How invisible aligners shook up orthodontic care

Orthodontic care is one of the oldest branches of dentistry. Even mentioned by Hippocrates in one of his great manuals of early medicine. The reasons for orthodontic intervention have changed over the millennia. Back in the Edwardian era and the turn-of-the-century, orthodontist treatment focussed on resolving medical problems, often at the extreme inconvenience of the user. Headgear from that period looks challenging to sleep in, let alone eat and generally live in.

Patient-centred care

The phrase patient-centred care may sound strange to the modern ear; what sort of medical care isn’t? But it hasn’t always been the case and the previous style of medicine was disease focussed, where the priority was the treatment of an underlying condition not the quality of life of the patient during the treatment process. This changed fairly early in dentistry, probably because of the largely private nature of dental care requiring a degree of wooing of its patients.

Braces have become more practical and less intrusive in everyday life, with priorities made on brackets that do not disrupt speech or abrade the inside of the mouth, a common cause of mouth ulcers with badly fitted orthodontic tools.

It was in this spirit of patient-centred care and a time of rapid technological progress that Invisalign Weybridge stepped into the ring.

A successful 90s startup

Disrupting established industries with new computer-based technologies was a double-edged sword of the 90s startup, but those that got it right the Googles, Facebooks and Amazons of the world really got it right. So did many clear aligner companies.

These were built on an already established, but undeveloped dental technique of plastic splints which allowed teeth to be moved in the same way as a brace, but using very precisely shaped plastic trays that were worn over the teeth like a thin, minimalistic gum shield that fitted tightly pushing them into new positions.

What stopped this technology in its tracks was the excessive number of hours it took to design and fabricate each individual plastic tray. Each tray was only effective over a short distance, as it was relying on the elastic formation of the material itself to provide a force that in traditional orthodontist care would come from a high tension archwire, that was altered with each brace adjustment performed at the orthodontist throughout the treatment process.

The technology at this time was cutting-edge, and turned out to be the secret ingredient behind changing these experimental dental splints into the clear aligners that could find widespread adoption and use by tens of thousands of patients. 3D scanners would be used to create an extremely accurate digital representation of the patient’s teeth. This was then used to calibrate a simulated human mouth, with all of the anatomical features meticulously replicated from the structural properties of enamel and gum tissue, to the tendons which anchor teeth to the jawbone. Fine treatment could be simulated in a digital environment, each of the teeth traversing from their misaligned stage to optimally-biting healthy positions.
dentist scanning teeth of a patient

The forces required to alter the position of the teeth were predicted and from this, the required aligners could be printed using a 3D printer. This reduced the cost of production for clear aligners, and thus made them more affordable for the majority of patients.

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