Occasionally, we find that certain patients will benefit from a more detailed view of their dental and skeletal anatomy that only 3-dimensional (aka Cone Beam Computed Tomography or CBCT) X-rays can provide. These types of X-rays allow us evaluate the teeth or skeletal structures in 3-Dimensions and measure or compare in any arbitrary direction. We can plan for more complex treatments (like surgery, etc.) or help our local dentists and surgeons to plan for implants and grafting. These are incredibly important when are late in terms of their eruption timeline. They may be "blocked" by other teeth or adjacent structures or they may be causing harm to those neighboring teeth and structures.
These X-rays have a higher "cost" in terms of radiation exposure and this is something to be aware of but this isn't anything to be worried about. We tend to equate the amount of X-ray exposure to how many days of background radiation we receive just by being on planet earth or alternatively how much radiation exposure we receive flying in a plane for one hour at 30,000 feet. Often this type of comparison will assuage a patient's (or parent's) fears. Suffice it to say, any X-ray taken by a dentist will be 10 or even 100 times less radiation exposure than a hospital X-ray (chest CT for example). We would be happy to discuss this further if your treatment would benefit from the added diagnostic assistance of a 3-D X-ray.
As always, we request women who are or may be pregnant to please inform us prior to receiving any X-ray exposure.
Intraoral scanners allow for some impressive changes in the world of orthodontics. We can keep digital records of where our patients started, finished, and even compare to where they are now all from a digital file that is easily stored on a hard drive. Some scanners can even take shade measurements and help dentists prepare for future crowns, veneers, and implants. Now we can also avoid using those "goopy" impressions for most (if not all) purposes. We can even send the digital files to our orthodontic laboratories for more efficient appliance fabrication and quicker delivery to our patients! Those files can also be 3-D printed to form physical models. Some offices will even print their own 3-D models. Under rare circumstances, we can manipulate the digital "teeth" and fabricate our own appliances (Clear Aligners, etc) from the 3-D printed models. A patient who has completed treatment can use that 3-D printed model to create a set of retainers whenever they need them. What's that your retainer cracked? We can make a new one off your models. You accidentally tossed your retainer in the garbage in Moses Lake? We can make a new one off your models. The dog at your retainer? We can make a new one off your models. You lost your 3-D Printed model? We can use the digital file to print another one. This capability is incredibly exciting for the world of orthodontists and saves our patients and their loved ones a great of time and potentially a great deal of money and heartache.
This is a very exciting aspect of orthodontics in the 21st century. One of the big orthodontic breakthroughs of 80s and 90s was the notion that orthodontists could place an appliance (a certain type of braces) on the teeth of almost any patient that walked into their office and apply a certain set of archwires (the metal wires that extend from "brace" to "brace") and most patients would be treated to a satisfying finish. The idea that most patients could fit into a single "box" (or category) and be treated successfully was game-changer. Those were exciting days and orthodontists reveled in this new power.
The 21st century brings a new line of thinking. No longer are orthodontic appliances "one size fits all" in the sense that most patients can be fit into a single box or category of treatment but. These days our appliances can be custom-tailored (like a bespoke suit) to fit each patient's individual needs and tooth movement objectives. We can provide custom brackets, or custom archwires, or even custom clear plastic appliances to help each patient find the perfect "fit" for their tooth movement objectives. Each patient's needs can be addressed by custom-tailored solution that is optimized for treatment efficiency.
CLEAR ALIGNERS - INVISALIGN, CLEAR CORRECT, AND SURESMILE
Not even twenty years ago, if you had considered orthodontic treatment your options were often braces and ... well, other types of braces. These days thanks to the advances of Clear Aligners from Invisalign (you can read more about the history and advancements, here) as well as ClearCorrect and SureSmile are providing patients another option to achieve a beautiful smile. While not every patient is a good candidate for this type of treatment, the list of patient-types who are "disqualified" is dwindling every year. These types of treatment can even tackle such difficult scenarios as: crossbites, ectopic (out-of-position) eruption, surgery, and even mandibular advancement. The future is bright for this type of orthodontic appliance.
Clear Aligners aren't the only classification of appliance that has been thrust into the "customized" category. The "old reliable" braces style of appliance is joining the "customized appliance" ranks. Now brackets can be customized for an individuals unique set of teeth. Archwires, can also be customized to move teeth precisely into the ideal position. This has been shown in some studies to significantly reduce the amount of time a patient is in treatment. The SureSmile technique provides customized archwires bent by a robot to precisely place your teeth in an ideal position.
First a patient's records (intraoral scan, photos, and X-rays) are sent to technicians to plan the customized tooth movements. The plan is perfected via a digital back-and-forth to refine each patient's tooth movements for their own customized needs.
That plan is then translated into individualized (customized) archwires to perfectly dial-in a patient's treatment needs and objectives. No two patients have the same treatment needs so no two archwires are alike. The orthodontist is able to compare the treatment result with American Board of Orthodontics (ABO) treatment standards. These are the highest standards in the orthodontic profession. An orthodontist treating to these standards will routinely deliver the highest level of care possible.
The patient progresses through the customized archwires allowing each to exert its influence over his or her teeth. Finally, the patient is finished with heightened efficiency and an excellent clinical result and receives their retainers to maintain this exceptional outcome.
Even with all of these amazing technologies, some patients will still want their treatment to be faster. We can push the human body to the limit by introducing certain stimuli. Sometimes, we can heighten the inflammatory response that allows teeth to move (like with PROPEL or Wilkodontics). Other times, we use vibrational therapy to help aligners fit better and make treatment more comfortable. Finally, certain wavelengths of light have been shown to stimulate cellular response in the cells responsible for remodelling human bone. This quicker remodelling allows for faster tooth movement and a quicker treatment finish.