Like many orthodontists, I welcomed the decision to adopt a computerized practice-management and charting system that made our office "paperless." Eliminating the physical storage of plaster models, or becoming "plasterless," was another primary interest for our practice. Approximately 8 years ago, we selected Cadent’s OrthoCAD iCast digital modeling product as our solution for model storage and retrieval. It also provided state-of-the-art diagnostics and the ability to communicate electronically with referring doctors and patients.

My interests soon progressed to assisting OrthoCAD in development and delivery of its iQ product, which uses digital modeling and virtual alignment to help with indirect bonding. iQ uses digital mapping of the patient’s unique dental anatomy, joined with the orthodontist’s prescription plan and bracket of choice, to provide a virtual alignment that demonstrates both bracket expression and alignment capabilities. Virtual alignment also allows users to consider multiple treatment plan options and share these options with both the referring dentist and the patient. We found this particularly useful in planning prerestorative orthodontic cases with referring dentists.

The initial OrthoCAD product proved to have a cumbersome method of transferring the patient’s virtual bracket information from the computer to the patient’s dentition. It used an intraoral camera with a "smart bomb" targeting method to locate the optimal bracket position directly to the patient’s tooth. Once the computer position was matched to the patient’s tooth, the bracket was cured to that location. I experimented using this same intraoral camera and "smart bomb" targeting method to the patient’s plaster model and then used standard techniques to fabricate carrier trays for an indirect bonding process. Merging the CAD/CAM technology with time-proven indirect bonding techniques proved to be the optimal method to transfer the virtual bracket positioning to the patient. Our experience with the new techniques was described in a publication in 2005.

Perhaps the most anticipated new technology in our office has been Cadent’s iTero iOC intraoral scanner. It eliminates alginate or PVS impressions and creates a digital model that is more accurate than those created from impressions. We have found that patients experience less anxiety, less gagging, and less discomfort than with other impression techniques. Parents and patients also appreciate that we are using advanced technologies for their orthodontic care.

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