Digital Retainers- Part II / Impression-Less Orthodontics

By Anthony M. Puntillo D.D.S., M.S.D.My last article received so many comments that I felt it warranted an extension of the discussion.  In the last twenty years of practicing orthodontics, our profession has gone paper-less, film-less, brace-less, wire-less, and coming soon….IMPRESSION –LESS.  Several companies now produce intraoral scanners and by all accounts they are selling them like hot cakes.  I want to reiterate that I have no financial interest in the sale of any of these machines.  However, if you have not bought one yet, my guess is most of you within the next five years will.  We would all love to eliminate our post-lunch gaggers.  But there are more tangible reasons why this trend is gaining momentum.

First and foremost the majority of our patients simply dislike having impressions taken.  Second, intraoral scans produce more accurate models for the fabrication of better fitting appliances. Third, intraoral scans eliminate the expense and wasted time associated with impression retakes and inaccurate model pours.  Fourth, intraoral scans allow for the elimination of alginate, PVS, and plaster expenses.  Finally, the move to digital patient records has been driven largely by the improved efficiency in handling, manipulating and transferring files, photos, and radiographs.  The same benefits also can be said for models.

Digital models have been around for several years.  I believe the recent mainstreaming of intraoral scanners and 3D printers has now pushed us to a “tipping point.”  Most orthodontists today using intraoral scanning, still digitally transfer their .stl files to the lab of their choice for fabrication of models or an appliance.  But what if you could simply hit “print” and create a bubble free model in your own lab?  The model could then be used to create an in-house retainer or indirect setup just as you would with a plaster model.   In fact, this is now possible.  Some may say that the costs of 3D model printers are too expensive.  Depending upon the size of their practice, you may currently be correct.  I say currently because most of us can remember the costs of color printers when they were first released.  Now they are very affordable and ubiquitous.  Why?  Because corporations such as Hewlett Packard discovered that they could sell the machines at a loss and make their profit on the sale of ink.  I submit to you it will not be long before the same dynamic occurs with 3D model printing.  And when this happens, we will all have one in our office and alginate and plaster will go the way of film-based photography.

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