Invisalign Introduction:
Invisalign is the product of Align Technology Inc. The company was founded in 1997 by Zia Chishti and Kelsey Wirth. The author of this article started working with Align Technology in 1998 after completing a three year orthodontic residency at UCSF. Presented here are two cases that were treated with Invisalign. One of which is a lower interproximal reduction case and the other a lower incisor extraction case. The reader should keep in mind that both of these patients were treated in a small clinical trial conducted by the author and funded by Align Technology. The author does have proprietary interest in Align Technology.
Nov. 30, 2000 -- Forget the gunmetal-gray strapping -- it's not the only way to get straight teeth. That's essentially the marketing pitch behind a new type of orthodontic device that promises a straight smile while being easy on the eyes.
The Invisalign process uses a series of clear, plastic molds to
gradually move the teeth. They're kept in place 24-hours a day --
except for when brushing, flossing, and eating -- and changed out
every two to three weeks as the teeth straighten. The shape of the
molds -- and hence the final position of the straightened teeth
-- is determined by creating a three-dimensional movie
of
each patient's mouth. It simulates, from beginning to end, the stages
the teeth will go through as they're adjusted.
The manufacturer of the system, Align Technology, Incorporated, of Sunnyvale, Calif., says the molds offer a more efficient way of straightening teeth, because at different stages in the process, only the teeth that need to be moved are moved. Still, that saves no time. The company says the Invisalign process works at about the same rate as conventional braces -- and can cost 20-50% more.
And there's something else: Children can't use them. The company says its computer imaging technology doesn't work for growing teeth.
So where’s the market? Right here: Twenty or 30 years
ago we weren't treating too many adults,
says Michael Rennert,
DDS, an orthodontist in Montreal and president of the American Association
of Orthodontists. Today, I would say the average orthodontist
in an urban practice probably has 20-30% of the practice in adults.
That's compared to about 5% in the past, he says. Rennert adds the
new adult market has money and is concerned with both how the mouth
looks and works. But not all of them can use the Invisalign system.
It is certainly something that has a place in every orthodontist's
armamentarium ... for select, minor adult cases.
Which does not necessarily mean the other adult cases have to stuff
tire chains into their mouths. Rennert says today's conventional
braces are smaller and less conspicuous -- and even work better
than the old clunkers. The wire is still there, but the [newer]
appliances are much more comfortable,
he says. The traditional
metal brace can be replaced by clear braces and braces from behind.
But hold on. Robert L. Boyd, DDS, chairman of the department of
orthodontics at the University of the Pacific in San Francisco,
says that even with more complicated cases, he has seen good results
with Invisalign. There's no doubt it will take its place as one
of the methods to straighten your teeth,
he says. On simple
cases, it worked quite well. With moderate to moderate-difficult
cases -- those needing the equivalent of one year of treatment with
braces -- it worked very well. And that represents 40-50% of the
market.
Boyd, who conducted studies of Invisalign, says that
in three short years, about half the orthodontists in the U.S. have
learned to use the system -- and patient demand is high.
Cost is not as much of an issue because it's less doctor time.
So we're charging 20% to 25-30% more than conventional braces.
Boyd says in his neck of the woods, few patients worry about the
extra cost.
But that may not be the case elsewhere. The fees are high,
says Elidio Deleon, DMD, chair of the department of orthodontics
at the Medical College of Georgia in Augusta. Let's say basic
braces are $3,000. If you want Invisalign, there's $500 for the
set-up then 'X' number of dollars for each retainer. If you're in
an area like California, where it's more affluent, then patients
are certainly willing to give it a try. In our area, an excess of
money is just not available. Money is a driving force.
Furthermore, that money could be wasted if patients aren't compliant,
Deleon says. This appliance is totally dependent on whether the
patient chooses to wear it.
Yet to be determined is whether
Invisalign can also move teeth in complex cases -- such as when
a pulled tooth has created a large space or if there is excessive
crowding.
Still, there's no doubt that Invisalign has created a buzz -- even
in lower-income areas. People believe that a smile is critically
important to their success and they're really jumping on it,
Deleon says. A lot of people are calling here about it.
But,
he adds, for every ten that do, just one has a mouth that might
benefit.
Seattle Cosmetic Dentist - Invisalign vs. Braces
Another option for the vain at heart is Invisalign. Patients wear a series of clear, removable orthodontic aligners that are adjusted as the teeth shift into place without metal or wires. A series of custom-made aligners are worn each for a period of two weeks. Each aligner moves the teeth progressively into place. Average total treatment time: a few months to 1 1/2 years. While orthodontists say Invisalign can be a good alternative to traditional braces, there are limitations.
Invisalign does not do a great job on vertical problems, where
the teeth are at different heights, teeth are lower or higher than
others. It doesn't not do a good job on teeth that are severely
rotated, and it does not do a good job at correcting bite issues,
says Sebastian, who also says Invisalign would also not be the best
option for fixing severely overcrowded teeth.
Sebastian says Invisalign can cost an average of $500 more than a one-year treatment with traditional braces.
Case Study
Invisible Braces:
The Orthodontics Industry Goes Wireless
A new high-profile start-up company, Align Technology, says its
3D computer imaging and manufacturing systems are key to straightening
adult teeth without uncomfortable metal braces. Their system, called
Invisalign (www.invisalign.com),
utilizes 3D scanning hardware, automatic surfacing software, 3D
animation programs, and rapid manufacturing systems --powered in
part by Geomagic technology --to produce customized, removable,
clear plastic appliances called aligners.
Combined with an
orthodontist's treatment plan, these retainerlike aligners provide
an innovative alternative to traditional braces.
Align Technology will make history as the first company to lead
the wave of mass customization in the 21st century.
-- Ping
Fu, President and CEO, Raindrop Geomagic
How Invisalign Works
- Step 1
The patient meets with an Invisalign-certified orthodontist who takes an impression and x-rays of the patient's teeth, prescribes a treatment plan, and sends the impression to the Align Technology lab. - Step 2
At Align's lab, a physical model is cast from the patient's impression. That model is then digitized using a 3D scanner. Next, the data is imported into the Invisalign computer system, where it's used to produce precise, manufacturable digital models and start-to-finish 3D animations of the patient's personal treatment plan. - Step 3
The orthodontist reviews the 3D models and animations and approves the treatment plan. From these images, Align Technology manufactures a unique set of clear, plastic aligners that are custom-fitted to the patient's teeth and mouth. - Step 4
The patient wears each stage of aligners for approximately two weeks before switching to the next in the series. Week by week, the patient's teeth are straightened, millimeter by millimeter. Total treatment time is similar to traditional braces and usually ranges from six to 24 months depending on the complexity of the case. A single patient's treatment series may contain up to 60 pairs of upper and lower aligners.
Our rapid design and manufacturing processes require automation, throughput, and customization -- all of which Geomagic has the unique ability to provide.
-- Zia Chishti, CEO, Align Technology
The Invisalign system has received FDA clearance, meeting all medical device specifications. Raindrop Geomagic's patented technology and engineering services enable Align to optimize its manufacturing process to meet current demand and increase capacity in the future.
Imagine viewing a 3D animation of the next two years of changes to your daughter's teeth -- the day after her first visit to the orthodontist.
-- From Raindrop Geomagic's first corporate brochure, 1997
Dr Rhys Spoor DDS Aesthetic & Restorative Dentistry - Providing services in cosmetic dentistry to the area of Seattle, Washington.
