For centuries people have been attempting to move and straighten teeth to improve the way their smiles look as well as their ability to chew properly and maintain a healthy mouth. Today’s clear aligners and colorful braces and retainers are well accepted, but braces and orthodontics were not always so cool.

Here’s a quick look at the history of braces and how much orthodontics have changed along the way.

Articles

Braces Have Come a Long Way in the Cool Factor

SmileDirectClub has announced their new Lifetime Smile Guarantee™, an offering that will allow customers to qualify for one free set of aligners annually.

If customers complete their clear aligner therapy with SmileDirectClub and order two retainers per year through their retainer prescription, they will qualify for the Lifetime Smile Guarantee.

This program was designed to help SmileDirectClub members gain more value from their membership and to help members maintain upkeep of their smile, according to a press release from the company.

This offering will guarantee customers the ability to qualify for free aligners. 


SmileDirectClub Announces New Lifetime Smile Guarantee Program

Anatotemp is announcing the inclusion of the Anatotemp SC anatomic dental implant healing abutment and scan body library into the 3Shape dental implant laboratory and model creator software.

By using the Anatotemp SC, which is both an anatomic healing abutment and digital body scan body, it is able to perform multiple functions and save the implant clinician time and energy, according to a press release from Anatotemp.

Anatotemp will incorporate anatomic dental implant healing abutment and scan body library into the 3Shape dental implant laboratory and model creator software. 

Anatotemp SC Teams Up with 3Shape to Streamline Digital Dental Implant Workflow

3D printing technology has many capabilities for restorative dentistry regarding patient experience and practice growth. 3D printing also opens up many possibilities for same-day dentistry. We spoke to two of our dental technology experts to hear how you can incorporate 3D printing into your restorative workflows. Here's what they had to say. 

John Flucke, DDS and Technology Editor for DPR, uses his 3D printer in restorative workflows in many ways. For example, his private practice in Lee's Summit, MO, uses the 3D printer for temporaries, surgical guides, and virtual implant placement, among other capabilities. He says 3D printing ramps up what you can do in same-day dentistry for a patient with a missing tooth (or teeth) or mixed dentition that wants their teeth "fixed." With a cone-beam device and a 3D printer, you can treatment plan implant placement. He says you can put the implants in precisely the places you want them down to the tenth of a millimeter and 3d print the surgical guides.

"Somebody can walk in either completely edentulous, edentulous with an ill-fitting denture, or partially edentulous, and within 24 hours, they could have implant surgery and have the situation rectified," Dr Flucke says. "And that is something we have never been able to do before."

Moreover, the surgical guide provides such precision that you don't have to guess if you have the placement correct, he says. Dr Flucke says that hand skills in these cases are not as important as the skill in designing with the software.

"The actual drilling of the holes in the patient for the implant anybody could do because it's been so simplified," Dr Flucke says of the 3D printed surgical guides. "But you have to know what you are doing with the software."

Dr Flucke says you can print anything you can imagine, adding that on his desk, he has a butterfly he printed. You can print dentures, screw-retained temporary crowns that you place on the day of surgery, or occlusal guards, to name a few. Like the surgical guides, it is best to design the appliance in the 3D printer's software to optimize the fit and minimize adjustments. 

"In the computer, you can design a nightguard and then print it and it fits. You can line it up, just like everything else, so that when you put it in the patient’s mouth, you don't have to make adjustments," Dr Flucke says.

However, you can make adjustments to your restorations if necessary, he says, and they are easier and more efficient with 3D printers. For example, in a full-mouth reconstruction for a heavy bruxer who has worn down their teeth by several millimeters, you can make a prosthesis that is a few millimeters taller than the teeth are now to see how it feels in the jaw joint when the patient chews. If the prosthesis isn't tall enough, you add a couple of millimeters to the design and print a new one to see how that feels, Dr Flucke says. 

"Printing one of these in an hour is so nice," Dr Flucke says. "It used to be when people would do this, they literally would do it either with plastic crown and bridge temporary material or sometimes building the teeth out one by one with composite. You can imagine what that must have been like for both the doctor and the patient."

3D Printing is also great for when a patient loses a denture. The practice can print a new denture from the existing digital files, and the patient or caregiver can come to pick it up. It will fit because it is the same denture they had before.

"That is the great thing about all this digital stuff," Dr Flucke says.

Dr Flucke had a patient who called in because her dog ate her occlusal guard. It was simple for him to replace because the files were in the cloud. Like a Word document, he says, you can print as many copies of the files as you want.

"I said, 'okay, you want a new one? Let me just hit the print button, and in about 52 minutes, you can come by and pick it up,'" Dr. Flucke says.

Dental materials manufacturers release new 3D printed permanent materials so dental professionals can 3D print final crown restorations instead of milling them. Right now, there are at least three available, which are resin-based monomers. However, they are brand new, so there isn't much research on whether these materials can hold up long-term.

Dr Flucke says that he wouldn’t be worried about using these materials. Still, he would set proper patient expectations and only use the materials for a permanent restoration on a case-by-case basis at this point. For example, he would have concerns about using these materials with a placement where powerful occlusal forces exist or where the patient has broken crowns before. Furthermore, any restoration placed with these materials would need to have appropriate preps and margins before feeling comfortable. He says exercising caution with untested materials is paramount because you are "dancing on the edge" of innovation. 

"When you have something brand new, you want to make sure you are using it in the most judicious way possible," Dr Flucke says.

Dr Flucke says that you and the team must be comfortable working with the software for your 3D printer. He also recommends making it part of what the team members do in the office. It not only frees up the dentist's time for the hands-on work he or she needs to do, but it gives the team more job satisfaction to work with technology. They appreciate it.

"If you're compensating the team with a bonus based on production goals, then printing more occlusal guards in a month is good for everybody. It's not like the team members feel like, 'Oh great! One more thing I have to do,'" Dr Flucke says. "My team looks at it like it helps them get closer to hitting their production goals for the month. That rising tide floats everybody's paycheck."

Jeff Rohde, MS, DDS, has a private practice in Santa Barbara, CA, and has been delivering same-day dentistry care for many years. He feels that same-day dentistry technology like his 3D printer allows him to provide the same high-quality care he always has, but faster.

"Same-day dentistry is not hurry-up, garbage dentistry," Dr Rohde says. "Same-day dentistry is a way to deliver high-quality care, just using new technologies."

Recently, his 3D printer allowed him to provide a temporary stent for an older adult in her 70s who had fallen and shattered her bridge, which extended from the back molar to the front tooth. Dr Rohde did a CEREC® scan, which he then sent to the lab for a 3D Digital wax-up. They sent the model as an STL file, which Dr Rohde printed in-house. A week later, the lab returned her permanent restoration. When Dr Rohde compared the final bridge with the temporary one he had printed a week earlier, he saw that the temporary was as good as her original bridge, which he credits to the design software and scaffolding with which he had to work. 

Another area where the 3D printer comes in handy is with long-term Provisionals. For example, Dr Rohde says, if a patient has knocked out teeth in the anterior and may or may not have an implant, you need to make a flipper. Dr Rohde and the team do a digital scan, print the model, which he says takes about thirty minutes to print, and then scan the model into the system. He then designs an Essix retainer with temporary tooth mills out of a material that he doesn't have to fire and then bonds into the retainer's edentulous space. The patient leaves with a perfectly-matched, clear aligner Essix retainer with a tooth on the same day. All of this takes an hour to fabricate, he says.

These are only two recent examples of how he uses the 3D printer. He says there are many ways to use it to deliver the care you want faster with the help of same-day dentistry technology. Moreover, that workflow is the future of dental care.

"That's where we are going," Dr Rohde says of the same-day dentistry workflow using 3D printing. "How can we do more rapid treatment to the final result without compromising?" 

Dr Rohde knows that some dentists are resistant to the idea of incorporating same-day dentistry and 3D printing technology into their workflows. He says he often has conversations with dentists that say they don't want to design their restorations. Dr Rohde explains that the software has improved to the point that it is not difficult to create restorations. 

However, Dr Rohde also says that the decision to move forward comes down to how the dentist wants to grow their practice. Same-day dentistry experiences are better for patients and provide quality care faster. You only have to numb patients once, and patients don't have to come back. While it's not the only way to provide quality care, Dr Rohde thinks using same-day dentistry technology like 3D printers is the better way to do so.

"We should be using the latest materials and technology that can give our patients a better experience," Dr. Rohde says. “What kind of practice do you want to have?”

3D printing has the power to capture our imaginations for what is possible in same-day dentistry. We spoke to a couple of our dental technology experts to find out how to incorporate 3D printers into restorative workflows.  

How to Incorporate 3D Printing into Restorative Workflows 

Henry Schein One announced the launch of Dentrix Imaging Center, a digital imaging system designed to manage all images within Dentrix versions G7.3 or higher.

Dentrix Imaging Center was designed with efficiency solutions in mind, allowing for just one imaging module for one system, rather than multiples between different software, according to a press release from the company.

Dentrix Imaging Center is capable of procuring various images such as intraoral 2D, 3D, panoramic, cephalometric, and CAD/CAM from various imaging hardware.

To learn more about Dentrix Imaging Center, visit the website 

This new imaging software aims to simplify image management in the Dentrix System. 

Henry Schein One Announces New Dentrix Imaging Center

Oral wellness company ARKRAY USA, Inc.’s latest version of SillHa Software called mySaliva enhances the company's exclusive SillHa Oral Wellness System for salivary screening. The system is used by dentists and oral healthcare professionals to assess, educate, and collaborate with patients regarding their oral health and wellness.

The mySaliva report offers a comprehensive assessment using 7 key analytes of oral wellness that are clinically validated and indexed in easy-to-understand, patient-friendly terms: low, moderate, or high risk for oral disease. Customizable fields allow for personalized feedback.

Patients and healthcare professionals can then monitor and compare test results over time in subsequent visits, using mySaliva charting features to measure the effectiveness of preventative measures or changes in a patient's oral health.

The new mySaliva software was designed with extensive user feedback resulting in a patient-centered, visually appealing format, according to ARKRAY USA. Dental professionals can now generate immediate, customizable, clinically validated reports chairside in 5 minutes to begin an oral health discussion with their patients.

"Using innovative technology in a simple format fits today's model of engaging patients in their health care and promotes discussion to develop confidence between patients and health care providers and a ‘seeing is believing’ attitude among even the most treatment-resistant patients while promoting quality oral health care,” says ARKRAY USA President Bob Guest. “We feel SillHa is going to be a valuable tool for all dentists to motivate patients to set goals for better oral health and monitor progress towards them. This has the potential to change the path to preventive dentistry."

ARKRAY USA’s salivary screening system is used by dentists and oral healthcare professionals to assess, educate, and collaborate with patients regarding their oral health and wellness.

New mySaliva Offers Enhanced Reporting Software for SillHa Oral Wellness System

Carestream Dental has debuted the CS 2400P, a portable, battery-free x-ray generator. The CS 2400P is small enough to be handheld and its battery-free recharging system is designed to be fast and convenient.

The unit is said to be able to go from completely discharged to ready-to-go in less than 3 minutes thanks to its battery-free design. The CS 2400P is also able to capture multiple shots before needing to be recharged, which is said to only take seconds.

The CS 2400P’s exposure parameters are designed to be similar to those of a conventional generator (70 kv; 3,5 mA), so image quality is not sacrificed by the unit’s compact size or portability.

Its portability means it can be transferred between operatories and it frees up valuable space within the practice. For more information, visit 

The new CS 2400P is a portable, battery-free x-ray generator that can be transferred between operatories and frees up wall space.

Carestream Dental Debuts Portable, Battery-free X-ray Generator

A universal material that you can use anywhere sounds excellent to many clinicians. However, one material that works in every case and every mouth sounds too good to be true, which may leave some dentists feeling skeptical. We spoke with 2 dentists about universals today and whether the term “universal” is accurate or aspirational.

Universal materials describe products that you can use anywhere in the mouth, on any tooth, and expect to get consistent results. For example, a universal composite resin is intended for use in anterior and posterior cases. It should produce long-lasting restorations that have the mechanical properties and esthetics needed for either area. Dental professionals want to ensure that a universal composite has:

enough strength to stand up to compressive forces;

sufficient esthetics to look natural and blend in with surrounding dentition;

satisfactory polishability to maintain the restoration's luster; and

adequate handling that can produce the desired results when working with it.

Jeff Lineberry, DDSDDS, FAGD, FICOI, AAACD is a cosmetic dentist in private practice in Mooresville, North Carolina. He has a streamlined definition.

“It’s a no-nonsense, keep-it-simple kind of resin,” Dr Lineberry says.

Jason Goodchild, DMD, vice president of clinical affairs for Premier Dental Products, says the idea of universals comes from 20th-century hybrid composites. In the earlier days of composite resin technology, dentists used macro fills in the posterior for their strength and micro fills in the front for their esthetics. The next idea was to mix the resin’s particle sizes to make a hybrid, which had the macroparticles strength and the microparticles esthetics.

“It’s almost like universal composites may be evolutionary of hybrid composites because we used to use hybrids everywhere,” Dr Goodchild says.

Simplicity is essential with universal composites. Dr Lineberry uses shade matching as an example of how universal composites streamline the restorative process. Also, he says many universal composites are more translucent than other composite resins, creating the chameleon effect so the composite blends with the surrounding dentition. The chameleon effect makes it easier to shade match with a single shade, which is convenient for dentists.

“People want a composite where they don’t have to figure out shade. They don’t want to have to think about whether it’s an A2 or a B3. They want something they can stick in the tooth, and it blends in well. They don’t want to have to think about it much more than that,” Dr Lineberry says.

Dr Goodchild says manufacturers and dentists would also like to get to a place with universal materials where there are fewer things to consider. He thinks dentists would like to know if they see “this,” then they use “that”—what he calls “cookbook style” dentistry.

“That ‘if-then’ approach is beneficial for a dentist, who is moving fast and encountering so many different clinical situations,” Dr Goodchild explains. “Wouldn’t it be nice if you just had a material that works everywhere?”

Does Universal Really Mean Compromise?

Today’s universal composites are no longer struggling with the balance of strength and esthetics. Dr Lineberry credits that to the development of nano-hybrids and the mechanical properties their composition produces. Esthetics are a concern only in specific cases when using a universal.

“It’s where you get into some of the odd colors or characterizations when you see that one composite doesn’t do it all,” Dr Lineberry says.

Knowing the limitations of your product is essential too. Dr Lineberry says that he would not layer enamel and dentin shades with a universal on a complicated case because the results might not be as predictable as if he used his composite kit. Moreover, those universals that rely heavily on the chameleon effect for shade matching might not work in every case you encounter in your chair.

“It works,” Dr Lineberry says of universal composites that use the chameleon effect, “and probably for a lot of your patients, they will be excellent. But if you have an esthetically demanding situation, it might not fit the bill for that.”

Part of the desire for finding that universal material is feeling overwhelmed by the number of new materials that launch in the industry. Dr Goodchild says it is a lot to digest and challenging to stay up-to-date to get the best results possible.

Dr Goodchild counts himself among dentists who want a material with minimal considerations that can work almost anywhere with as few compromises as possible. However, he adds that it isn’t possible to have one material optimal for use in every tooth and area of the mouth for every clinical situation without making compromises. The manufacturers’ approach, he says, is to give clinicians a material that minimizes those trade-offs—an approach that goes beyond composites.

“That’s true on every level in dentistry. That’s cement, adhesives, composites, and even impression materials, although we don’t call them ‘universal’ impression materials,” Dr Goodchild says. “We want to be able to use them anywhere in the mouth.”

What to Look for in a Universal Composite

Some dentists love digging into the details of materials. Others only want what produces consistent results, which means they might be using a composite that’s been around for 10 years or more. Moreover, Dr Goodchild says, if dentists can get a universal material that works pretty well most of the time, then why change?

“It takes a lot to get the dentist to switch because that’s an unknown for them,” Dr Goodchild says. “They think, “I know how this stuff works. I don’t know how your stuff works.’”

He says the idea of a universal material is still evolving. Manufacturers and clinicians are still working on what universal means to them. Does it mean inject it into the cavity in one step? One layer and done? Or should there be a couple steps so that it blends into the tooth? Moreover, there are different features that clinicians like more than others. For example, in the traditional packable composite category, 3M™ Filtek™ features excellent handling, but in the chameleon category, Tokuyama’s Omnichromalends exceptionally well, he says.

“Having both would be better. To me, that’s the home run if you have the chameleon effect and the handling all in one,” Dr Goodchild says of the universal composites.

He adds that the improvements now are incremental, not monumental. The characteristics he notices now about the different composites are details like whether it blends, works well in his hands, tends to pull back, or packs easily.

“Don’t get me wrong,” Dr Goodchild says. “I don’t think we’ve reached the pinnacle of resin technology in dentistry. We still have room. But on our current path of methacrylate-based resins, we’re doing incremental changes.”

Dr Lineberry agrees: “Most of the universal composites, and composites in general, have the same wear characteristics, volumetric shrinkage, and things like that. But some handle differently. Some stick to the instruments. Some slump and are not as firm. Others are very firm. So I would say find the one that works well in your hands.”

In addition, Dr Goodchild notes that the universal label in dentistry might be overused, with many players in the market now with different universal features.

"There are the packable ones, the blending types, and the ‘all in ones,’ which are like self-cures,” Dr Goodchild explains. “It doesn’t necessarily simplify things, and now we’re numb to the idea of universal because we hear it so much.”

“It’s kind of a marketing thing,” says Dr Lineberry.

That being said, Dr Goodchild says that choices and options are good for universals and that he enjoys the fact that if you ask 10 dentists about how they do a composite, you get 10 different answers—which, he says, is OK as long as the result is the same.

“It’s like typing an address into Google Maps. You get 3 different ways,” he says. “Each of them gets you there. They are just taking you on a different path.”

Although they’re marketed as well-suited for restorations anywhere in the mouth, some dentists remain skeptical about whether they’re really suitable for every case.

How Universal are Universal Materials?

BencoDental has provided BencoNET Managed Support, a computer and software protection program that will be able to keep patient and office data secure, according to a press release from the company.

A dental practice can purchase a FortiNet router and security package and then they will be able to add BencoNET Managed Support. This remote support can monitor software systems to ensure proper antivirus functions. This Managed Support also includes an antivirus software to protect the server.

BencoNET Managed Support protects data through two levels of security. 

BencoDental Provides Software Security in the Form of BencoNET Managed Support

GreenMark Biomedical Inc. has announced its FDA clearance for marketing of their LumiCare™ Caries Detection Rinse as a 510(k) Class II Medical Device.

LumiCare rinse illuminates sub-surface porosites in the enamel by way of bioresorbable starch-based nanoparticles that degrade in the enzymes of saliva. Using this visualization process, caries can be detected earlier on, according to a press release from the company.

GreenMark hopes to integrate LumiCare into dental practices soon.

To learn more about LumiCare, visit the website 

GreenMark Biomedical has secured clearance from the FDA to begin marketing their LumiCare Caries Detection Rinse. 


New mySaliva Offers Enhanced Reporting Software for SillHa Oral Wellness System

Carestream Dental Debuts Portable, Battery-free X-ray Generator

How Universal are Universal Materials?

BencoDental Provides Software Security in the Form of BencoNET Managed Support

GreenMark Gains FDA Clearance for LumiCare Caries Detection Rinse