Corporate Profile: Orchestrate 3D by Benjamin Lund, Editor, Orthotown Magazine

by Benjamin Lund, Editor, Orthotown Magazine

A second-generation orthodontist, Dr. Todd Ehrler was so fascinated by 3D technology that he even incorporated it into his master's thesis. As a practicing orthodontist, Ehrler created the Orchestrate (OS) 3D software from a direct need in his own practice for a system that would allow him to be in complete control of his patients' 3D digital data. He designed an orthodontic CAD system from the ground up with the help of Rapidform - a leader in CAD/3D manufacturing software. After several years of beta testing, the result is the newly released Orchestrate 3D system, which allows orthodontists to scan, design and fabricate aligners, retainers and bonding setups - all in house.

In May of 2012, Orchestrate partnered up with long-time orthodontic industry favorites, Ortho2, as its sales and marketing arm. Since then the two companies have been working in tandem to create "a fully paperless and plasterless solution." The OS system has been adopted in practices all across the country and Canada and has been so successful that several residency programs have incorporated it as a clinical and instructional tool. Herein, we talk to Orchestrate CEO Dr. Ehrler about the features of the software, and what to expect from OS down the line.

Dr. Ehrler, before we begin, please tell me a little about your background.
Ehrler: As a second generation orthodontist, I joined my father's private practice after finishing my residency. In graduate school, I had been fascinated by 3D technology and the incredible opportunities it can offer orthodontics. In fact, my master's thesis utilized 3D data from a CBCT machine to measure the volumetric increase in the nasal cavity after rapid maxillary expansion. I have always regarded 3D technologies as the future of orthodontics.

You recently introduced the Orchestrate (OS) CAD/3D manufacturing software. What can you tell me about this new system?
Ehrler: What makes the Orchestrate 3D System so unique and unlike anything currently available is that it allows the doctor to take virtually any digital model and use sophisticated CAD/CAM tools for archival-digital model storage, diagnosis and treatment planning, moving teeth in precise increments to design appliances, and printing 3D stereolithic models for appliance fabrication.

The core software allows the orthodontist to create as many or as few appliances as desired at any point during treatment. And you pay only for what you print, so it is cost effective to fabricate individual or just a few aligners or retainers when necessary. The OS system is also fully scalable to meet each office's needs. Many offices get started by sending in their models or impressions to the OS lab to be scanned, and then add a digital scanner and/or printer later.



How did developing OS come about? How long was it in development? Tell me about its creation.
Ehrler: In my practice, I needed a system that would allow me to be in complete control of my patients' 3D digital data for diagnosis, treatment planning and appliance fabrication. Six years ago, I began researching commercially available 3D scanners, CAD/CAM software programs and 3D printers. I had the great fortune to begin working with Rapidform, a company that provided technology for NASA, the military, automotive, aerospace and countless other industries. Through the study and usage of this cutting-edge technology, I constructed a system in my office designed specifically for orthodontic practices. The results were so significant that we commenced Alpha testing in offices across the United States to further refine and shape the system. After discussions with several companies, we decided to partner with Ortho2 for our sales and marketing due to its long, stable history and its independent, orthodontic focus.

What exactly were your goals in developing this new software?
Ehrler: The bottom line was that it had to be simple and easy to use. Orthodontists are accustomed to a high degree of precision, efficiency and delegation. The Orchestrate 3D system was designed to meet, and we hope exceed, these expectations. This product allows orthodontic offices to integrate the system in a simple and effective manner. And orthodontists can delegate as much or as little as they choose to a trained staff member. The system has been implemented with equal success in both doctor-intensive, and highly staff-delegated practice models.

What sort of input did OS glean from real-world orthodontists when it was being developed?
Ehrler: For the past two years, orthodontists across the U.S. and Canada have alpha/beta tested the OS system. The input from the real-world clinical application in these offices was instrumental in the development of our current product. Testing the system among diverse practice styles, practice sizes and patient demographics provided us with excellent feedback and guidance that could be directly integrated into the product. We also found that a rapid return on investment was universal. The unique value of Orchestrate became overwhelmingly evident as orthodontists discovered that they could maintain tighter control of cost and tooth movement. Orchestrate became a 3D tool that allowed the judgment, experience and education of the orthodontic specialist to be validated and provide a clear distinction from systems being used by non-specialists. In fact, many orthodontic residency programs such as UConn and UCLA have incorporated Orchestrate 3D software as a clinical and instructional tool, which will further enhance our product development.

When a practice purchases OS, what sort of training will they undergo to ensure they are proficient with the new software?
Ehrler: As training is one of the most important pieces of the puzzle, we have an Orchestrate trainer schedule remote or in-office training sessions with the office until they are proficient. There are also numerous help tools in the software and via our Web site.

How are designs fabricated in office versus a lab?
Ehrler: This is a difficult question because there are so many labs that utilize different techniques and technologies. Three-dimensional printers that can be purchased are often similar to those used in dental labs; however, the most notable, and most desired, distinction is the control that the Orchestrate system gives the doctor. The skill, training and judgment of the orthodontist will be fully utilized by the Orchestrate system when determining exactly how many and which appliances are fabricated.

Will OS integrate with tools orthodontists already have in their offices, or do they have to purchase everything through OS in order for the system to work properly?
Ehrler: The Orchestrate 3D system was designed to work for offices that want to send in their models or impressions to our lab or offices that want a fully in-house CAD solution. In addition, Orchestrate is cross-compatible with virtually any existing 3D scanner and 3D printer.

What sort of ROI can a practice expect with OS?
Ehrler: We have seen dramatic ROI in most OS practices - some offices have even recouped their investment in less than a month. The doctor can save on digital model storage and fabrication of appliances such as clear aligners and retainers. Since they are able to fully control the design and fabrication processes, costs are diminished exponentially.

How are you monitoring feedback with this new system and what are you doing with that data once you've received it?
Ehrler: We continually ask our users what they would like to see in the system. We value all suggestions from our professionals and will work to implement the most constructive into future releases. Also, we recently began using UserVoice, a software system which helps us track suggestions from our users and implement them in future updates.

Of course, the big question is, how much will OS cost an orthodontic practice (first cost and life-cycle cost)?
Ehrler: The core system is $299 per month and $15 per model printed at the OS lab. This includes up to four licenses of the OS software, which can be used in multiple locations. It also includes all enhancements, training and support. For offices that are looking for a complete in-office CAD solution, we also sell desktop and intra-oral scanners and a 3D printer, which can be added at any time. As mentioned, the OS system can be integrated with any existing 3D scanner.

What other new technologies does OS have cooking for the future?
Ehrler: With this technology at the fingertips of the orthodontist, there are countless new innovations on the horizon. Currently, we are exploring techniques that drastically reduce the number of patient visits by enabling patients to take photographs with their mobile devices, then e-mail them to the office for the doctor to monitor treatment and determine the next steps. In our pilot program, the results achieved so far have been incredible. We are finding up to a 75 percent reduction in required office visits by the patient.

To learn more about the Orchestrate system, visit www.orchestrate3d.com.
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