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

Shifting Gears by Dr. Andrew Sarpotdar

Start Discussion More by this author (7)
Categories: Orthodontics;
Shifting Gears 

From manual mastery to digital precision

by Dr. Andrew Sarpotdar

This may age me, but I remember the pride I felt driving my first car, a 1998 Ford Ranger with a manual transmission. Even in the ’90s, stick shifts were uncommon, but the street cred from knowing how to drive one was epic. That skill got me a summer job as a valet at the W Hotel in downtown San Diego, where I parked the latest luxury cars the wealthy patrons could afford.

I loved my manual, but after long road trips and a few stall-outs on the hills of Del Mar Heights, I began to appreciate an old adage: Just because I could do something didn’t mean I should keep doing it. Trading that Ranger for an automatic Lexus ES350 was bittersweet, but it made the long commute to my first associate job so much smoother!

I still take pride in being able to drive stick. The connection between driver and machine—the way you feather the clutch, match revs, and slot each gear—gives you a feel for the car’s soul that an automatic driver will never know.

As orthodontists, we’re similar. We are masters of smile creation, trained to perfection in the art of zero-prescription braces, cephalometric analysis with nothing but a pencil and tracing paper, leveling an arch with nothing but Australian round wire and Snoopy loops. Some even joke they can move teeth with chicken wire and chewing gum. But we must not let our hard-earned skills prevent us from embracing technology that can make our lives easier and our treatment more effective. As Dr. Alfred Griffin, CEO and founder of Lightforce, says: “What holds orthodontists back is that they’ve mastered the past.”


Shifting gears, the digital age of bonding
Technological innovation isn’t new to our field. The Andrews prescription reduced reliance on wire bending, and nickel-titanium wires eliminated many of the specialized appointments once needed to align teeth with steel or gold. In 1972, Elliott Silverman and Morton Cohen first described indirect bonding (IDB), placing braces on plaster models and transferring them to the patient using custom trays. Over time, this technique offered benefits: delegating bracket placement, improved accuracy through direct visualization, and shorter bonding appointments. The downside was increased lab time and technique sensitivity.

As digital imaging, 3D scanning, and printing evolved, many of those drawbacks were resolved. Intraoral scanners replaced messy impressions while improving accuracy. Virtual setups allow visualization directly on a screen, enabling real-time manipulation of final tooth positions and automated diagnostic tools like Bolton analysis, grid overlays, and even CBCT-based root visualization. Multiple treatment simulations can be created without cutting stone models.

3D printing also revolutionized tray fabrication and enabled direct printing of customized braces, as with Lightforce, allowing for precise slot parallelism. Digital workflows minimize the cumulative errors common in analog processes—distortion, shrinkage, and casting inaccuracies—while improving documentation and reproducibility. Some systems, like Ormco Digital Bonding and Solventum’s Clarity Digital Bonding, even integrate aligner workflows for hybrid treatments.

Of course, every advancement carries costs: scanners, software, printers, and staff training. Every company I interviewed cited employee training and workflow modification as the biggest implementation challenges. I evaluated five of the leading digital IDB options through personal use or direct interviews: Ormco Digital Bonding (ODB), Lightforce, KLOwen, OrthoSelect’s Dibs AI, and Solventum’s Clarity. Below, I’ll outline best-practice workflows and highlight differences among these systems.


The digital drive train, office workflow
For all options, a digital scanner is essential; however, the companies listed are all “scanner agnostic,” accepting .stl files from any scanner via export or direct upload. Submissions should be delegated to a reliable assistant and tracked using software such as EasyRX or Asana (I use the latter for cost and versatility).

Treatment goals must be clearly communicated before submission, via handwritten notes, a laminated diagnostic checklist, or detailed chart entries (my preferred method for simplicity). Within 24 to 48 hours, labs typically return an initial setup showing final tooth positions and bracket placement.

Unlike clear aligners, IDB setups have no staging; you’re positioning braces to achieve your desired outcome using standard mechanics. I prefer to hide the braces and wires initially but keep the occlusal heat map and grid overlay visible to evaluate final tooth position, then use 3D controls to fine-tune the occlusion, Bolton ratios, and smile arc. A cool feature is the ability to anticipate black triangles that result from alignment of overlapping contacts; thus, IPR can be planned in advance. I also love comparing diagnostic photos side-by-side with virtual setups to fine-tune smile arcs, something far harder when hand-placing brackets upside down.

Once satisfied, I resubmit for bracket placement refinement (usually back within 24 hours). After final approval, delivery typically occurs within a week or two.


Putting rubber to the road: The bonding process
The process mirrors analog IDB: Clean teeth with pumice, apply etch/primer, then seat the trays. I recommend bonding in sextants—starting posteriorly for easier tray seating and error isolation (mistakes are limited to one sextant rather than the whole arch). Full tray seating is critical to replicate the digital plan, and early mistakes usually stem from incomplete seating, so make sure your team is well-trained and monitored in this step.

Remove excess cement before curing (Solventum’s flash-free braces eliminate this step). Cure through the tray, peel lingual-to-buccal, then perform a secondary direct cure from multiple angles. Remove any remaining flash with a polishing bur, and you’re ready for wires.


Under the hood: A look at the big five
Ormco Digital Bonding
This is my office’s primary system and it’s important to note that I serve as a paid knowledge expert for Ormco. My experience with the product, along with discussions with Senior Product Manager Kees Wind, informs these insights.

Features: ODB integrates seamlessly with my preferred Damon Ultima brackets and Spark aligners, allowing mid-treatment transitions between the two. The software, currently app-based (web version coming soon), is one of only two systems offering CBCT integration for root visualization (the other is Dibs AI).

ODB supports Symetri Clear Braces, Damon Ultima, and Damon Q2—since the latter two are variable-torque, I consider this a “semi-custom” system. Ultima uniquely combines passive self-ligation with near slot-filling engagement for the benefits of both.

Turnaround and pricing: Typical turnaround is about three business days for setup, one day per revision, and five days post-approval for delivery. Pricing ranges from $300–$600 per case, including brackets, with discounts available through groups such as Mari’s List and Premier Orthodontic Practices.


Clarity Digital Bonding
Thanks to Dr. Christian Groth, key opinion leader for Solventum, for providing details. Like ODB, Solventum’s Clarity Digital Bonding integrates with its Clarity aligner platform for seamless hybrid workflows with braces and aligners. Its web-based portal handles both systems.

Features: It features the flash-free APC 2 bracket—the only built-in flash-free system (except when using Dibs AI with compatible brackets). Options include Victory metal, SmartClip, and Clarity Advanced ceramic.

Turnaround and pricing: Turnaround is two to four business days to setup, with one day between revisions, and 10 days from approval to delivery. Pricing is volume-based; brackets are purchased separately and loaded by the office.


Lightforce
Founded Griffin in 2015, Lightforce introduced a fully custom, 3D-printed bracket system, a true shift from traditional injection-molded brackets. Each bracket base conforms precisely to the tooth surface, eliminating variable glue thickness and ensuring parallel slot walls—making this not just IDB, but a new category of fully custom braces.

Features: Currently offered in clear twin design, Lightforce provides a second backup set with jigs for replacement. Lost brackets must be reordered promptly, which adds administrative work and may complicate transfers between offices. Re-bonding or re-positioning also requires rescanning and remanufacturing; however, these limitations may be offset by unmatched customization and resulting efficiency. The software is web-based and even includes in-app note charting.

Turnaround and pricing: Typical turnaround is 17 hours for initial setup, 14 days from approval to delivery—around four weeks total. Pricing averages less than $800 per case, including braces, revisions, and replacements.


KLOwen
Founded by Dr. Brandon Owen in 2019, KLOwen bridges the gap between stock and custom systems. It combines a library of 15 bracket options per tooth with differential base glue thicknesses, yielding torque prescriptions from +25° to –35°.

Features: Available in metal twin, clear twin, and metal self-ligating designs, KLOwen’s proprietary brackets and fully web-based software have improved dramatically since being brought in-house in 2025.

Turnaround and pricing: Turnaround averages three weeks (seven days for setup, 24-hour revisions, and less than two weeks for manufacturing). Pricing runs about $400 per twin case, $475 per self-ligating with initial volume commitment. Typical ongoing pricing is less than $475 for twin and less than $575 per case for self-ligating, including preloaded braces. Mari’s List members receive additional discounts.


Dibs AI
Thanks to Ryan Williams, VP of Sales, for insights. Dibs AI evolved from 21 years of lab experience into a modern digital IDB solution. The system focuses on addressing historical barriers that prevented IDB from becoming standard of care.

Features: It’s the most affordable and most universal option—$165 per case (brackets not included)—and supports any stock bracket. Offices can even ship their inventory directly to Dibs for tray loading. The system offers both “slop” measurement and bracket prescription customization, along with CBCT integration for root visualization. It’s available as web-based or PC software and doesn’t require a technician once trained—making in-house planning feasible.

Turnaround and training: Comprehensive training is included with a volume commitment or purchasable separately. Turnaround is industry-leading: five to six days total, including 24-hour doctor approval and three to four days shipping. About 20% of users print trays in-house, reducing time even further.


The finish line
Each of these systems represents a different balance of cost, customization, and convenience:
  • Dibs AI excels in affordability and flexibility.
  • KLOwen offers a balance of stocked inventory with an exceptionally high degree of customization.
  • ODB provides tight integration with established Ormco systems including Damon Ultima and Spark Aligners.
  • Solventum’s Clarity integrates with their braces and Clarity aligner systems and emphasizes the benefits of flash-free bonding.
  • Lightforce stands alone as the fully custom frontier.

Ultimately, which system works best for you is a matter of preference, but all of them will require a shift in mindset. Like giving up my beloved manual transmission, embracing digital workflows doesn’t erase our mastery; it builds upon it.

We shouldn’t cling to the “old ways” out of nostalgia or pride. Mastery of the past should empower us to evolve, not hold us back. In orthodontics, as in life, growth often requires letting go of what once defined us—so we can drive further, faster, and with greater precision than ever before. 
Author Bio
Dr. Andrew Sarpotdar Dr. Andrew Sarpotdar is a board-certified orthodontist in private practice with his wife, Dr. Jenny Sun, in the greater Phoenix area. He attended dental school at UCLA before earning a master’s degree in orthodontics from Columbia University in 2013. Sarpotdar is a co-founder of the Orthodontic Pearls Facebook group, along with its corresponding annual meeting, the Mother of Pearls Conference, and is a strong advocate for collegiality and shared learning within the profession.
More In Orthodontics
Expand Your Reality
Expand Your Reality
Dr. Michael K. DeLuke
CE Credits: 1.5
Game Changers: Remote Monitoring and Referral Marketing
Game Changers: Remote Monitoring and Referral Marketing
by Dr. Roger P. Levin
September 2025
Poll: Treatment Planning
Poll: Treatment Planning
October 2023
Slop-py Work: Calculating Theoretical Torque Loss Utilizing Rectangular and Square-Shaped Archwires
Slop-py Work: Calculating Theoretical Torque Loss Utilizing...
Dr. Elizabeth R. Michalczyk, Dr. Noam Green and Dr. Alise Senderak
CE Credits: 1.5
Orthotown Magazine
November 2025
Orthotown Magazine November 2025 Read Current Issue Read Archived Issues
Sponsors
Townie® Poll
What percentage of your treatments involve traditional ortho (brackets, wires, etc.)?
  
Related Articles
A Voice in the Arena: Eyelets–The Magic Bracket
A Voice in the Arena: Eyelets–The Magic Bracket
by Dr. Chad Foster
March 2025
Product Profile: OrthoVOIP
Product Profile: OrthoVOIP
March 2024
Townie Treatment Case: TADs, Clear Aligners and Overkill
Townie Treatment Case: TADs, Clear Aligners and Overkill
by Dr. Bill Dischinger
September 2023
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
The Orthotown Team, Farran Media Support
Phone: +1-480-445-9710
Email: support@orthotown.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