Digital Impact

Orthotown asked, and Townies replied. When Townie Choice Awards voters weighed in on which recent purchases had made the biggest impact on their practices, the results overwhelmingly skewed toward digital technology. Townies declared these pieces of office tech as the biggest game changers for their practices—and here, in their own words, they share why.

The choices were revealing—often literally, focusing on intraoral scanners, CBCT, CAD/CAM and digital X-rays, which show more to clinicians and patients alike, making both acceptance and performance of treatments easier. Townies also favored lasers, and with new technology and lower costs, electrosurgery instrumentation has resulted in expanded treatment options with fewer complications for many practices.

Finally, comfort is still king, as Townies claim that adding new dental chairs can sometimes be just the right improvement that elevates a practice to the next level. Sometimes all the technology in the world—or the practice— won’t be worth its weight unless patients like where they’re sitting.

Over the next pages, you’ll hear Townies discuss which instruments and equipment earned their votes as game changers.

Intraoral scanners
Orthotown Editorial Director Dr. Dan Grob says:
From simple photos of teeth used to show patients their oral conditions to detailed high-resolution images, the intraoral scanner is gradually and completely transforming how we practice orthodontics. Digitization is here. Intraoral scanners allow, with a pass of the wand, an unhindered and complete view at a fraction of the time required by traditional methods.

Whether it be for viewing, clear aligner therapy or laboratory procedures such as indirect bonding and retainers, a scanner used by trained clinical assistants can streamline the workflow in almost any orthodontic practice. No wonder that many offices now have more than one! End providers are adapting and providing solutions from quick laboratory turnaround to simulated outcomes.

Townies are saying …
“We’ve used the iTero Element intraoral scanner for all our diagnostic records for several years. I love the ability to pull up the models on my computer when I meet with a referring doctor. Probably my favorite thing: When working on interdisciplinary cases, I do a digital scan of the patient along with radiographs and photos. I can send these to the referring doctors for review so they don’t need to get the patient into their offices, check the size of the spaces for missing teeth and then communicate this back to me.”
Dr. Thomas E. Merrill,
Merrill Orthodontics
East Wenatchee, Washington
“drtomfish’s”

“The Trios 3 by 3Shape significantly affected patient comfort and reduced chair time and lab turnaround time. Great indirect marketing tool for the practice as well.”
Dr. Edmund Khoo, New York University College of Dentistry
New York City
“orthokhoo”

“[Carestream Dental’s] CS3600 Scanner. Reduces lab time for my team and increases patient comfort.”
Dr. Alexander Cranford,
Cranford Orthodontics
Newnan, Georgia
“adcran”

Intraoral scanners

“We’ve been intraoral scanning on a regular basis in our three practices since February 2004, so I can honestly say that I’ve seen firsthand the evolution of intraoral scanning and the tremendous positive impact it’s had on our practices. We now have four 3Shape Trios 3 Pod intraoral scanners, and use them 99 percent of the time in our practices for all procedures—SureSmile labial and lingual wires, SureSmile aligners, indirect bonding, retainers and all Phase I procedures. Most importantly, our patients love the fact that we no longer have to take impressions on them anymore; we hear positive comments about this every day in clinic.”
Dr. Ed Lin, Orthodontic
Specialists of Green Bay
Green Bay, Wisconsin
“eyl1967”

“iTero Element. Patients love the ‘no-goop’ scans!”
Dr. Mark Clauss, Clauss Orthodontics
Watertown, Connecticut
“Bowser161”

“When I purchased the 3M True Definition scanner in 2014, it was the perfect option for a low-cost entry to the digital impression world. It made a significant impact in the way our clinical systems and patient experience have developed since. I’ve eliminated the ‘fit/impress’ appointment and can deliver expanders and other lab-fabricated banded appliances at the patient’s first appointment, which is well-received by busy parents and patients eager to start!
We also have retainers ready to deliver at the debonding appointment, because the lab virtually removes the patient’s braces using the digital impression files. Additionally, our clear aligner impression procedure is seamless, accurate and much more comfortable for our patients.”
Dr. Jacquelyn Schieck,
Schieck Orthodontics
Northfield, Minnesota
“jschieck”

“3M True Definition scanner: no more impressions or supplies. Efficient. Direct digital work sent through 3M to lab of choice.”
Dr. Murray Johnson, Cape Pediatric
& Family Dentistry
Harwich, Massachusetts
“drmurrayjohnson”

“We have three generations of the iTero in our three offices, the latest being the Element. We use it for almost everything that would require an impression. Patients love it and are fascinated by the technology. With Invisalign, it is quick and easy to scan midtreatment if some teeth aren’t tracking well, if an adolescent has erupting teeth that now need to be captured, or if an adult has unexpected new dental work. These are all incidents that happen routinely. Having to constantly take PVS impressions was a nightmare for the patient, staff and scheduling. With the latest-generation scanner a scan is less than five minutes. Our team is begging us to replace the older models!”
Dr. Linda E. Rigali,
Rigali & Walder Orthodontics
Florence, Massachusetts
“linortho”

Digital X-rays

Orthotown Editorial Director Dr. Dan Grob says:
Just as CT scans changed the practice of medicine, CBCT X-ray machines can help in dental diagnosis and treatment and eliminate guesswork in our practices. Once a rarity, used in surgical offices for implants and removal of disease and teeth, CBCT is now finding use in routine daily practice. With radiation levels constantly going down and the costs being reduced, the cone-beam X-ray machine will soon become the go-to piece of equipment in all offices.

I’m sure the day will come when whole-head scans will become as ubiquitous as the cephalometric X-ray for detailed orthodontic evaluations. Better outcomes are sure to be the benefit, while hidden surprises will be reduced.

Townies are saying …
“What I love most about the Vatech PaX-i is the quality of the images. It’s also extremely reliable; I have yet to call a service tech over the past four years. Put it this way: Whenever we have a second-opinion exam and the patient brings in his own panoramic image, we always take another one in our office because the quality is significantly better with the PaX-i. I bought it mainly because it had the one-shot ceph feature and because it had the smallest footprint, compared to the other makes and models in its class. I have limited office space, and this was one of two units that fit the space.”
Dr. Jonathan W. Rucker,
Rucker Orthodontics
Temecula, California
“jruck720”

“I use Cranex D from Sordex. I think digital 2-D pano/ceph are irreplaceable in an orthodontic practice. It’s one of the only pieces of technology that’s truly a one-time cost without any support fees, subscriptions or calibrations. 3-D imaging is wonderful—it’s inspiring to look at and we can get so much information—but the reality for me is that I don’t need any of that information on a routine basis. What I need is a reliable image that lets me know that there is a problem. That’s it. The specialist who’s going to address that problem needs the 3-D information, but a 2-D pan/ceph is still the workhorse for me.”
Dr. Andrew Hayes, Hayes Orthodontics
Ballwin, Missouri
“ahayes”

“When our office updated its pan/ceph machine, we went with Carestream’s CS8100 SC. This upgrade provided our office with crisp, clear imaging for easier diagnosis of treatment. The system also integrates with Carestream’s CS OrthoTrac, which allows for access of the images on any workstation nearly instantaneously. This has vastly improved our communication with patients, who are able to better understand our treatment goals with the aid of such visual images. The combination of the seamless images and digital charting has improved the quality of our overall orthodontic treatment and simplified our record-keeping.”
Dr. Katie Evans Moffit,
Sansing Orthodontics
Alexandria, Louisiana
“katieriver25”

“I’d say that purchasing a Vatech America imaging unit was one of my smartest decisions ever. Having worked with several other imaging brands throughout residency and practice, I knew what was out there. The clarity and resolution of the images are insanely great; I’ve never seen better. The sharp images make me that much more confident in my diagnosis, measurements and treatment planning. I love the clean, modern look of the machine, and my patients love the talking instructions during operation. It integrates seamlessly with our ortho software, which makes capturing and viewing images quick and easy.”
Dr. Brandon Foltz,
Avenue South Orthodontics
Nashville, Tennessee
“nashvilleortho”

“I had purchased a practice that used processed film for its X-rays and had all paper charts, so it was my goal to update the practice and convert to digital within the first year of ownership. The Sirona XG5 3-D-ready digital pan/ceph allowed my team to work much more efficiently, reduced radiation levels and eliminated harsh chemicals used for processing from the practice. Furthermore, the images are much more reliable for diagnosis and treatment planning. To see structures clearly gives me much more confidence. I’m glad that I chose to invest in this piece of equipment as early on as I did. The 3-D-ready aspect of this model will allow me to add on 3-D cone beam capability easily in the future.”
Dr. Estee Wang, Lakes Orthodontics
Maplewood, Minnesota
“bracesarecool”

Lasers / radiosurgical

Orthotown Editorial Director Dr. Dan Grob says:
Once not even common in general dentistry, lasers are making higher-quality care more commonplace in the orthodontic setting. With uses like cleaning up gingival tissue during, after and even before treatment, and removing excess tissue for cosmetic contouring of the smile arc, many types of lasers have found their way into orthodontic clinics. The machines are user-friendly and have streamlined appearances and settings and instructions that take fear out of the treatment equation. The emphasis on airway and muscle function is also encouraging frenum removal, leading to better tongue position and swallowing patterns. Sleep apnea and breathing should be improved! To elevate your practice game, you may wish to investigate all that lasers can do in an orthodontic practice.

Townies are saying …
“I have Zap lasers—wireless and wired, in separate offices. The use of lasers in our office shortens treatment times by uncovering teeth that are stubborn and will take many months to erupt on their own pace. In addition, we can save our patients from paying additional fees to other providers to uncover some of the palatally impacted teeth that we can expose using our laser. Parents appreciate this when it works well.”
Dr. Clark Colville,
Orthodontic Specialists
Seguin, Texas
“Seguinortho”

“I use AMD Lasers’ Picasso for reduction of hyperplastic tissue to prevent white marks around the gingival third of my ortho patients and to expose partially impacted cuspids for bonding. In my 48 years as an orthodontist, I’ve always had a focus on dental health, and what an opportunity orthodontists have to help patients develop lifetime oral hygiene habits! When gingival tissues become inflamed and swollen during care, my team will do all it can with the usual tools to restore gingival health. With a laser, I now have another choice for a patient whose result and great smile may be marred by white marks. Tissue can be recontoured by us in the office rather than at the periodontist. When I do it, my families appreciate the service, and oral hygiene goes to a new level and stays there. The same goes for impacted cuspids as they are guided into occlusion—better tissue management.”
Dr. Edward Amley,
Amley & McEntire Orthodontics
St. Petersburg, Florida
“edamleydds”

“I’ve used three different diode lasers over the past 10 years; two of the companies are no longer on the market. For the past three years I’ve been using the Picasso Lite. Lasers add a great level of efficiency to patient care. In the new era of ‘accelerated orthodontics,’ I can’t think of a single piece of technology that expedites treatment any better. Having the ability to bond teeth that are caught up in thick, soft tissue can easily expedite the treatments by several months. It’s really hard to measure something that’s said to expedite treatment, but with diode lasers the metric is easy: ‘Three minutes ago, I couldn’t see that tooth, and now there’s a brace on it with a force directing the tooth into place.”
Dr. Andrew Hayes, Hayes Orthodontics
Ballwin, Missouri
“ahayes”

“The Dento-Surg 90 FFP Radiosurgical Instrument is more efficient than laser with gingival recontouring, uncovering canines and simple frenectomy.”
Dr. Mark McKenna,
McKenna Orthodontics
Morristown, Tennessee
“Gotitstr8”

Popular laser brands
• AMD Lasers (amdlasers.com)
• Biolase Technology (biolase.com)
• Deka Laser Technology (dekalasers.com)
• Ivoclar Vivadent (ivoclarvivadent.us.com)
• KaVo America (kavousa.com)
• Lares Research (laresdental.com)
• Lumenis (lumenis.com)
• Millennium Dental Technologies (millenniumdental.com)
• Sirona (sirona.com)
• Zap Lasers (zaplasers.com)

Dental chairs

Orthotown Editorial Director Dr. Dan Grob says:
Whether it be worn-out vinyl (from anxious patients grabbing the armrest in anticipation of an uncomfortable procedure) or a desire for a total office makeover, the need for upgraded, durable dental chairs continues. Townies are always gravitating toward sleek designs that are easy to clean and operate. Cross-contamination and sterilization requirements make the ability to turn around between patients a breeze. Foot controls are replacing side switches, and integration with chairside units is almost a given. The ability to install and mount computers for visualization and chart entries has arrived. No more workarounds. For an upgraded look and better ergonomic function, new equipment should be a part of your office upgrade.

Townies are saying …
“I have Ross Orthodontic chairs and stools that have been in use for 20-plus years. They look great and function as well as when they were first installed. This has been a great choice for equipment.”
Dr. Clark Colville,
Orthodontic Specialists
Seguin, Texas
“Seguinortho”

“Boyd. The comfort and durability is superb and the choices of fabrics and colors accent my clinic nicely. I get compliments daily from patients: ‘I need to get one of these at home.'”
Dr. Andrew Hayes, Hayes Orthodontics
Ballwin, Missouri
“ahayes”

“We have used Dome for all our offices for the past 23 years. Very durable, excellent quality and easy to change out the chair colors and get new upholstery.”
Dr. Donna Galante, Cater Galante Orthodontic Specialists
Rocklin, California
“DrGalante”