Braces Without Impressions – Digital Tooth Correction with Intraoral Scanner

Many people have unpleasant memories of traditional impressions at the dentist: the tray, the cold impression material, the pressure in the mouth. At JUST KFO in Cologne, we capture teeth and jaws with an intraoral scanner instead. This is a small camera that moves along the dental arches and creates a three-dimensional model on the screen. We don’t need impression material for this.

The scan is the foundation for everything that follows: planning tooth movements, fabricating aligners and retainers in our own in-house laboratory, and monitoring progress during treatment. Below, we show an example from our practice of how a scan becomes an aligner treatment, and where the scan reaches its limits.

What does “braces without impressions” mean?

In digital impression-taking, an intraoral scanner is used instead of conventional silicone or alginate material.
This small, handheld device scans the dental arches with a camera and calculates a precise 3D model of the jaw.

We only need a traditional impression in exceptional cases; the digital model serves as the foundation for:

• digital treatment planning,

• fabrication of braces or aligners,

• Progress monitoring during treatment.

How the intraoral scan works

The scan is performed directly in the practice. Your orthodontist moves the scanner head over tooth surfaces and gums. The camera continuously captures individual images, which the software immediately assembles into a 3D model; you can watch on the screen as your dentition appears tooth by tooth. The scanner works with light, not X-rays. In an orthodontic study with 180 patients, each third of whom were scanned with one of two scanners or impressed with alginate, those who were scanned preferred the digital impression; how long the recording took depended on the scanner (Burzynski et al. 2018). In a second study with 24 people who had experienced both methods two weeks apart, the scan was rated as more comfortable (Yuzbasioglu et al. 2014).

Your advantages:

• Less gag reflex, no taste of impression material

• Immediately visible result on the screen

• Data stored digitally; our laboratory prints models as needed for fabricating aligners and retainers

How the scan works at JUST KFO

We scan with a Trios 5 from 3Shape. You sit comfortably in the treatment chair, can swallow in between, and take a break if you wish. If an area is not fully captured, we rescan it specifically rather than repeating the entire impression.

Immediately afterward, you see your dentition as a 3D model on the screen. We show you where teeth are crowded or rotated, and explain what we are planning. For fabricating aligners or retainers, the data set goes to our own in-house laboratory; shipping to an external laboratory is not necessary.

What the scan means for planning, fit, and treatment progress

Precise treatment planning

The 3D model shows teeth and gums precisely. We use it to plan and simulate tooth movements, for example for treatment with aligners or fixed braces.

High fit accuracy

Braces, retainers, and aligners are fabricated digitally based on the scan. The cleaner the scan, the better the appliance will fit. Minor adjustments during placement may still be necessary, for example if teeth have shifted between the scan and insertion.

Faster treatment start

Because no impression needs to be sent to an external laboratory and we fabricate appliances in our in-house laboratory, shipping and waiting times are eliminated. How quickly your treatment begins still depends on diagnostics, planning, and your preferred appointment date.

Digital progress monitoring

With regular scans, treatment progress can be digitally documented and compared. This allows us to see at follow-up appointments whether the teeth are following the plan.

Scanning for children and adults

The intraoral scanner is suitable for patients of all ages.
Children who are anxious about traditional impressions often find the scan more comfortable.

For adults, for example before treatment with aligners or ceramic brackets, the scan provides a precise foundation for planning and fabrication.

From digital scan to custom braces

After the scan, the 3D model is transferred directly into our planning software.
There we simulate the tooth movement, discuss the planned result with you, and can show you a digital preview of your future smile. The planned outcome is a simulation; we check at follow-up appointments how closely each tooth is following the plan.

Subsequently, the corresponding appliances — whether fixed or removable — are custom-fabricated:

• Aligners (clear trays)

• Fixed braces: For fixed braces, we plan the position of the brackets digitally on the 3D model.

• Retainers to stabilize the result

From scan to appliance: an example from our practice

We described the process from scan to finished appliance in a professional publication based on an anonymized case (Schupp, Funke, Haubrich 2020). A 36-year-old patient had narrow dental arches and crowding in the upper and lower jaw. From her scan, a virtual treatment goal was first created in the planning software. The orthodontist defined this goal herself and did not delegate it to an external service provider, just as she determined the division of tooth movement into 14 steps and the position of the attachments.

For each step, a model was printed on a 3D printer, and two aligners of different thicknesses were thermoformed on it. The patient changed aligners weekly; after 28 weeks, the dental arches were expanded. How long treatment takes varies from case to case. You can find the complete case with photos in our treatment example for crowding, and the details of the workflow in the professional publication The Digital Workflow in In-Office Aligner Therapy.

Intraoral scanner vs. traditional impression — the comparison

Where the scan reaches its limits

A scan is only as good as its capture. Saliva, a restless tongue, or hard-to-reach wisdom teeth can cause gaps in the data set that we need to rescan. A laboratory study on full-arch scans found significant differences in accuracy between different scanners (Patzelt et al. 2014). That is why we check every scan on screen before it goes into planning.

Even digitally, we cannot do without materials entirely: For aligners and retainers, our laboratory prints models on a 3D printer on which the aligners are formed. We only take a traditional impression in exceptional cases.

Intraoral scan at JUST KFO in Cologne-Rodenkirchen

We use the scan for diagnostics, for planning aligner and braces treatments, for monitoring during treatment, and for new retainers. If you are considering tooth correction and would like to know what is suitable in your case, schedule a consultation appointment at Hauptstraße 50 or by phone at 0221 93 53 020. After booking, we will send you a link by SMS or email to our digital medical history form, which you can complete at your convenience at home.

Frequently asked questions about braces without impression