Orthodontic Practice US January/February 2019 Vol 10 No 1

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CLINICAL

Figure 7: Incognito lingual brace

gold low profile bases that are designed to maximize the efficiency and, at the same time, be almost invisible. ClearCorrect is an easy-to-use, clear aligner system that is more affordable than Invisalign. The system works well; you plan your treatment and get a digital setup, maybe not as slick and with as many options as the Invisalign ClinCheck, but an alternative worth trying. Dolphin 3D is a tool for simply processing digital 3D data such as medical CT scans, cone beam CT scans, MRI, and facial 3D scans. It allows case administration, practice management, analysis, and visualization for easy treatment planning, documentation, and presentation. You can find software for planning surgical guides for implants and order them from the SICAT lab Portal. You can use the SICAT Function for tracking motion of the temporomandibular joint for diagnostics and therapy. Furthermore, it is possible to assess the upper airway space for the appliance-based treatment of sleep apnea using SICAT Air. Stratasys makes some amazing highend 3D printers such as the Objet30 for making quality models and surgical guides and the J700 for production of clear aligners. As purchasing, running, and maintaining printers like these isn’t practical for most of us, it can be useful to send a scan and let labs produce orthodontic and crown/bridge models as well as guides. In orthodontics, we easily end up with a lot of physical models, so digitizing is a great way of keeping precious office space, and then the models can be quickly produced when needed. 10 Orthodontic practice

Figure 8: Invisalign clear ortho appliance

OnyxCeph provides an all-in-one dental imaging software for case-related 3D/2D data, allowing virtual treatment planning for occlusion and jaw alignment, virtual setups, aligner planning, placing virtual brackets and wires, generating transfer and treatment trays, evaluation of treatment progress, and of course, presentation of cases, patient education, and documentation. The final pre-installed recipient is CA Digital, where you can order CA® ClearAligners. It has a clever system where three different material thicknesses are used over a 4-week period to gradually move teeth in a safe and comfortable way. CA also allows the clinician to either order finished aligners or just models if you want to produce the aligners in your practice lab using a thermoforming machine and retain full control over the process and

reduce the cost. CA also makes the beautifully cut Memotain® retainer wires in Nitinol, a shape-memory alloy, to allow very close fit and detailing, accurate positioning, and high durability of a lingual retainer wire.

Conclusion CEREC Ortho is a very versatile software that has many uses apart from the popular Invisalign. It benefits greatly from the bilateral bite registration and the detailed guided scan. It can sometimes be difficult to get a quick scan, but it gets better with some practice. The guided-scan pattern you have to use slows you down but provides a predictable result that is easy to implement in your digital workflow. The pre-installed recipients in the CEREC Ortho software make it easy to connect to some of the big companies as well as your favorite labs using Sirona Connect Portal. OP

REFERENCES 1. Drake CT, McGorray SP, Dolce C, Nair M, Wheeler TT. Orthodontic tooth movement with clear aligners. ISRN Dent. 2012;2012:657973. doi: 10.5402/2012/657973. 2. Gu J, Tang JS, Skulski B, et al. Evaluation of Invisalign treatment effectiveness and efficiency compared with conventional fixed appliances using the Peer Assessment Rating index. Am J Orthod Dentofacial Orthop. 2017;151(2):259-266. 3. Knösel M, Klang E, Helms HJ, Wiechmann D. Lingual orthodontic treatment duration: performance of two different completely customized multi-bracket appliances (Incognito and WIN) in groups with different treatment complexities. Head Face Med. 2014;10:46. 4. Melsen B. Adult Orthodontics. Oxford, UK: Wiley-Blackwell; 2012. 5. Miller KB1, McGorray SP, Womack R, et al. A comparison of treatment impacts between Invisalign aligner and fixed appliance therapy during the first week of treatment. Am J Orthod Dentofacial Orthop. 2007;131(3):302. 6. Naziri E, Schramm A, Wilde F. Accuracy of computer-assisted implant placement with insertion templates. GMS Interdiscip Plast Reconstr Surg DGPW. 2016;13;5:Doc15. doi: 10.3205/iprs000094. 7. Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review. Angle Orthod. 2015;85(5):881-889. 8. Rosvall MD, Fields HW, Ziuchkovski J, Rosenstiel SF, Johnston WM. Attractiveness, acceptability, and value of orthodontic appliances. J Orthod Dentofacial Orthop. 2009;135(3):276.e1-12. 9. Sarment DP, Sukovic P, Clinthorne N. Accuracy of implant placement with a stereolithographic surgical guide. Int J Oral Maxillofac Implants. 2003;18(4):571-577. 10. Wooten C. ClearCorrect: Competing at the cutting edge. The Business Journals. https://www.bizjournals.com/houston/ stories/2009/08/24/smallb1.html. Published August 23, 2009. Accessed December 26, 2018. 11. Zheng M, Liu Z R. Ni Z. Yu. Efficiency, effectiveness and treatment stability of clear aligners: a systematic review and metaanalysis. Orthod Craniofac Res. 2017;20(3):127-133.

Volume 10 Number 1


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