By Alison Werner

Every issue of this magazine presents readers with new, ever-advancing products, but how many orthodontists actually use anything beyond basic brackets and wires in their practices? To find out, Orthodontic Products launched a series of reader surveys.

The goal of our fifth survey was to discover if and how our readers use customized bracket and wire systems. To gather our data, we sent an e-mail survey to our subscribers, with the incentive of a $50 gift card for filling it out. We received a total of 247 responses, though not all respondents answered all of the questions (and some questions allowed for more than one answer).

In the accompanying charts, each answer is labeled with the percentage of respondents who gave that answer. Here’s what they had to say.

Do you use customized bracket and/or wire systems?


While customized bracket and wire systems allow orthodontists to adapt the systems to an individual patient’s teeth, only 24.4% of respondents said they currently use customized systems in their practices. The remaining 75.6% of respondents said they don’t currently use such systems, relying instead on their hands-on skills rather than digital technology for treatment.

If you answered “no,” what would make you start using these systems? (Check all that apply.)


Among those respondents who said they do not currently use customized bracket and wire systems, cost and proof of effectiveness seem to be the major barriers to adoption. While 59.3% of respondents want to see lower prices before they jump on board, 54.2% want more proof that the systems are clinically advantageous. Meanwhile, 27.7% of respondents want easier access to training before they integrate these systems into their practices.

If you do use customized brackets or wires, what system(s) do you use? (Check all that apply.)


3M Unitek’s Incognito was the system of choice for 50% of respondents who reported that they currently use customized brackets or wires. For 33.3% of respondents, Insignia, from Ormco, was their brand of choice, while 25.6% treat patients with American Orthodontics’ Harmony system. Rounding out the responses, 16.7% of respondents reported that they use Suresmile from Orametrix, while 6.4% use RMO’s Lingualjet system in their practice.

What percentage of your cases do you treat with these systems?


For those respondents who said they currently use customized bracket and/or wire systems in their practices, the vast majority of respondents reported using such systems sparingly to treat cases. Almost half of respondents (49.2%) reported using these systems in 10% of the cases they treat. On the other end of the spectrum, only 3.8% of respondents reported using these systems to treat 100% of their cases.

Do your patients request specific systems? (Check all that apply.)


According to the orthodontists who participated in the survey, the majority of patients who sit down in the treatment chair aren’t asking for a specific system (91.4%). And when they do, 4.8% of patients request the Incognito system, while 1.4% request Insignia and 3.3% Suresmile.

Do patients treated with these systems express less, the same, or greater satisfaction with their results?


When it comes down to it, satisfaction with the results is the key factor in any treatment choice. A majority of respondents said that patients express the same satisfaction with their results (67.6%). Meanwhile, 15.9% of patients report less satisfaction when using a customized system; while16.6% report greater satisfaction.

Do you charge the patient extra for using these systems? If so, how much?


The vast majority of respondents who have added customized systems to their practices are not charging patients more for the option (61.9%). However, a significant number said they do charge extra, with 16.8% reporting that they charge patients less than $500 extra, while 10.3% charge between $501 and $1,000 extra. Meanwhile, 11% of respondents charge patients more than $1,000 extra for the use of customized systems.

Do you find these systems an improvement over standard brackets and wires in any of the following categories? (Check all that apply.)


When it comes down to it, those orthodontists who have adopted customized bracket and wire systems see the biggest advantage in treatment time (44.6%), when compared to standard systems. Additionally, chairtime required (36.2%), clinical precision (37.7%), and cost (37.7%) rank equally among respondents, demonstrating that there is some consensus when it comes to the benefits of these customized systems over standard brackets and wires.

In the end, these answers show that while the use of customized bracket and wire systems remains low among respondents, there is willingness among orthodontists who have not yet taken the leap to incorporate these systems into their practice once prices come down and more evidence emerges to show they are clinically advantageous. Orthodontists, and patients, want treatment options that promise results, and if the evidence is there, more orthodontists are likely to embrace the use of customized options in their practices. OP



For more information on all of the products and companies mentioned throughout this survey, visit our Market Guide.