How is an orthodontic treatment designed at Impress?
Impress orthodontic treatment is embedded in science, and we are continually devoted to becoming more efficient thanks to clinical research. Our proprietary software helps our highly qualified orthodontists correct even the most complex cases and allows them to do so with instruments beyond just clear aligners. We are redefining what modern orthodontics looks like for our patients by delivering high-quality care in the most technology-enabled and patient-centric way possible.
Let's explain how our orthodontic treatment is prescribed and designed uniquely for each patient.
Step 1 consultation + scans
Your journey begins at your free in-person consultation with one of our trained orthodontists. We will take a 3D intraoral scan and a 360º X-ray (known as cone beam computed tomography or CBCT X-ray) during your consultation. These two images are overlaid into an exact model (patent pending) that allows our orthodontists to look at your teeth, roots, and underlying bone with a high degree of detail instead of just the surface of your teeth -- this is the start of what makes Impress x Uniform different.
The CBCT X-ray we use is an extremely low dose (a single x-ray is the same amount of radiation as flying from San Francisco to New York), and it is comfortable (no bitewings or anything in the mouth)! These x-rays are rarely available in orthodontic or dental offices and are typically only used for diagnosis. We’re one of the few, if only groups that use them for treatment planning, in addition to diagnosing any issues.
A part of your treatment plan may include the use of orthodontic auxiliaries and/or dental procedures to assist in correcting bites, gaps, and crowding. These include attachments and IPR. Orthodontic appliances, such as brackets, rubber bands, and bite ramps can be prescribed in conjunction with clear aligners for hybrid treatments to reduce total treatment time and allow the orthodontist to treat malocclusions previously only treatable with braces alone.
Step 2 building a 3D model of your teeth
Once you start treatment, your 3D intraoral scan and CBCT X-ray are uploaded into our clinical team’s EMR (electronic medical record). This is where the magic begins to happen. Your 3D scan and CBCT X-ray are superimposed on top of each other to create the most detailed 3D model available of your teeth, roots, and bone. This 3D model is one of the most critical aspects of your treatment. It gives our orthodontists visibility into exactly how your teeth will move and allows us to plan out the course of your treatment in the most predictable and efficient manner. How? The roots of teeth aid in dictating how teeth will move, by having this information we can avoid things like root collisions and complicated or inefficient movements - all of which add time to treatment.
Step 3 treatment planning
Once the detailed 3D model is built, it then progresses to the treatment planning stage. This is when we create the ideal sequence of movements to align your teeth. We do this by moving each tooth, tooth-by-tooth into their planned result. Each aligner has a prescripted amount of movement. By wearing a new aligner each week, the sequence of movements can safely move your teeth (note, most patients spend a week on each aligner stage, although patients who are less diligent about wearing aligners 22 hours a day may need two weeks for each stage).
The alignment phase also takes into account any orthodontic appliances that have been prescribed for treatment. Most patients will need attachments and IPR, for example, while for the most complex cases, we may add braces across a segment of a few teeth to assist with a particularly challenging movement. Our treatment planning software assists in staging the movements to achieve the exact positioning for each tooth.
Step 4 printing
Lastly, we finish the process by fabricating (or printing) your clear aligners. Once your orthodontist has finalized and approved your treatment plan, we send the plan and set-up to our manufacturing team.
Making aligners is roughly a two-step process. During the first step, a 3D ‘positive’ model of each arch (upper and lower) for each stage of movement is made.
The second step is that a very thin, clear plastic material (BPA free of course) with specific material properties is shaped over that positive model and then carefully cut out and polished. That final clear plastic model of your teeth is your aligner, which is custom-molded just for you, based on a precisely planned set of movements.