One of the flip sides of the Covid – 19 situation is that the Identiti team have had time to experiment with the excellent aligner software from 3shape and are delighted to announce they are now able to produce aligners as an additional tooth moving solution to their clients. Changing times and ever changing advice about AGP’s has driven this useful addition to the product range. Both Sue and Rob use 3shape and Cliodhna from Dublin based ESM has also joined them for some remote training sessions to highlight some of the features and workflows within the software.
Rob – from a clinical view I have never really been a fan of aligners, I much prefer fixed appliances because they enable one to adapt to changes that happen during treatment. Teeth do not always move as you expect them to and aligners set the treatment from the start. While revisions can be done, the teeth can take a lot longer to move from that point if say a tooth loses space and becomes more rotated. But, in this present climate we felt that an aligner option would be very useful.
Sue – I don’t think many of my clients will be surprised when I say I’ve not been a fan of aligners in the past either. Using the updated software has changed my view, it allows you to program the parameters you will allow per aligner. We have set up a few different options as we feel that finishing aligners from a recently debonded fixed case will tolerate a great degree of movement than aligners that are treating a case from day 1.
Rob – indeed, myself and others on the Identiti training team have got together and decided on the parameters for different scenarios. It is pointless pushing the limits of movement, the treatment won’t work and everyone will be dissatisfied. This sadly often comes back as a complaint against the lab, I understand how frustrating this can be for the technician (I qualified and worked as a technician before going on to become a dentist and then onto specialist training). I think Sue finds it quite handy to be able to say “Computer says no” if a client is pushing the boundaries of what we are comfortable will work.
Rob – and patient compliance is key, it’s really important to continually motivate patients who can be a bit lax with wearing the aligners. Interestingly they tend not to work so well if worn inside a pocket!
Sue – I’m also impressed with other elements, as well as calculating the number of aligners needed from the set up based on the parameters you chose, you are also able to schedule when you want each tooth to start moving. In some cases it might be required to move a certain tooth out of the way before you can start moving others. The software allows you to do this.
Rob – we started working on the aligner idea as a non AGP for clients but wanted to keep things quite simple, treating cases requiring tipping and rotations. Again, the software allows you to see what type of movement each tooth has undergone.
Sue – but if there are cases that require extrusion for example, there are a range of attachments also that we can bring into play. Who knows, as we get more comfortable with cases and are seeing good results, then I’m sure we’ll venture into more complex movements, with greater use of attachments. Our clients know that as a small lab, the service we offer is pretty bespoke, so I’m always happy to discuss individual cases and work on them as “projects” to help us develop the product.
Rob – another handy addition are intersection values, which basically show you how much you might have overlapped teeth in the set up, which actually give you a value in terms of the IPR required. The report feature shows these values as well as the amount and type of movement for each tooth per aligner. This enables one to gauge what would be safe in terms of IPR.
Sue – there are some other useful features, you can set the software so that it automatically adds the patient name to the model and also the subset up number to a molar, makes it so much easier in handling the horseshoes as they come off print. Also great for the patient so they don’t mix up aligners! Investment in a new 3D printer, an Asiga Max from Bracon means we can print more horseshoes more quickly than before as well.
In all, the team are very excited to have had the opportunity to bring this new product to you.