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Digital Imaging Feature: Orthodontics in 3D Wm. Randol Womack, DDS, Editorial Director, Orthotown Magazine

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Orthodontics in 3D





































by Wm. Randol Womack, DDS,
Editorial Director, Orthotown Magazine

With CBCT technology becoming integrated into so many aspects of orthodontic treatment today, I thought it would be informative to our readers to interview one of the progressive innovators in this area of dental technology. I had a very interesting phone interview with Dr. Doug Chenin, a general dentist and director of clinical affairs at Anatomage, Inc., in San Jose, California, who has become an expert in the field of 3D technology.

Doug, where is the future of 3D imaging heading in orthodontics and what should we expect?
Chenin: The first thing to realize is that the future of 3D orthodontics is here and now! It is not a far off idea or something that will eventually happen; it is a reality that thousands of clinicians and patients are currently benefiting from daily. This is not to say that it is not evolving and progressing on a daily basis as well. We will see more 3D virtual treatment objective possibilities and more indirect treatment applications as well. Particularly with developments in the realm of 3D jaw tracking, hinging, and occlusion, much of which is already possible with "virtual study models."

What about the effect 3D will have on actually treating patients?
Chenin: Indirect treatment devices are also going to increase, so that the 3D orthodontists will be able to image their patient in 3D, treatment plan their cases, do bracket placement and ultimately get therapeutic devices that will carry out their treatment prescriptions.

The injection of computers into orthodontic treatment has been rather intimidating to many orthodontists. Isn't this technology going to meet a lot of resistance?
Chenin: Programs like "In-VivoDental" 3D imaging software, and some others as well, are so easy to learn that it allows clinicians of any computer skill level to immediately use it. The ease at which the orthodontist can benefit from visualizing their patients' 3D anatomy is remarkable. Once this is realized, an orthodontist can hardly NOT make the investment of time and dollars.

Assuming that the average orthodontist will embrace this new technology, what will be the benefits?
Chenin: Beyond the wonderful 3D visualizations, it allows for traditional images to be reconstructed such as panoramic and cephalometric radiographs. Furthermore, it allows for advanced applications like complete TMJ, airway assessments (most important today with Sleep Apnea becoming so evident) and virtual TAD treatment planning in 3D. For example, one stand-alone program, the "In-VivoDental" 3D software, provides for two complete CBCT scans to be superimposed to each other, which makes pre-treatment/post-treatment assessments possible. This imaging technique shows change over time thus adding time as the fourth dimension to CBCT technology and orthodontic imaging. On top of all of this, the images are breathtakingly aesthetic which greatly facilitate patient education, motivation and case acceptance.

Virtual study models are now available in many different formats from a lot of new companies. How does 3D affect this alternative to plaster models?
Chenin: One of those programs, the AnatoModel service by Anatomage gives orthodontists the ability to obtain a 3D digital study model of their patients' complete dental and skeletal anatomies from a CBCT scan without having to take impressions. These are different from other 3D digital study models in that they come directly from the CBCT scans of patients, rather than from CT scans of stone models. These virtual models can be viewed with the 3D software and thus make CBCT scans a one-stop solution for radiographic and study model patient records. This streamlines the record taking process, saves chair time, staff time and materials. These virtual models are not like any other study models, in that they contain not just crowns of teeth, but also their roots, as well as impactions, developing teeth and alveolar bone. Furthermore, each tooth can be individually segmented and modeled independently allowing for 3D orthodontic simulation and treatment objectives.

This sounds fantastic. But what is the advantage of this
type of information?
Chenin: With this kind of 3D imaging enhancement, the orthodontist can show the patients/parents how they plan on carrying out treatment with patient specific anatomy. It also allows for multiple simulations to be done, thus fully showing the alternatives a patient may have. The ability to demonstrate treatment options is a great advantage to the treatment planning process. This also enhances the impact of a patient consultation and provides the patient/parent with complete disclosure of all treatment options in a visual format that was previously not available through convention diagnostic aids. This is the new generation of 3D imaging called Dynamic CBCT.

It is clear how these imaging modalities facilitate diagnostics and treatment planning, but how do they help the orthodontist with the bottom line?
Chenin: Orthodontists who use 3D imaging, either by getting their own machine, using a colleague's machine, or referring to an imaging center are quickly establishing themselves on the cutting edge. They are making their prospective patients aware of this. We know, today, that patients are searching for and evaluating practices on their technology status. With this technology, orthodontists will be showing 3D imaging of a sample case at new patient consultations to make the patients/parents aware that they employ the latest technology when needed. It works especially well for any case dealing with impactions. 3D imaging is greatly facilitating patient education, explanations of why orthodontic treatment is needed and is ultimately increasing case acceptance. It also decreases the chances of losing that patient to another orthodontist that the prospective patient may have visited for a consultation.

So you are saying that 3D imaging is becoming a part of
competing for patients?
Chenin: I believe this is becoming critical to thriving in today's orthodontic environment and it is happening very quickly with the evolution of this technology. The fact is that this technology is so amazing, to even the layman, that they will tell their friends about it and the 3D orthodontists ultimately will get referrals based on their "amazing new 3D technology" as patients often describe it to their friends and family.

Doug, thank you so much for you insight in to this revolutionary new technology that is having such an impact on all aspects of orthodontic treatment today.
Chenin: It was my pleasure.
Interviewee Bio

Dr. Doug Chenin earned his DDS degree from the University of the Pacific Arthur A. Dugoni School of Dentistry in San Francisco. Dr. Chenin is the director of clinical affairs at Anatomage, Inc., the company that created the InVivoDental 3D Imaging Software and the AnatoModel Service. He is involved in all aspects of research and development of the company's 3D technology. He regularly teaches continuing education courses with Anatomage's advanced 3D software to doctors and dental auxiliaries at both beginning and advance levels. He is involved in facilitating and participating in research projects throughout multiple dental schools across the nation. Dr. Chenin is also Adjunct Faculty at the University of the Pacific Arthur A. Dugoni School of Dentistry in the Orthodontics Department, where he teaches residents how to use 3D imaging to its fullest potential for both clinical and research applications.
Orthotown Magazine
November 2025
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