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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