Message Boards
Today's Active Topics Today's Active Cases Browse Forum Categories My Recent Activity My Messages Private Groups My Marked Threads My Subscriptions
Today's Active Images Today's Active Polls Most Active Topics Global Townie Map Advanced Message Board Search Message Board Terms of Use

Big Steps Forward for SureSmile Software by Benjamin Lund, Editor, Orthotown Magazine

Start Discussion More by this author (119)



In March 2012 OraMetrix, maker of SureSmile orthodontic treatment system released a new version of SureSmile to its community of orthodontists worldwide. The latest release, SureSmile 6.0 takes orthodontic treatment planning to a new level enabling orthodontists to plan treatment with the 3D models that include highly accurate tooth crowns, roots and the supporting bones. Orthotown spoke with Chief Technology Officer Phil Getto to learn more.

What is SureSmile?
Getto: First released commercially in 2004, SureSmile is a computer-based orthodontic treatment planning system that enables orthodontists to use optical or cone beam CT scans to create 3D models of patients’ teeth. The orthodontist plans treatment, supported by technicians in the SureSmile Digital Lab, by moving teeth in three planes of space to their optimal positions. A robot then uses the plan to create custom wires with bends to .10 mm of precision. The wire is sent to the orthodontist to place. SureSmile has been shown to straighten teeth in a third less time than traditional orthodontics.

SureSmile 6.0 refers to the most recent release of SureSmile, which for the first time includes the ability to plan treatment with models that show the position of tooth roots in the alveolar bone. SureSmile is the only orthodontic tool to provide this capability.

What are the most significant innovations in SureSmile 6.0?
Getto: Of the over 50 enhancements in this version, the three most significant are:

Root Position in Bone: Doctors can now visualize solid models of tooth roots with respect to the supporting bone and to plan treatment targeting specific root positions within the bone.

Restorative Features: Doctors can now easily incorporate restorative plans into their models and adjust for changes in tooth shape and size.

Simplification: Doctors find SureSmile easier to use with the new tools to simplify workflow including checklists and guided planning.

What has changed that has made this capability to model tooth root in bone possible?
Getto: CBCT changed the playing field. With a CBCT scan taking just a few seconds, doctors have much more information about a patient’s anatomy; information that is not available from optical scanning alone. In 2005 we made the strategic decision to develop the tools required to create tooth models from CBCT. With these tools we are able to provide orthodontists a richer, more comprehensive model of the patient’s anatomy.

How are 3D models created from CBCT data?
Getto: The challenge in using CBCT scan data was to develop software tools to process the cone beam data into a form we need for SureSmile. We had to turn the scans into 3D models of individual crowns and roots (often with brackets) so that the orthodontist would be able to manipulate each individual tooth model. We first looked at other companies working with similar technologies including medical CT companies and CT visualization companies. To our surprise nobody had the tools to create surface models of teeth, roots and bones from CBCT scan data. We designated several full-time engineers to develop the algorithms to be able to extract the surface data from a CT scan. Our goal with the first CBCT compatible release was to give the orthodontist the choice of optical or cone beam scanning options by providing the same level of accuracy of the tooth models with brackets regardless of scanning modality.

To reach a point where we felt the accuracy of the crowns and roots were comparable to what we were achieving with optical scanning, we worked with the CT companies to improve the data quality. In 2008 we released the first CBCT-compatible version of SureSmile. It included all of the same functionality of previous releases plus the ability to visualize roots from CBCT scans. The orthodontist now had the choice to obtain data using either an optical scanner or cone beam scanner.

Once we provided the ability to visualize roots, orthodontists wanted to see if we could also show the bone. This was an exciting idea because orthodontists had never been able to see bone clearly but rather planned and treated based on assumptions about root positions in bone. Since SureSmile 6.0 has been released, orthodontists now know where the roots fit in the bone and they are re-thinking how they treat patients based on the data. Placing roots in bone is one of the primary objectives of orthodontic care and is critical to the long-term dental health of the patient.

In building the ability to visualize roots, we had already done some work trying to extract information about the maxilla and mandible. However extracting bone data from a 30-second scan was much more difficult than the teeth because CBCT data is not as clear in those areas. Most challenging was identifying the crestal areas of the bone especially due to the presence of metal brackets.

We did some significant mathematical modeling to figure out a way to extract data by identifying volumes of regions and using gray scale. We had to use many different algorithms in iterations to be able to model the bone. To date, no other company lets you translate this type of data into a therapeutic appliance.

What are you hearing from the field?
Getto: Orthodontists are saying that the tools in SureSmile 6.0 are challenging the way they think about cases. They tell us that it is much easier to use the software. In addition, bone modeling and restorative features have become invaluable to their treatment planning especially in consultation with restorative dentists. As part of the beta version of the software released in the fall of 2011, we asked six orthodontists to plan six cases without turning on the bone functionality. They were then asked to re-plan the same six cases using the bone functionality. In all 36 cases, the orthodontists said that they modified the original treatment plan based on the capability to plan the root position in the supporting bone.

In regard to restoration, prior to SureSmile 6.0, the software had to assume the teeth always stayed the same shape through treatment. A model would be built based on a scan (from optical or CBCT) and the tooth anatomy stayed the same through treatment. Now with the restorative modeling features, orthodontists can change the anatomy of teeth in the model to simulate and plan for veneers, implants, crown or interproximal reduction.

SureSmile doctors have also told us that the software is easier to use than ever before. Ten years ago, SureSmile could only model the crowns and they were not connected to the rest of the patients face and smile. Today they can see models with full facial anatomy and treatment plan using the tools that guide the user through the planning process.

What is next?
Getto: Our customers are constantly coming up with great new ideas for refinements of our existing tools and technologies. We certainly see opportunity for collaboration on multi-disciplinary treatment. As the number of specialists involved in the care of a patient increases, the need for clear and effective communication becomes a priority. Over the last year, we have been working to port the existing SureSmile application to the cloud to provide our customers access to SureSmile anywhere, to better support collaboration and communication between providers and reduce the barriers to getting started with SureSmile by eliminating the need for dedicated on-site servers.

Our customers say the ability to visualize patient anatomy in 3D and plan treatment in advance with full consideration of the cranial-facial structure and translate those plans into customized appliances will revolutionize the standard of care. Ultimately, it is all about providing the best possible care to the patient.
Orthotown Magazine
October 2025
Orthotown Magazine October 2025 Read Current Issue Read Archived Issues
Sponsors
Townie® Poll
When did you last increase your fees?
  
Site Menu
Message Boards Magazine Continuing Education Podcasts Blogs Classifieds News Events Townie® Poll Ebooks Townie Choice Awards
Company Info
Contact Us Advertise With Us Howard Farran DDS, MBA Policies and Agreements
Site Help
Sally Gross, Member Services Specialist
Phone: +1-480-445-9710
Email: sally@farranmedia.com
©2025 Orthotown, a division of Farran Media • All Rights Reserved
9633 S. 48th Street Suite 200 • Phoenix, AZ 85044 • Phone:+1-480-598-0001 • Fax:+1-480-598-3450