on rather similar criteria. Based on your experiences would rank any of the schools grossly different than I have.

If we considered ONLY the areas of critical thinking and treatment planning I would move Washington up a couple spots and Baylor down a couple spots. However, clinically I don't think UW offers the experience many would expect just based on name alone. You will be excellent at diagnosis and treatment planning, but I just don't know if you get enough clinical experience to be as comfortable as you would at some other programs.

 

[gryffindor]

The way I see it....you can learn as much theory as you want, but unless you are actually able to apply it while you are in school you aren't gonna learn a damn thing. Obviously some learning has to happen once you graduate too, but then that's why they call it a dental "practice"...hehe Don't really feel like spending a whole lot of time doing research either!

So I guess the top 5 clinical from what everyone is saying would have to be (in no particular order)...

Washington, UNC, Michigan, Montefiore and one of (St. Louis/Baylor/Connecticut/VCU)

Does this sound right...or are any of the big ones missing?!

Any other comments about the facilities/stipends/tuition fees/profs/crime rates/etc...

Some of those schools you listed are usually tossed around as "top ortho programs" not necessarily "top clinical ortho programs." "Top" is referring to a stellar faculty, good support for residents, good learning experience (this include didactics), but possibly also a meaningful research requirement. If you don't feel like doing a lot of research, then you would have to find out at which programs research is a joke. Any program that has a master's requirement is going to make you take master's courses that will not be about orthodontics. This is why I was making the case for a program like Montefiore or Mayo or Albert Einstein being more "clinical" since they are not master's programs and treat a huge number of patients and are therefore likely to encounter a lot more clinical variety (clefts, syndromes, surgical cases, etc.).

But it is very important to learn theory. Anyone can put brackets on and slip in a wire and watch teeth move. To know why they're moving and how to do damage control when they don't go where you thought they would is where the theory part is important.

In the end, all that matters is that you are in an accredited program. I think our experiences when we get out will be a lot like the new dental school graduates. We'll know a lot of stuff, but we'll still have a steep learning curve the first few months out to get accustomed to how private practice functions (unless you stay in academics). Most of us were pretty resourceful to have really good credentials to get into an ortho program. If you end up in a program that is lacking in one area, you will figure out a way to make up that deficiency and supplement your education.

 

[ortho07]

What does everyone think about the program at Tufts?? Just curious since thats where I matched.

 

[wayoutwest]

I agree, Ohio state should be included in this discussion. I thought they compared well with Michigan. Both are great programs.

 

[Ramzi]

.

 

[Kfiles]

What are the thoughts on Iowa's Program?

 

[Jaybe]

According to TM Graber, ortho programs of the west coast are the best.. he told me that UIC is one of the best...
I'd like to know more about UIC's program as I'm doing my residency there... I believe they have an excellent staff but I don't know much about their facilities... why do you think they are dungy?!

Have you been there???

I felt they were a bit dank. It felt like a basement or something. Their seminar room was okay. One thing that bugged me is that you have to walk your patients to the other end of the building to take radiographs. They plainly don't have enough clinic chairs for the number of residents. That's going to be your biggest hurdle. However, facilities are really the least important criteria.

You will be able to see tons of patients, and probably lots of syndromes given the size of the city. I think it would be a good program if you don't require much structure. But its chaotic. Big time. Standing around in that clinic makes my head spin.

 

[Jaybe]

What are the thoughts on Iowa's Program?

I really like the program director and his wife (also an Orthodontist on faculty). The residents and faculty form a really cohesive group, which I liked. The Program is borderline too short. You just cannot finish a moderate to difficult case properly in less than 24 months. Therefore, the clinical value was compromised, in my opinion. I want to start and finish some tough cases while in residency.

 

[Jediwendell]

Top "clinical" program to me means prepares you for private practice in the best way possible. I would interpret this as getting experience in the newest and best techniques. Right now I would base my choice of top clinical programs on two things: 1) Placement of/utilization of miniscrews and palatal implant anchorage and 2) wide variety of brackets and techniques with a focus on self ligation.

Self ligation and absolute anchorage are the future. If you are learning a bunch of Tweed like at Michigan or Oklahoma you are doing nothing for yourself. Learning it is great, but you won't ever utilize it in private practice. Self ligation is key. Almost 35-40% of my cases are self ligation at my program. It is key to get experience with these brackets as they are a little different than the traditional types. 15% of my cases have miniscrews or palatal implants. That is great experience for me and I feel pretty good about using them when I get done now. It isn't quite as simple as just sinkem and usem. As for the number of starts issue, I think 50-70 is great if you want strong clinical. 25-40, like some programs mentioned above, is too few to feel really confident about what you are doing in most situations. Even if the extra ones are just class Is it is important to get a few more cases under your belt. 100 is too many. There is no way that you can get any sort of proper supervision with that many cases, but I'm sure you learn a lot anyway.

If you just want the "top five" regardless of clinical or not

UNC
Washington
Baylor
Michigan
Forida

 

[Tarheel]

Top "clinical" program to me means prepares you for private practice in the best way possible. I would interpret this as getting experience in the newest and best techniques. Right now I would base my choice of top clinical programs on two things: 1) Placement of/utilization of miniscrews and palatal implant anchorage and 2) wide variety of brackets and techniques with a focus on self ligation.

Self ligation and absolute anchorage are the future. If you are learning a bunch of Tweed like at Michigan or Oklahoma you are doing nothing for yourself. Learning it is great, but you won't ever utilize it in private practice. Self ligation is key. Almost 35-40% of my cases are self ligation at my program. It is key to get experience with these brackets as they are a little different than the traditional types. 15% of my cases have miniscrews or palatal implants. That is great experience for me and I feel pretty good about using them when I get done now. It isn't quite as simple as just sinkem and usem. As for the number of starts issue, I think 50-70 is great if you want strong clinical. 25-40, like some programs mentioned above, is too few to feel really confident about what you are doing in most situations. Even if the extra ones are just class Is it is important to get a few more cases under your belt. 100 is too many. There is no way that you can get any sort of proper supervision with that many cases, but I'm sure you learn a lot anyway.

If you just want the "top five" regardless of clinical or not

UNC
Washington
Baylor
Michigan
Florida

I agree with Jedi, but of course I am biased.

 

[antidentite]

I think Jediwendell is a little too matter of fact with that list. I interviewed at all the listed programs except Florida which I did not even apply. I too was interested into going to what I felt was the best program. The "best" program may be different for each applicant. Only 2 of these 5 were in my top 5 rank list. I listed what I have heard as top 5 above and I am guessing that holds as much weight as anyone elses top 5 which ammounts to little.



If you just want the "top five" regardless of clinical or not

UNC
Washington
Baylor
Michigan
Florida

 

[vorosvirag]

Top "clinical" program to me means prepares you for private practice in the best way possible. I would interpret this as getting experience in the newest and best techniques. Right now I would base my choice of top clinical programs on two things: 1) Placement of/utilization of miniscrews and palatal implant anchorage and 2) wide variety of brackets and techniques with a focus on self ligation.

Self ligation and absolute anchorage are the future. If you are learning a bunch of Tweed like at Michigan or Oklahoma you are doing nothing for yourself. Learning it is great, but you won't ever utilize it in private practice. Self ligation is key. Almost 35-40% of my cases are self ligation at my program. It is key to get experience with these brackets as they are a little different than the traditional types. 15% of my cases have miniscrews or palatal implants. That is great experience for me and I feel pretty good about using them when I get done now. It isn't quite as simple as just sinkem and usem. As for the number of starts issue, I think 50-70 is great if you want strong clinical. 25-40, like some programs mentioned above, is too few to feel really confident about what you are doing in most situations. Even if the extra ones are just class Is it is important to get a few more cases under your belt. 100 is too many. There is no way that you can get any sort of proper supervision with that many cases, but I'm sure you learn a lot anyway.

If you just want the "top five" regardless of clinical or not

UNC
Washington
Baylor
Michigan
Forida

Wendell has a knack for bringing much-needed sanity to some of these run-away discussions. Reputation (of your training program) does virtually nothing for you as an orthodontist. Your clinical judgment and experience are the most important thing you'll take from residency. It's true, having many competent faculty around can facilitate the growth of your clinical judgment. Few of us have that sort of luxury, however, w/ the current famine for faculty. In my opinion, number of faculty (unless severly low) shouldn't be a primary reason for choosing a program. Interestingly, some faculty strangle learning by limiting systems available and through other clinic policies. "I'm not going to let my residents do that," they say. A program w/ a lot of independence is my kind of program.

I echo what the Jedi said: leeway to try multiple systems, especially self-ligation is huge. Utilizing miniscrews is another important component of your residency. If you don't try this stuff now, you'll likely end up like most of the older orthodontists at local district meetings who are aren't using these innovations.

 

[Jediwendell]

I'm going to add another dimension to this discussion if you are interested in the best clinical training.

My feeling is that fewer full time clinical faculty may be better if you have a lot of good part time faculty that come in on a regular basis for purely clinical training. Many full time faculty either don't have as much clinical experience or are too grounded in "evidence based" to see reality. Does this mean you shouldn't read the literature and follow it the best you can? Of course not, but you should be aware that there are many ways to do things and sometimes newer is better. We have several part timers at my program that come in every other week that used to be full time faculty. It has been interesting to watch them grow over time (one of them is even using Damon now). Private practice is much different than full time faculty probably realize.

 

[ortho07]

What does everyone think about the program at Tufts?? Just curious since thats where I matched.

Anyone have any thoughts?

 

[gryffindor]

Anyone have any thoughts?

Mad expensive but done in 2 years. What else matters? There are a lot of alumni of this program, and a decent number of them are around teaching at least part-time.

 

[vorosvirag]

I'm going to add another dimension to this discussion if you are interested in the best clinical training.

My feeling is that fewer full time clinical faculty may be better if you have a lot of good part time faculty that come in on a regular basis for purely clinical training. Many full time faculty either don't have as much clinical experience or are too grounded in "evidence based" to see reality. Does this mean you shouldn't read the literature and follow it the best you can? Of course not, but you should be aware that there are many ways to do things and sometimes newer is better. We have several part timers at my program that come in every other week that used to be full time faculty. It has been interesting to watch them grow over time (one of them is even using Damon now). Private practice is much different than full time faculty probably realize.

Yep. I like what I read. In my opinion, full-time ortho faculty are not as behind the times as full-time general dentistry faculty in dental school. Yet, they're clearly not up w/ what's going on in private practice on average. Many are still so tied to old ways they bash straightwire approaches, self-ligation, and other trends they've never tried.

Where I did dental school we had little opportunity to do implants because so many faculty in the general student clinic didn't know how to place or restore them. We were limited by what our professors knew. The part-timers were always more innovative than the full-time guys who seemed (on average) to have stopped expanding clinical skills upon graduation in the 60s.

Similar arguments can be made for some full-time ortho faculty. No to Damon because it is a fad that will pass shortly. What about the Tweed guys in ortho departments? Why don't they thrive in private practice and stay where most think greater opportunities are? My best guess is they need a university setting with virtually no competition (almost nobody wants to teach full-time in a department) to prop up their philosophy and feed their children. They might argue that the pure Tweed philosophy isn't about $--it's about perfect results. Well, the vast majority of us are seeking a union of two things: perfect results and productivity.

 

[Jediwendell]

No to Damon because it is a fad that will pass shortly.

I have seen a lot of strange stuff with my Damon cases vorosvirag. Very strange things. Our guy that is using it has compiled all of his cases consecutively and has shown the good and bad. There is a lot more good than bad. I'm not convinced that it is a fad at this stage. I don't think it is any different than any other self ligating appliance, but I think self ligating is important. Particularly passive SL in the early stages of treatment- level and align. I like to have a more active clip in the later stages but darn if my Damon cases aren't going well.

 

[vorosvirag]

I have seen a lot of strange stuff with my Damon cases vorosvirag. Very strange things. Our guy that is using it has compiled all of his cases consecutively and has shown the good and bad. There is a lot more good than bad. I'm not convinced that it is a fad at this stage. I don't think it is any different than any other self ligating appliance, but I think self ligating is important. Particularly passive SL in the early stages of treatment- level and align. I like to have a more active clip in the later stages but darn if my Damon cases aren't going well.

The intention of my earlier post was to make it clear that some ortho dept. faculty claim that Damon's system will soon fall by the way side. I've heard a "prominent" program director say that Damon's stuff is a fad that will fade. I don't know how these people can say such things. I believe that Damon and other self-ligation systems are here to stay and should only improve w/ continued modifications. The % of orthodontists using self-ligation is steadily growing.

This follows my broader message that many full-time faculty at ortho programs are slightly to greatly out of touch--not only w/ private practice, but also w/ the positives of current trends.

I have a handful of Damon cases right now that are only a few months into tx. I'm excited to follow their progress. I'm also going to get into other self-ligation shortly.

 

[Tarheel]

I have seen a lot of strange stuff with my Damon cases vorosvirag.

That is one of the best ways I have ever heard it put. It seems to defy the current literature. I can't wait to find out more.

I have seen similar strange results with Bone Anchors. Dr. DeClerck was just at UNC showing some amazing class III skeletal corrections in 11-12 year old patients. I can't wait to see what they have at Moyers this weekend.

 

[Firm]

In order to be a strong clinical program you must treat lots of cases. There is no substitute for experience. So if you want a strong clinical program, look for the ones that treat tons of cases (100+). Research doesn't make you strong clinically, it makes you strong in research.

 

[Firm]

The intention of my earlier post was to make it clear that some ortho dept. faculty claim that Damon's system will soon fall by the way side. I've heard a "prominent" program director say that Damon's stuff is a fad that will fade. I don't know how these people can say such things. I believe that Damon and other self-ligation systems are here to stay and should only improve w/ continued modifications. The % of orthodontists using self-ligation is steadily growing.

This follows my broader message that many full-time faculty at ortho programs are slightly to greatly out of touch--not only w/ private practice, but also w/ the positives of current trends.

I have a handful of Damon cases right now that are only a few months into tx. I'm excited to follow their progress. I'm also going to get into other self-ligation shortly.

I am all about self-ligation. There are two drawbacks though. 1.) When finishing cases friction is your friend when making finishing bends. 2.) Cost. When you open your own office and you see the difference between self-ligation and single or twin wing brackets it's mind blowing. The self-ligation can cost 8-9 times other brackets. Makes you cringe when you get a bond failure.

 

[Firm]

Top "clinical" program to me means prepares you for private practice in the best way possible. I would interpret this as getting experience in the newest and best techniques. Right now I would base my choice of top clinical programs on two things: 1) Placement of/utilization of miniscrews and palatal implant anchorage and 2) wide variety of brackets and techniques with a focus on self ligation.

Self ligation and absolute anchorage are the future. If you are learning a bunch of Tweed like at Michigan or Oklahoma you are doing nothing for yourself. Learning it is great, but you won't ever utilize it in private practice. Self ligation is key. Almost 35-40% of my cases are self ligation at my program. It is key to get experience with these brackets as they are a little different than the traditional types. 15% of my cases have miniscrews or palatal implants. That is great experience for me and I feel pretty good about using them when I get done now. It isn't quite as simple as just sinkem and usem. As for the number of starts issue, I think 50-70 is great if you want strong clinical. 25-40, like some programs mentioned above, is too few to feel really confident about what you are doing in most situations. Even if the extra ones are just class Is it is important to get a few more cases under your belt. 100 is too many. There is no way that you can get any sort of proper supervision with that many cases, but I'm sure you learn a lot anyway.

If you just want the "top five" regardless of clinical or not

UNC
Washington
Baylor
Michigan
Forida

You probably won't use implants in private practice, unless you sink them yourself. Watch your malpractice insurance shoot through the roof, and your practice efficiency decrease.

 

[Tarheel]

You probably won't use implants in private practice, unless you sink them yourself. Watch your malpractice insurance shoot through the roof, and your practice efficiency decrease.

I don't think miniscrews will have a huge impact on Malpractice. (ie If you don't have to use local anesthesia then risk is probably negligible.) I'll admit the plates are more invasive and I wouldn't touch them myself. I also feel that the two minutes it takes to place the miniscrews is definitely worth the anchorage provided in terms of practice efficiency. When indicated they are awesome and extremely helpful for your biomechanics.

 

[NUKE]

Louisville is in the clinic 30hrs./week.

 

[Firm]

I don't think miniscrews will have a huge impact on Malpractice. (ie If you don't have to use local anesthesia then risk is probably negligible.) I'll admit the plates are more invasive and I wouldn't touch them myself. I also feel that the two minutes it takes to place the miniscrews is definitely worth the anchorage provided in terms of practice efficiency. When indicated they are awesome and extremely helpful for your biomechanics.

You'll always use local anesthestic. Anytime you use local, or perform surgery your malpractice insurance increases

 

[Jediwendell]

You probably won't use implants in private practice, unless you sink them yourself. Watch your malpractice insurance shoot through the roof, and your practice efficiency decrease.

I won't use implants most likely, although I have placed enough to be quite efficient at it. The issue with implants is the cost of equipment.

Miniscrews, on the other hand, are easy to place and have little morbidity/mortality issues. I will definitely place them.

 

[antidentite]

if by always you mean never. i have not used local on any of my mini screw placements, just topical, and the patients have not reported any significant pain.

although i plan on using these alot in private practice, i still do not see myself placing many of these myslef unless it is in a very easy spot. i spend alot of time setting up wire guides and taking PA's to make sure I am going into the right spot, and even then i am never that sure because i don't trust the angulation of the radiograph.

You'll always use local anesthestic. Anytime you use local, or perform surgery your malpractice insurance increases

 

[ortho08]

I believe the current AAO malpractice policy covers TAD placement and diode lasers. We're placing most under topical, but have used LA on a small number of apprehensive patients. The key to topical placement IMO is patient selection.

As far as the "best program". Just be sure you are starting a healthy number of patients - 50 is a good number. You want to be in clinic as many hrs or days as possible. Make sure a lot of systems and philosophies are taught. You want a fair amount of self ligation - more than just Damon. Incidently, of the 5 systems I've used and am familiar with Damon is one of my least favorite along with Smart Clip for different reasons. You want a fair mix of cases: extraction, nonextraction, orthagnathic, phase 1, cleft/syndromic, Class II/III, impactions, etc. You want a fair amount of funcional appliances taught and brackets systems used. In other words you want a well rounded program.

1 more meaningless list of the best clinical schools:

VCU
UNC
Houston
Baylor

 

[vorosvirag]

A practical response here about the top 5 schools. I will agree that a heirarchy exists. Some programs are better than others. However, how many positions are available at anybody's top 5?

If VCU, UNC, Houston, and Baylor each have five residents every year (I'm not sure of their exact #s) only 20 spots are available at those schools. There just aren't many spots. I encourage all of you gunners out there setting your sights on these four or anyone else's "top 5." However, the numbers are just too tough to keep everybody happy. Plenty of "merit" spots were available if you were qualified to get into dental school. For ortho, sorry. Not enough "merit" spots available. More kids want in to those top 5, 10, and 20 programs than chairs are available.

I guess what I'm saying is that don't be disappointed if you don't get into one of these "top" programs. There just aren't enough chairs for all the "deserving." In fact, many of these "top" programs have lots of legacy (home-cooking) positions handed down. I further believe many "sleeper" programs are more laid back, though less tightly organized and operated than some of the "elites." I enjoy my independence and the relaxed environment I find myself in. We have enormous autonomy in appliance selection, number of patients treated, and many other areas. If you're determined, you'll do extremely well wherever you are planted.

 

[Jediwendell]

Ther are a lot of good ortho programs out there that will teach you what you need to know. I think the reputation thing is blown way out of proportion in ortho. Baylor residents learn the same thing I do, they just have the reputation factor going for them. Some places have a tangible reason they might be better, ie VCU each resident gets their own assistant. Pretty nice. Some have other reasons- UNC and Proffit. Some are less expensive. Some have a masters and some don't. You just have to look at each program with an open mind and really look at what they have to offer. The most important things to consider, IMO are: 1) location- it is difficult to move across the country if you don't have connections, 2) modern treatment options and 3) cost- I don't want to pay anyobody 50 grand to go to a residency if I don't have to.

 

[boobah]

Some have a masters and some don't.

I don't understand why orthodontists advertise the M.S. in their title. It makes the D.D.S. look like a B.A. or some other college degree. Getting a masters after getting your doctorate? Other health professionals don't get a M.S. after completing residency. Would you ever see a M.D., M.S.? Even if my program gave me a M.S. I don't know if I would advertise it.

 

[Billy Gilmore]

1) location- it is difficult to move across the country if you don't have connections

just to clarify...

are you speaking of getting into a program accross the country is difficult without connections or the move itself being difficult?

it is possible to get in without connections... the move itself might be a bigger hassle

 

[Tarheel]

just to clarify...

are you speaking of getting into a program accross the country is difficult without connections or the move itself being difficult?

it is possible to get in without connections... the move itself might be a bigger hassle

I think having connections becomes more of an asset upon completion of residency because there is a lot of networking involved and most orthodontic alumni associations are rather close knit. (In other words it is not a bad idea to attend an ortho program close to where you would like to practice.)

 

[Tarheel]

I believe the current AAO malpractice policy covers TAD placement and diode lasers.

At Moyers symposium they discussed this and made it very clear that the AAO insurance already covers placement of miniscrews.