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Orthodontic Articles & News by Dr. Scott Frey

Taco Bell addict. Board Certified Orthodontist at Hatcher & Frey Orthodontics. Click here to Facebook me / Stalk me on Instagram

Easily Calculating Resolution for 3D Printers

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Printer Resolution3D Printer Resolution

One of the more confusing concepts within 3D printing is understanding the resolution of the printer itself. I had several conversations during the AAO on this subject with people so I think the topic is worth revisiting.

People often misquote Z axis resolutions as the printer’s “resolution” because all additive manufacturing must occur in layers, and layer thickness is something that can be roughly compared between printers. In reality the Z resolution is only a very small part of the equation. The XY resolution actually has a far more significant impact on print quality and accuracy.

Perhaps the reason why XY resolution is rarely mentioned is that you can only make a direct comparisons between XY resolutions among pixel/projector based printing technologies like DLP-SLA, MSLA, and Polyjet. You cannot really make a direct comparison between these technologies and Laser-SLA.

With DLP, MSLA, Polyjet, and other “projector” based 3D printers, their XY resolution is defined mainly by the size of the pixels. If you want to understand the XY resolution of any of these types of printers, here is how:

  • DLP-SLA -> Divide the length or width of the build platform by the number of pixels in the projector for that dimension (1920 x 1080p for an HD projector), then multiple by 25,400 to convert to microns. This will give you the pixel size in microns for either the X or Y dimension (pixels are rectangular). For example , to achieve a 50micron XY resolution the build platform can only be the size of a 3×5 card with DLP printers.
  • MSLA -> This technology uses an LCD photomask to shape the UV light, so the pixel size is based on how the LCD photomask is manufactured and is constant. You can simply ask the manufacturer what the pixel size is of their photomask to get the XY resolution. One advantage of this technology is that you can have high XY resolution with a larger build area.
  • Polyjet -> The printers using this technology list the DPI for their projectors, which makes conversion easy. The Stratasys printer uses a 600dpi resolution in the XY, which is a 42micron XY resolution.

Laser-SLA printers are a completely different animal than pixel based printers (I think the featured image for this post helps highlight that difference). The XY resolution for these printers is actually determined by the pointing precision of the laser, which allows it to achieve a level of precision in the XY dimension that is finer than the laser spot size itself. For example, the pointing precision of the custom galvos on the Form2 is less than 10microns.

Now that we have clarified 3D printer resolution a little further, this should help you filter out the noise a bit better. In the end though, the resolution specifications on these machines are only a glimpse into the potential accuracy of a printer, and they don’t provide an adequate means of comparison for projector and laser-based 3D printers. The information we really want is the dimensional accuracy of the objects being produced, which we will look at from prints in a few days. 

12 Months the New Target for Treatment Time

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Rocket TurtleThe New Normal

In the age of instant gratification, parents and patients (and doctors) expect orthodontic treatment to be far more efficient than the traditional 24mo estimates of generations past. A recent survey conducted regarding their perceptions of orthodontic treatment found that the majority of patients (74% of adolescents and 59.2% of adults) felt that treatment should be completed 12 months or less.

Patient Treatment Time Expectations
Uribe F, 2014.

Understanding patients’ perceptions toward treatment is important because when treatment length is significantly out of step with their expectations this will have an impact on both case acceptance and patient compliance. Adolescents in particular had strong negative opinions in the survey about treatment going longer.

Our failure as a specialty to recognize this shift in expectations has left a vacuum now filled with gimmicks like 6month smiles and “Fast Braces” where patients are considering paying for inferior results simply to avoid a what they think will be a 24 month “sentence.” Shorter treatment times don’t have mean cutting corners, and it is about time that we start communicating what we have to offer more effectively to the public. 

Given the advances in technology, patients’ perceptions about how long treatment should take with decent compliance are actually pretty spot on. My target treatment time for all patients, in Invisalign or braces, is now 12 months. This is 100% achievable with Invisalign or with precision passive self-ligating braces in combination with digital technology.

Here is a treatment summary from my last 10 removals from braces and Invisalign showing total visits, clinical minutes, and months in treatment. The Invisalign group exhibited a slightly greater degree of difficulty and had a greater proportion of adult patients, but for both groups the average treatment time was right around a year.

Consecutively Treated PatientsI don’t really see many Class I mild crowding patients, so this wasn’t a slouch sample. Below is a representative case from the sample of a patient treated with fixed appliances. The patient was a 13yo Female. Treatment was completed in 11mo, 3mo with Carriere Motion Appliance for unilateral class II, followed by 8mo in SLX brackets.

Braces Sample Before & AfterHere is a representative case from the sample of a patient treated with Invisalign. The patient was a 39yo Female. Treatment completed in 15mo, with weekly aligner changes.

Invisalign Sample Before & AfterI think it is time we start embracing 12 months as the new normal for the targeted treatment time for our patients. Given the strains on motivation and the oral environment that occur with extended treatment times, delivering excellent results as efficiently as possible is the right thing to do for our patients. The concern that I hear doctors voice about people on flexible financial contracts skipping town after treatment is a red herring and really isn’t a reason not to do our best.

Are Passive Self-Ligating Braces Really Faster?

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Faster BracesMaximizing the Working Properties of Orthodontic Archwires

Long before there was the Damon System, which brought the idea of self-ligating braces and faster treatment into the mainstream, George & Fred Schudy sought to maximize light forces and favorable wire properties during initial alignment1. They realized that while the greater range and lighter forces offered by nickel titanium archwires provide significant treatment advantages, the wires alone were only a partial step forward toward increased efficiency. Their conclusion was that we must consider basic changes to the bracket systems themselves.

The Schudy article established 3 criteria that appliances must leverage to maximize the working properties of orthodontic wires:

  • Increasing interbracket distance
  • Small, flexible initial archwires
  • As much intra-bracket play around initial wires as possible

A bracket system that meets these requirements would maximize the expression of desirable wire characteristics and increase alignment efficiency.

Passive Self-Ligation Increases Treatment Speed?

The findings in this study that intrabracket space has nearly as much impact on the clinical workings of an orthodontic appliance as does interbracket distance is a particularly important discovery. However, despite acknowledging that intrabracket space also reduces friction between the bracket and the wire, making leveling faster and easier, they found it difficult to resolve the puzzle between increased intrabracket play and regaining control using traditional edgewise appliances1. Their solution to this paradox at the time was a bimetric appliance utilizing single-wing brackets and differential slot sizing; however, passive self-ligating brackets now provide a particularly elegant solution to this dilemma.

The use of a passive self-ligating brackets rather than traditional elastic or steel ligation, allows doctors to leverage the benefits of maximal intrabracket space during initial alignment, while still being able to gain control during the final stages of treatment. The significance of this intrabracket space is illustrated in a study conducted at the University of Connecticut2, where you can see that with a 1mm in-out discrepancy passive self-ligating brackets remain inactive until an 020 wire is placed.

First Order Bracket Play
Holbert MB, 2008.

Naturally, the differences between the various bracket types become less apparent as these 1st order discrepancies are made more severe and as wire diameter increases, but the sweet spot for intrabracket space is simply wider for passive self-ligating braces.

On the flip side, you can have too much intrabracket space. Schudy’s paper outlined their concerns about a failure to adequately fill the bracket slot late in treatment resulting in the expenditure of needless effort and time in the form of repeatedly removing arch wires to place “artistic bends.” This has certainly been the case as of late with some passive self-ligating systems.

But Muh Meta Analysis

Well haven’t systematic reviews and meta-analyses shown no difference with traditional braces? I’m glad you bring that up. These flippant references to systematic reviews or meta-analyses that people love to toss around are not an argument on their own. No one should put their faith completely in the reviewers to properly audit and analyze papers for them. Always double check their assumptions and methods to rule out the possibility of confirmation bias.

The major irony about the Chen article3 being so frequently cited to support the idea passive self-ligating brackets perform no differently than traditional braces is that it is actually an indictment against their own argument.

When we take the time to examine their analysis of the differences in total treatment time between self-ligating and traditional braces, we see that they identified three randomized control trials meeting their standards for inclusion in their review. Both the Eberting and the Harradine papers, show a clear reduction in total treatment time with self-ligating braces; however, the inclusion of the Hamilton paper nullifies this result.

Total Treatment Time Meta-Analysis
Chen et al, 2010.

I tracked down all three of these papers to look at their methodology, and what I found in the Hamilton paper was puzzling. Although they had a sufficient sample size, they were comparing active self-ligating brackets and single wing traditional braces instead of comparing passive self-ligating braces and traditional twins. Furthermore, the authors stated that “a number of” patients in both groups had Phase 1 treatment with a Herbst or Pendulum appliance, which certainly had an effect on total treatment time since both groups in the Hamilton paper had far shorter treatment times than either of the other papers. This is a big no no. If you are going to pool data together for a statistical analysis, you can’t combine apples and oranges. If the authors were doing their job, they would have excluded the Hamilton paper and their conclusions would show a clear advantage for passive self-ligating braces when it comes to treatment time.

Getting Down to Brass Tacks

Passive self-ligation certainly provides an elegant solution to the dilemma of intrabracket space, but it is not the only treatment approach that takes advantage of these principles. Simply put, we must apply the lessons of Schudy’s paper, and adapt our fixed appliances and our biomechanics to increase treatment efficiency by striking a balance between efficient alignment and controlled finishing. The one thing orthodontists should not be doing is burying their head in the sand because patients are not looking to spend more time in braces or even any time in braces at all.

References:

  1. Schudy GF, Schudy FF. Intrabracket space and interbracket distance: critical factors in clinical orthodontics. AJODO 1989;96(4):281–94.
  2. Holbert MB. First Order Archwire Deflections: Comparing Conventional, Active Self-Ligating and Passive Self-Ligating Mechanisms. SoDM Masters Theses 2008:171.
  3. Chen SS-H, Greenlee GM, Kim J-E, Smith CL, Huang GJ. Systematic review of self-ligating brackets. AJODO 2010;137(6):726.e1–726.e18.

DIY Dental Monitoring Solution

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TeleOrthodonticsTeleorthodontics for Patients

The Dental Monitoring Software is based on the principle that because patients all carry their smartphones they can update you on their orthodontic progress at any time without having to take time off work or school to come to your office. This is certainly true; however, smartphones already provide this capability without the need for additional software.

There is certainly still value in the 3D monitoring service offered by Dental Monitoring, but you can implement a simple means of photographic patient monitoring today at almost no cost by scheduling FaceTime appointments or by simply having patients send you updates using the camera on their phone. Today we are going to go step by step with how to build a simple remote monitoring system using Google Forms.

Implementing Remote Monitoring

Items Required: 

  • C-shaped cheek retractors (can be bought cheaply on Amazon)
  • A GSuite account with Google Forms
  • A designated treatment concierge to review submissions and contact patients
  • Patients who own smartphones

Step 1: Record Example Photo Monitoring Videos 

Record with a team member some example videos that demonstrate exactly treatment progress information should be captured on a smartphone. You should record 3 example videos: one with teeth apart and aligners in, one biting down with aligners removed, and one teeth apart and aligners out. Videos work better than individual photos because data capture is continuous and the video can then be paused during viewing. To capture the videos, the patient can either hold the camera in front of a mirror of have a friend help, and they simply turn their head while keeping the camera still. It helps to keep traction on the cheek retractors with a free hand to visualize the side bite more effectively.

Step 2: Upload Example Videos to GSuite Youtube Account

Once you have your 3 example videos recorded, you will then upload them to your office GSuite account as ‘unlisted’ videos. Unlisted means that the videos do not show in search results and only people with the link are capable of viewing them. You will embed these uploaded videos into your Google Form.

Uploading Unlisted Video to Youtube

Step 3: Create Google Form

Google forms within GSuite are HIPAA compliant and very easy to use so they are ideal for these purposes. They also allow users to upload files; however, this is limited just to people within the office network at the current time. When they change this feature, it will become even simpler to use for these purposes.

Start by filling in an appropriate title and description for the Photo Monitoring Google Form. In the settings require that an email address be entered and create a short answer section for the patient’s full name. This will allow you to link the survey results with the videos sent from the patient.

Photo Monitoring Google Form

Next create a linear scale question allowing the patient to self-assess their level of compliance. 

Create Linear Scale Question for Compliance

Add a multiple choice question to gather information about the patient’s progress (i.e. is this a routine progress update, did the bite correction with elastics get completed, is something broken or loose, etc.). You can also upload photos to accompany the choices to help guide the patient.

Photo Exam Type

Next enter a text section with written instructions for the patient on how to capture the videos you require to perform remote monitoring of the patient. Below these instructions is where you will embed the videos that you previously uploaded, so your patients have an example of a good video capture.

Instructions for Video Capture

Currently patients will still have to email you the videos (cannot upload directly to the form if they are not on your office network), so you will need to provide an email address and instructions on where to send the photos following form submission. Under settings you can have a confirmation message appear after submission with this information. I also like to add a message at the end of the form to remind them.

Remote Monitoring Survey Response

Link the form to a spreadsheet in GSuite and adjust your notifications settings so that your treatment concierge is notified about submissions and is able to contact the patients for follow up.

Dental Monitoring Notifications

Once your form is complete you can use a short-link to share with patients on remote monitoring via email or text.

Step 4: Set Up Recurring Emails When Needed

Once your Google Forms are complete you are ready to implement your remote monitoring program to help patients who are traveling, patients in retention, or simply want the convenience of telemedicine. Setting up recurring emails within GSuite by installing any number of plugins from the Google Marketplace is simple and allows you to set it and forget it.

Remotely Monitoring Patients

This do-it-yourself teleorthodontics system is extremely useful for accommodating patients who might find it challenging to come to the office and certainly can make traditional orthodontic care more convenient for all patients. In addition to the simple photo monitoring, I highly recommend that everyone add an appointment code in their practice management software to accommodate FaceTime appointments. Facetime appointments work just like any other appliance check visit, but are simply done using a computer or smartphone in a private area to video conference with the patient.

Once you are up and running with these new appointment codes and systems, the following situations are ideal for offering more convenient options for your patients:

  • Better communication regarding loose/broken appliances, wire pokes, and other patient concerns so that your team can schedule repair appointments more effectively
  • Reduced appointments when using appliances that do not require doctor activation (Invisalign, elastic bite correction, jack screw expanders, habit appliances, etc.)
  • Improved monitoring during retention
  • Better coordination of care for patients who travel a distance or have challenging schedules

If you happen to be patient reading this article, know that orthodontists are generally a very forward thinking and flexible bunch so even if your doctor hasn’t presented this as an option, I am sure they would be more than happy to accommodate you. Hope you all found this post helpful!

What to Look for at the AAO 2017

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AAO Annual Session 2017With the AAO kicking off today, we thought it would be worthwhile to give a quick run down of some of the things that caught our eye at the annual session this year. We don’t have any formal posts planned over the weekend, but I’ll be checking in throughout the session on Facebook to share interesting finds and updates. Hope to see you there!

New Products

  • Invisalign’s Mandibular Forward Advancement (pending US release) – There will be a heavy Teen focus at the Invisalign booth this year, and for those of us looking forward to their functional aligner appliance there will definitely be additional information to prepare you for when it gets to the US.
    Invisalign Mandibular Forward Advancement
  • Henry Schein’s New Color Class II Motion Appliances – The ‘Colors in Motion’ are very cool and will be a lot fun for patients.
    Colored Class II Motion Appliances
  • EasyRx – For those of you not familiar with this product, it is a really nice in-house service for coordinating 3D printing within your practice, and worth a look. They are rolling out the ability to do some processing of the models from within the Rx form so you will be able to in a few clicks add a base, hollow out the .stl files, label them, and queue them for printing at any location right from the cloud (no noodling around with MeshMixer).
    EasyRx Workflow
  • The Wireless Trios – Probably going to cost waaaaay too much, but will still be cool to look at.
    Wireless Trios Scanner
  • Various 3D Printers & Software across the exhibit hall. Make sure you check our series of posts on 3D printing so you don’t overpay and find the right machine for your practice needs.

In the Lecture Halls

  • Saturday 9-10AM: LeeAnn Peniche – BYOB: Be Your Own Brand
    • I have never used LeeAnn, but I have heard great things. Will be worth getting up early for.
  • Saturday 10:15AM: Hugo De Clerck – Rotations of the Maxilla and the Occlusal Plane: The Key to Successful Orthopedics
    • Will have some great information on what actual orthopedic effects on the maxilla look like, since most people are only familiar with protraction dogma.
  • Saturday 2:15AM: Rebecca Bockow  – Goal Oriented Treatment Planning with Corticotomy Facilitated Orthodontics
    • Not familiar with this speaker, but will try to swing by to check out the content. We should always be looking to modify gingival phenotypesto reach our treatment goals rather than treating to the pathology.
  • Saturday 3:00AM: Antonino Secchi – Leveling the Occlusal Plane to Solve Vertical Problems
    • I saw Antonio’s topic and now I know why he was so impressed by my Invisalign lecture that he attended last year. Great guy!
  • Sunday 9:15 – 10:15AM: Maria Bailey – Millennial Moms: 202 Facts Marketers Need to Know
    • Unless you actually happen to be a millennial like myself, this should be a great talk to catch to help guide your understanding of how to connect with this generation of parents/patients.
  • Sunday 10:30 – 11:30AM: Chris Bentson – State of the Orthodontic Industry
    • Chris always has solid information.
  • Sunday 3:00PM: Mani Alikhani – Vibration and Perforation: What Do They Have in Common?
    • Vibratory stimuli are much harder to direct, but still a useful tool for bio-stimulation. If you are prescribing these types of interventions, it is good to examine the physiology behind them to better guide your judgement.
  • Monday 10:15AM: Branislav Vidovic – The Influence of Orthodontic Treatment on Facial Balance
    • This talk sounds like it might cover some similar concepts that I cover in my Soft Tissue Orthodontics courses so might be interesting to check out.
  • Monday 10:45AM: Chris Chang – Three Major Applications of Extra-radicular Screws
    • Chris has a very interesting practice and I always enjoy seeing him present.
  • Tuesday 9:00AM: Seung-Hak Baek – Surgery-First Approach for Skeletal Class III Patients
    • Even if you do very few surgical cases, everyone needs familiarize themselves with surgery first approaches. Much better for insurance approval, speed of treatment, and patient acceptance.
  • Tuesday 10:25AM: Jianyong Wu – Treatment and Post-Treatment Effects of a New Magnetic Palatal Expansion Appliance
    • If you are still hanging around on Tuesday, you might poke your head in and see what the appliance looks like. We definitely need a better range of options for expansion with more precise (and lighter) force levels that we can prescribe.

The Guru is Dead. Long Live the Guru

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The Iron ThroneFalse Arguments from Authority

There are entirely too many business gurus out there claiming to be in possession of “special knowledge” which is evidently denied to everyone else. The more unpredictable the changes within the specialty, the more people appear who claim to have all the answers about how to run a successful practice.

There is just one problem….. In an increasingly uncertain marketplace, existing business models offer little value, regardless of who is ‘selling’ them. Who out there feels that with the flow of venture capital into the dental space, crushing student loans levels among new graduates, and rapidly shifting technology that the practice of orthodontics is becoming more certain?

Building an orthodontic practice that treats patients well takes hard work. If you are looking for a proxy-parent to tell you how to do it, I hate to break it to you, but there is no such thing as an authority. Furthermore, those offering advice must be subjected to greater scrutiny.

The best way to excel in an uncertain market is to learn faster than your competition. By testing your intuitions quickly and inexpensively, you can help minimize risk, and build a model for practice that best suits your patients today.

A Quick Look at Dental Monitoring

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Dental MonitoringWhat is Dental Monitoring?

We are constantly looking for innovative treatment methods and products that can help make treatment more convenient and comfortable for patients. Recently, we had the Dental Monitoring folks come by the office and I think the 3D monitoring product has good potential to help practices; however, they will need to adjust their business model slightly to achieve maximum impact. 

Dental Monitoring is a software service that allows patients to use their smart phones to capture tooth movements and communicate them to their orthodontist. This comes in the form of simple 2D photo/video monitoring of tooth position and full 3D monitoring and rendering of tooth movements.

They currently offer three separate plans, which are billed per patient on a monthly basis and you can cancel at any time:

Dental Monitoring Subscriptions

  • Photo Monitoring ($7.90/mo, 24hr turnaround) – Intra-oral pictures are automatically organized and evaluated by their technicians for broken appliances, poor hygiene, whether established treatment goals have been met and can be used in retention to check for tooth movement.
    • DM GoLive (12hr turnaround) – Same as photo monitoring, but designed for Invisalign patients, and additional photos are taken with aligners in place. Based on the position of the teeth relative to the aligners and their aligner fit, the patient is given a ‘Go’ or ‘No Go’ to advance to the next aligner. You can specify whether the patient must take photos before each aligner change or at set intervals.
  • 3D Monitoring Lite ($9.90/mo, 48hr turnaround) – The doctor must upload an .STL file of an initial intra-oral scan (can also upload CBCT to show roots). With the photos and the locators on the the cheek retractors, the software and technicians are able to generate a 3D model of the current tooth position to within 7-9microns (company data). 3D Evaluations can only be done once a month.
  • Full 3D Monitoring (15.90/mo,  48hr turnaround, volume discounts) – The Full plan is the same as the Lite, only with unlimited 3D evaluations that can be performed during treatment. Both the Lite & Full 3D monitoring allow for quantification of dental movements.

Dental Monitoring Interface

How is this Useful to Your Practice?

The Dental Monitoring service is built on the premise that everyone now carries a smartphone; however, that also means that photo monitoring and FaceTime appointments can be implemented without purchasing additional software. We routinely do this for international and out-of-state patients already so I don’t see the photo monitoring plans offering much value to the practitioner. 

The DM GoLive, is an interesting concept, but weekly photo submissions add additional compliance burdens on patients and in my view would be counterproductive to treatment. The patients compliant enough to complete these weekly evaluations aren’t the ones need the service to help titrate their aligner wear effectively. Additionally, all of this can be implemented in-house with a team member assigned to review Invisalign compliance without additional costs.

As opposed to the 2D photo monitoring products, I think there is huge potential in the 3D monitoring plans. Since the 3D modeling is quite accurate (on par with intra-oral scanners) and quantification of individual tooth movements can be performed, as you can see in the chart below:

Quantification of Tooth MovementRemote 3D modeling, opens the door to a few important applications:

  • Scheduling Optimization – By using 3D monitoring over a specific time period with carefully selected cohorts, you can refine appointment intervals and your mechanics to optimize your schedule.
  • Reduced Appointments? – Promises of reducing the number of appointments fall a little bit flat because only appointments that don’t require the orthodontist for activation can be eliminated for the patient; otherwise, you are already over-scheduling. Where you will save appointments would be with elastic correction, self-activated appliances like Invisalign, specific space closing mechanics, etc., but this can all be done with in-house photo monitoring.
  • Streamlining Repositioning Appointments – Combining the 3D monitoring with a low-dose CBCT you have the ability to track roots, allowing you to pre-plan your reposition appointment prior to the patient arriving in the chair. This saves clinical time and allows you to evaluate root position without having to take a radiograph.
  • Virtual Retention Visits – With 3D monitoring, the stability of alignment can be evaluated without an official visit (ex: while patients are away at college). However, they need to implement pay-per-monitoring pricing for this to be most effective.
  • Treatment Research & Data-Mining – The ability to quantify individual tooth movements is going to be a huge benefit to researchers, and will help independent practitioners evaluate new products in a more objective fashion. One of the biggest problems in assessing treatment acceleration modalities is that many of the studies lack interim data between wire intervals so the exact impact on the rate of tooth movement is unclear.
  • Appliance Fabrication – The service will become exponentially more valuable when the 3D modeling can be used to fabricate appliances and retainers while saving the patient a visit. Retainers to recapture slight shifting for out of town patients  can be fabricated and sent without a visit, customized finishing archwires can be fabricated in advance of appointments, refinement scans for additional clear aligners with Invisalign, and digital removal of brackets or attachments from patient scans can be used to make final retainers are just a few of the possibilities.

The current verdict on this service is that there is big potential, but it’s main value is in the remote 3D monitoring. If you want photo monitoring only, patients already have a smart phone and the means to provide this data. Additionally, I would love to see them implement a pay-per-scan option, since many of the applications above are better suited for a single use than a monthly plan. This is especially true for retention patients and use for reposition appointments.

Greater Practice Profitability With Invisalign

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Make it Rain

A Profitable Practice with Invisalign

One of the biggest reasons why orthodontists fail to offer Invisalign to their patients is because of the ‘expensive’ Invisalign lab fee. The conventional wisdom is that while treating more clear aligner patients can increase overall practice revenue, the practice’s profitability will decline as a result of using a more expensive product. Additionally, many orthodontists feel the need to charge more for Invisalign and offer less flexible financial terms than they would with braces. These are false assumptions that need to be rectified for the benefit of our patients.

Having a profitable practice is certainly important if you want to be able to reinvest in technology to improve patient care and offer more affordable financing. However, most orthodontists, perhaps due to limited business knowledge, struggle to properly evaluate the true impact integrating new technology can have on profitability. It isn’t always simple addition and subtraction.

The rest of this post is available only to orthodontists and orthodontic residents registered with the Ortho Cosmos

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Pacing Your Growth with Invisalign

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Pace Your GrowthSetting Goals for Invisalign Growth

Many orthodontists are under the misconception that in order to increase the percentage of Invisalign in their practice they will have to burn through short term cash flow and run a less profitable business because of high lab fees. If this were true, Invisalign wouldn’t have a very successful business model.

Using Invisalign to create a more modern, leaner practice model with a more efficient clinical team, doesn’t have to strain your practice’s finances. Today we’ll discuss the most financially sensible way to make this shift. In the process, we will demonstrate that you do not need to charge patients more, and that Invisalign treatment is completely compatible with low initial down-payments and flexible financing for patients.

The rest of this post is available only to orthodontists and orthodontic residents registered with the Ortho Cosmos

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Decoding Invisalign’s Optimized Attachment & Optimized Feature Hierarchy

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Invisalign Attachment SelectionOptimized Attachment Selection

Optimized attachments and optimized aligner features are just a small part of what makes Invisalign a very powerful tool in the hands of a skilled orthodontist. Barring special instructions from the doctor, Invisalign’s software will identify and place optimized attachments based on the movements prescribed by the orthodontist. This automation helps make designing treatment more efficient, but with complex movements, thresholds are often met in the software for several competing optimizations at the same time. So how exactly does the software decide between potential options?

Invisalign’s software helps guide this process by using a number of algorithms to establish a decision tree for the automatic placement of optimized attachments. By understanding the logic behind this hierarchy…..

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