The orthodontic profession needs to adapt, and embrace advancements, trying to implement and simplify digital technologies in the daily orthodontic workflow. By adapting to change, we are today comparable to a situation in history, when travelling by plane became more regular, some adaptive sail-makers started to deliver their canvas to the plane-builders as a cover for the wing-frame-work, instead of disappearing with the vanishing sailboats. I do not advocate blind adoption, but a thorough evaluation of all that there is to offer. Of course there are always new technologies that will fail, or lead to a dead-end. The easiest way is to evaluate if there's a benefit in a new available technology for an orthodontist, is to ask, "if the patient can profit from it? Not just the orthodontist!"
In an era of instant gratification, people desire the needs to go faster nowadays, and having a look at the success of companies, delivering a new smile for the patients to their homes, obviously there's a high demand for reducing the chair-side time in the orthodontic office. The process demonstrated in this article is an innovation that can benefit chair-side efficacy and open new possibilities to direct metal printing in orthodontics, an area that is generating a lot of interest.
The intraoral scanner used in this procedure was the Trios 2 from 3Shape (Copenhagen, Denmark). Of course, the STL-file (surface tessellation language, three-dimensional non-colored data) can be produced with a lab-scanner or CT, or from the impression-tray/gypsum-cast directly. The STL-file from the jaw needs to be imported in software where it's possible to manipulate three-dimensional files. In this virtual space, the orthodontic appliance can be designed. First the tooth surface needs to be defined, then the distance between tooth surface and appliance should be locked, so it will be always the same. Now it's possible to design the bonding site of the appliance. It can have the same shape as a classic molar band, just not passing through the contact-points to the neighboring tooth, or like a C-clasp shape from partial prosthodontics or just a supportive stick following the shape of the tooth. From that point there are no limits for the appliance design. Starting from a space-maintainer, a rapid-palatal expander, a trans-palatal arch, a lingual arch, to a Herbst-appliance or a mandibular advancement (MARA) appliance is possible.