If your dental school was like mine, orthodontics was a series of lectures and a couple of wire-bending exercises. I learned about craniofacial growth and made a Hawley. Of course, we never used any of this knowledge on patients. Moving teeth was a complex process and treatment was spread over several years; how could a third-year dental student be safely and responsibly dropped into the middle of a case?
But then, at the dawn of the new millennium, a company came along and changed orthodontics forever. Align Technology introduced Invisalign, a bold idea indeed. Sure, we first think of the clear aligner as its major innovation, a series of trays and composite resin buttons that could be delivered much more easily than bonding brackets. But I’d say the real advancement was the support platform: (1) a team of remote orthodontists using sophisticated software and creating treatment plans for dentists, and (2) comprehensive continuing education courses certifying provider dentists to ensure that there was a certain level of orthodontic competence. An early form of teledentistry mixed with proper provider education brought orthodontic care to a wider audience than ever before.
Today, the clear aligner field is a bloody one, with ferocious legal battles between competitors, DIY alternatives that cut out local providers, and a wave of early-adopter dentists who are 3-D printing aligners for themselves. It’s fascinating to wonder what the future will hold for a treatment modality that still felt like a closely guarded secret by its specialty only 18 years ago.
In this issue, we take a look at one of the more recent technological innovations to benefit orthodontic care: digital impressions. I’ve invited Dr. Mike Meru, an orthodontist, and Dr. Tarun Agarwal, a general dentist and technology expert, to share their thoughts about how digital scanning has changed their workflows.
I firmly believe that, at least in my lifetime, we will always need orthodontists. And we’ll always need brackets and wires to accomplish the more challenging tooth movements. My father, Dr. Joseph Salierno, an orthodontist, impressed upon me that clear aligners are an excellent treatment option, but they are not a replacement for keen diagnosis and treatment planning. The same could be said for all of the great innovations we are witnessing in this technological revolution. I may not need to make a Hawley anymore, but the know-how is more important than ever.
Chris Salierno, DDS