Page 5 - GP Spring 2025

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As her tinnitus went from rampant to tamed, the corners of and shape of her lips, and
outline of Cupid’s Bow, also improved (Figures #5, 5a). The reformulated basal alveolar
osseous process and soft tissues made everything healthier, stronger and improved

4
the esthetics.
Figure #2

Figure #2a

Figure #2: Anterior open, start. Figure #2a: Anterior open, 4 years into therapy.
No tooth was modified with an occlusal adjustment or interproximal reduction (IPR).
Some teeth had buccal attachments placed. A direct composite no-prep restoration
was placed on the retained primary tooth #D whose root completely resorbed
decades earlier (Figures #3, 3a). It was the only tooth not repositioned.

Figure #2

Figure #2a

Figure #5a

Figure #2: Anterior open, start. Figure #2a: Anterior open, 4 years into therapy. Figure #5

Figure #5: Modest smile, start. Figure #5a: Modest smile, 4 years into therapy.
No tooth was modified with an occlusal adjustment or interproximal reduction (IPR).
Some teeth had buccal attachments placed. A direct composite no-prep restoration

was placed on the retained primary tooth #D whose root completely resorbed
The TFI and Tinnitus and Hearing (THS) surveys, (Figures #6a,b,c [2015]; #6d,e,f [2024]),

decades earlier (Figures #3, 3a). It was the only tooth not repositioned.
Figure #3

Figure #3a
quantify and qualify the deleterious in
Figure #3: Right buccal anterior, start. Figure #3a: Right buccal anterior, 4 years into therapy. fluence tinnitus had on her life for almost 50
years, and the dramatic improvement experienced during the past nine. The duration
7
of the tinnitus episode, how often it was annoying; her ability to cope with it,
Larger than average buccal and distal translations, intrusions and extrusions of teeth
The TFI and Tinnitus and Hearing (THS) surveys, (Figures #6a,b,c [2015]; #6d,e,f [2024]),
Larger than average buccal and distal trans-
facilitated the expansion of her mandibular arch (Figures #4, 4a). The distance
quantify and qualify the deleterious influence tinnitus had on her life for almost 50 years,
lations, intrusions and extrusions of teeth
facilitated the expansion of her mandibular concentrate, think and focus clearly, relax, rest peacefully, etc., all showed lifestyle-
and the dramatic improvement experienced during the past nine. The duration of the tin-
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between lingual cusps of the mandibular right and left premolars was increased by
arch (Figures #4, 4a). The distance between
lingual cusps of the mandibular right and altering improvement.
about a centimeter. nitus episode, how often it was annoying; her ability to cope with it, concentrate, think and

focus clearly, relax, rest peacefully, etc., all showed lifestyle-altering improvement.
left premolars was increased by about a
centimeter.
Figure #3 Figure #3a
Figure #3: Right buccal anterior, start. Figure #3a: Right buccal anterior, 4 years into therapy.
Larger than average buccal and distal translations, intrusions and extrusions of teeth
facilitated the expansion of her mandibular arch (Figures #4, 4a). The distance
between lingual cusps of the mandibular right and left premolars was increased by
about a centimeter.

Figure 4. Mandibular arch, start.
Figure #4 Figure #4a
Figure #4: Mandibular arch, start. Figure #4a: Mandibular arch, 4 years into therapy.
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Figure 4a. Mandibular arch, 4 years into
Figure #4 therapy. Figure #4a
Figures 6a, 6b, 6c: (TFI-Pages 1,2; THS [2015])
As her tinnitus went from rampant to tamed, the corners of and shape of her lips, and
Figure #4: Mandibular arch, start. Figure #4a: Mandibular arch, 4 years into therapy.
As her tinnitus went from rampant to
tamed, the corners of and shape of her lips, Figures 6d, 6e, 6f: (TFI-Pages 1,2; THS [2024])
outline of Cupid’s Bow, also improved (Figures #5, 5a). The reformulated basal alveolar
and outline of Cupid’s Bow, also improved
4
osseous process and soft tissues made everything healthier, stronger and improved
(Figures #5, 5a). The reformulated basal Figures #6a, 6b, 6c: (TFI-Pages 1,2; THS [2015])
Pre-existing dental conditions (follow-up):
alveolar osseous process and soft tissues Missing teeth: #7, 10, 17, 32
the esthetics.
made everything healthier, stronger and im- Figures #6d, 6e, 6f: (TFI-Pages 1,2; THS [2024])
Primary teeth present: #D,G
proved the esthetics. Mobility: tooth #D, Cl 0.5 – Cl 1
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(unchanged)
Teeth transposed: #6/#D
Overjet: 12mm / (5-6mm after active therapy)
As her tinnitus went from rampant to tamed, the corners of and shape of her lips, and
Overbite: 5mm / (1-2mm after active therapy)
outline of Cupid’s Bow, also improved (Figures #5, 5a). The reformulated basal alveolar
Duration of Active Therapy: 5.5 years
Duration of Passive Therapy: 5+ years,
osseous process and soft tissues made everything healthier, stronger and improved
ongoing
the esthetics.
Figure 5. Modest smile, start. Pre-existing medical condition:

Figure #5a
Figure #5 7 Henry JA, Griest S, Zaugg TL, Thielman E, Kaelin C, Galvez G, Carlson KF. Tinnitus and hearing survey: a screening
Tinnitus: neither disclosed nor discussed before care was started.
Note - prior to 2022, if a patient wanted to point out they had tinnitus, they would have
tool to diQerentiate bothersome tinnitus from hearing diQiculties. Am J Audiol. 2015 Mar;24(1):66-77. doi:
selected “list any other disease, syndrome or condition not listed” and write in “tinni-
Figure #5: Modest smile, start. Figure #5a: Modest smile, 4 years into therapy.
tus.” It was six years later, during the nighttime retainer phase, when she first disclosed
10.1044/2014_AJA-14-0042. PMID: 25551458; PMCID: PMC4689225.
the decades spent suffering with severe chronic tinnitus.
The TFI and Tinnitus and Hearing (THS) surveys, (Figures #6a,b,c [2015]; #6d,e,f [2024]),
quantify and qualify the deleterious influence tinnitus had on her life for almost 50 5
years, and the dramatic improvement experienced during the past nine. The duration

7
Figure #5 Figure 5a. Modest smile, 4 years into www.nysagd.org l Spring 2025 l GP 5

Figure #5a
of the tinnitus episode, how often it was annoying; her ability to cope with it,
therapy
concentrate, think and focus clearly, relax, rest peacefully, etc., all showed lifestyle-
Figure #5: Modest smile, start. Figure #5a: Modest smile, 4 years into therapy.
altering improvement.
The TFI and Tinnitus and Hearing (THS) surveys, (Figures #6a,b,c [2015]; #6d,e,f [2024]),
quantify and qualify the deleterious influence tinnitus had on her life for almost 50
years, and the dramatic improvement experienced during the past nine. The duration
7
of the tinnitus episode, how often it was annoying; her ability to cope with it,
concentrate, think and focus clearly, relax, rest peacefully, etc., all showed lifestyle-
altering improvement.

Figures #6a, 6b, 6c: (TFI-Pages 1,2; THS [2015])
Figures #6d, 6e, 6f: (TFI-Pages 1,2; THS [2024])

Figures #6a, 6b, 6c: (TFI-Pages 1,2; THS [2015])
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Henry JA, Griest S, Zaugg TL, Thielman E, Kaelin C, Galvez G, Carlson KF. Tinnitus and hearing survey: a screening
Figures #6d, 6e, 6f: (TFI-Pages 1,2; THS [2024])
tool to diQerentiate bothersome tinnitus from hearing diQiculties. Am J Audiol. 2015 Mar;24(1):66-77. doi:
10.1044/2014_AJA-14-0042. PMID: 25551458; PMCID: PMC4689225.
5

7 Henry JA, Griest S, Zaugg TL, Thielman E, Kaelin C, Galvez G, Carlson KF. Tinnitus and hearing survey: a screening
tool to diQerentiate bothersome tinnitus from hearing diQiculties. Am J Audiol. 2015 Mar;24(1):66-77. doi:
10.1044/2014_AJA-14-0042. PMID: 25551458; PMCID: PMC4689225.

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