Entrevista Dra. Patrícia Vergara
No segundo dia da XXXVI Reunião da SPODF teremos a oportunidade de assistir a uma palestra da Dra. Patrícia Vergara, professora clínica associada de Ortodontia na Universidade de Cartagena, Colômbia e na Universidade de Salamanca, em Espanha.
A Dra. Patrícia irá abordar um dos desafios mais significativos na área da Ortodontia: a identificação precisa das áreas envolvidas na má oclusão, com particular destaque para o sorriso gengival. Muitas vezes, este tipo de má oclusão está associado a problemas estéticos óbvios, mas o seu diagnóstico e tratamento requerem uma compreensão mais profunda.
Esta apresentação terá como foco a classificação da má-oclusão relacionada com o sorriso gengival, dividida em cinco tipos distintos. Cada tipo apresenta características únicas que exigem abordagens terapêuticas específicas e adequadas. Para isso, a Dra. Patrícia promete partilhar segredos de diagnóstico e biomecânica essenciais para tratar eficazmente esta má-oclusão.
Até lá, a Dra. Patrícia teve a gentileza de responder a algumas perguntas para a nossa Newsletter.
Dra. Patrícia Vergara, you are very well known in Portugal from your regular presence here as a speaker and for giving courses about TADs.
If we are not wrong, you graduated from in Universidad Metropolitana de Barranquilla, in Colombia. Since that, you have made many courses in Japan (the MEAW technique), San Diego, Arizona, Brazil, Taiwan…
For sure you don’t consider orthodontics a static profession. What makes you look for constant training? What drives you to always learn more and more?
I believe that we must keep up with the times, there are new ways to achieve orthodontic movement that until a few years ago could only be achieved with braces, but in addition to that there is a lot of information that we still do not have and it is not necessarily new information. That is why I am looking for information anywhere in the world that enriches my knowledge.
“There must be a framework that enhances the beauty of the teeth, and that framework is the face and all the structures around it: nose, lips, smile, eyes, everything”
Over the years, how do you think patient’s expectations and demands have changed?
The expectations of patients are now very high, and I see that there is a great demand of two large groups, one who is looking for aesthetics a lot and does not care about the function and there are others who are very interested in not having pain. Now there are many patients with pain, therefore you must prepare to be able to treat these problems that not all orthodontists know.
Do you still use conventional brackets, or did you switch totally to aligners?
The reality in Colombia does not yet allow you to offer only aligners in your treatment. I do both in my office. I still use conventional braces and I love them.
In these times of “orthodontic simplicity” with aligners, don t you think it’s more difficult to convince patients to a MEAW orthodontic treatment?
Of course, it is difficult for a patient to use the MEAW technique and the orthodontic reality is that many treatments with aligners will be used in the future. It simplifies the work of the orthodontist and it gives the patients the aesthetics that they come looking for.
What is your opinion on the new techniques helping orthodontics, for instance, orofacial harmonization? When should we use them to access excellence in treatment?
Now we can see that orthodontics is aimed at creating harmony, not only of the teeth in terms of alignment, but also in terms of function. There must be a framework that enhances the beauty of the teeth, and that framework is the face and all the structures around it: nose, lips, smile, eyes, everything. Of course, it is great that everything is a harmonious whole. I think that the orthodontist should suggest to the patient any additional procedure that would enhance the orthodontic work that we have done, a good shape of the lips, a good quality and thickness of the lips, a Botox, for example, would be good to be able to find that perfect harmony.
“Certainly, the mini-implant came to revolutionize the way of doing orthodontics”
Regarding orthognathic surgery, do you think that we, as orthodontists, by using these new techniques, are treating much less patients with surgery?
Undoubtedly, with the use of the tools we have at our disposal at this time, such as mini-implants, we could avoid the patient having to go to the surgeon many times. That is why we must train ourselves to know how to place them very well and to use good biomechanics.
The topic of the Portuguese Meeting is TADs. Do you think these devices were the true revolution in Orthodontics?
Certainly, the mini-implant came to revolutionize the way of doing orthodontics because the treatments with my implants are safer, more predictable and allow us to have that skeletal anchorage that we need so much to be able to control undesirable movements. I am very happy that this is the most important topic in this meeting because the use of the mini-implant allows us to have a lot of imagination, to design new biomechanical systems, and allows the orthodontist to put all his biomechanical knowledge at the service of the malocclusion of the patients.
What would you say it was as important as TADs in our specialty?
For me, the mini screw is very important. But it is just one more tool among all the ones we have to treat malocclusions. For me, it is very important that the orthodontist knows that any dental movement that I can make with my screws or with any biomechanics affects other structures, not only muscular ones, but also joint ones, so you have to know about occlusion.
What has been the most important innovation of the past 20 years in orthodontics?
In the last 20 years, we started with mini-implants, which have been used by orthodontists for a long time. Then came the digital part, which is very important, and definitely the whole digital part. It is what is revolutionizing the whole field of orthodontics at the moment. Obviously we can’t ignore the development in terms of technology and the materials with which the wires and brackets are made, especially all that design technology that is being visualized in the design of pre-adjusted brackets and obviously self-ligating brackets, for me all of these took the prize.
What do you consider to be the next paradigm that will emerge in orthodontics?
It is very difficult at this point to know what the next paradigm is because apparently with so much technology available and now affordable, what I think is that we are going to need less from the big companies to design our devices. Therefore, we are going to have more work in our offices doing ourselves everything that the big companies now do for us.
What do you see as the next advantages or problems in next 10 years in orthodontic, and what will be the next big challenges?
What I see coming is that there are many, many people doing orthodontics with aligners and they are losing manual skills, they are losing opportunities to imagine designing biomechanical systems because they are very dependent on the technicians who help them design their biomechanics and that worries me because we are only looking at teeth and they are not integrating all the others important structures as ATM and muscles.
Finally, What piece of advice can you give to orthodontist out there?
That there are no intelligent systems or intelligent brackets, that the intelligence is in the orthodontist, that orthodontic treatment that treats only teeth is causing many joint problems, that we must then take these aspects into account. That they do not stop studying and training.
And at last, some more personal questions, if you want to answer: It’s not the first time for you in Portugal. Could you describe a favorite place or a special moment that have marked you here? Would you see yourself living here?
Portugal is a beautiful country. It has incredible geography, beautiful landscapes and what I enjoy most about Portugal is its food. I ate for the first time in Portugal. The barnacles were something that left a deep impression on me because I had never seen those little animals. All of Portugal is beautiful from the north to the south. Would God want me to come and live here? I would be delighted. The people of Portugal are very nice, friendly and beautiful.
