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  • The Hidden Biomechanics of Fixed Appliances & Aligners | Orthodontics In Interview | MADHUR UPADHYAY

    The Hidden Biomechanics of Fixed Appliances & Aligners | Orthodontics In Interview | MADHUR UPADHYAY

    · orthodontics In summary

    “The reality is none of us use light continuous forces.”

    “Friction is awesome. Friction is great, we would be miserable if there was no friction
 (with) uncontrolled movement everywhere”

    “Segmented arch mechanics are very tough to gain three-dimensional control over the tooth.”

    “The last major landmark in fixed appliance and in orthodontics was the pre-adjusted edgewise appliance.”

    “The root is not moving according to the wish of the orthodontist (with aligners)”

    I’m joined by Madhur Upadhyay for a deepexploration of biomechanics, biology, and the true limits of orthodontic innovation. We examine advances in appliances, aligners, and digital workflows and why they have, as of yet, not improved speed or quality of clinical outcomes,and innovation is still governed by the same biological constraints that dictated tooth movement a century ago. However progress has been significant in workflows for both fixed and aligner therapy.

    We also discuss why complex biomechanics arerarely implemented in routine practice, whether pre-adjusted appliances were the last major landmark innovation, and what aligners can, and cannot, achieve in terms of root control in terms of biomechanics. The conversation extends toartificial intelligence in diagnosis and treatment planning, asking whether automation enhances clinical care or gradually replaces critical thinking. We conclude with thoughts of micro and nano-plastics and the focus needed on this topic in orthodontics.

    Please like and subscribe if you find it useful!

    Please visit the website for this interview podcast:

    https://orthoinsummary.com/the-hidden-biomechanics-of-fixed-appliances-aligners-orthodontics-in-interview-madhur-upadhyay/

    .

    Publications by Madhur Upadhyay

    Biomechanics of clear aligners: hidden truths & firstprinciples 2022 https://doi.org/10.1016/j.ejwf.2021.11.002

    ClearAligners in Extraction-Based Orthodontic Treatment: A Systematic Review andMeta-Analysis 2026 DOI: 10.1111/ocr.70052

    #OrthodonticsInSummary
    # Madhurupadhyay
    #Orthodontics

    #biomechanics

    #TADs

    #OrthodonticsInInterview

    #FarooqAhmed

    #OrthodonticBiomechanics

    #DentalEducation

    Farooq Ahmed

    🕒Timestamps of Key Questions & Answers
    01:43 Are We Overestimating Orthodontic Innovation?
    02:41 If Technology Has Advanced, Why Is Fixed Appliance Treatment No Quicker?
    08:55 Why Are Aligners Still Only 50% Predictable?
    12:23 Why Are Biomechanical Set Ups of Cantilevers Unpopular In ClinicalPractice?22:41 Have Bracket Prescriptions Stopped Innovation?
    26:42 MBT vs Roth – Does Prescription Really Matter?
    28:22 Can Aligners Truly Move Roots, OrIs It Just Tipping?
    33:37 Is Software Innovation Just a Distraction from Aligner Material Limits?
    36:15 AI in Orthodontics, Will It Replace Clinical Thinking?
    43:00 What Are The Most Misunderstood Concepts in Biomechanics
    51:07 The Micro and nano-plastic in Aligners

  • MISMARPE / DOME what is it?

    MISMARPE / DOME what is it?

    · orthodontics In summary

    MISMARPE / DOME what is it?

    Join me for a look at maxillary expansion combining both surgery with miniscrews. Seemingly opposite ideas have been brought together to offer potentially greater versatility in expansion, with less surgical complexity andcomplications.

    MISMARPE – minimally invasive surgery miniscrew assistedrapid palatal expansion Haas 2021

    Or

    DOME Distraction Osteogenesis Maxillary Expansion Liu2017

    Protocol

    · Osteotomy

    o Anterior vertical incision interdental toperiform fossa

    o Lateral incisions to the base of zygomaticprocess of maxilla

    o Without releasing the pterygomaxillary suture

    o Activate in surgery up to 20x ensure diastema

    o Duration 24 minutes (14.4-32) Junior 2021

    o Less pain – Mild on VAS

    · Expansion

    o 7 days no expansion

    o Expansion of rate 0.25 - 0.50 mm,

    § Some until diastema and slow to 0.25 per day

    Advantages

    · Less osteotomies required

    · Under sedation or local anaesthetic

    · Greater anchorage for force delivery throughminiscrews

    · Less intra-operative haemorrhage – due to a lackof pterygopalatine disjunction

    · Parallel expansion – Lin 2015 Vs V shapeexpansion

    Age

    Limitation of MARPE was age, with 20-30 years females 94% 20-30years males 80%, MARPE success 30-37 = 20% Olivera 2021, MISMARPE 96% successage 20-59, 24 patients majority over 30 years old Piccoli 2023.

    Expansion amount

    · Direct comparison show no significant differenceda Silva 3mm, and no difference in molar angulation 2023

    Indicated for:

    · Failed MAPRE

    · Age- greater 30 females and 25 for males

    Could MISMARPE / DOME replaceSARPE?

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  • Direct To Print Aligners, Will It Change Clear Aligner Therapy? 8 MINUTE SUMMARY

    Direct To Print Aligners, Will It Change Clear Aligner Therapy? 8 MINUTE SUMMARY

    · orthodontics In summary

    Direct To Print Aligners,Will It Change Clear Aligner Therapy? 8 MINUTE SUMMARY

    In this episode, I review direct-to-print alignersand how the material offers potential biomechanical advantages through itsmaterial properties when compared with conventional thermoplastic aligners. Theunique feature of force recovery of the material and current emerging evidence.The episode also explores the current limitations of the evidence base anddiscusses why, despite theoretical advantages, direct-to-print aligners havenot yet entered routine clinical practice. This podcast is based on a recent lectureby Jean-Marc Retrouvey.

    Timestamp

    00:27 – What are direct-to-print aligners?

    01:10 – How do direct-to-print aligners deliver force?

    02:39 – Push and pull forces and adaptation

    03:58 – Reactivation with heat, unique force recovery

    05:09 – Variable aligner thickness

    07:08 – Why haven’t direct-to-print aligners changed aligner therapy yet?

    Material photopolymer resins

    Force delivery – Push and Pull

    Engage with undercuts not possible with thermoformedaligners

    o Deliver forces to areas seen as non-engagedsurfaces

    § Non-engaged surface – greater displacement thanTFA (Hertan 2022)

    Force delivery – Adaptation

    · Closer adaptation 20-30% more accurate 30um or 0.03mm (48 um Graphy Zendura, Essix Ace and DPA Koenig2022).

    · Uniform thickness

    i. TFA Non-uniform thickness – due thermal process, thinner areasend of aligner

    ii. TFA sharp distribution around attachment / transition

    Force delivery material properties

    · TFA Stress relaxation – Reduce force with time,12 hours reduce 60%, DPA reduce to around 50%, but with recovery increase to75% Xu 2025

    i. Moment to force ratio more sustained for bodilymovement, in vitro study

    · Thickness customisation

    o Creating a force couple: 0.8 labial, Vs 0.5mmlingual , creating moment within the aligner

    Direct to Print Aligners 2 types: Shape memory Vs Activememory

    · Similarclaims:

    1. Re-activate force recovery through heating inwater reactivation and reverse stress relaxation and creep

    2. Customise thickness, trimlines and auxiliaries

    3. Less attachments

    4. Speed of printing aligner

    5. Less wastage

    · Shapememory: Graphy 2019

    1. Transition temperature – low 45 degrees, from30-45 degrees = increase temperature = reduce force. Re-activates inside themouth to maintain properties. Choi 2025

    · Activememory LuxCreo 2022

    1. Transition temperature – high 60 degrees =maintain elasticity

    2. Re-activated with warm water = restores mechanical properties

    Challenges:

    1. Little clinical research to support biomechanicalsuperiority

    2. Loss of force from insertion Xu 2025 50% in 12hours

    3. Effectiveness seems camparable for mild to moderatecases:

    a. PAR change DPA 86%, refinement of 40% VanessaKnode 2025,

    b. PAR change TFA 88.9% Jaber 2022, refinement of 70-94%Ladewig 2005, Kravitz 2023

    See Jean-Marc Retrouvey’s lecture in full: https://www.youtube.com/watch?v=j7fJmxgXHqU

    Previous podcast on Direct To Print Aligners February2024

    https://orthoinsummary.com/direct-to-print-aligners-are-they-really-different-to-normal-aligners-8-minute-summary/

    #aligneronorthodontics

    #directtoprint

    #orthodontics

    #orthodonticsinsummary

    #Farooqahmed

    #Orthodontics

    #Luxcreo

    #graphy

    #clearalignertherapy

  • Has MARPE Found Its Place?

    Has MARPE Found Its Place?

    · orthodontics In summary

    Has MARPE Found Its Place?

    Join me for our first podcast of 2026 looking at Miniscrew AssistedExpansion, and where this treatment modality currently stands in clinicalpractice. With discussions of different designs (MSE Vs MARPE), rapid andslow activation protocols, orthopaedic effects, and predictors of success. Thispodcast is a summary based on an excellent lecture from Angle-Net by DanieleCantarella and Benedict Wilmes.

    01:18 – MSE vs MARPE designs: key differences
    03:55 – Anchorage, bone quality, and force delivery
    05:29 – Skeletal effects: parallel suture split and expansion amounts
    06:42 – Asymmetry, resistance areas, and biomechanics
    07:00 – Class III correction: where MARPE really adds value
    09:26 – Rapid vs slow activation and what actually happens to bone
    10:28 – Predicting success: age limits, failure rates, and when to considersurgery

    #MARPE

    #MSE

    #expansion

    #orthodontics

    #orthodonticsinsummary

    #Farooqahmed

    #Orthodontics

    #dentalpodcast
    #orthodonticcommunity

  • Reflections on 20 years in Orthodontics | Orthodontics In Interview | BJÖRN LUDWIG

    Reflections on 20 years in Orthodontics | Orthodontics In Interview | BJÖRN LUDWIG

    · orthodontics In summary

    Reflections on 20 years in Orthodontics | Orthodontics In Interview | BJÖRN LUDWIG

    “We focused so much ontechnology that maybe we neglected diagnostics.”

    “Anecdotal is inspiring,but we need evidence for the average orthodontist.”

    “If we don’t protectacademic journals, orthodontics becomes vulnerable, legally and professionally.”

    “Orthodontics grows whenwe are open, critical, and enquiring.”

    In this special episode, I’m joined by BjörnLudwig for a reflective conversation recorded during the few weeks of hispublic speaking career, as he brings his landmark Ortho 50 series to aclose. We look back on two decades of clinical practice, academic leadership,and contribution to the orthodontic community, and ask whether modernorthodontics has truly improved on the outcomes of the 1990s.

    We discuss evidence versus clinicalexperience, the impact of technology on diagnosis and treatment planning, thepressures facing academic publishing, and the evolving role of key opinionleaders. Björn also speaks candidly about family, health, Oscar and legacy, andhis decision to step back from speaking in orthodontics, offering thoughtfulinsight into what really matters in an orthodontic career.

    02:41 – Why is today’s orthodontics nobetter than the outcomes in the 1990s?

    04:54 – How do we improve outcomes intoday’s clinical practice?

    06:36 – Evidence vs experience: shouldwe trust trials or clinical experience?

    09:13 – When research proves us wrong, howshould orthodontists respond?

    11:19 – The role of your parents inshaping your orthodontic career

    14:06 – As Editor-in-Chief of KieferorthopĂ€die,what changes have you seen over the last decade?

    17:59 – Do Key Opinion Leaders help orharm orthodontics?

    21:37 – Quick fire: proudest research, 3best clinical tools, and 3 biggest clinical regrets

    27:52 – What advice would you give tothe next generation of orthodontists?

    29:51 – Health, Ortho 50, and knowingwhen to step back

    Click on the link below to view previous episodes, to refresh topics,pick up tricks and stay up to date.

    Please like and subscribe if you find it useful!

    #OrthodonticsInSummary
    #BjörnLudwig
    #Orthodontics

    #ortho50

    #TADs

    #OrthodonticEvidence

    #OrthodonticsInInterview

    #FarooqAhmed

    #OrthodonticBiomechanics

    #OrthodonticResearch

    #DentalEducation

    Farooq Ahmed

    🕒Timestamps of Key Questions & Answers

  • Is There Really A Consensus On Aligners? A Delphi Author Explains| Orthodontics In Interview | VINCENZO D'ANTO

    Is There Really A Consensus On Aligners? A Delphi Author Explains| Orthodontics In Interview | VINCENZO D'ANTO

    · orthodontics In summary

    “Even though the panelistswere huge aligner users, the statements are not so in favour of aligners, they are surprisingly reasonable.”

    “It’s very difficult to find a real aligner experts without a conflict of interest. Almost impossible.”

    “If you explain the differences honestly, most of my extraction patients choose fixed appliances. I’m not selling aligners.”

    “Direct printing is the real breakthrough, but right now it has too many shortcomings to be a standard technology.”

    “I am pessimistic. We must fight for our profession — against the idea that technology can replace orthodontists.”

    In this episode, I’m joined by Vincenzo D'AntĂČ, lead author and contributing author of this year’s two major consensusstatements on clear aligners. We explore the key findings from these landmark papers and how they translate into real-world clinical practice. Vincenzo shares his own views on aligners, their limitations, and his pragmatic approach to integrating hybrid mechanics, particularly skeletal anchorage, into alignertreatment. We discuss recent innovations in aligner therapy, distinguishing those with genuine clinical value from those that are ineffective. We also hear Vincenzo’s candid concerns about the future of orthodontics.

    03:00 – Why did youcreate this Delphi aligner consensus?

    05:03 – How were thealigner experts selected for the study?

    06:51 – Do conflictsof interest affect aligner consensus statements?

    11:49 – Crowding: Whydoes the Alharfi 2025 SR show better outcomes for aligners?

    15:49 – 7 vs 10 vs 14days: How often should patients change aligners?

    20:03 – Are complexmovement failures a design flaw or inherent to aligners?

    22:19 – What trulylimits clear aligner biomechanics?

    25:46 – Is hybridorthodontics the future of predictable aligner treatment?

    29:35 – What hybridmechanics do you use most in practice?

    32:05 – Can wereliably treat extraction cases with aligners?

    36:03 – Is betterOHRQoL worth compromised occlusal outcomes?

    39:11 – Do alignerswork for growing patients, or is this just marketing?

    41:34 – Why ishigh-quality aligner research still so weak?

    44:30 – Final advice:What should orthodontists focus on for the future?

    Click on the link below to view previous episodes, to refresh topics,pick up tricks and stay up to date.

    Please like and subscribe if you find it useful!

    Please visit the website for this interview podcast:

    https://orthoinsummary.com/is-there-really-a-consensus-on-aligners-a-delphi-author-explains-orthodontics-in-interview-vincenzo-danto/

    Spotify podcasts for other platforms

    YouTube

    https://youtu.be/jpMUbYINxzg

    #OrthodonticsInSummary
    #VINCENZOD'ANTO
    #Orthodontics

    #ClearAligners

    #AlignerTherapy

    #HybridOrthodontics

    #SkeletalAnchorage

    #TADs

    #OrthodonticEvidence

    #OrthodonticsInInterview

    #FarooqAhmed

    #VincenzoDAnto

    #OrthodonticBiomechanics

    #OrthodonticResearch

    Farooq Ahmed

    🕒Timestamps of Key Questions & Answers

  • Retention, What Should We Do Now?

    Retention, What Should We Do Now?

    · orthodontics In summary

    Retention, What Should We Do Now?

    Join me for a update on retention, I explore a review of currentliterature and what the changes are recommended to our retention protocols,research of stability, critical look of retainerfailures and factors to consider in design and location of fixedretainers, as well as monitoring recommendations based on Clinical PracticeGuidelines. This podcast is based on recent literature as well as two excellentlectures from this year’s British Orthodontic Conference by Marie Cornelis(Australia) and Simon Littlewood (UK).

    Recommendations for the maxilla:

    · Low risk of relapse = Removable retainer (polyethyleneor polyurethane)

    · High risk of relapse = Dual retention with fixedand removable retainers

    · Fixed retainer

    o 3-3 if occlusion allows, most likely 2-2 designunless high risk of canine relapse

    o Location slightly gingival due to occlusalforces and account for Increase in overbite with age (Littlewood)

    Recommendations for the mandible

    Lower arch

    o Low risk of relapse = fixed retainers

    o High risk of relapse = dual arch

    o Fixed retainer 3-3

    § Position slightly incisal Mandible: slightlymore incisal, greater cleanability, less gingival inflammation – Petsos 2023

    Monitoring regime

    · 1 month – fixed retainer (greatest timepoint offailure)

    · 3 month – removable retainer (motivation ofcompliance)

    · Every 3-4 months Wouters 2018

    · 1 year retention necessary Wouters 2018

    · Annual check-up Wouters 2018

    o Greater likelihood of compliance if annualcheck-up

    o General dentist

    Improve compliance

    · 2/3rds stop wearing after 4 years,All-Moghrabi 2018

    · Visual photo of relapse to patient and parentsincreased compliance Vs patient only or instructions only Lin 2015 (1.5Hrsgreater wear)

    Clinical PracticeGuideline For Orthodontic Retention Wouters 2019 (open access paper)

  • Dental Monitoring, Is It The Future Of Orthodontics? | Orthodontics In Interview | PHILIPPE SALAH

    Dental Monitoring, Is It The Future Of Orthodontics? | Orthodontics In Interview | PHILIPPE SALAH

    · orthodontics In summary

    “The purpose of Dental Monitoringisn’t to disconnect you from your patient, it’s to make sure you see them atthe right moment for the right reason.”

    “Fix problems early andyou don’t have problems. If you intercept an issue straight away, you can oftenavoid side effects altogether.”

    “If you don’t change yourprotocol, DM won’t reduce appointments, you do. The technology empowers smarterscheduling, not magic.”

    “AI isn’t replacingorthodontists. It’s replicating their eyes, helping you catch what you’d wantto see, every single week.”

    In this episode, I’m joined by PhilippeSalah, CEO and founder of DentalMonitoring. We explore the evolution of AI-based remote monitoring in orthodontics, how it aims to change the way we communicate with patients, provide data of our practice but also where the evidence remains mixed. Philippe addresses questions on reliability, patient compliance, and the impact on rapport when monitoring replaces in-personvisits. We discuss the real-world challenges of cost, protocol adaptation and workflow change, as well as the future role of AI, sustainability, and data-driven insight in clinical practice.

    02:07 – How did youcome up with the concept of Dental Monitoring?

    08:50 – How accurateis Dental Monitoring, and what happens if the AI misses something?

    13:55 – Where do yousee the benefits of Dental Monitoring if studies show limited reduction invisits or treatment time?

    18:56 – Is remotemonitoring less able to build patient rapport compared to in-person officevisits?

    24:53 – DentalMonitoring comes at a financial cost, what is the return on investment forclinicians?

    29:48 – Is DentalMonitoring for every patient, given compliance and scanning challenges?

    33:02 – AI consumesglobal energy resources, how does Dental Monitoring address environmentalresponsibility?

    36:52 – Tell us aboutDental Monitoring Insights and how it impacts clinical practice.

    42:28 –What advicewould you give to orthodontists

    Click on the link below to view previous episodes, to refresh topics,pick up tricks and stay up to date.

    🕒Timestamps of Key Questions & Answers

    #OrthodonticsInSummary
    #DentalMonitoring
    #AIinOrthodontics
    #DigitalOrthodontics
    #RemoteMonitoring
    #OrthodonticInnovation
    #AlignerTechnology

    #OrthodonticEvidence
    #FutureOfOrthodontics
    #FarooqAhmed

    Farooq Ahmed

  • Will AI Change Orthodontics? | Orthodontics In Interview | JEAN-MARC RETROUVEY

    Will AI Change Orthodontics? | Orthodontics In Interview | JEAN-MARC RETROUVEY

    · orthodontics In summary

    “Will AI it replace the orthodontist? No. Will it replace the bad orthodontist? Hopefully, yes.”

    “With AI, you could probably get prediction accuracy down to less than 10% , because it can analyze what the human brain cannot”

    “Computers are designed to crunch data. That’s all they do. The rest is up to you.”

    “AI is not going away. There are billions invested in this technology. You better get on with the program.”

    “Don’t drive your car inreverse
 Don’t go backwards.”

    In this episode of Orthodontics in Interview,I’m joined by Jean-Marc Retrouvey, researcher and innovator in AI-drivenorthodontics. We explore the concept of the “virtual patient” and how artificial intelligence is reshaping orthodontic diagnosis, biomechanics, and aligner staging. Jean-Marc shares his candid thoughts on the pace of change inacademia versus industry, the role of AI in predictions within orthodontics, and how clinicians can embrace AI without losing their judgment. With insightsfrom his work in both universities and industry projects, Jean-Marc offers a compelling vision of how orthodontics will evolve in the AI-era.

    · 01:47 What isthe “virtual patient” concept?

    · 03:39 Wherewill AI impact clinicians, diagnosis vs outcomes?

    · 07:21 Can AIbe our biomechanics co-pilot?

    · 10:34 Why arealigner companies behind in AI?

    · 12:57 Whatpractical changes will AI bring to aligner staging?

    · 15:20 Why didyou say academia is too cautious for AI’s pace?

    · 19:24 Shouldorthodontic AI education come from industry, and is that biased?

    · 22:13 DoesRicketts’ 1983 “judgment over computers” still hold?

    · 25:13 Will AIreplace clinician experience and literature in EBP?

    · 30:44 Are weat risk of data overload with 3D/CBCT integration?

    · 35:01 How dowe use AI responsibly given its environmental costs?

    · 37:59 Why movefrom academia to industry, and what are you building at LuxCreo?

    · 41:11 Whitepapers vs peer-review: what’s the real difference?

    · 44:35 Your one piece of advice toorthodontists?

    Click on the link below to view previous episodes, to refresh topics,pick up tricks and stay up to date.

    Please like and subscribe if you find it useful!

    Please visit the website for this interview podcast:

    https://orthoinsummary.com/will-ai-change-orthodontics-orthodontics-in-interview-jean-marc-retrouvey/

    Spotify podcasts for other platforms

    YouTube

    https://youtu.be/UDfDTtLZm4A

    #orthodontics

    #farooqahmed

    #jeanmarcretrouvey

    #AIorthodontics

    #clearalignertherapy

    #orthodonticsinsummary

    #orthodonticsininterview

    Farooq Ahmed

    🕒Timestamps of Key Questions & Answers

  • Aligners Algorithms and Autonomy |Orthodontics In Interview | Guy Deeming

    Aligners Algorithms and Autonomy |Orthodontics In Interview | Guy Deeming

    · orthodontics In summary

    “The biggest variable with any clear aligner treatment is the patient themselves — not the plastic.”

    “We must remain the conductors of the orchestra, not the technicians of an algorithm.”

    “Aligners are not inferior to fixed appliances — but neither are they magic. The truth lies somewhere in between.”

    “Research often lags years behind reality, so we’re not judging today’s aligners with today’s evidence.”

    In this episode of Orthodontics in Summary,I’m joined by Guy Deeming, orthodontist, business leader, and Director of Professional Development at the British Orthodontic Society We dive into the reality of clear aligner therapy, discussing the recently published Delphi Consensus Statements and if theyagree with his clinical practice. Guy discusses compliance and where the orthodontist role has changed in the era of algorithms. Guy shares candid insights into alignerlimitations, clinical pearls for complex cases, and his vision for orthodontic education.

    · 01:12– Are aligners now the go-to appliance for mild to moderate crowding?

    · 03:22– Delphi consensus statement:What are aligners’ limitations?

    · 05:16– Why do clinical results differ so much from research findings?

    · 11:08– “no-go” cases for aligners?

    · 15:28– Extreme cases on social media: genuine progress or misleading?

    · 17:56– Are orthodontists just technicians of aligner companies’ algorithms?

    · 24:57– Profitability, corporate influence, and the in-house aligner movement.

    · 28:30– Extraction cases with aligners: realistic or flawed?

    · 32:52– Distalisation: predictable movement or just tipping?

    · 36:31– Should orthodontic training programmes include formal aligner training?

    · 44:50– Direct-to-print aligners: fad or the next revolution?

    · 48:08– Guy’s one piece of advice to orthodontists on approaching aligner therapy.

    Click on the link below to view previous episodes, to refresh topics, pick up tricks and stay up to date.

    Please like and subscribe if you find it useful!

    YouTube

    https://youtu.be/wITGxEw1ZNs

    #orthodontics

    #farooqahmed

    #guydeeming

    #aligners

    #clearalignertherapy

    #orthodonticsinsummary

    #orthodonticsininterview

    Farooq Ahmed

  • AI in Orthodontics, Where Are We And Where Are We Going 10 MINUTE SUMMARY

    AI in Orthodontics, Where Are We And Where Are We Going 10 MINUTE SUMMARY

    · orthodontics In summary

    Join me for a podcast summary looking at Ai in orthodonticsand its clinical application. A growing topic in orthodontics, and one of themost featured topics at this years AAO. This summary is based on 3 lectures fromthis year’s summer meeting by Juan Francisco Gonzalez & Jean Marc Retrouvey,Tarek ElShebiny , Jonas Bianchi and Lucia Cevidanes. We will look whatAi is, the way it works and its clinical application, as well as a criticalview on this young field.

    What is Ai:

    1. Technology that enables computers and machinesto simulate human intelligence, perform 1 task very well, e.g. voice command, Youtuberecommendations

    2. Predictive modelling, makes calculations, convert information into numbers or categoriesand recognise patterns

    Levels of Ai: Machine learning, Neural Networks and Deep Learning

    1. Machine learning

    a. The ability for a machine to learn from data andpast experience to identify patterns and make predictions

    2. Neural Networks

    a. Specific model which relies on interconnectednodes, which perform a mathematical calculation of associations , patterns, andprobabilities

    3. Deep learning

    a. Is a complex version of neural networks

    Virtual patient

    · CBCT segment + STL file – segmentation of theteeth and roots, with labelling of different stuctures

    o Can print model, visualise ideal vector andcalculate ideal vector

    o However clinician still required to establish biomechanics

    · CBCT integration for aligner cases, Unpublishedthesis Khalid Alotaibi:

    o Treatment planning confidence increased 50%, leastchange was treatment planning modification

    Diagnostic data:

    · Ai cephalometric tracing

    o 46% of 24 landmarks 2.0mm within

    o 4 different programmes Iortho, Webceph, Orthodc, cephx

    o All landmarks had good overall agreement butvariation in identification

    · Facial Analysis

    · Automated 3D facial asymmetry analysis usingmachine learning Adel 2025

    o Study – 7 landmarks

    o Identified manually and with deep learning

    o 5 accurate, 2 significant difference but notclinically relevant

    Diagnostic accuracy of photos

    · Clinical photos assessment by Ai, and comparedto clinical examination

    · Sensitivity 72%, specificity 54% Vaughan & Ahmed2025

    Growth prediction

    · Poor agreement age 9

    Comparison between direct, virtual and AI bonding

    · DIBs – uses Ai for bonding

    · Compare Ai Vs user modified indirect bonding Vsdirect bonding (gold standard), 0.5mm significant

    · Incisors accurate

    · Premolars and lower laterals inaccurate

    Monitoring

    Previous podcast exploring the accuracy of remote monitoring

    o with Ferlito 2022 80%repeatability from 2 scans 44.7% repeatability and reproducibility

    Bracket removal from scan and retainer fit

    Tarek Assessment of virtual bracket removal by artificialintelligence and thermoplastic retainer fit AJODO 2024

    o Retainers for both – clinically acceptable

    FDA approval of Ai in dentistry

    · FDA - Software of Medical Diagnosis

    § 4 dental:

    · Dental Monitoring

    · Ray Co

    · X-Nav technologies

    · Densply Sirona

    What’s next

    · More data learning to train AI model

    · Robotics customising appliances per patient

  • Orthodontics In Interview: CHRIS LASPOS Can you really treat complex cases with aligners?

    Orthodontics In Interview: CHRIS LASPOS Can you really treat complex cases with aligners?

    · orthodontics In summary

    Can you really treat complex cases with aligners?

    “We’ve done a study of myextraction cases... when you do one or two sets of additional aligners, thenyou will be able to get everything to ideal”

    “I will never try to bring17 and 18 mesial to close space”

    “The staging that eachcompany does, it does make a difference. If your technician doesn’t understandhow to move the teeth in the right stages
 it’s never going to happen”

    “If I have a patient whois not wearing the Class II elastics, then you cannot distalize.”

    “If you learn to say no tosome of your patients, then you will be a more successful orthodontist.”

    In this episode of Orthodontics in Interview,we sit down with world-renowned orthodontist Dr. Chris Laspos to explore thereal-world efficacy of aligners, hybrid treatment strategies, and the evolvingrole of auxiliaries and digital planning in modern orthodontics. With over 25years of experience and a background in craniofacial care and surgicalorthodontics, Chris shares insights into clinical decision-making, caseplanning, and the mindset needed for success. Extraction treatment, anterioropenbite and distalisation are discussed and how to improve outcomes, thisinterview is packed with clinical pearls and honest reflections of alignertreatment.

    00:00 - Introduction

    01:45 - How did you find your way into aligners as an orthodontist?

    03:42 - How do you reconcile aligner efficacy data with your clinical results?

    06:24 - Can extraction cases be effectively treated with aligners?

    07:10 - Do you prefer fixed appliances or aligners for extractions?

    09:10 - Do you use more auxiliaries with aligners to compensate for efficacy?

    12:03 - Are aligner systems heading toward minimal differences like fixed appliances?

    12:49 - Do some aligner systems truly offer better outcomes?

    17:59 - How do you manage anterior open bite cases with aligners?

    21:02 - How predictable and reliable is distalization with aligners?

    24:27 - Can aligners be used effectively in surgical orthodontic cases?

    27:54 - What are your thoughts on remote/virtual monitoring?

    30:26 - What are common mistakes orthodontists make with aligners?

    32:33 - Should general dentists use aligners in practice?

    34:15 - Could AI or case simplicity justify aligners by non-specialists?

    38:12 - Beyond clinical skill, what makes a successful orthodontist?

    orthodontics

    #farooqahmed

    #chrislaspos

    #aligners

    #clearalignertherapy

    #orthodonticsinsummary

    #orthodonticsininterview

    Farooq Ahmed

  • Interproximal Reduction, When, Why, and How | 9 MINUTE SUMMARY

    Interproximal Reduction, When, Why, and How | 9 MINUTE SUMMARY

    · orthodontics In summary

    Interproximal Reduction, When, Why, and How | 9 MINUTE SUMMARY

    In this episode, I dive into the fundamentals of interproximal reduction(IPR) when to use it, why it matters, and how to do it effectively.

    We’ll cover how much IPR can safely be carried out, compare differentclinical protocols and their pros and cons, and take a critical look at howaligner software plans IPR (and where it may fall short).

    This summary is based on Dr. Flavia Artese’s insightful lecture at therecent American Association of Orthodontists Annual Session in Philadelphia,along with insights from my own clinical research and experience.

    How much IPR is possible?

    Recommended amount œ to 1/3 of outer enamel

    Estimate with periapical radiographs are inaccurate, under-estimateas well as over estimate Meredith 2017 Brine 2001

    Quantity of the enamel each interproximal surface Kailasam2021 systematic review, with an excellent table created by Bosio in 2022 highlightingthe enamel present and hypothetical safe reduction, ranging from 0.3-0.7mm,with 5-10% greater enamel on the distal surfaces

    Can all teeth have IPR?

    · Triangular teeth are ideal

    o Large interradicular distance, roots canapproximate with no issue

    · Square shaped teeth not ideal

    o Reduced interradicular distance, rootapproximation of 0.8mm = loss of crestal bone Taera 2008

    Are we accurate with IPR? Johner 2013 AJODO

    · Manual strips Vs rotary disc Vs oscillatingstrips = all underperformed IPR by up to 0.1mm

    Protocols:

    Small Vs Large

    · 0.1-0.2mm manual strips

    · 0.3mm+ larger reduction

    · Polishing required – If not = 25 um furrows retainplaque Jack ï»żSheridan1989

    Separation posterior region

    · Separator – Requires measuring of premolarbefore and after

    · Bur – needle bur

    o Parallel occlusal plane

    o Recontour tooth surface to create contact point

    · No separator - requires contact point to be broken, advantageis the measurement of the IPR site is accurate

    Bolton’s analysis

    · Based on excess, rather than tooth removal

    Proportionality

    · Width

    o Canine 90% of central incisor

    o Lateral 70% of central incisor

    IPR planning

    Bolton’s discrepancy + Tooth proportionality

    = whento add or remove tooth structure

    However

    · “Don't do pre-emptive stripping for balancingtooth mass ratios between arches. Chances are it will work out just fine” Jack Sheradin 2007 JCO

    Method of use for 4 mm of IPR:

    · Posterior to anterior – Jack Sheridan

    o Posterior IPR first, followed by distalisation,e.g. 4-5 first, distalise 4

    o Maintain arch length with stops etc, maintainanchorage

    · Anterior to posterior – Farooq

    o Anchorage preserving

    o Tony Weir 2021 the most common site in clinicalpractice was the lower anterior segment

    IPR on overlapping teeth

    · Not possible to achieve ideal anatomy withmotorised IPR instruments

    · Posterior IPR first, distalise, followed byanterior alignment and IPR – Flavia

    · Use of handstrips is possible on overlappingteeth - Farooq

    Limits of IPR

    · 4-5mm, although Sheridan described possible 8.9mm,technically challenging

    · IPR is not a possibility for sagittaldiscrepancy:

    Greater Bolton’s discrepancies in class 3 and class 2malocclusions, SR 53 studies Machado 2020, greater in class 2 and 3 casesalbeit a small difference of 0.3-0.8%

    Retained primary 2nd molars

    · Idealise occlusion

    · Consider root morphology divergence, as post IPRspace may not close

    o If divergence greater than crown, reconsider asspace closure unlikely

    Why do we need to use IPR with aligners? Dahhas 2024

    · Alogrythm reduces the number of aligners

    · More IPR rather than saggital correction

    · IPR staged inappropriately with large IPR whilstcontact point overlap, which is difficult to perform adequate anatomicalreduction

  • CBCT, what’s the harm and should it be routine? | 9 MINUTE SUMMARY

    CBCT, what’s the harm and should it be routine? | 9 MINUTE SUMMARY

    · orthodontics In summary

    Join me for a summary of CBCT use inorthodontics, where I look into the current risk of cancer with CBCT use, the differenceit can make to treatment planning, and the 3 most common incidental findingsorthodontists should be aware of. This was one my highlight lectures from lastyears British Orthodontic Conference by Consultant Dental Radiologist, SimonHarvey.

    How much radiation comes from dentalCBCT, medicine?

    Effective dose of modern machines:

    · Dose from full DPT with adigital system = 20-25”Sv

    · KAVO, MoritaX800 4 x 4cm =16uSv

    · FDA values of CT scans acrossthe boy from Lubar 1500uSv – Heart 16000uSv

    FACT 1 – effective dose in dental imagingare far below the rest of medicine

    Background radiation

    · Terrestrial radiation

    · Cosmic radiation

    o Flight London – New York 56uSv– cancer UK ‘does not effect risk of cancer, even for frequent flyers’, 4uSvper hour

    o Pilots do not have an increasedrisk of cancer

    UK 3000 uSv annually

    FACT 2 – EFFECTIVE DOSES IN DENTAL IMAGINGARE FAR BELOW THE NATURAL BACKGROUND RADIATION

    American Association of Physicist inMedicine AAPM

    “evidence supporting increased cancerincidence or mortality from radiation doeses below 100mSv is inconclusive” –cancer incidence and mortality from the use of diagnostic imaging are highlyspeculative, discourage these prediction of hypothetical harm

    FACT 3 EFFECTIVE DOSES IN DENTAL IMAGINGARE SO LOW, THEY DO NOT CAUSE CANCER

    Clinicians improved confidence andconsistency in treatment planning decisions.

    Impacted canine:

    · 3 radiographs - namely occlusal view, opg , periapical = still not confident about prognosis.

    · CBCT = clear follicle and impactedcanine proximity to adjacent tooth, = easily make up the decision estimatingprognosis

    o 22%-44% change of plans Hodges 2013 Stoustrup 2024 change in treatment plans ofimpacted teeth. The majority related to change in planning, with approximately10-20% a change in exposure Vs extraction. Keener 2023

    · Cleft – quantification of bonedefect volume for grafting and localisation of ectopic teeth

    · Surgery – location of importantanatomical structures

    3 Commonincidental findings for orthodontists

    · Dense bone island-

    o Radiopacity with no radiolucenthalo

    o Mandibular premolar region

    o Harmless, may resorb roots ifcontact it

    · Sinus mucosal thickening

    o Antrum floor intact

    o Only concern if 5mm+

    · Trabecular pattern

    o Around inferior dento-alveolarcanal

    o No corticated boarder

    o normal in children, technicalreason is physiologic response as more RBC’s are developing surrounding thatarea.

    Pregnant women –yes as not irridating pelvic reason, CBCT beam is horizontal so no risk

    Conclusion

    1. CBCT superior for resorption,material change to treatment plans and improve confidence of the orthodontists

    2. No recommendation for takingfull mouth CBCT instead of DPT ahead of starting every orthodontic treatment asroutine and x rays should never go hand in hand

    3. Small volume CBCT does is solow it doesn’t cause cancer

  • Orthodontics In Interview: Aligners, Limited or Just Misunderstood? TOMMASO CASTROFLORIO

    Orthodontics In Interview: Aligners, Limited or Just Misunderstood? TOMMASO CASTROFLORIO

    · orthodontics In summary

    Orthodontics In Interview: Aligners, Limited or Just Misunderstood? tommaso castroflorio

    “The biggest difference in overcoming the limitation (of aligners) is to understand how to control aligner deformation”

    “We need to improve the available knowledge about aligners, because we need to control the companies, we do not need companies controlling us”

    “I think you can treat also complex cases, in my practice I treat extraction cases”

    “There are limitations in every technique, I think that the good orthodontist understands how to manage the limitation and how to overcome them”

    “Large mass 3D printing will represent an important evolution in orthodontics, aligners and braces”

    Tommaso explores the current understanding ofaligners, there limitations in terms of an appliance and scientific research. We explored the debate of aligners treating complex cases, why attachment designs still have limitations, and the role of aligners as functional appliances. We discuss emerging concerns of micro and nano-plastic toxicity andenvironmental concerns of aligners.

    TIMELINE

    00:00:00 Introduction of Dr Tomasso Castroflorio

    00:00:51 Tomasso's Early Experiences with Aligners

    00:08:21 What are the Limitations of Aligners?

    00:11:24 How do we Overcome Limitations with Aligners?

    00:17:59 Should Aligners be Restricted to Mild to Moderate Cases?

    00:20:22 Research IndicatesAligners Only Tip Teeth into Extraction Sites, Do you Agree? 00:25:50 Importance of Visualization in Orthodontics?

    00:29:27 Are Functional Appliance Aligners Advantageous over Conventional Functional Appliances?

    00:35:08 Has There Been Over-emphasis on Attachment Design?

    00:44:18 What are the Consequences of Microplastics and Aligners?

    00:50:32 What is the Future of Aligners?

    00:53:54 Who do you Admire the Most in Orthodontics

    00:55:36 Advice from Tomasso to all Orthodontists

    Click on the link below to view previous episodes, to refresh topics, pick up tricks and stay up to date.

    Please like and subscribe if you find it useful!

    Please visit the website for this interview podcast:

    https://orthoinsummary.com/orthodontics-in-interview-aligners-limited-or-misunderstood-tommaso-castroflorio/

    #orthodontics

    #farooqahmed

    #tomassocastroflorio

    #aligners

    #clearalignertherapy

    #orthodonticsinsummary

    #orthodonticsininterview

    Farooq Ahmed

  • Impacted canines, resorbed teeth Part 2 | 3 MINUTE SUMMARY

    Impacted canines, resorbed teeth Part 2 | 3 MINUTE SUMMARY

    · orthodontics In summary

    Join me for a summary of recent long-term research of resorbed teeth due to impacted canines. This podcast is based on an excellent lecture by Julia Naoumova delivered at last year’s British Orthodontic Conference. Part 2 with focus on the prognosis of resorbed teeth from impacted canines, and follows on from part 1 with explored outcomes of open Vs closed exposures of impacted canines – see here for part 1.

    Root resorption of incisors reported at 19-67% Erikson 2000 Walker 2005, Mitsea 2022

    Anna Dahlén and Julia Naoumova 2024 retrospective CBCT study n =27 incisors

    Mean Follow-up average 9 years (5.5-14.6)

    Patient reported outcomes

    Survival 100%

    Horizontal grade 3 moderate resorption n=17 (resorption inner dentine not involve pulp moderate)

    Horizontal grade 4 severe resorption n=12 (pulp exposed severe)

    Vertical grade 3+ severe resorption n=7 (resorption 2mm-1/3rd moderate)o

    Vertical grade 4 extreme resorption n = 1 (resorption 1/3rd +)

    No significant difference in any grade of resorption long term of the following:

    Symptoms

    Mobility and ankylosis

    Discolouration

    Increase gingival pocketing but not clinically significant

    RR horizontal changes with time

    No change 81%

    Worse 4%

    Improve 15%

    RR vertical changes with time

    No change 43%

    Worsen 57%

    Expected as had orthodontic treatment as well

    Previous research

    1-23 years Survival 93-100% Falahat 2008 , Bjerklin 2011, Becker 2005, Jönsson 2007

    Jönsson 2007 showed grade 1 mobility when root length < 10mm

    Conclusion:

    Extraction of asymptomatic based purely on root resorption should be routinely performed

    Paper by Anna Dahlén and Julia Naoumova 2024

    Longitudinal study of root resorption on incisors caused by impacted maxillary canines—a clinical and cone beam CT assessment

    https://doi.org/10.1093/ejo/cjae052

  • Impacted canines, what’s the latest? Part 1 | 6 MINUTE SUMMARY

    Impacted canines, what’s the latest? Part 1 | 6 MINUTE SUMMARY

    · orthodontics In summary

    Join me for a summary of the management of impacted canines, the latest evidence regarding different techniques for alignment. This podcast is based on an excellent lecture by Julia Naoumova delivered at last year’s British Orthodontic Conference.

    Part 1 will focus on recent findings of a modified open exposure technique Vs closed exposure, in terms of duration but also other key outcomes, health, pain, use of analgesics, time absent from school and costs. The next episode, part 2, will look at the prognosis of resorbed incisors related to impacted canines long term.

    Previous research no difference between closed Vs open exposure for alignment, aesthetics, treatment time, surgical success, treatment times. Limited to 2D views Parkin 2017, Sampaziotis 2018, Cassina 2018.

    Questionnaire of current decision making of open Vs closed: n=48 orthodontists = current clinical decision making by orthodontists based on preference Naoumova 2018

    Multicentre RCT Margitha Björksved 2018, 2021

    Modified open exposure with Glass ionomer OPen Exposure, first described by Nordenval 1999

    6/12 of spontaneous eruption

    Traction with orthodontic appliances

    Results

    Total time: no difference 26 months (95% CI −3.2 to 2.9, P = 0.93)

    Canine eruption time: Open exposure quicker by 3 months 8.5 months Vs 11.5 months (95% CI 1.1 to 4.9, P = 0.002). With no traction in open exposure group

    No difference in periodontal status, root resorption, surgery time, complications,

    Pain: greater in closed group

    Greater pain with bilateral open exposure

    Closed exposure more painful applying traction

    Analgesics use (preliminary data):

    Day 1 nearly all patients use

    Day 5 drops to less than 50% of patients use

    Day 10 most have stopped taking analgesics

    Costs: – no difference

    €3,400 healthcare costs

    €6,300 including patient costs

    Missed days of school (preliminary data)

    Day 1 - 76% open Vs 65% closed exposure

    Day 2 - 3% open Vs 6% closed exposure

    Open exposure with GOPEX Not appropriate for:

    Close to adjacent tooth, to avoid material on adjacent teeth

    Very high canine position

    Older patient – start traction straight away, probability of ankylosis increases Cernochova 2024

    1% at age 15

    4% at age 20

    14% at age 25

    97% at age 45

    Conclusion:

    Both open and closed techniques are viable, however with open exposure of GOPEX technique the canine erupts spontaneously and quicker

    Less pain with open exposure unless bilateral

    Most patient will miss 1-2 days from school

    Pain relief common for the first 5 days, but maybe used until day 10

    Papers

    Open vs closed surgical exposure of palatally displaced canines: a comparison of clinical and patient-reported outcomes—a multicentre, randomized controlled trial

    Margitha Björksved

    Open and closed surgical exposure of palatally displaced canines: a cost-minimization analysis of a multicentre, randomized controlled trial

    Margitha Björksved

  • Will dental monitoring change orthodontics?  6 MINUTE SUMMARY

    Will dental monitoring change orthodontics?  6 MINUTE SUMMARY

    · orthodontics In summary

    Join me for a summary looking at remote monitoring in orthodontic clinical practice, and if it can improve, quicken and enhance orthodontic clinical practice. This podcast is based on an excellent webinar by Jonathan Sandler and Juan Carlos Varela, as part of the Angle-net webinar series. I discuss how Dental Monitoring works, the proposed advantages and a review of the emerging research on this innovation in orthodontics.

    What is Dental Monitoring?

    AI software which assesses occlusal and dental changes through a series of intra-oral photographs taken by the patient using their smartphone

    How does it work?

    Upload STL / digital study model

    Ai segmentation of teeth which maps digital study model to the photos

    Aligner fit analysis:

    Discrepancy between tooth surface and aligner fit

    Either proceed, continue wear or see clinician

    Fixed appliances

    Assess rate of movement and schedule appointment

    Other proposed benefits

    Oral hygiene assessment

    Breakages

    Retention changes

    What do patients think of it?

    Patients attitudes to remote monitoring

    81% interested in reducing number of appointments due to telemonitoring – Dalessandri 2021

    25% of patients found scans difficult to perform, with duration of scan 2-17 minutes Hansa 2020

    Does it reduce appointments and make treatment quicker? Sangalli 2024

    Decrease the number of in-office visits by 1.68–3.5 visits

    No difference in treatment duration

    No statistical reduction in emergency appointments

    Are treatment outcome better (aligners)?

    No difference in tooth movements Hansa 2021

    No difference in number of refinements Hansa 2021

    PAR changes – no difference in quality of outcomes Jarad Marks 2024

    Is oral health better?

    DM reduced plaque scores Costi 2019

    31% Improved hygiene Manzo white paper

    Other innovations with remote monitoring?

    Remote STL files

    Scan taken without patient attending the practice

    Scanbox

    Formulate STL file and fit aligner in surgery

    Is Dental Monitoring accurate? Ferlito 2022

    80% repeatability from 2 scans

    44.7% repeatability and reproducibility

    Discrepancy between scanbox and intra-oral scan varied between 0.5-1.9mm, angular measurements maximum error 8.9 degrees

    Conclusion

    2-3 appointments less

    No difference in overall duration

    Some people struggle to use

    Accuracy and repeatability variable

    No difference in the quality of the outcome

    Areas which are of concern

    Unknown accuracy of occlusal assessments from a reliable retruded contact position

    Patient motivation maybe better delivered in person

    Ai environment cost 2-3% of energy used by data centres

    Other ways to reduce time?

    Diagnostic and treatment planning acumen

    Identify main aspect of malocclusion and address through efficient mechanics

  • Overcorrection with aligners, when and how? 7 MINUTE SUMMARY

    Overcorrection with aligners, when and how? 7 MINUTE SUMMARY

    · orthodontics In summary

    “We do not accept the weaknesses of out appliances as absolutes, but rather we adjust out treatment mechanics to account for them Mazyar Moshiri,

    “If you are not willing you use elastics – you are not able to get finishing like braces” Mazyar Moshiri“We cannot have a reasonable discussion of efficacy and accuracy until we study the appliance as orthodontic clinicians, and not as scientists Mazyar MoshiriJoin me for the first summary of 2025, exploring finishing with clear aligners. Mazyar Moshiri explores overcorrection with aligners, when they should be used and his protocol. It was a lecture from last year’s AAO winter meeting..This episode consists of overcorrection methods of 4 malocclusions: deep bite, anterior openbite, class 3, and expansion. Maz also shares his pearls on what to watch out for when using clear aligners with overcorrection. EXTRAS: Mazyar Moshiri has kindly given permission for the summary slide of his overcorrection protocol to be included in the podcast notes, please see the podcast website https://orthoinsummary.com/Overcorrection Deep bite - achieve AOBOver-intrusion lower incisors to achieve a 50-100% of total movement predicted Favourable if proclaining teeth, unfavourable if retrocliningUse of attachments on premolars, note the hierarchy of attachment design places anchorage for anterior intrusion 5th, “Drs have to doctor the Clincheck”.Anterior openbite Posterior intrusion – overcorrect with occlusal bite blocksclass 3 triangular elastics canine and premolarsForce down on posterior bite blocksMay require controlled relapse following overcorrection, done in refinementNOTE – aligners continuous force system, reciprocal extrusion of anterior teeth is expectedClass 3 caseRetract lower incisors with retromolar tads and 6 Oz 3’16thSide effect – increase in curve of spee – similar to retraction on a NiTi wire, aligner is not stiff enough to resist Correction in refinement with anterior intrusion to eliminate premature contacts, DO NOT EXTRUDE POSTERIOR TEETH, as aetilogy is anterior iatrogenic extrusionExpansionOvercorrection of 1-2 mm, greater the further posteriorAttachments, plan buccal attachments +/- palatal attachments, to account for likely buccal tipping, ensuring buccal root torque and preventing palatal cusp droppingTip: for palatal cusp dropping place occlusal attachment on the palatal cusp to prevent extrusion during expansionCaution – if already in buccal version, consider limited correction

  • Orthodontics In Interview: ALFRED GRIFFIN What can digital fixed appliances do better? LIGHTFORCE

    Orthodontics In Interview: ALFRED GRIFFIN What can digital fixed appliances do better? LIGHTFORCE

    · orthodontics In summary

    “it's a platform for mass customization”

    “I think Lightforce system has more friction than it should right now.”

    “We operationalize great outcomes.”

    “People that need to have a Cochrane review to prove to themselves the sky is blue, those are not the people that should be using Lightforce right now”

    Alfred and I discuss his digital bonding system, Lightforce, we explore the product as well as the strength of the claims around it. Alfred replies to criticisms of the product as we explore the emerging evidence of his digital bonding system.

    Alfred gives his opinion on the digital evolution within orthodontics, we have a candid discussion on the use of digital orthodontics and where there are still areas of significant improvement needed.

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