Earned Placement: Indirect Bonding - Real-World Experiences

Earned Placement: Indirect Bonding - Real-World Experiences 


Dr. Lindsay Limbaugh
Dr. Lindsay Limbaugh
Dr. Tal Jergensen
Dr. Tal Jergensen
Dr. Samuel Waddoups
Dr. Samuel Waddoups

Recent advancements in artificial intelligence (AI), 3D-printing technology and materials science have dramatically improved the practice of digital indirect bonding (IDB). OrthoSelect has been at the forefront of making IDB easier and more effective for orthodontists through its Dibs AI software platform, which combines patent-pending AI algorithms with precise 3D-printed tray designs to shorten bonding appointments, enhance bracket placement accuracy and help orthodontists make their practice more efficient.

To find out how well Dibs AI actually works to achieve these goals, we asked three orthodontists who recently implemented the platform in their practices to discuss their experiences: Dr. Lindsay Limbaugh of Huntsville, Alabama, and Drs. Tal Jergensen and Samuel Waddoups, partners in Temecula, California
Tell us about you and your practice.

Jergensen: I graduated from Virginia Commonwealth University in 1989, then completed my orthodontic residency at Eastman Dental Center in Rochester, New York, in 1992. I started my orthodontic practice from scratch in 1993 in Hemet, California, and added a Temecula office in 1995. Throughout my years in practice, I have focused on introducing new technologies to be more efficient in the delivery of treatment to patients. We typically see 60–70 patients a day and annual new patient starts are near 700.

Waddoups: I went to Nova Southeastern University. I have four locations in Southern California and have been in practice for 10 years.

Limbaugh: I graduated from the University of Alabama (UAB) School of Dentistry in 2003 and from UAB’s orthodontic residency in 2006. I moved to Huntsville immediately after graduating and partnered with an orthodontist; when he retired in 2015, I became the sole practitioner. Since then, the practice has doubled in both the amount of collection and production.

How long have you been using Dibs AI?

Limbaugh: I began using it in 2020, and wholeheartedly embraced it within two to three months.

Jergensen: We’ve been using Dibs AI for nearly a year.

What originally prompted you to try using the platform in your practice?

Waddoups: My partner wanted to do it—to be honest, I wasn’t interested at first!

Jergensen: We hired an MIT student and gave him an assignment to research the different options for digital indirect bonding. He found OrthoSelect and determined it was the best of all the systems.

Limbaugh: I became interested in Dibs AI because my practice volume had reached a point where it couldn’t grow any more because of lack of doctor time. I noticed my clear aligner treatment planning was so much more streamlined, and I wanted something similar for my braces patients.

Any concerns when you first started?

Jergensen: Would it be simple enough for the staff to implement?

Waddoups: I worried I’d be spending a lot of training time like I did with clear aligners: tons of courses and “experts” having to explain how to make the dang thing work correctly. The OrthoSelect team trained my staff, and my previous training with clear aligner software made Dibs AI pretty easy and intuitive.

Limbaugh: My biggest concerns were not only the workflow but also how my lab assistants would be able to manage the system. However, it was a very easy transition.

What was it like getting Dibs AI implemented into your practice— good and/or bad?

Limbaugh: Our experience has been absolutely positive. We came up to speed with the software and started treating patients with the system very quickly.

Jergensen: Initially it was difficult, because we didn’t understand everything—but nevertheless, the first case we did was fantastic. Then, the other assistants didn’t follow instructions, which was discouraging, but OrthoSelect was great at helping us overcome our lack of experience, and we have it down now.

Waddoups: Doctor chair time went way down for my initial bonds, and I am now able to bond all the way to the 7s in one appointment. Some doctors may be amazing and can do that anyway, but I’m picky about my 7s.

Now that Dibs AI has become part of your practice, what has been your experience?

Limbaugh: Dibs AI allows for very efficient bracket placement, leading to minimal repositions down the road. It creates a wonderful patient experience, and I have gained new patients just from word-of-mouth about how easy the bonding process is.

Jergensen: It has been fantastic. My time has been freed up to spend time with new patients. Our patient bonding appointment times have been cut in half. We learned that following the guidelines from OrthoSelect make for a happy office!

Waddoups: It’s a fast turnaround—less than a week to get the trays. My staff clicks in my brackets and butters them up for me, and bonding is a breeze. It does take a bit of technique and learning on the staff side. We quickly learned some tricks, so our bond failure rate has been as good as or better than doing it by hand.

Have you experienced anything from using Dibs AI that you didn’t expect?

Jergensen: Much happier patients because they have their mouths open for less time and our bond failure rate has decreased. We love being able to bond all 7s upfront and starting them in treatment. This has cut down our treatment time.

Waddoups: I liked it more than I thought I would. I can schedule initial bondings at any time of the day, knowing that I can move to the next exam quickly. It’s perfect for doctor-time efficiency. It has also resulted in fewer repositions and quicker marginal ridge alignment than I’ve obtained by hand in the past. Smile arch positioning is a lot of fun using Dibs AI as well. The anterior vertical control is very precise!

What have been the business benefits?

Jergensen: Efficiency leads to cost savings. Our schedule has opened up, which means we are able to spend more time training and being with patients to educate them. Happy doctor, happy staff!

Limbaugh: It allows my practice to continue to grow because my start appointments take half as long to complete, opening up my schedule for more starts. Another way it opens the schedule is down the road when I don’t have to do as many bracket adjustments.

What is the cost/benefit trade-off?

Waddoups: Lab cost is much less than my chair-time overhead. If you are a busy practice and struggling to get to your exams because of bondings, throw a couple of Dibs AI cases into the mix and give it a try!

Jergensen: The benefits far outweigh the cost. We initially started with OrthoSelect because the cost was more reasonable than other options. The amount of chair time per patient has decreased; therefore, our profits have improved as well.

Limbaugh: Initially, I was concerned about the added cost, but that’s no longer a worry of mine. It absolutely pays for itself with efficiency.

Dr. Jergensen and Dr. Waddoups, how did you decide to have OrthoSelect 3D-print your IDB trays?

Jergensen: We felt it was the most cost-effective way with the least amount of failure. Our experience has been perfect!

Waddoups: I have my own 3D printers, but the turnaround time at OrthoSelect is really quick. I ran the numbers, and it was more cost-effective and efficient to have OrthoSelect print them.

Dr. Limbaugh, you do your own 3D printing. How did you decide to do that, and what has been your experience?

Limbaugh: I wanted the ability for a very flexible schedule, so printing the indirect bonding trays allows me to schedule as quickly as I need to. The scariest part was worrying if we could handle the software, but the training we received was great. After a few minor learning curves, we’ve hit the road running! Are you tracking direct-bonded cases vs. those you do with Dibs AI?

Jergensen: We see that our schedule has lightened, patients are in the chair for less time, and I have more free time—a lot more!

Waddoups: I’m tracking bond failure and repositioning. As I mentioned earlier, bond failure has been similar–and perhaps slightly better if you include the hassle of bonding 7s. I’ve had a few repos, but very few. Dibs AI is beating my hand-positioned repositions stats so far!

What advice would you give to your colleagues who still rely on direct bonding?

Waddoups: Give it a try to see if it makes sense for your practice. My staff loves it, and I love being more efficient. My chair time at a bonding appointment is now to stop by, give them a high-five and check out how cool they look with braces. It does require a small amount of time in front of the computer outside of their visit, so you’ll want to consider that as well.

Jergensen: Bite the bullet and make the change! Trust the leaders in this technology and follow their instructions. Limbaugh: I would encourage all of my colleagues to give Dibs AI a try. You will find a happier office: doctor, team and patients.

To find out more about how Dibs AI can transform your practice, visit dibsai.com.
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