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17 AGO. 2023 · Innovation is rampant in orthodontics—to the point that we’re seeing innovation within innovation. Take 3D printing, for example. The 3D printer alone—just the printer itself—has been revolutionary. It has allowed the orthodontic practice to https://orthodonticproductsonline.com/clinical-tips/digital-workflow/cost-savings-and-control-drive-in-office-3d-printing/. But it wasn’t the 3D printer alone that facilitated this. Along the way, additional innovations were needed—chief among them the thermoforming plastic material. And now, these materials are further evolving with a new material that allows for direct 3D-printed aligners. Orthodontic Products Chief Editor Alison Werner spoke to Ki Beom Kim, DDS, PhD, the Dr Lysle Johnston Endowed Chair in Orthodontics, and the program director in the orthodontic department at the https://www.slu.edu/cade/index.php at Saint Louis University, on a recent podcast episode about a new material that allows for direct 3D-printed aligners.
Kim and his colleagues have spent the last 3 years testing the Direct Aligner photopolymer material from the South Korean 3D printing material company http://itgraphy.com/ENG/. Their findings were recently published in https://progressinorthodontics.springeropen.com/articles/10.1186/s40510-022-00443-2. The team found that controlling material dimensions, structure, and properties of aligners directly—compared to thermoforming plastic sheets—has the potential to make the process of tooth movement faster, less wasteful, and more precise.
- “If you have a 3D printer, you can now directly print this aligner without having [a] model, without going through the thermoforming process,” said Kim, adding that, with this new FDA approved material, the in-office lab can skip several steps in the current manufacturing workflow, including cutting out the aligners and polishing before delivery to the patient.
- What’s more, according to Kim, with a direct printed aligner, the clinician can more precisely control the thickness and insert bumps as needed. Kim shared that he and his team found that when the orthodontist can control the thickness they can “control the geometric inside of the aligner.” That, and the ability to add bumps, creates a huge opportunity for the orthodontist because it helps reduce the need for attachments, he said.
For Kim, the shape memory polymer used to make the material is very interesting.
- He says it somewhat mimics the behavior of NiTi wire. The difference being that a NiTi wire can be exposed to cold temperature to become more flexible, while this Direct Aligner material becomes totally flexible when placed in warm/hot water. The advantage of this shape memory, according to Kim, is that the patient can maintain the shape—and thus the forces—of the aligner at home. Kim points out that patients remove their aligner up to 10 to 20 times a day to eat. “So think about the plastic deformation” every time they remove the aligner, said Kim. But with this material and some warm water, the shape can be restored. Kim uses the analogy of a deformed plastic Coke bottle. Once it’s deformed, it’s not going back to its original shape. But with this material, he can advise patients to put their aligner in warm water at the end of the day if they notice it’s not tight enough. “It will go back to the original shape so they can maintain [a better fit] every day,” he added.
Now when it comes to forces, Kim shares he has been able to apply bigger activations per aligner, thus saving time in treatment and decreasing the number of aligners over the course of treatment. With traditional thermoforming plastics, Kim points out, something like a .5 mm activation per aligner can create a force level that causes the patient too much discomfort and even pain. But with this material, Kim can do that.
- “I’m constantly putting .5 mm activations and even 5° rotation per aligner, and then have patients wear [the aligner] just a little bit longer—maybe 2 weeks. Sometimes we go longer,” said Kim, adding that with a standard activation of .25 mm per aligner, to move 1 mm you need four aligners. “But if I can put .5 mm activation per aligner [and] have them wear [it] for 2 weeks, then I need only two aligners.”
In this episode, Kim also talks about the hardware requirements, including 3D printer compatibility with the material needed, and the need for a specific type of curing machine. He also talks about the staging software needed to plan cases using direct 3D-printed aligners. What’s more, he talks about retention and his plans to test an on-site retainer-bending machine from https://www.yoatcorp.com/, a medical technology manufacturer based in Seattle. OP
9 JUN. 2023 · Infection prevention expert Jackie Dorst, RDH, BS, is back on the Orthodontic Products podcast to talk to host Alison Werner about the end of the COVID-19 public health emergency and what is means for the orthodontic practice.
The COVID-19 public health emergency, issued on January 31, 2020, by the U.S. government put in place temporary measures to increase the federal government’s ability to detect and contain the virus. On May 11, 2023, the U.S. Department of Health and Human Services allowed the public health emergency to expire. This will bring an end to a number of programs, including those that gave access to free vaccines and treatment for COVID infections. But, as Dorst explains in this episode, the sunsetting of the CDC’s COVID data tracking efforts will have the most impact on the healthcare sector. As Dorst explains, that data provided information on community infectivity which could be used to guide the sector’s infection control protocols.
In this episode, Dorst breaks down what the end of the public health emergency means for orthodontic practices and her recommendations going forward. She points to the end of staff and patient health screenings for COVID, but reminds practices that basic health screening is still important to protect staff and other patients from other infections. Dorst also talks about the importance of having a return to work policy for staff members who are ill, whether it’s COVID or not and the role masking can still play in the practice beyond those procedures that result in splatters and splashes. And from there, Dorst reminds listeners that OSHA’s respiratory protection standard, which predates the COVID-19 pandemic, and vaccine guidelines are unaffected by the end of the public health emergency. She talks about best practices and shares resources for practices.
To close out the episode on the public health emergency, Dorst addresses the CDC’s recent announcement regarding ventilation in buildings and public spaces. And while it doesn’t pertain to healthcare spaces, she reminds listeners of the CDC guidance for healthcare spaces, including orthodontic offices. OP
Resources mentioned in this episode:
Immunize.org—Healthcare Personnel Vaccination Recommendations
31 MAY. 2023 · In this podcast, American Association of Orthodontists (AAO) President Myron Guymon, DDS, MS, joins host Alison Werner for the Orthodontic Products podcast on the Medqor Podcast Network. Guymon, who just started his 1-year term as AAO president, shares his priorities for his term and talks about the ongoing work of the AAO.
Guymon, who is a graduate of Baylor Dental College (now known as Texas A&M School of Dentistry) and went on to open his practice in northern Utah, started in leadership at the component level with the Utah Association of Orthodontists before moving on to leadership roles within the Rocky Mountain Society of Orthodontists. As he was closing out his presidency of the Utah state association, he had his first opportunity to become involved with the AAO with its Council on Communications.
In this episode, Guymon talks about the benefits of being involved in state, regional, and national orthodontic associations. As Guymon says, “We are so much better together as a group.” At the same time, he acknowledges that not every orthodontist wants to get involved in leadership; but there are still a myriad of opportunities to still get involved and make a difference—whether it’s serving on a committee or task force, or simply sending a text to a legislator.
Guymon, who stepped into his term as AAO president for 2023-2024 at the close of the recent AAO Annual Session in Chicago, shares that his number one priority for his term is to be help shepherd the many initiatives that have been launched in recent years—such as TechSelect and the New Product Showcase. As Guymon puts it, the AAO seeks to support and encourage innovation in the profession.
From there, Guymon talks about the latest campaign from the AAO Consumer Awareness Program—or CAP—and the association’s advocacy work. At the federal level, the AAO remains focused on such issues as student load relief and the RAISE Act. But it’s at the state and regulatory level, that Guymon says the AAO has been able to have a more immediate impact. He talks about the AAO’s approach and how its team has been able to monitor and react quickly to ensure the health and safety of the profession and patients.
In this interview, Guymon also shares his thoughts on how the profession has evolved, the AAO’s diversity and inclusion work and upcoming Winter Conference in San Antonio and next Annual Session in New Orleans, and how the AAO can work with DSOs/OSOs. OP
17 MAY. 2023 · In this podcast, sponsored by DentalMonitoring, Orthodontic Products Chief Editor Alison Werner is joined by Blake Davis, DDS, an orthodontist in private practice at Kirkland Redmond Orthodontics in Washington to talk about remote monitoring, the role it plays in practice growth, and how it fits into the digital workflow of today’s orthodontic practice.
When Davis started his private practice 6 years ago, he was limited on space; the only spaces available were under 1,200 feet. But within this space, Davis built out four chairs and relied on technology and a digital workflow to make that small space as useful and productive as possible.
Three year’s later, Davis’ practice went a step further and went fully digital—adopting customized treatment for both aligners and brackets, and with that remote monitoring—all in an effort to grow the practice.
As Davis describes it, the decision to go fully digital was a big one, but it was also purposeful and intentional. And a key component of that was choosing the right technologies. On the bracket front, that was LightForce’s custom 3D-printed bracket system. And for remote monitoring, it was DentalMonitoring. That platform, he says, allowed him to “exponentially grow and change” his practice’s capacity.
In the 2+ years since implementing DentalMonitoring, Davis says his practice has seen increased production, starts, and volume, all while not growing the team—and having more time to spend with family.
Davis, who didn’t implement DentalMonitoring until the latter half of 2020, talks about he relied on a self-created app in the early days of the pandemic to monitor patients virtually. But he and his staff could only manage 50 to 60 patients at a time. Knowing he needed a more robust system to expand, he turned to DentalMonitoring and with its AI tools now monitors close to 1,000 patients in his practice. DentalMonitoring, he says, has allowed him to increase his practice’s capacity without adding additional salaries or infrastructure costs.
In this episode, Davis not only shares the advice he was given when implementing DentalMonitoring—to go all in and use it with both his bracket and aligner patients—but also how DentalMonitoring has been key to growing his practice while keeping his fixed costs in check. He also talks about the data he looks at to know that this platform is helping him grow and giving him the ROI he needs to know this is a worthwhile investment. What’s more, he talks about how his practice manages patients using DentalMonitoring, including the staffing and scheduling considerations. OP
11 MAY. 2023 · In this podcast episode, host Alison Werner is joined by Deborah Solomon, DDS, an orthodontist in private practice in Beverly Hills and Los Angeles to talk about her boutique practice, which includes an at-home concierge service, and why she recently implemented a Retainers for Life program into her practice.
To get started, Solomon talks about how she spent the first part of her career as an active-duty general dentist with the U.S. Air Force and then worked for a corporate practice after finishing her orthodontics residency. It wasn’t until the pandemic hit, when she had time on her hands, that she decided it was time to start her own practice from scratch. Solomon shares how two local dentists—one a general dentist, the other a pediatric dentist—helped her start her boutique practice, offering her space within their practices. The two doctors seeing her work were soon referring their patients to her.
The pandemic was also the reason Solomon built out an at-home concierge service. The city of Beverly Hills had stricter rules than the city of Los Angeles around orthodontists seeing patients in-person in those early days. To keep seeing patients in her boutique practice, Solomon took advantage of the fact that she had an iTero Flex intraoral scanner from Align Technology and a portable dental unit and hit the road. In this episode, she shares what the set up looks like for her and her assistant; why this is a great way to connect with the rest of the patient’s family, and how this service can be a great way to connect with and serve immunocompromised patients and those with anxiety.
From there, Solomon talks about how she recently implemented a Retainers for Life program into her boutique practice. Solomon’s goal is to make the program affordable for her patients and to make it something they sign up for when they sign up for orthodontic treatment. She breaks down her fees and how her treatment coordinator includes it as part of the initial consultation. As Solomon puts it, “No patient starts treatment without understanding that you need to do retainers after.”
Finally, Solomon talks about the orthodontic technologies and products that have her attention—from uLab Systems and Brava by Brius to 3D printing; and how she has carved out a niche for herself in the very saturated Los Angeles orthodontic market with a boutique practice that stands out with its unique at-home concierge and retainers for life offerings. OP
21 ABR. 2023 · In this episode, sponsored by https://www.straumann.com/clearcorrect/en/doctors.html, Orthodontic Products Chief Editor Alison Werner talks to https://www.drloweortho.com/, an orthodontist in private practice in Fresno, Calif. A frequent lecturer on aligner therapy, he joins the podcast to talk about aligner treatment, why he’s opted to use ClearCorrect aligners in his practice, and the features the brand brings to the table.
In practice since 1991, Lowe is an early adopter of clear aligners, and has watched the treatment modality evolve over the last 25 years. Digital technology has been a key driver of the evolution in aligner treatment, he says, even more so in the last 5 years. But it’s not just intraoral scanning, treatment planning, remote monitoring, and AI technology that have moved the treatment modality forward; the thermal plastics have increased the range and predictability of movement. As Lowe puts it, there has been “tremendous change” in the last 5 years.
Lowe has been a ClearCorrect user for much of his career. He shares how he initially came to the brand with the intention of treating mild malocclusions with aligners, but after using it for some time, he saw how the ClearCorrect aligners could be effective with moderate and then more complex malocclusions. What’s more, he talks about patient response to the aligners. At times, Lowe has used other aligner brands in his practice—and has even used multiple aligner brands with the same patient, which allowed him to receive some unique patient feedback. One point they made, they preferred ClearCorrect’s high trimline over the scalloped trimline found on other brands. That increased comfort translates into better retention and more predictable movement, according to Lowe.
As Lowe talks about the more predictable movement that comes with better retention, he makes the point that more predictable movement allows him to avoid using a lot of attachments. Lowe believes much of aligner therapy today is over engineered, with an over reliance on attachments. From a clinical standpoint, for him, ClearCorrect’s high trimline allows him to treat the way he wants to treat.
In this episode, Lowe also talks about ClearPilot 6.0, ClearCorrect’s latest https://orthodonticproductsonline.com/practice-products/software/treatment-planning/clearcorrect-releases-clearpilot-5-0/ and its global footprint. ClearCorrect accepts scans from multiple intraoral scanners when planning aligner treatment. In addition, the company has the ClearCorrect Clinic app which the team can use to communicate with and educate patients. He also shares how he appreciates his relationship to ClearCorrect and the fact that they listen to experienced clinicians as they seek to improve the product. As he says, “They understand that the orthodontist is truly their customer.”
Lowe also shares his experience growing his solo orthodontic practice and working with a pediatric dentistry group practice. He talks about the benefits and challenges of each, balancing his clinical and business owner roles, and the dynamics of the two practices. In addition, he talks about how he has embraced remote monitoring to make treating patients who are on the go easier and more efficient. OP
20 ABR. 2023 · In this episode, sponsored by https://ormco.com/en-us, Orthodontic Products Chief Editor Alison Werner takes a deep dive into the company’s Damon Ultima System, with https://smilesbyaos.com/michael-bicknell-orthodontist-elmhurst-il/, an orthodontist in private practice in Illinois. Bicknell, who was part of the team of clinicians who validated the system before its roll out in 2021, has since transitioned his practice into a full-Ultima practice, giving him a keen understanding of the https://orthodonticproductsonline.com/treatment-products/brackets-wires/brackets/close-up-look-new-damon-ultima-system-ormco/.
As a frequent lecturer, Bicknell talks about the evolution of brackets and how the biggest challenge has always been an issue of geometry. With the Damon Ultima System, Bicknell sees a pre-manufactured bracket that is able to apply forces in three dimensions that are predictable and exact, addressing that issue of geometry.
Bicknell is quick to point out that Ultima isn’t an upgrade of a previous version of Damon passive self-ligating brackets. As he says, “What Ormco did is they went back to the drawing board, and they tried to get their engineers and people in the same room to develop a system of brackets and wires that are engineered to work together from the ground up to deliver a certain expectation.” And that expectation was to create a “pure system that would put the teeth where they want to go in about a year, but also have a passive system.” Damon Ultima was designed so that the brackets and wires talk to each other and express exactly what the orthodontist wants, says Bicknell. He further explains that this system eliminates the times that you, as the orthodontist, aren’t moving teeth. That translates into fewer visits and shorter treatment time.
In this episode, Bicknell shares how the Ultima system has impacted his cases and finishes, practice productivity, and how it allows his team to feel like experts. What’s more, he talks about how this has translated into improved job satisfaction for his staff at a time with many practices are facing staffing shortages.
Bicknell, who has been practicing for 20 years, talks about how he is so much more excited about orthodontics now than he has ever been. For him, the juxtaposition of enhanced technology and manufacturing capabilities are allowing more exciting products to come to market. As he says, “If we can invent something, but we can’t make it, what’s the point?” What’s more, he points out that products and technology have evolved so that the treatment pathway is not only a straighter line, but a shorter one as well.
In addition to sharing his experience with Damon Ultima System, Bicknell shares his experience building his two-office practice west of Chicago. He talks about the differences between building a practice from the ground up and acquiring an established practice. And finally, he shares what excites him about the future of orthodontics. OP
29 MAR. 2023 · Orthodontic Products and Levin Group teamed up again for the 2nd Annual Orthodontic Practice Performance Survey to find out how practices faired in 2022. In this podcast, Orthodontic Products Chief Editor Alison Werner is joined by Roger P. Levin, DDS, founder and CEO of the practice management consulting firm, Levin Group, to take a deep dive into the results. Levin shares strategies to help listeners navigate the impact of increased overhead costs and economic uncertainty in the year ahead.
23 MAR. 2023 · Join Orthodontic Products’ Chief Editor Alison Werner as she talks with Alyssa Emory-Carter, DDS, MS. In this podcast episode, sponsored by https://ormco.com/en-us, Emory-Carter, who is in private practice in Texas, https://orthodonticproductsonline.com/practice-management/practice-profiles/how-choosing-right-aligner-system-can-help-build-practice/, and how she is using https://ormco.com/en-us/spark in her practice and the benefits she has found, from achieving better outcomes and to more efficient systems.
Only 6 years out of her residency, Emory-Carter is early in her career. But in that short time, she has taken ownership of three orthodontic offices, starting with the one owned by the orthodontist who treated her as a child. Each office has one thing in common—it serves the community she grew up in. In this episode, Emory-Carter shares how she knew the time was right to jump on these opportunities and why the decision is about more than potential extra income.
From there, Emory-Carter talks about building out these offices to run at full capacity, and how staffing, systems, and technology have been key. Included in that is Ormco’s Spark Clear Aligners. Emory-Carter talks about how each of the offices she bought didn’t previously offer aligners and shares how she integrated them and got staff to see the benefits to the system. Emory-Carter talks about the benefits of Spark Clear Aligners, from the integrated hooks and CBCT integration in the software platform to the proprietary TruGEN materials used to manufacture the aligners. What’s more, Emory-Carter talks about the results of her own in-office analysis comparing Spark to other clear aligner brands. A key finding was how many fewer refinements she was doing with Spark Clear Aligners. This translates into less patient burnout, better compliance, and shorter treatment times.
In this episode, Emory-Carter also talks about both her patients’ and her staff’s experience with Spark. She shares how the former find the aligners comfortable and less likely to stain, while the latter appreciates the attachment template and the Spark dashboard.
To round out the episode, Emory-Carter talks about the role remote monitoring plays in managing her aligner cases and the technology that she has on her radar. OP
9 MAR. 2023 · As an orthodontist, you are always looking for ways to improve your practice and provide the best possible care for your patients—and clear aligners can meet both those needs simultaneously. Join Orthodontic Products Chief Editor Alison Werner as she talks to https://www.smiledesignmanhattan.com/, a dual certified orthodontist and periodontist in private practice in New York City, about the many benefits of clear aligners, how they impact the practice, and why he has chosen https://www.straumann.com/clearcorrect/us/en/patients.html for his patients.
First, Berant shares his experience working in a multi-specialty practice, Smile Design Manhattan, founded by Lee Gause, DDS, a cosmetic dentist, and how his own multi-disciplinary approach to care ensures not only a beautiful smile, but also healthy teeth. In addition, Berant talks about how rewarding it can be to work with a team to ensure excellent patient care.
From there Berant talks about why he prefers to work with ClearCorrect aligners to treat his cases. One of the key reasons he was drawn to ClearCorrect was its parent company, Straumann Group. As a periodontist, he was familiar with many of their subsidiaries and their product lines. When ClearCorrect came under the Straumann Group umbrella, Berant saw an opportunity for synergies in how he practices.
Berant offers his take on patient experience with ClearCorrect aligners. He points to the fact that patients seem happy with the fit. Given that an aligner that isn’t fitting properly can quickly lead to poor tracking and patient non-compliance, Berant welcomes the fact that he sees less of this with the ClearCorrect aligners, keeping treatment plans on track and finishes on time.
In this podcast, Berant also shares his take on the ClearCorrect https://orthodonticproductsonline.com/practice-products/software/treatment-planning/clearcorrect-releases-clearpilot-5-0/. He shares how he appreciates that ClearCorrect has given the clinician the freedom to place the attachments and cutouts where and how they want them, while also providing responsive customer support.
For Berant, digital technology and aligners go hand in hand when it comes to practice growth. He shares how the ability to use the treatment planning software to show potential aligner patients their final smile during a consult eliminates the need to “sell” patients on treatment. And he shares his decision-making process for deciding on an aligner brand for his patients.
To close out the episode, Berant puts on his periodontist and orthodontist hats simultaneously and talks about how orthodontics fits into overall oral health. He shares a story about the daughter of one of his patients and how recognizing that her teeth grinding was related to an airway problem helped get her the treatment she needed to find better overall health and improve academically.
Información
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| podcasts@medqor.com |
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