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Industry Insights: AI-Powered Bonding

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Industry Insights: AI-Powered Bonding 

A conversation on digital indirect bonding with OrthoSelect

There has been growing interest in digital indirect bonding (IDB) among orthodontists of late. We recently spoke with Ryan Williams, VP of sales and customer success at OrthoSelect, to get his perspective on changes in this sector of the industry. OrthoSelect is the creator of Dibs AI, a leader in the IDB space.


There has been growing interest in IDB recently. Why now?
The most recent data indicate that fewer than 20% of doctors use any form of indirect or digital bonding. Why? Because it hasn’t made sense—specifically, business sense. Until now, the work has not been worth the benefit for most doctors. However, technology has now made digital bonding more efficient than direct bonding, and the demand is growing!

Over the past five years, two technology shifts have opened the door for orthodontists to benefit from digital bonding.

First, in 2019, we discovered the recipe for 3D printing high-quality, accurate bracket transfer trays (or jigs). With trays that worked, the door opened to build the software and systems needed to make it easy and efficient for doctors to use their favorite brackets and achieve faster treatment results at a lower cost.

Second, aligner providers pioneered the concept of “digital orthodontics” and “digital workflows.” Aligners helped most doctors digitize their practices, paving the way for digital bonding with brackets and wires that follow that same digital workflow. While the “efficiency pendulum” may have swung toward aligners for a time, it is now swinging back toward brackets and wires.


What are the most common reasons doctors seek out digital IDB?
We help solve many different problems. Let me boil them down to the top three:

 1. Efficiency. This is easily the top reason doctors give, but different doctors define efficiency in different ways:
  • Most doctors want shorter treatment times. Better planning visibility and accurate bracket placement deliver efficient tooth movement, faster treatment and better finishes with fewer appointments. Patients love it, and doctors make more money with less work—this is why that pendulum is swinging back to brackets and wires.
  • Some doctors focus only on the bonding appointment. They have workflow logjams or scheduling issues and seek to reduce the chair time needed to bond a patient. Most want to delegate bonding so they can spend their time on consults and other, more valuable tasks.
2. Digital bonding reduces staffing challenges. Finding, hiring and training good people is hard and business owners find they can do just as much work with fewer or less expensive staff.

3. A digital workflow has multiple benefits for doctors. Now, practices can have consistent processes regardless of whether a patient is an aligner or bracket candidate. Staff members are empowered to do bondings. Appointments stay on track, and things run more smoothly in the office—staff never want to go back to an old-school analog process.


How does digital IDB compare with aligner treatments?
There are similarities in the digital workflow process, but our doctors prefer brackets and wires for the mechanics, better compliance, freedom of bracket choice and a 75% discount on their lab fees. Saved appointments and business efficiencies are virtually the same—so doctors enjoy the same chair-time efficiencies with brackets and wires without the fees of aligners.


What are the pros and cons of the major digital IDB systems?
We see five major players in the market. Based on our experience and discussions with doctors, here’s how they compare:

Dibs AI
  • Pros: The lowest fee available, a five- to six-day turnaround time, compatibility with all brackets and an in-office printing option.
  • Cons: Doctor digital time for case approval is approximately 10 minutes, and some clinical training is required for best results.
LightForce
  • Pros: Custom setups and custom brackets.
  • Cons: A four- to six-week turnaround time, high fees, no metal bracket option, frequent reordering of brackets and jigs, and no in-office printing option.
Solventum 3M
  • Pros: A single vendor for aligners, brackets and indirect bonding—also offers prepasted brackets.
  • Cons: 3M brackets only, two- to three-week turnaround time, thermoformed trays and no in-office printing option.
Ormco
  • Pros: A familiar software for both aligners and digital bonding.
  • Cons: Limited bracket options (Ultima only), more complicated clinical delivery, a two- to three-week turnaround time and no in-office printing option.
KLOwen
  • Pros: Custom case setups and custom metal brackets combined with digital bonding by Dibs AI.
  • Cons: A two- to four-week turnaround time and a higher cost. The in-office printing option is being discontinued.

What makes Dibs AI special?
Dibs AI has revolutionized digital bonding. Here are the top five things Dibs AI provides:
  1. Affordable pricing. One of the lowest on the market.
  2. Five- to six-business-day turnaround time from case submission to delivery, with the doctor’s preferred brackets inserted/preloaded.
  3. True-torque expression. We no longer assume full expression of the wire—we calculate slop for more accurate predictive models.
  4. Reusable and patented trays with a sure-release nonstick coating for a better clinical experience.
  5. Doctors can choose their own brackets. We do not force doctors to change their preferred bracket system—we configure our system to their bracket prescriptions.

What is the difference between digital bonding and indirect bonding?
Technically, Dibs AI doesn’t use the indirect bonding method. We still call it that because it helps doctors understand the concept of what we do, but Dibs AI does not print models to manually place brackets on them to create thermoformed trays, as with old-school indirect bonding.

Instead, it is entirely digital, generated by AI algorithms in real time on the computer screen. We simply print the tray itself at the end. We have eliminated massive amounts of labor, processing time and materials. As a result, we pass along those efficiencies in lower fees while still printing, processing, packaging and shipping hundreds of cases per day within 24 hours of case approval.


What data-driven research has been conducted and what have been the results so far?
Based on ongoing feedback from our doctors, three studies can be summarized as shown in Figure 1.
Industry Insights: AI-Powered Bonding
Fig. 1

Taking the average of these three studies and applying it to calculate our impact on revenue per appointment, the results are as shown in Figure 2.
Industry Insights: AI-Powered Bonding
Fig. 2

This is an impressive, approximately 25% increase in profit for those who implement the system.


What are the effects of Dibs AI on office workflow?
Dibs AI digitizes the bracket and wire workflow—essentially matching it to the aligner workflow doctors already use. This simplifies office processes and creates consistency, regardless of whether a patient chooses aligners or brackets. The big hidden benefit is boosted staff morale and a sense of empowerment to conduct bonding appointments with 100% confidence that the doctor has approved the case and the brackets are in the right spot.


What are the biggest challenges doctors face when implementing Dibs AI in their practice?
The No. 1 challenge for new Dibs AI clients is the belief that the indirect bonding they did in the past allows them to “wing it” and skip training on Dibs AI. Think about it—if old protocols didn’t work the first time, why would they work on a new digital system?

We do not use failed protocols from past systems. Today, we work with AI technology with more accurate predictive outcomes, a completely new tray design made of entirely new materials that soften as they warm. We’ve also added new techniques to reduce flash for a superior patient experience.

The second challenge is that doctors either overestimate or underestimate the power of AI-driven software. Some believe the AI will do their jobs for them, somehow learning only their good habits—and none of the bad—in just a few cases. This isn’t reality. Machine learning requires a ton of data. And let’s be honest, do you really want AI to replace you?

Doctors often assume that AI means the software will make decisions for them and eliminate the need to review cases. However, doctors still need to be doctors and review each case to ensure optimal results.

Others underestimate bracket placement in Dibs AI. Our advantage is that we start with the end in mind. We visualize the future tooth position and occlusion relative to the bracket prescription. We calculate wire engagement to predict third order bends and a host of other advantages that are impossible to see without simulated models.


How is AI used in the software today, and what does the future hold?
AI in digital bonding is in its infancy. So far, AI has simplified and automated digital bonding, eliminating many hours of work and reducing case costs using dozens of sophisticated algorithms. The future will bring more automation, as well as increasingly accurate simulations, biomechanics, treatment recommendations and cost-effective customizations of case setups to specific doctor preferences.


For more information, visit dibsai.com.
Ryan Williams In his role as vice president of sales and customer experience for OrthoSelect, Ryan Williams sees the unique issues orthodontists face and enjoys assisting doctors in implementing technology they can use to become more efficient, effective and profitable. Williams has a background in technology marketing and sales with a degree in finance and accounting, including an MBA from the University of Utah. Outside of work, Williams is a husband and dad of five. He loves to travel, ride dirt bikes and play golf with whatever time is left!



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