Recent advances in orthodontics/ dental crown & bridge courses

RECENT
ADVANCES
IN
ORTHODONTI
CS
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

Contents
Introduction
Advances in Bonding materials
Advances in Brackets
Advances in Wires
Advances in Appliances
Advances in Retainers
Advances in Anchorage
Advances in Softwares
Advances in Lingual orthodontics
Advances in Accessories
Future scope
Bibliography

Introduction
Orthodontics : An area of dentistry concerned with
supervision, guidance & correction of growing &
mature dentofacial structures, including those
conditions that require movement of the teeth or
correction of malrelationships & malformations
of related structures by adjustment of relationship
between & among the teeth & basal bone by
application of forces and the stimulation or
redirection of the functional forces within the
cranio facial complex.

Introduction
Orthodontics is a field in dentistry that is
dedicated to the correction of facial and dental
irregularities through the use of brackets and
other appliances.

New technology is
allowing orthodontists
to produce better
results, with fewer
visits and shorter
overall treatment time,
as compared to time
of 1 to 3 years to
complete treatment
during which the
patient visited every 4
to 6 weeks.

An analysis of the various
dimensions of orthodontic
advancement reveal that
the biological problems
have remained singularly
unchanged.
New solutions to the old
problems have resulted in
advancements in
orthodontic materials and
their cascading effect on
the appliance design and
treatment strategies.

The recent advances in
orthodontic materials shall
be covered under the
following headings.
 Bonding materials
 Brackets
 Wires
 Appliances
 Retainers
 Softwares
 Lingual orthodontics
 Accessories

Bonding Materials

Bonding
materials
Bonding in orthodontics is semi-permanent in nature, bond
strength should be high enough to resist accidental
debonding during the whole course of treatment but also
low enough so that excessive force need not be applied
during debonding at the end of the treatment.
With the increased demand for adult orthodontics, the
clinician is often faced with the problem of luting brackets
and retainer wires to metal-ceramic fixed partial dentures,
crowns, veneers or even full ceramic restorations.
To overcome this problem 6th
& 7th
generation cements are
being introduced by which it is possible to bond
orthodontic materials to Gold, Amalgam & Porcelain.

6th
generation cement
The history of dentin bonding
is quite remarkable and
productive.
The self-etching adhesives
involve a mechanism in which
as soon as the decalcification
process is initiated, the
infusion of the evacuated
spaces by dentin bonding
agent is begun.
As a result, the potential for
residual vacancies amongst
the collagenous fibers is
dramatically reduced or
eliminated altogether.

Light Cure Bonding
Cement Capsules
It is a 6th
generation cement.
Band cement in disposable
capsules is a no-mix, light-
activated, glass ionomer cement
that contains fluoride to control
decalcification under the bands
during extensive treatment.
It eliminates excessive waste
and cross-contamination
between patients.
The narrow-tipped design helps
accurately dispense adhesive
directly into the molar bands.

7th
Generation
It is a fluoride releasing 7th
generation composite which
was formed to over come the
problems faced in 6th
generation
like application of bonding
agents.
These cements have come with
a basic property of no-mix.
The seventh generation
essentially accomplish the
same objective as the 6th
generation.
However, all the ingredients are
in one bottle.
It provides
 superior bond strength
 drift proof bracket placement

Porcelain BondingThere are two viable options when bonding to
porcelain:
(1) bond it mechanically by etching the porcelain
with hydrofluoric acid
(2) bond it chemically using a silane coupling
agent.
The disadvantages of a hydrofluoric acid etch
are that it involves a porous, roughened surface
in the porcelain due to removal of the outer
glaze, which is extremely difficult to regain.
The use of silane coupling agents enhance the
bond strength by promoting a chemical bond
between the resin composite and the ceramic.

Mechanism:- Silane molecules
after being hydrolyzed to silanol,
can form polysiloxane network or
hydroxyl groups to cover the silica
surface. Monomeric ends of silane
molecules react with the
methacrylate groups of the
adhesive resins by free radical
polymerization.
So using a silane coupling agent
help to obtain a chemical bond
provides bond strengths
comparable to a hydrofluoric acid-
etched surface without destroying
the porcelain glaze.

Brackets

Self-ligating Brackets
In - Ovation
A new type of self-ligating
bracket, called In-Ovation
is a twin bracket made
entirely of metal, and
utilizes a special clip built-
in bracket.
The pressure from specific
types of arch wires
activates the clip and
delivers specific torque to
each tooth, resulting in
fast, directed results.

SPEED Bracket
“Speed” bracket
introduced by Dr
Herbert Hanson in 1976
and became available in
the market in 1980.
Stands for-
S - Spring loaded
P - Precision
E - Edgewise
E - Energy
D - Delivery

Self Ligating Brackets
These types of brackets are
self-ligating brackets often
referred to as 'train-tracks'.
SPEED Appliance has a
Super-Elastic Nickel
Titanium spring clip to
entrap the arch wire.
These type of brackets do
not hinder with the
movement of wire and
moreover they keep a
check that wire remains in
position.

Control achieved
Once the wire gets deflected spring clip
provided with the deflection control of the
wire sets it into a proper place.

Advantages
Chair time reduced
Hygiene levels are
increased
Does not get degraded as
the modules do during a
single treatment
appointment.

Time brackets
One of the major
disadvantage of SPEED
brackets were, they
require heavy forces to
slide the clip open
during subsequent
visits.
To overcome this there
is a new development
known as Time
brackets.

Advantages
 Easy to open throughout treatment
 Controlled delivery of forces
 More hygienic in patient

Damon III
Recently a new type of
Damon bracket, Damon
III, which is part ceramic
(clear or tooth-colored)
and part metal. These
brackets appear smaller
on the teeth and are
supposed to be more
comfortable for the
patient.

Smart clip brackets
Another type of self-
ligating systems,
Smart Clips
brackets do not
have a "sliding door"
or separate clip.
The arch wire is held
in place with a
specially designed
clip built into the
bracket.

Synergy Brackets
Better than Damon III by:
1. Synergy brackets have less
friction.
2. Synergy brackets provide
more control throughout
the treatment process.
3. Synergy brackets are
problem-free.
No sides or clips to deform,
break or clog unlike self-
ligating brackets, outstanding
bond strength, and no “food-
traps” to cause hygiene
problems.
Synergy brackets are easy to
place unlike self-ligating
brackets.

4. Synergy is the only bracket that
takes advantage of today’s super
elastic wires.
5. The Synergy system gives greater patient comfort. Synergy
brackets are much smaller and have a significantly lower profile.
Bulky self-ligating brackets are prone to bond failures.
6. Synergy permits the look the patient wants without
compromising functionality. Synergy brackets can be ligated in
colors, and its compact size gives a more appealing look.
7. Synergy has greater practice profit potential. A 6-8 week interval
between patient visits, fast overall treatment time and a much lower
cost.

Clear Brackets
Clear brackets
— These brackets bond
to the outside surfaces
of your teeth, similar to
conventional brackets.
However, their clear or
natural color gives them
a less noticeable
appearance.

Ceramic brackets
To overcome the aesthetic
problems ceramic brackets
were introduced which offer
a less visible alternative as
they blend with the tooth
color.
Some ceramic brackets are
not as strong as metal and
may require longer treatment
time.
Some ceramic brackets are
also slightly larger than
metal ones and may be
more difficult to adapt to.

Fiber glass
To over come problems
associated with ceramic
brackets, fiber glass brackets
were introduced.
Advantages over ceramic
 These were less bulky,
 Did not get stained
 They were transparent, so
were more esthetic and took
the color of the tooth.
 They did not pop out as
ceramic brackets.
 They were more economical
But there was a problem
associated with it of bonding.
These brackets did not form a
strong bond with the tooth
and got debonded in between
appointments

Silica Copolymer
To overcome the
problems
associated with
the bonding of
the fiber glass a
new material was
introduced of
silica copolymer.

Different Shapes
Now the children can go for
brackets of different shapes
whatever they want.
Orthodontist Clarke Stevens, DDS,
in Nebraska developed brackets
shaped like hearts, flowers,
footballs, baseballs, and stars.
He calls his product Wild Smiles
Brackets.

APC
Now a days brackets are available with
bonding agent already placed for
Pick
Position
Cure

APC - Adhesive Coated
Appliance System
The APC System is still the only orthodontic bonding system that
precoats each bracket with adhesive.
No messy mixing problem is there.
No bracket handling problems with each individual bracket clearly
identified and pre-oriented on a special foam liner that virtually
eliminates bracket rotation in transit.
Fewer steps, less time with the APC™ System

Indirect Bonding
Given by H.STUART in
2003
In this technique flowable
composites are used
which is applied to the
brackets placed in the
tray.
Then this tray is placed in
patients mouth and
cured.
This technique allows
precision placement and
is less time consuming.

New Coating Around
BracketsEarly tests on a new coating for
orthodontic brackets and wires developed
by researchers suggest that it could inhibit
plaque growth and decalcification
common in patients wearing fixed
appliances without decreasing the bond
strength between brackets and teeth.
The coating is made from a calcium
phosphate base that releases zinc - a
common ingredient in mouthwash and
toothpaste - onto braces and surrounding
teeth. Zinc inhibits the growth of acid-
producing bacteria that dematerialized
teeth, and minimizes dental calculus
formation.

Wires

Technology such as nickel-titanium-alloy wires, have
replaced the traditional stainless steel wires of the past,
providing patients with a temperature-sensitive wire that
allow for continuous movement of the teeth over longer
periods of time. For patients this means enhanced
comfort, decreased treatment time and less visits to the
orthodontist.

Thermal-Activated
archwires
It was introduced by Evans &
Danning in 1996
In these wires desired shape
of arch was incorporated
using heat.
These wires are ligated in
the patient’s mouth and get
activated to return to its
original shape due to heat
present in the oral cavity.

Advantages
 Desired arch form
could be achieved
 A gentle continuous
force for tooth
movement.
 Excellent for initial
leveling and
aligning.
 Provides maximum
spring and memory
with minimum
friction.

Nitanium reverse curve
of spee
Reverse curve of spee
Low force wire
designed for open bites
Prevent molar rotation
Maintain anterior torque
without crown tipping

NICKEL-FREE
TITANIUM BETA III
ARCHWIRESIt was given by Dr Burstone & Goldberg
Beta III™ is a comparable nickel-free
titanium archwire that provides the strength
and versatility of stainless steel along with
the resiliency of nickel titanium.
Beta III™ offers a smooth surface for
excellent sliding mechanics and superior
bend performance. It provides twice the
bend and deflection of stainless steel
without permanent deformation.

CNA
Due to problems
associated with nickel-
titanium of
 not withstanding cold
bending
 not fabricating loops,
 not be weldable or
solderable
CNA came to origin
3-nitroaniline-2-chloro-
4-nitroaniline
alloy(CNA)

CNA Mushroom Loop
Arch Wire
Advanced special
memory alloy material
Improved loop shaped
Increased efficacy of
space closure
Anterior intrusion,
retraction
Elastic engagement

CNA Nitanium Intrusion
Arch
Optimal control of
torque and angulations
of teeth in early stages
of treatment
Less breakage
Less friction
Deep bite
Anterior intrusion
Posterior extrusion
Distal molar tip back for
posterior anchorage
preparation.

Superelastic
composites wires
Superelastic composites have the
potential to be used in orthodontics.
The use in orthodontics is the
improvement of tooth alignment in
order to avoid tooth root resorption
which can be caused by the
application of oversized forces
during orthodontic treatment.
Superelastic SMA-polymer
composites have the potential to
substantially reduce those forces.
The design of these composites is
based on a soft polymeric core and
a superelastic shape memory metal.

Fiber Reinforced Composites as a
Substitute
for Metallic Wires
Fiber reinforced composite wires for orthodontic
purposes are fabricated using a procedure called
pultrusion.
This wire may also be further shaped into a different
morphology by further curing, a process known as
beta staging.

Appliances

Bite-Jumping Screw
Introduced by MARC
GESERICK in 2006.
A new method has been
developed to simplify
progressive bite
advancement in Twin Block.
Screw is incorporated
longitudinally in upper bites
blocks with a screw heads at
70 degree angle to lower bite
block.

6mm of
antero-
posterior
correction
in either
class II or
class III
cases can
be done.

Transforce Arch
Developing Appliance
Given by Dr. W.
Clark in 2004.
This contains nickel-
titanium springs
which generate
force
It has a malleable
arms parallel to the
incisal edge for easy
adjustments

It has many
advantages over the
previously
developed
appliances used for
arch expansion
 Invisible for adult
arch development
 Less bulky
 Can be given in
lower arch
 It also helps in
expansion of arch in
sagittal direction

InvisAlign
A new technology that allows tooth
alignment without brackets has
been recently introduced is called
InvisAlign™. The Invisalign
System™ offers the first true
alternative, by utilizing advances in
3-D imaging technology to create a
series of customized plastic
aligners.

InvisAlign
InvisAlign uses computer
technology to create a
sequence of finely-
calibrated clear plastic
aligners-as few as 12 or as
many as 48, depending on
your particular case.

InvisAlign
Patient will wear each
aligner for about two weeks,
removing them only to eat,
brush, and floss. As you
replace each aligner with the
next, your teeth will move-
little by little, week by week-
until they reach the final
alignment your orthodontist
has prescribed.

Composites Biteplanes
Carano in 2001 gave the
use of Composite bite
plane placed on the
lingual surfaces of
maxillary incisors and
canines to open the bite
during typical fixed-
appliance therapy.
Forces produced are
more physiologic,
produced by patient
musculature and normal
function.

Deep-bite correction by
lingual bracket bite
plane occurs gradually,
1 mm of intrusion per
month, but this is often
faster than other
methods.
Advantage:
 Intrusive forces both
on the upper and
lower incisors
 Lack of posterior
contact permits
some extrusion.
 Retention .

FLIP LOCK HERBST
APPLIANCE
Miller R., 1996 - The Flip-Lock Herbst appliance offers
several advantages over conventional Herbst designs:
• Improved patient comfort and acceptance
• Fewer clinical problems compared to screw or pin
attachments
• Less chair time for reactivation
• Less frequent emergency appointments
They are divided into -
 First generation
 Second generation
 Third generation

FIRST GENERATION
The first generation was made from a dense
polysulfone plastic but breakage occurred
because of the forces generated within the
ball-joint attachment .

SECOND GENERATION
FLIP LOCK
In the second generation, the plastic was
replaced with metal. However, fracture
problems persisted.

THIRD GENERATION FLIP
LOCK
The third generation is
made of a horse-shoe
ball joint. This system
has proved to be more
efficient than the
previous models, both
in terms of application
as well as its resistance
to fracture

THE MAGNETIC
TELESCOPIC DEVICE
This consists of two tubes and two plungers with a semi-circular section
and with (Nd,Fe,B) magnets placed in such a manner that a repelling
force is exerted . It is fixed using the MALU system
This appliance has the advantage of linking a magnetic field to the
functional appliance. Its main disadvantages are its thickness, the
laboratory work necessary to prepare it and the covering of the
magnets.

FORSUS
FATIGUE RESISTANT DEVICE
given by WILLIAM VOGT in 2004
This is an innovative three
telescopic appliance with a coil
spring in its exterior part. This
feature makes it resemble some
flexible functional appliances
(AFF).
In comparison with AFF its great
advantage lies in coil spring which
is resistance to breaking. The coil
spring is applied by sliding it on a
rigid surface avoiding angulations
at the fixed points.

Lingual orthodontics

Incognito-appliance
Adult patients often refuse to wear
orthodontic appliances bonded to the
outer aspects of their teeth because
they are visible when speaking.
In order to offer orthodontic treatment
for these patients, orthodontists use
brackets bonded to the inner aspects
of the teeth that are completely
invisible during normal activity.
Since 2004, Incognito appliance is
used which is extremely flat and thus
comfortable for the patient.
Most problems like
 tongue irritations
 speech problems
 rate of lost brackets
has declined dramatically.

Retainers

Clear
Retainer
The most common type of retainer is the
Hawley retainer, which is made of a
metal wire that surrounds the teeth and
keeps them in place. It has an acrylic
base that sits in the palate or floor of the
mouth which is bulky and uncomfortable
to the patient. To over come this another
type is clear retainer.
This clear or transparent retainer fits over
the entire arch of teeth and can also be
produced from a mold.
It can be worn 24 hours per day

Bonded Retainer
A bonded retainer is
a wire permanently
bonded to the
lingual side of the
teeth (usually the
lower teeth only).
Available preformed
also.

Anchorage

Orthodontic Mini
Implants
They are designed to
be temporarily
implanted so that
dental movements with
the bio-mechanical
advantage of achieving
maximal anchorage
can be achieved.
They are made of
stainless steel

They do not induce
Osseo integration
Once orthodontic
movement have been
achieved they can be
easily removed
The upper part features
groove similar to a
button to facilitate
application of elastic
chains, elastics or
springs.

Softwares

Insignia
It is a fully interactive
software designed to
incorporate treatment
plan into a virtual 3D
model.
It gives a
 Patient specific brackets
 Computer assisted
bracket placement
 Custom wire
 All phases of treatment
adjustments

Digital Imaging
Software
Now we can
 Create a treatment plan with just a
few mouse movements
 Quickly teach our ideas to patients,
surgeons, and students.
 Concentrate on facial structures
and beauty rather than on holding
protractors to measure angles and
distances.
 Let the computer generate
numerous analyses,
superimpositions, measurement
tables, growth and treatment
predictions, and much more with a
simple touch of a button.
 Print, store, or e-mail our results.
 Make it easy for your colleagues to
reliably reproduce your decisions.

Paperless
operations
Whether we realize or not
within next few years our
records would all be
digitalized.
Features
Computerization of
patient records
Internet access to every
part of the world
Requirements
Softwares
Computer
Patient Information
Delivery system

Photographic ‘Kesling
set-up’
The ‘Kesling set-up’ is a visual aid to communication
between the clinician and the patient at the treatment
planning stage.
It helps the clinician to plan the stages
Type of orthodontic treatment required
Gives the patient an idea of what is achievable and
what is involved.
It can also highlight the limitation of tooth movement
alone, indicating the need for surgical intervention.
Kesling described the concept of planning individual
orthodontic tooth movement in 1945.

Accessories

Slide Low Friction
ligatures
Older ligating modules
were said to put
pressure on the wire
thus increasing the
friction which would
cause harm to the
patient. So these new
variety of ligation was
developed in which the
module would not put
pressure on the wire.
It is also available in
clear colour.

Reverse palatal arch bar
This provides
excellent control of
upper first molar that
requires
stabilization,
rotation, torquing or
expansion
In this the loop is
reversed to prevent
the gag reflex.

Colored Motif For Plates
There are different
motifs which can
be placed on the
plates to make the
little patients more
motivated

BENDISTAL PLIERS
BENDING SUPER
ELASTIC
TITANIUM WIRES
HAS BEEN
IMPOSSIBLE
UNTIL BENDISTAL
PLIERS MADE IT
POSSIBLE

V- Bend technique of Bendistal
Pliers
can done by simple intraoral wire
adjustments !!

HELP STOP PAIN
BEFORE IT STARTS!
This appliance is designed by STACY STE. MARIE in 2003, to intercept and
reduce pain associated with orthodontic adjustments. It must be used
immediately following each treatment, before experiencing pain. Use after pain
has begun will be ineffective.
The "good vibrations" unit is a battery operated appliance with two attachment
terminals labeled "hi" and "low". The universal mouthpiece fits either terminal
and the unit is turned on and off with a push button switch.
TREATMENT TIME:
15 minutes immediately following every orthodontic appointment.www.indiandentalacademy.com

Alfa Triple Tray
A Tray, capable of
taking both the
maxillary and
mandibular
Impressions along
with the bite
registration all at the
same time, is ideal
for preliminary
impressions.

Chairside Acrylic Dental
Casts
Acrylic dental casts can be made
immediately for extra oral case
evaluations or for quick fabrication
of simple appliances, such as 3-3
lingual retainers. The entire
process takes 5-15 minutes.
Take alginate impressions, and
pour Triad Gel light-cured acrylic
into the occlusal surfaces (the
entire impression is not poured to
save time and expense).
Cure the acrylic for about a minute,
then remove the acrylic cast from
the impression
Any bubbles in the acrylic will
usually be inconsequential.
After removal of the acrylic, the
impressions can be used to make
conventional casts if desired.

Future
Advances
A novel concept under development are
brackets using so-called smart brackets. The
smart bracket concept consists of a bracket
containing microchip capable of measuring the
forces applied to the bracket/tooth interface.
The goal of this successfully demonstrated
concept is to significantly reduce the duration of
orthodontic therapy and to set the applied forces in
non-harmful, optimal ranges.

BIBLIOGRAPHY
J. S. Russell,Current Products and Practice Aesthetic Orthodontic
Brackets; Journal of Orthodontics, Vol. 32, 2005, 146–163
C. Amundsen,Clinical pearl: LingLockTM—the flossable fixed
retainer Journal of Orthodontics, Vol. 32, 2005, 241–243
Ashima Valiathan and Siddhartha Dhar, Fiber Reinforced
Composite Arch-Wires in Orthodontics: Function Meets
Esthetics Trends Biomater. Artif. Organs, Vol 20(1), pp
Kocaderell, I.; Canay, S.; Akça, K.: Tensile bond strength of ceramic
orthodontic brackets bonded to porcelain surfaces, Am. J. Orthod.
Dentofac. Orthop. 119:617-620, 2001
www.alizadehorthodontics.com
www.caesar.com/Superelasticcompositesfororthodonticarchwires.ht
m
www.dentalbraceswikipedia.com
http://www.orthomgt.com
http://www.ormco.com/ci
www.osseo.org

BIBLIOGRAPHY
Transforce Lingual Appliances Development,
JCO,2005;39;3:137-142
Bite Jumping Functional Mand. Advances,JCO,
2005;39;19:696-700
Birt Melsen,Mini-Templates: Where Are We? ,JCO,
2004;39;9:539-547
H. Stuartmccrostie, Indirect Bonding Simplified, JCO,
2003;37;5:248-257
S.S. Marie, Vibrator Stimulation As A Method Of Reducing
Pain After Orthodontic Appliance Adjustment,JCO 2003;37;
4:205-208
Karl Leinfelder ;The Future of Dentin Bonding, 2006
www.sciencedaily.com
www.32teethonline.com
www.docshop.com
www.ghwire.com

BIBLIOGRAPHY
White, L.W.: An expedited indirect bonding technique. J. Clin.
Orthod. 35: 36-41, January 2001.
Williom Vogt, Forsus Fatigue Resistant, JCO,2006; 40; 6 : 368-377
All Digital Office, JCO. 2005
J. Y. Lin, Miniscrew, JCO,2006; 40; 6 : 378-384
P. Ginge, Bonding All Indirect, JCO,2006; 40; 6: 361-367
J. M. Donko, Precoated Brackets For Bonding, JCO,2006; 40 ; 6 :
389
Paperless Operation, JCO,2006
R. J. Weinstein, Acrylic Occtiens, JCO,2006; 40;7 :418
M. Geserick, Bite Jumping Screw For Modified T. Block, JCO,
2006;40;7:432-435
http://en.wikipedia.org/wiki/Retainer_(orthodontic_device)

BIBLIOGRAPHY
Composite Biteplanes,JCO, 2006;40; 1: 55
Glass Fibre Retainer, JCO, 2005;39;3:179
W. Hamula, Invisalign Office, JCO, 2005; 39;3:
259-263
Self Ligating Brackets, JCO, 2005;39;4:264
New Low Friction Ligating System,JCO, 2005 ;
39;8:464-470
Invisalign,Jco,2006; 40;3:171-174
Titanium Alloy Archwires, JCO, 2006;40;3:185
S. Ranco, Composite Biteplanes,JCO,2006;39;5
S.Khouri,Bend Distal Pliers,JCO, 2003;37;10
Ultrasonic Cleaners,JCO,2004;38;10:570

BIBLIOGRAPHY
Proffit William R. : Contemporary Orthodontics,ed.3,
2006, C.V . Mosby, 148,163-165
Graber T.M. , Vanarsdall, Vig; Orthodontics:
Principles and Practice, C.V. Mosby, ed. 4, 2oo5; 49;
53-54; 60; 78.
JCO-Online Copyright 2003 -VOLUME 31 :
NUMBER 02 : PAGES (118) 1998 ,PEARLS
Chairside Acrylic Dental Casts J. BURTON
DOUGLASS, DMD
Journal of Orthodontics, Vol. 32, No. 2, 85-88, June
2005 British Orthodontic Society, Photographic
‘Kesling set-up’, Jonathan Sandler and Satnam Sira

BIBLIOGRAPHY
www.angleortho.com
www.ejo.oxfordjournal.org
www.invisiblebraces.com
www.lingualbraces.com
www.speedsystem.com
www.archwired.com
www.backwell-surgery.com
www.jorthod.maneyjournals.com
www.springlink.com
www.wildsmiles4you.com

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Kürzlich hochgeladen (20)

Recent advances in orthodontics/ dental crown & bridge courses