In Orthodontics as in all other areas related to health, it is essential to integrate new technologies into our daily practice, which undoubtedly assists us in formulating a good diagnosis, makes treatments more predictable and improves the effectiveness of our results. That’s one of our secrets to maintaining our top rating as an orthodontist in Chester.
I decided to take the plunge into the digital world about 2 years ago when the technology available was already sufficiently developed and accurate to be considered a useful and valid tool for my daily practice. I purchased my first 3Shape TRIOS® scanner from ESM Digital Solutions back then and it has completely changed the way we work. We have embraced this new technology and this has allowed us to move from an analog to a fully digital workflow.
So how has does 3Shape TRIOS® work for my practice?
No more analog
We no longer use alginate, PVS or plaster models. We scan all our patients in order to obtain initial study models prior to starting treatment. This saves us infinite amounts of storage requirements (as we legally need to keep these for 11 years), saves cost on impression materials and shipping costs to Labs.
Ultimately, it is the benefit to our patients that makes this such an appealing advantage. Patient comfort is paramount. Patients do not experience that sensation of suffocation, no horrible gag reflexes (especially in children) and no unpleasant taste or smells. Scanning is far more tolerable, fast and comfortable than traditional impressions.
Diagnosis and treatment planning
Scanning is much more than just a storage solution. With the aid of 3Shape Orthoanalyzer® software, we can also diagnose, treatment plan and execute our cases.
- We can diagnose and measure dental discrepancies (Bolton analysis, tooth size anomalies, space requirements, etc.).
- We can do virtual set-ups: we can move teeth, simulate the effect of dental extractions and arch expansions, etc. This not only gives us valuable information prior to executing any irreversible dental procedure but it also gives our patients a visual representation of what their teeth might look like before they even start their treatment: we can start our treatments with the end in mind.
This is probably one of the main clinical reasons I decided to embrace the technology as I have always been a passionate advocate of indirect placement of brackets. For years I placed brackets directly on stone models and fabricated my transfer jigs in order to place these directly onto the patient’s teeth. Although accurate, this analog method was time-consuming and became logistically unfeasible. Digital indirect bonding, on the other hand, is quick, precise and extremely easy to use. I scan the patients with my TRIOS®, place my brackets virtually with Orthoanalyzer®, create the transfer jigs with Appliance designer and directly print these inhouse on our 3D printer.
Our treatment philosophy is characterised by clearly defined treatment goals. Possibly the most important of these goals is to have healthy and stable Temperomandibular joints (TMJ’s) before, during and after orthodontic treatment. In my practice we first need to stabilise any articular problems before embarking on any irreversible orthodontic treatment. We scan the patient, design and 3D print the splint in much the same way we produce our indirect bonding trays.
Integration with external companies
We offer a variety of treatment modalities including Invisalign and Lingual orthodontics. 3Shape TRIOS® is the only external scanner that can directly send stl. files to Invisalign®. This partnership had a huge impact on my decision to choose TRIOS® over other scanners in the market. Being an Invisalign provider, I wanted a scanner that would also work for my Invisalign® patients.
Communication with labs
Scanning with TRIOS® allows us to send stl. files directly to the lab in the click of a button. Communication is easier, less turn around times, less shipping costs. The benefits are mutual, and it’s a much more effective way to work. Because of the virtual nature of this partnership, any issues, doubts or problems can be dealt with instantly.
Many of our cases will require a degree of interdisciplinary treatment planning (especially with adult patients), be it with our restorative, Implantologist or maxillofacial colleagues. Being able to accurately communicate, exchange ideas and formulate/execute combined decisions is paramount.
Mid treatment records
Very often in orthodontics, we need to stop, analyse our progress and make any changes required before finishing our cases. It is normal for us to take mid-course records to make sure we are on the right track. With TRIOS® it is very east to take a scan even if patients have brackets bonded to their teeth.
One of the biggest advantages of using TRIOS® is being able to take a scan of both jaws whilst brackets are still bonded and sending them off to the lab for them to design and fabricate the patient’s retainers. With Orthoanalyzer®, we can virtually remove the brackets and have the retainers ready on the day we debond. This optimises our workflow incredibly and there is less risk of teeth relapsing as we don’t have to wait for them to come back after the appliance is removed. Less time means less risk. Similarly, if a patient has lost or broken a retainer and assuming the time-lapse isn’t long, we have the ability to send them a new one immediately without the need for a new scan.
The incorporation of digital technologies in orthodontics have brought many exciting changes in recent years, but most of these technologies require a commitment from both the orthodontist and the manufacturer in order to make the workflow efficient and effective. One of the most innovative aspects of digital integration in dentistry has been the advent of digital intraoral scanning like the TRIOS 3Shape® scanner.
Although traditional impression-taking techniques have proven to be accurate for generations, they can be uncomfortable for patients. The speed and accuracy of this technology allows for greater precision and less error. In addition, it greatly improves the communication between the clinicians and the laboratory. In a recent pole we took, 100% of our patients preferred digital scanning to traditional methods with impression materials.
How do I sum up my experience with TRIOS 3Shape®?
I see it as a contemporary technological breakthrough that provides a better and more comfortable experience for both myself and my patients. Once you embrace this technology and the numerous advantages that inadvertently come with it, it is very hard to go back to an old and outdated analog world.