Summary: Dr Sherif Kandil, CEO of K Line Europe, discusses ClearX aligners and 4D technology on the Orthodontic Products podcast ahead of their debut at AAO Annual Session this weekend.

Key takeaways:

  • ClearX aligners use 4D technology developed by NASA to shift between temporary and permanent shapes.

  • Patients receive boosters to transition aligners at home, reducing plastic usage and enhancing the treatment experience.

  • The company will also debut its OEM services at the AAO Annual Session, which aim to expand the reach of ClearX aligner and accelerate adoption of the eco-friendly solution.

Sherif Kandil, DDS, MSc Ortho, CEO and founder of K Line Europe, joined Alison Werner on the Orthodontic Products podcast to discuss the groundbreaking ClearX aligners, which integrate 4D technology. With ClearX aligners set to debut at AAO Annual Session in New Orleans this weekend, Kandil took the opportunity to shed light on the journey that led to the creation of this innovative aligner system.

Kandil’s career trajectory began in Cairo, Egypt, where he exclusively focused on aligners in his dental practice. Transitioning to Germany to study orthodontics, he eventually founded K Line Europe with a mission to redefine orthodontics through innovation. Intrigued by NASA’s development of 4D printing technology, Kandil saw a role for the technology in aligner development.

READ THE ARTICLE: Beyond 3D: ClearX Aligners With 4D Technology Enter U.S. Market

ClearX aligners utilize 4D technology to pre-program temporary and permanent shapes, allowing them to shift between the two with the application of a booster. This revolutionary approach reduces plastic waste by up to 50%, a critical step toward eco-friendliness in orthodontics.

According to Kandil, the patient experience is at the heart of ClearX aligners. Patients receive a booster along with their aligners, enabling them to transition to the second form easily at home. As a result, a single aligner can be used for two stages of treatment, reducing the plastic waste.

From an orthodontist’s perspective, Kandil explains that ClearX aligners offer treatment plans with outcomes that are as predictable as the leading aligner brands on the market. With refinement rates as low as 0.2% to 0.5%, Kandil explains that ClearX aligners promise high-quality results with minimal mid-course corrections.

In this episode, Kandil also talks about K Line Europe’s OEM services for the US market—which will also be launched at the company’s booth at the AAO Annual Session. The OEM services provide access to the company’s aligner technology for aligner providers, DSOs, and dental labs. Through the company’s OEM services, Kandil says K Line Europe aims to expand the reach of ClearX aligners and accelerate the adoption of eco-friendly solutions in the orthodontic market. OP

Podcast Transcript

Alison Werner 0:04
Hello and welcome to the Orthodontic Products podcast. I’m your host Alison Werner. Today’s guest is Dr. Sherif Kandil, the founder and CEO of K Line. Europe, the manufacturer that produces ClearX aligners, an aligner system that incorporates 4D technology. ClearX aligners will make their debut at AAO this weekend. So this is a perfect time to learn more about this aligner company what this aligner company brings to the table, Dr. Kandil. Thanks for joining me.

Dr Sherif Kandil 0:28
Thanks a lot for hosting me, Alison.

Alison Werner 0:30
Great. So let’s dive in. Can you tell our listeners a little bit about your career and what led you to founding this company and to get into this aligner system?

Dr Sherif Kandil 0:40
Well, I mean, it all started for me first practicing dentistry of myself back in Egypt in Cairo almost 12 years ago, where I first started my practice and I I kind of like exclusively focused on aligners from day one. It was a very, very new thing back then in the Egyptian market. And I transitioned from that to even offering these aligners according to also other doctors. And then by time I started to think okay, I think it’s about time to study orthodontics in in Germany and move with the career and everything towards to Germany accordingly. So, I mean, back then in Egypt, I had my own orthos in my practices and had also my orthos is in in the lab who who did the treatment planning. And then when I moved to Germany, I finished my orthodontic studies then decided to establish K Line Europe. So started to see them the world from a totally different angle as an orthodontic entrepreneur. And from from one, there was this mission to to redefine orthodontics or innovation. So this was like always, on my mind, how could we improve status quo and and go with the evolution of orthodontics to the next stage? And yeah, the thing that caught me really heavily was when I’ve seen once NASA, having these articles, very interesting articles about 4D printing. And it was like very, very new, almost think it was back then in almost the year 2000, I think maybe 14, where where I first saw it, and then it kind of struck me wow, this is such an amazing technology that NASA did it before with ortho the orthodontic world through their innovative NiTi wires that they introduced for straight wires, and it’s kind of like changed orthodontics in the 1980s. And they did it again through plastic this time. And that’s how the whole idea came from and started to work on the idea of 4D aligners.

Alison Werner 2:52
Okay, so can you break down what this 4D technology does for an aligner? What incorporating? It does?

Dr Sherif Kandil 2:59
Yeah, so it’s certainly the idea of 4D first of all is related to time, time and, and shape shifting. So that’s the fourth dimension that we refer to in 4D. Now, how do we do that? It’s some refers to the manufacturing process through which you pre-program an object in a certain shape. And then after you put in a certain stimulus, it changes its shape back to the pre-programmed one that you had from the beginning. So in other words, let’s say in the aligner world, what we do is basically we pre pre-program and aligner to have a temporary memory and a permanent memory. So it’s like almost like there are two steps of thermoforming that are done that control these two steps or control these two shapes accordingly. There is one shape that the patient wears, which is the temporary shape, and it fits perfectly on the teeth. And then after one week of wearing the patient, where we’re going to describe later, boosts the aligner, which stimulates the aligner or the plastic polymer to change its geometry to the permanent shape of the thermoforming that was done in the manufacturing process. And that’s how it it moves from one shape to another, whether in the manufacturing and we reverse that when the patients received the aligners and they boost it at home.

Alison Werner 4:15
Okay, so at a you’re going to be debuting the ClearX aligner classic system. Can you talk about what that system brings to the table and what orthodontists can expect when they see this?

Dr Sherif Kandil 4:32
Sure. I mean first of all, we are super excited about this opportunity. We have been since we started since our debut in March 2023 in Cologne, we started with almost sole focus on the European market, and now we are getting for the first time into the US market with this amazing product. The AAO on our booth where you were going to be like almost all the time showing live demos, live sessions showing exactly how aligners change their shape. So we’re going to be showing, you know a live how an aligner before boosting looks like. And then we’re going to place it inside the booster, and then we take it out and then we show the doctors how the aligner feature of shapeshifting works. Now then, this technology, it brings so many things on the table. And it’s just the very first step of so many other steps that that will open the gate towards internet of medical things that is lacking, in my opinion, in a lot in orthodontics. Now let’s start with step by step. I mean, currently, where do we stand, we stand at a point where we are harnessing to have two shapes. And with that we decrease the plastic waste and decrease the number of aligners by half. That’s again, what I said is just the first step, because we have, we have already the proof of concept of that it could even decrease even to almost 75%. So imagine all the aligner waste that we have per per single day that would shrink by 50%, if everyone adopts the same technology. Now, we’re producing almost like 1.2 million aligners per single day, we’re going to talk about globally, everyone, including align and all others, all combined almost 1.2 million aligners per day. That is humongous amount of plastic that is thrown in landfills at the end or in the oceans. And we’re determined to decrease that. And that’s again, that’s the very first step towards later on working on many steps that are taking the path towards internet of medical things where we start to integrate more of like biology, monitoring, lifestyle into the treatments of the patient to create a customized treatment throughout the journey of patients. I’ll talk about that in a bit. But for now, just wanted to give you like an idea in total, like what does it bring right now on the table in terms of advantage, and where it should be going in the future. And while it’s going there in the future, the the idea itself of decreasing the plastic brings other advantages as well with it to the customer or the patient in that in that sense. Where first it increases the compliance. So you’re it’s like exactly you’re having let’s say go or compare, let’s say, a diabetic patient without any monitoring app or without any monitoring gadgets. Same goes for, for example, me trying to you know, like, do sports every single day or exercise every single day without my smartwatch, right. I mean, we need gadgets, to I mean, as humans, we need gadgets to commit more to to give more, to feel more responsible for something but also to feel rewarded. And that’s exactly what patients feel when they start to boost their aligner and they take it out, and they will start to wear it and then they feel immediately the difference. It’s like it feels like it’s a new aligner. So that’s the kind of like the reward that is that is that kicks in for the patients that they feel that they’re part of something. And this something is rewarding as well to them. And this increases the compliance massively in an orthodontic treatments. I mean, we were doing a lot of research on that comparing the compliance of patients with standard aligners and compares it to 4D aligners, and the results are staggering. I mean, it’s, it’s, most of the patients were reporting that they feel the sense of responsibility, they feel that they also part of something big, where they’re working, or they’re not just only fixing their teeth and getting beautiful smile, but they’re also part of something that is eco friendly. And again, they have their hands in it as well. So it’s also fun. Okay, so yeah, that’s mostly from falling.

Alison Werner 8:44
Perfect. I know we have a little bit of a lag. No, the sustainability aspect I find really interesting because it is, because as I’ve talked to you before about that you’ve explained this to me before, so I’ll just kind of explain to our readers, as I understand it. With this, you know, one aligner can get a patient through two weeks because you’re using that booster. And we’ll talk a little bit more about that to transition the aligner to that second stage. So you’re cutting back, as you said, on the aligner waste. So let’s break this down a little bit further. From the treatment planning stage, what can orthodontists, what should orthodontist experienced with that? Is it any different from treating with a traditional aligner?

Dr Sherif Kandil 9:25
Um, well, when it comes to the treatment, let’s say complexities of cases or malocclusions that can be treated, there is no difference at all, it’s it’s almost more or less the same. When it comes to the the setups for the doctors will just realize that the results that could be achieved with any other aligner system is achieved with half of the aligners with ClearX. That’s basically the only difference that they will see between, let’s say both setups of treatment plans designed by ClearX and any other standard aligner system.

Alison Werner 9:57
Okay, great. So then when the patient gets their package, they’re going to be getting their aligners and then a booster. So can you talk about the patient experience? And then exactly what that booster is you kind of showed it there for a second there and that it does transition to the second form. But how does it do it?

Dr Sherif Kandil 10:20
Absolutely, I’ll show it again. So, so the patients when they receive their box, it includes the booster, the accessories, obviously, and also, yeah, the aligners were, where there was almost like a place for let’s say, almost like four to five aligners that are, let’s say, aligner sets that the doctor could give to the patient. Now, the booster is a very simple device, as you can see here. And we designed the boosting process in a very, very simple way that anyone can do it through which the patients will be literally just placing the aligners inside the booster, they’ll just boil water and pour boiling water directly on the aligner and just close the lid for 10 minutes, take it out wear the aligner once again, now what do they experience when they take the aligner out and wear it, one is definitely they feel like okay, it’s like a new aligner, it feels like a there was some pressure on certain areas where the teeth are moving or should be are programmed to move. That’s one. Second is is that there will be like a refreshing for the mechanical properties that would happen also for all the other areas in general the plastic through which when you when you heat the aligner to a certain temperature, which is more of the same temperature that is required for the shape shifting to happen, it starts to recover also the original shape of the areas that say especially at the back teeth were because of the grinding or the bruises and even if the aligners are on the aligners for like a whole week, what happens is that the back teeth, sometimes the aligners start to just like move out a little bit, you know, they start to distance themselves slightly from the teeth. Now when we boost the aligner, the aligners snap again, once again on the teeth of the back. And that’s what the patients also reports like, I feel like okay, in the front, for example, there is like sort of areas where I feel that there’s pressure, but I also feel in the back that it snaps more as if it’s a new aligner once again. Aligners are almost disinfected, or, you know, because I mean, you put pour boiling water. So most of the bacteria, I mean above 72 degrees are, are are dead. The aligner comes out of the booster, it’s a hygienic clean aligner, it’s super fresh for them, when they wear it, it feels like it’s new. And, and they continue wearing it for another week. And then they, they change to the next aligner and so on. So keep the keep doing that throughout the whole cycle. Now, the one thing that makes the experience even more exciting is that this is also connected to the mobile app. So the patient when they start the treatment at the very start, at the very beginning, there is a mobile app, which is optional, I mean, they could have it or they could not depends on if they want to have the full experience or not. And through the mobile app, I mean, they they will very easily just scan a QR code that is a customized QR code for that particular patient generated with every single case manufactured. And when they scan that code, the treatment details will be uploaded automatically or populate automatically inside the app for that particular patient so that they would see exactly this calendar, when am I starting, when is the next boost, etc, etc. So it gives kind of notifications or reminders for the patient, but also makes it a little bit of you know, like a kind of a gamification process that kind of also incentivizes the patient or gives the feeling of reward throughout the whole treatment.

Alison Werner 13:32
Great. Can you talk about because I’m sure people are wondering what you know, because you’re using boiling water and heat to change the shape of the aligner, what’s to prevent, like a hot drink, for example, changing the shape of the aligner?

Dr Sherif Kandil 13:47
I mean, it could happen. But in one case where someone would be, let’s say drinking very, very hot coffee and keep it in their mouth for 10 minutes. That’s only maybe a scenario where that would happen. But other than that, it would never, it would never boost with you know, normal drinking or, you know, normal normal lifestyle. Because again, it was designed in a way so that it needs temperatures above 90 degrees, and would be kept for a few minutes time, ideally above five minutes, and we say 10 minutes, and then you have to take it out. So it’s highly, very, very highly unlikely that it would happen anywhere else except probably through the boosting process.

Alison Werner 14:28
Okay, great. So what else would you like doctors to know about treatment progression or, you know, outcomes for these cases and their use of this aligner system.

Dr Sherif Kandil 14:43
So I think the doctor should look at it from several perspectives. So we’re trying to accelerate the adoption of eco friendly solutions in the aligner market. And we do know and we have to be very transparent about this like so many doctors are not the most eco-friendly enthusiasts. But we’re trying to raise that awareness. And we’re also trying to like annex for the advantages that come through the ClearX with the eco-friendly part with other advantages related to the, the mechanical part and the biomechanics, as well as to the efficiency of the aligners. Because we use very high quality multi layered material as well, that comes with very, very amazing properties, in terms of anti-stain are pleased with the same quality before it’s boosted. And we we’ve done all the studies to prove that as well. And to validate all these steps before the boosting after the boosting, how does the material react? How does it push the teeth? What are the, the the forces exerted on the teeth after the boosting all these things? So at this point of time, I think what I would tell doctors is that eco friendliness is certainly something that is, is about time that we start to take it more seriously in our practices, not just only for us, but also for our patients, it’s something that they could actually be marketed also very, very efficiently in, in practice. And we see that throughout so many practice using clinics in Europe, where patients prefer to use a more eco friendly product with less plastic than another one that uses double the amount of plastic, right. And on the other hand, all the properties of the material that bring the the results of the treatment to in almost, I’d say 80 to 82% of the cases directly without refinements to the end result. That’s a very, very profound statement yet all the data that we have prove that that our refinement rates are very, very low. And the the need for even mid course corrections is in the magnitude of almost 0.2 to 0.5% of our cases. So the teeth tracking is great. The the end results are very predictable. These are things that I think every orthodontist and dentist would love to always have from the very beginning to know that okay, I I trust to to reach this product I want to deliver to my patients, something that they would be proud of, but also what I would be proud of at the end to reach the results that I was promised or at least that was suggested to me all the treatment plans from the start.

Alison Werner 17:33
Great. One of the other things that you will have, you’ll have at a neighboring booth is K Line Europe’s OEM services. And you’ll be debuting that as well at AAP, and this is kind of the entry into the US market for this aspect of the company. Can you talk about what you’re offering with these OEM services?

Dr Sherif Kandil 17:52
So I mean, the OEM Service is, is a service where we prove we give access to a lighter innovation to to any aligner provider, whether it’s a company, whether it is a DSO, or even a dental orthodontic lab, we have all the tools that we have, we have developed by ourselves or even made available and we offer that in just considered like an open buffet for any for any partner of ours, who could just take part of it or take the whole thing, whether it’s treatment planning, aligners, having their own portal, having a mobile app, et cetera, et cetera. Now ClearX harmonizes with that really well or syncs really well with that as well, where we’re currently working on providing also cobranding option for ClearX. So we’re not limiting for for K Line, but rather, the goal is to make it available for everyone to use the same and also provided to to their doctors or the to their patients through a co-branding model that we that we’re offering starting at the AAO.

Alison Werner 19:00
Okay, great. And then do you will you have any in booth events or lectures coming up that our listeners can check out?

Dr Sherif Kandil 19:12
Yeah, I mean, we have, we have a schedule for the events where I myself will be giving mini sessions, through which the sessions we’re going to be showing live how the boosting process happens. And I always love to show the doctors how exactly the shape shifting happens right in front of their eyes, that it’s like, you know, the immediate belief, wow, this thing is real, you know, it’s not only looking good on videos, photos, but really they when they see it in front of them, then they start to also understand the full concept and the technology behind it. So yeah, I mean, we have the sessions where they include partial live demos as well as also a lot of updates about where we’re this technology is going to and a little bit in depth into the technical part of the material and the patient journey.

Alison Werner 20:04
Great. Well, Dr Kandil, thank you so much for taking the time to speak with me and I look forward to seeing you at AAO and for everybody to check out what’s ClearX aligners are doing so thank you.

Dr Sherif Kandil 20:14
My pleasure. Thanks a lot and see what they do.

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