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Choosing the Right Clear Aligner System

Clear aligners have revolutionized orthodontic treatment, providing an effective and discreet alternative to traditional braces. As a dentist, one of the key decisions you'll make when offering clear aligner therapy is selecting the right aligner system. This choice impacts various aspects of your practice, from software user friendliness and CBCT integration to the production of the aligners themselves. In this blog post, we'll delve into the factors that dentists should consider when choosing a clear aligner system.


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Software User Friendliness:

The ease of use and functionality of the aligner system's software is a crucial factor for dentists. A user-friendly interface and intuitive workflow are essential to streamline treatment planning, case submission, and progress tracking. Look for aligner systems with robust treatment planning software that allows for efficient virtual setups, adjustments, and modifications. Additionally, features like 3D visualization, digital models, and treatment simulation can greatly enhance patient communication and engagement.

There are a lot of options on the market and choosing the right system based on the software alone can be a challenging task if you don't have any experience with clear aligner treatments. As a rule of thumb you should expect the largest aligner companies in the world to have the best software. However even among the 4 biggest systems (Invisalign, ClearCorrect, SureSmile and Spark) you will find the planning software to vary highly in their user friendliness and in their ability for you to actually control what is going on in the different stages of the treatment plan (a rather crucial factor if you ask me).


Please be aware that not all aligner companies enable your intraoral scanner to work with their software.


CBCT Integration

Cone Beam Computed Tomography (CBCT) has become an invaluable tool in modern dentistry. When choosing a clear aligner system, it's beneficial to opt for one that integrates seamlessly with CBCT technology. CBCT scans can provide detailed 3D imaging, allowing for accurate evaluation of dental and skeletal structures. This integration facilitates more precise treatment planning, assessment of root positions, identification of impactions, and evaluation of bone quality—all of which contribute to more predictable treatment outcomes. That is at leaset the vision. Currently no system on the market has a CBCT integration that can be used for this purpose for real as they all rely on the visualisation of the surface and not on the raw x-ray data. This means you currently can only use the CBCT integration as a very rough indicator of wether teeth stay within the bone or not. However this kind of information is not enough and with the current way the information is presented also of limited validity.


Why then choose a system with CBCT integration or plans to integrate CBCT in the planning software. Because in the future we believe this will be an invaluable tool. Especially in the complex cases. In simple cases it is rarely of any use and would probably even be considered malpractice to radiate a patient just for an evaluation that was unnecessary for the procedure. But for the complex cases it is a totally different story.


We may be wrong. But we believe, that the 4 biggest clear aligner providers (ClearCorrect, Invisalign, Spark and SureSmile) are companies with more financial muscles than any other company in this market. As a consequence they are also the companies with the highest probability of getting this software integration right and make it work in an ideal way in combination with the other factors we describe in this blog post.


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Aligner Production Process:

Understanding the aligner production process is crucial for dentists. Some aligner systems produce their own aligners, others outsource the production of aligners to external labs, while others offer in-house manufacturing capabilities. All options have their pros and cons.


Industrial production

In a world with growing challenges with transportation of goods and geopolitical changes it may be worth considering where the aligners are being produced. Ideally the aligners are being produced in a factory like setting with streamlined robotic production of the aligners after the highest industrial standards. So far to our knowledge only the 4 biggest aligner brands are able to produce their own aligners in 3-4 different regions of the world in high quality industrial production facilities.


Outsourcing

Outsourcing aligner production saves time and equipment costs but may result in longer turnaround times. In addition we have experienced the quality of the aligners to be poorer than the industrialised production the 4 biggest aligner companies use. This has a direct effect on the treatment results. Some of the orthodontists in our treatment planning team have tried out several different clear aligner brands. Their conclusions are very clear: The bigger the brand the more precise the aligners and thereby the more predictable the treatment outcomes become.

If you don't want to spend more chair time than necessary on a clear aligner treatment. It is worth considering this factor in the total workflow.


Do it yourself

In-house production allows for better control over the manufacturing process, shorter delivery times, and easier adjustments. In recent years this option has grown in popularity. Although it is still a fraction of all aligners produced this way. There are however a lot of factors, that we would like to address.

  1. The production is time consuming and requires a lot of work performed by the team in the dental office. No matter the location of the practice. It is hard to argue this is a profitable alternative to the biggest aligner brands although the lab costs are considerable.

  2. In-House production requires an internal laboratory handling all the steps from design software, 3D printing, curing, trimming models, producing the aligners and packaging the aligners. The 3D printing process alone has so many potenital sources of error, that we do not recommend in-house production at all. Add to this the software has to be completely calibrated with the 3D printing proces and enable the doctor to control every single movement during treatment. So far we have not seen any software on the marked for in-house production able to do this. Should you choose to utilise this workflow. Please don't use a vacuum only or a pressure only machine to produce your aligners. It has to be a machine combining vacuum and pressure at the same time. In addition choose the aligner material available on the marked that the 4 biggest aligner companies use in their production. There is a reason they spend millions of dollars om material research.

  3. Most in-house 3D printers today are unable to handle reusable printable plastic. Just think about the amount of plastic that is piling up in the world just due to clear aligner production. We know that ClearCorrect is using a resin for their models that is being recycled. With a growing focus on the environment this is a factor that should be taken into account as well.

  4. It looks so cool. But is time consuming, costly and delivers a poorer quality of aligners than the other options. Therefore we consider this option to be an option for the geeks that really like to spend time on the processes and their machines rather than running a profitable practice. And it is perfectly fine if you like this.

In conclusion: Consider your practice's workflow and patient volume when evaluating the aligner production process.


Treatment Planning Support

Effective comprehensive diagnostics and treatment planning is a cornerstone of successful clear aligner therapy. Look for comprehensive treatment planning support, such as access to experienced orthodontists and highly experienced GP's (1000+ clear aligner treatment plans) who can assist with case selection, treatment strategies, and complex orthodontic movements. Having access to professional guidance will enhance clinical outcomes and boost confidence, especially for dentists who are new to clear aligner treatment.


Continuing Education and Support

This is vital when incorporating a new clear aligner system into your practice. Ensure that the aligner system you choose offers comprehensive training programs, webinars, and online resources to keep you updated on the latest techniques and advancements.


Reliable technical support is also crucial, so consider aligner systems with responsive customer service to address any technical or clinical concerns promptly. Even among the major four (ClearCorrect, Spark, SureSmile and Invisalign) the quality and responsiveness of the support varies considerably. Some companies are highly focused on you to sell more aligner treatment while others are focused on you having a great experience where you feel comfortable and confident during the entire integration process. This part is not to be considered lightly. There is nothing worse than having a problem in the practice being unable to get the support you need NOW.


Conclusion

Choosing the right clear aligner system is a significant decision that impacts your practice's efficiency, patient satisfaction, and treatment outcomes. By evaluating factors such as software user friendliness, CBCT integration, aligner production process, treatment planning support, and continuing education, you can make an informed choice that aligns with your practice's unique requirements. Remember, a well-chosen clear aligner system can streamline your workflow, enhance patient experience, and contribute to the success of your orthodontic treatments.


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Dentist Jesper Hatt

Many kind regards

Jesper Hatt DDS



Phone: +41 78 268 0078


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