How digital orthodontics is changing us

The advent of intraoral scanners, Digital Smile Design, 3D radiographs and different processing software has turned orthodontic treatment planning upside down.

The best known technique that uses digitalization is invisible orthodontics, especially invisalign, which, through its Clincheck software, allows us to plan in a three-dimensional way the movements we want in each tooth so that they are in perfect occlusion, function and esthetics. In addition, the patient can be shown a simulation of what the treatment will be like and the final result of the treatment.

With the software and the three-dimensional reconstruction of each individual patient’s case, we are able to know in advance what number of aligners we need and, since they have a time of use, we will know the approximate treatment duration our patient needs. This time may vary depending on certain factors, that is why it is always reported as “approximate”.

To start an invisalign treatment it is necessary to perform an intraoral digital scan or a scan of some impressions of the teeth made with a special material called silicone, some x-rays and digital photos of our patients. All this material is sent to the invisalign centers in STL files, the digital information is processed and three-dimensional images are developed with which we can see and work with our patient.

According to the clinical history with our patient, his needs and the clinical decisions of the professional, it will be decided which movements should be performed on our patient’s teeth. All these movements are controlled in 3D and digitally, and as many modifications as necessary can be made until an ideal and predictable result is obtained.

Once we are satisfied with the clinical result, is when we quote our patient and share digitally his clinical solution so that he can participate and see in animation how his mouth was, how his teeth are moving, how his treatment evolves and in which position his teeth will end up, both aesthetically and functionally.

Through the same Clincheck software, the progress of the treatment can be checked digitally each time the patient comes to the office, confirming that the movements are being performed correctly, and it also serves as an excellent tool for the patient to compare and see his or her evolution month by month with the beginning of the treatment.

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There are also other techniques that use this type of technology: Incognito (lingual orthodontics) and Insignia (vestibular orthodontics); these are techniques that use custom brackets made to measure, which are designed exclusively for each patient’s teeth. We also manufacture the archwires to be used according to the desired movement and the diagnosed malocclusion. All these techniques require a digital scan that generates an STL file that will be processed by the software of each technique or, failing that, a digitalization of silicone impressions.

In addition, by means of Digital Smile Design we can also simulate the changes in the teeth to be treated. This technique, DSD, will give us a valuable aid so that patients (whatever the orthodontic treatment to be performed (conventional brackets, porcelain or any appliance) can see themselves in their own mouth, in front of a mirror, before starting treatment. We will elaborate on this in more depth in a specific installment of DSD. A key example is when we have defects in the size of the teeth, called Bolton spaces, being able to perform a small simulation of how the smile will look if we add composite restorations, veneers, etc. at the end of treatment or if we do not add anything.

The 3D radiographs of the complete skull (CT and CBCT both digital) help us to plan not only dental movements, but also the movements made by the maxilla and/or mandible, in those patients who may have to receive combined orthodontic treatment with maxillofacial surgery.

In order to make use of all these tools that technology gives us, it is necessary to carry out a previous analysis, which must consist of intraoral photos, facial photos, study models and/or intraoral scanner, and something very important that can never be forgotten: the diagnosis and clinical history carried out by our most qualified professionals in Dentistry.