Aligners can be planned and fabricated entirely within the practice. This article uses a real case to show the advantages this digital in-office approach offers for treatment.
Digital in-office workflow for aligner therapy from intraoral scanning to fabrication.
Aligners from our own practice: fast, precise and all from one source
Clear aligners have become one of the most popular ways to straighten teeth almost invisibly. Many aligners are manufactured by external providers. In our Cologne practice, however, we can plan and fabricate the aligners entirely in our own laboratory — this is called in-office treatment. The following real treatment case shows what advantages this digital approach offers our patients.
What “in-office” means
In-office means: Everything takes place within the practice, from the digital impression to treatment planning on the computer to the finished aligner. Instead of a conventional impression using impression material, the dentition is captured in 3D using an intraoral scanner without any contact.1 Based on this, the orthodontist personally plans each individual treatment step and then fabricates the aligners in the practice’s own laboratory.
The advantage: planning in experienced hands
The most important step — defining the treatment goal and the precise sequence of tooth movements — is not outsourced to an external service provider or software, but is carried out personally by the treating orthodontist.2 This way, experience and knowledge of force relationships flow directly into the planning. Another advantage: The aligners are quickly available, which is especially practical when the treatment needs to be adjusted flexibly.
A treatment example
The Initial Situation
A 36-year-old patient came to our practice with the wish for a more beautiful smile. Her dental arches were significantly too narrow in both the upper and lower jaw, and there was crowding as well as slight rotations of individual teeth. She had already received orthodontic treatment during childhood. The bite itself was stable, so the focus was on the harmonious shaping of the dental arches.
The treatment process
After the digital scan, a virtual treatment goal was created on the computer and divided into individual steps. Small, tooth-colored auxiliary elements (attachments)3 on the teeth supported the planned movements, and fine elastic bands improved the occlusion. To provide sufficient space for the teeth, the interdental spaces were minimally smoothed in a few places. A total of 14 sets of aligners were fabricated, which the patient changed weekly.
The Result
After only about seven months, the dental arches were harmoniously shaped and the crowding resolved4 — with a stable Class I occlusion. To maintain the result, the patient wears a thin retainer at night. A detailed patient case can be found in our blog. The case shows how efficiently a well-planned aligner treatment can fulfill patients’ correction wishes.
What this case demonstrates
In-office aligner therapy combines the advantages of digital orthodontics with the experience of the treating orthodontist.5 Learn more about treatment with clear aligners on our dedicated page. What remains crucial for a good result is careful planning and consistent wearing of the aligners.6 How quickly this can happen is shown in our treatment case Crowding corrected with aligners in 7 months
Sources
- Patzelt, S. B. M., Emmanouilidi, A., Stampf, S., Strub, J. R., & Att, W. (2014). Accuracy of full-arch scans using intraoral scanners. Clinical Oral Investigations, 18(6), 1687–1694. https://doi.org/10.1007/s00784-013-1132-y
- Kravitz, N. D., Kusnoto, B., BeGole, E., Obrez, A., & Agran, B. (2009). How well does Invisalign work? A prospective clinical study evaluating the efficacy of tooth movement with Invisalign. American Journal of Orthodontics and Dentofacial Orthopedics, 135(1), 27–35. https://doi.org/10.1016/j.ajodo.2007.05.018
- Schupp, W., & Haubrich, J. (Hrsg.). (2015). Aligner Orthodontics. Quintessenz.
- Boyd, R. L., Miller, R. J., & Vlaskalic, V. (2000). The Invisalign System in adult orthodontics: Mild crowding and space closure cases. Journal of Clinical Orthodontics, 34, 203–212.
- Krey, K., et al. Complete digital in-office workflow for aligner treatment with a fused filament fabrication (FFF) 3D printer: Technical considerations and report of cases.
- Rossini, G., Parrini, S., Castroflorio, T., Deregibus, A., & Debernardi, C. L. (2015). Efficacy of clear aligners in controlling orthodontic tooth movement: A systematic review. The Angle Orthodontist, 85(5), 881–889. https://doi.org/10.2319/061614-436.1
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