Dental Asia May/June 2022

BEHIND THE SCENES
In other words, a motivated patient is a
successful patient.
Three months of progress with Braces On Demand appliances
Second, because 3D-printed resin brackets
do not provide the same amount of
enamel fracture risk and wear as porcelain
brackets, the clinician has more flexibility
to place 3D-printed aesthetic braces,
especially on the lower arch. This is
anticipated to have a positive impact on the
debonding process as well. Debonding
3D-printed braces is much less likely
to cause enamel fracture compared to
debonding porcelain brackets, making it
safer for the patient’s enamel.
Intraoral photo after five months of progress
upper arch and the lower 014 has provided
initial de-rotation of the lower arch. At this
point, a lower reverse curve 16x16 NiTi was
inserted to level the lower curve of Spee.
This lower levelling will then be evaluated
in eight to 10 weeks.
until she is ready to transition to clear
aligners. As it can be seen in the clinical
pictures above, the initial difficult rotation
and levelling challenges have been
completed on the upper arch and the lower
teeth will be completed soon.
Lastly, and most importantly, the efficacy
and affordability of 3D-printed brackets
made it possible to undertake a hybrid
treatment in the first place. Since the
braces were printed in-office, there was
no cost concern about making changes
mid-treatment, such as bonding additional
braces or transitioning to aligners. As
a result, the patient experience can be
adjusted “on the fly”, which provides a
competitive advantage in the modern
orthodontic landscape. For doctors, as well
as for patients and parents, this results in
less stress because both sides have more
control over the orthodontic journey. DA
CLINICAL CONSIDERATIONS WITH
AESTHETIC BRACKETS
From a clinical perspective, bonding the
lower arch with aesthetic brackets can be
a complex consideration for orthodontists.
Since the primary material for aesthetic
brackets is porcelain, orthodontists must
take great care to protect the opposite
arch against excessive occlusal wear.
In contrast, 3D-printed resin brackets
have less risk of enamel fracture and
wear than porcelain brackets, given the
material composition and properties.
The 3D-printed resin will perform safely
against normal forces of occlusion and do
not necessitate bite turbos to protect the
upper arch from enamel fracture.
The patient will continue to be treated
with upper and lower fixed appliances
The transition from fixed appliances to
clear aligners, including debonding the
3D-printed brackets, will be covered in a
future paper.
CONCLUSION
Using 3D-printed brackets made the first
five months of this case unusual in several
ways.
First, 3D printing had a positive impact
on patient interest and engagement. In
this case the patient was motivated by the
innovative approach and the excitement
of using the latest technology, even to the
point of requesting 3D-printed brackets for
the treatment of the lower arch. Patients
who show a genuine interest in the details
and technology of their treatment plan
take more ownership of the process.
ABOUT THE AUTHOR
Dr Tom Shannon
is a board certified
orthodontist and
graduate of the
University of Michigan
(DDS), the University of
North Carolina (AEGD),
as well the University
of Tennessee (MDS, Orthodontics). As a
leader in orthodontic simulation design,
Dr Shannon has been at the forefront of
in-office aligner production, 3D-printed fixed
appliances, and hybrid treatment options.
Currently in private practice in Southwest
Michigan, Dr Shannon is also a co-founder
of Braces On Demand and holds multiple
patents in the 3D printing space.
DENTAL ASIA MAY / JUNE 2022 53