The Tier V Orthodontic Practice Course

Tier V Strategy

The overall philosophy of the Roncone Strategic Orthodontic Seminar is to obtain the Tier V Orthodontic Practice! The Tier V Orthodontic Practice is the synergy and pursuit of error free diagnosis and treatment planning–physiologic clinical treatment–achieving superb functional, esthetic and stable results–while minimizing the number of appointments and time for each appointment and total treatment time. This should be accomplished while reducing overhead (under 40%).

Tier V Tactics

The Ten Systems of an orthodontic practice must be perfected in order to achieve the Tier V level:

  1. Organizational (Management)
  2. Employment
  3. Training
  4. Scheduling
  5. Marketing
  6. Enrolling Patients
  7. Diagnostic
  8. Clinical
  9. Communication
  10. Financial

Following these key “headers” and perfecting the “17 Critical Factors” will enable the practitioner to achieve an orthodontic version of the Six Sigma business―The Tier V Practice.

Perform total diagnostics on every part of your practice. The question should not necessarily be “How do I perform each procedure better and faster?” It should be: “Should I be doing what I am currently doing?”

It all begins with precise, flexible scheduling! Diagnostic and clinical efficiency–the elimination of all errors and emergencies–great, inexpensive marketing–elimination of delinquencies–exquisite staff training & seismic reduction of overhead (under 40%).

All of this is wrapped into a business plan involving accountability of each team member. All areas important to the practice are monitored through a computerized daily reporting system.

DAY 1: The Strategic Practice Plan

Your Practice is a Business! It should be run like one.

Not only should you be effective in every area of the practice, you should also be efficient. Every procedure should be standardized and measured. All three facets of the practice need to be accountable to the overall strategy: Marketing/Enrollment, Clinical Operations and Administrative/Financial.

All practice areas depend on The Six “S’s”:
1. Structure
2. Service
3. Strategy
4. Systems
5. Success
6. Sustainability

DAY 2: Strategic Clinical Operations I: The PhysioDynamicSystem (PDS) Philosophy

The Tier V Practice should follow a system centered around an integrated directional force system of treating malocclusions to a functional, esthetic result.

The PDS System is based on Six Steps to Clinical Success:
1. Relax the muscles
2. Make the proper diagnosis
3. The Roncone PDS Prescription
4. Ideal precise bracket placement
5. Two – three stages of treatment
6. Post-removal esthetic functional finish

DAY 3: Strategic Clinical Operations II: Early Orthopedics (Phase I) & The Philosophy of Tooth Movement

Much has been debated about the validity of Phase I Treatment. Is it really a necessity? If so, in what type of case? In almost 50 years of practice a great deal has been observed through analyzing full diagnostic records (panoramic, lateral, frontal cephalometric records, TMJ tomography, mounted models, CBCT scans and full set of patient photographs.)

Key Observations:

  • 82% of patients exhibit a frontal (transverse) maxillary asymmetry and the maxilla is too narrow compared to the mandible
  • 29% of patients between the ages of 10 and 15 years of age show signs of TMJ disease DJD
  • 41% 16 years and older show signs of TMJ disease DJD
  • A significant number of patients have airway issues and a majority have received no professional help

DAY 4: Strategic Clinical Operations III: Simplifying the Complex & Strategic Clinical Operations IV

Not only do we need to simplify orthodontic treatment mechanics but we also need to keep our final results stable on a very long-term basis. There are 26 reasons for relapse. Stability of results will be demonstrated in the following areas: Stability of: overbite, overjet, lower anterior crowding, intercanine width, condylar position, upper expansion and lower “expansion”.

While some orthodontists still have doubts about the relationship between orthodontics/occlusion and TMD problems there is no doubt in my mind that the two are intertwined. One need only look at a diagram of the skull, muscles, teeth and TMJ’s to see that they are very intimately related. This will be demonstrated over and over again.

Day 4 will concentrate on the following:
• Diagnosis and treatment of TMD
• Review of Anatomical and Neuromuscular considerations
• Headaches of various types and MPD
• Splints – various types and when to use them
• Physical therapy modalities used in office
• Post TMD treatment – what to do

DAY 5: Strategic Clinical Operations V

Hands-On TMJ Practical:
• TMJ Treatment Strategies and Protocols
• Proper splint fabrication and implementation (Hands-On)


The Tier V course offers a comprehensive, integrated approach to practice and clinical management and will be taken with other practitioners in a small group setting. You are there to learn and share together to maximize your practice performance while achieving a better balance in life!

Registration Fee Includes*
• Five-day session
• Manuals/workbooks
• Membership to the Orthobarbarian Study Club
• Personalized practice analysis


Course Dates:

Thurs. January 30 – Mon. February 3, 2020