ORTHODONTIC INSIGHTS liability protection). Get your standard set of intraoral photos along with any special shots that will assist you as you treat the case virtually. Now the fun begins. Your TechC — technology coordinator (yes, your office needs one of these just as we all needed treatment coordinators — TCs — back in the 1990s) uploads the case to your software of choice. We use suresmile® by OraMetrix for both clear aligners and robotically bent wires for conventional care. They also have their elemetrix™ product, which houses only the clear aligner and indirect bracketing capability. There are other software suites out there as well. Buy or lease your own, and learn how to use it. Moving teeth on the computer is fun, and you’ll be amazed at all of the stuff you were missing before. Computers don’t have saliva, lips, or tongues to block your view of the teeth. Let your TechC have a go at the alignment first, and you finalize the result the way you want based on your understanding of the case including any limitations you or the patient placed on the results. Once you have the final result established, you have to put your orthodontic brain in full gear to now design the aligner sequence to accomplish your goals. This is no different from how you sequence your conventional cases today. It’s doctor work. Computer algorithms are great at this, but nothing beats the brain of a well-trained specialist to create an ideal aligner sequence. For the most complex cases, doctor time is about 20-30 minutes. On simple cases, your time will be less than 5 minutes. Once the number of aligners exceeds 20 per arch, the math starts to turn around on you, and using a 3rd party starts to make some sense. For the past 2 years, since I started doing IYO clear aligners, I have not seen one case that I needed to treat with a 3rd-party company. Those are the tougher cases that generally get braces in my office or 3rd-party clear aligners in someone else’s office. For those simple cases where the patient went off to college, forgot her retainers, and her teeth moved a little, IYO aligners are a no-brainer. Industry analysts tell us that there are 20-30 million folks out there who fit this scenario “post braces with minor shifting.” Our specialty must re-commit to treating these cases and stop abdicating their care to the GPs or the DIY crowd. We have to own it! Some tech-savvy doctors are even using IYO clear aligners to finish their conventional cases. The appointment prior to de-banding is used to intraoral scan the patient. In the 34 Orthodontic practice
Figure 5: Post-restoration is a great time to make a final digital scan of the arches to allow the patient to remake clear retainers or bruxism devices from the 3D-printed models. The models can be used over and over with virtually zero damage
Figure 6: Virtual diagnosis and tooth movement is a skill worth learning. Your skill, speed, and comfort will increase with each case treated
Figure 7: The STL files are extremely accurate, and because you can move the teeth virtually, you can fine-tune with ease
software, you can see exactly what is left to finish. Braces are removed virtually, aligners (and retainers) are made from that 3D printed model, patients show up for de-band, and you already have their one or two aligners and their retainer ready for them. No gooey impressions to ruin their big day. Braces, and the final few painful adjustments, are complete, probably ahead of schedule. They love you!
Don’t delay your entry into IYO aligners one more day I’m hopeful that this call-to-action article has opened your eyes to the multitude of benefits that are possible when you, the doctors, are the experts at navigating the virtual world of orthodontics. In the future,
there will be three kinds of orthodontic care providers: 1. GPs who are supplementing their income by offering non-specialty care orthodontics. 2. Orthodontists who only offer braces and 3rd party delivered clear aligners. 3. Tech-savvy orthodontists who took the time and invested the energy and financial commitment to become expert at delivering modern orthodontic treatment with both of their own talented hands firmly on the virtual wheel. You get to decide. I hope you will join the ranks of your peers who have made the virtual leap. It will be good for your practice and really good for your patients. OP Volume 8 Number 3