Digital orthodontics is changing everything

I recall how proud I was as a boy when I was “mature” enough to own a Swiss Army knife. After seeing it, I remember wondering why they even called it a “knife.” With all its other capabilities, simply calling it a knife somehow diminished its true usefulness. After 8 years in the digital orthodontic world, I’m feeling the same way about technology.

In 2009, I chose to move to a digital technology platform, which would help me finish my cases to within fractions of a millimeter-precision that I was unable to achieve otherwise. I overcame the initial financial commitment, a significant learning curve, and a server-based technology that limited my mobility. Over the past 8 years, I’ve seen so many improvements that technology touches nearly every area of my practice. I can’t imagine going back to “the way things used to be.” To characterize this transition as simply a way to bend finishing wires absolutely diminishes the capabilities it gives me.

Adios, servers!  Where I used to be tethered to a local server, most of my technology is now cloud-based. With no server, my financial commitment dropped to near zero. My cases are now accessible anywhere I have Internet access. What this means is that now I have unprecedented opportunities for collaboration. My virtual “team” is always with me.

I can share files electronically with referring doctors or an out-of-town parent. I can show patients why elastic wear is critical and help them to understand why. I can collaborate with mentors across the planet and teach new users remotely.

Superpowered diagnostics  Where I used to align crowns of teeth, I am now able to see crowns, roots, and bone. I can “try out” different scenarios easily — extraction/non-extraction, surgical/nonsurgical. I can even determine how much molar intrusion is necessary to close an open bite. I have a Bolton analysis on every patient, and I can discuss restorative needs or determine IPR before I start. I can also see the occlusal relationships from the lingual, a huge benefit not available before.

Targeting precision with IDB  One of the best ways to reduce treatment time and minimize unwanted movement is bonding brackets in optimal positions. I build an ideal digital setup with great tools. I don’t have to guess at smile arc — I can see the upper anteriors and how they overlay the lower lip. I can see roots and bone and how they relate, and I plan final positions safely. I see the occlusion from all positions, and I can plan where I want to put contacts. Before we bond, I plan IPR and restorations, all with precision. After I’ve built the ideal setup, ordering the custom IDB is just one click. (By the way, this system is “bracket-agnostic” in that I can use whatever bracket set I like — I’m not limited to one manufacturer.)

Lingual with ease  Lingual braces are so difficult to position and manage that most orthodontists shy away from offering them. Using our technology, I can do an ideal setup and IDB brackets, and order all custom wires at the get-go. The company I work with even provides a mentor for consultation.

Clear aligners  Not all aligners are the same. Now I can do an ideal setup (with or without roots/bone), add virtual “bumps” to the teeth, and then, with one click, have a series of custom models with incremental changes. I determine the limits of movement, and the models are printed and delivered to the office, so we can fabricate clear aligners. I can also print them on my new 3D printer, all for a ridiculously low lab fee. It changes my “clear aligner” game!

Jump in!  I’m sure you’ve heard or maybe even thought that using digital technology providers like suresmile® (the one I use) is simply a more precise way to make finishing bends. (I’ve even heard an orthodontist say, “It’s for orthos who don’t know how to bend wires.”) This is far from the truth.

In my office, while it does bend a wonderful finishing wire, it is much more than that. Whether improving visualization, allowing tryout of different treatment plans, allowing me to precisely bond whatever brackets I like on an ideal setup, making lingual orthodontics predictable and manageable, or supporting in-house clear aligner therapy, digital technology is truly the Swiss Army knife of orthodontics.

If you haven’t jumped into the digital world, I encourage you to do so right away. The cost and learning curve to entry have dropped to where you’ll have an “easy button” to success.



Louis G. Chmura, DDS, MS, PC, an ABO Diplomate, received his MS in orthodontics from the University of Michigan in 1987 and has been in private practice in Marshall, Michigan, since 1991. Dr. Chmura has a special interest in systems and incorporating new technology (suresmile®, TADs, laser, cone beam CT, home sleep testing) and diagnostic considerations, including smile design and sleep apnea, into the orthodontic practice. Dr. Chmura is the first orthodontist to complete Advanced Laser Proficiency, as well as the first Orthodontic Fellow of the Academy of Laser Dentistry. He is a member of the American Academy of Dental Sleep Medicine and is on the Schein Orthodontic Sleep Advisory Board.

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