DT News - UK - Interview: "The appliance is unlimited"

Dental Tribune International

Tue. 29 September 2015

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At the IOC in London, Align Technology is showcasing the latest generation of its Invisalign system, which now offers clinicians a solution for first premolar extractions. Dental Tribune Online sat down with the company’s R&D director, John Morton (who yesterday spoke about the development process during a satellite symposium), to discuss the philosophy behind the product and how it can benefit orthodontics.

Dental Tribune Online: Malocclusion requiring the extraction of a first premolar affects only 20 per cent of patients in Europe and an even lower percentage of patients in North America. Why was Invisalign G6 developed with this specific orthodontic condition in mind?
John Morton: Looking at all the different types of malocclusions that exist, treatment by premolar extraction can be difficult and considered the gold standard for evaluating an orthodontic appliance . Premolar extraction may be less prevalent in the Western hemisphere than in the Asia Pacific region, where 50 per cent of cases are treated with first premolar extraction with maximum anchorage. We developed Invisalign G6 specifically to provide treatment to the Asia Pacific market.

When we launched the Invisalign system in China in 2011, we knew we needed this type of treatment. It took four years to develop, balancing movement of the canines and the anterior and posterior of the arch. Part of the goal of this project was to make clear in the minds of orthodontists that Invisalign aligners are a true orthodontic appliance capable of well-controlled movements required for extraction space closure and not just a piece of plastic.

Invisalign clear aligners have extended the user base significantly with each generation of innovation. How important is feedback from clinicians in the development process?
It is very important, but there is a difference between us as a company and orthodontists in general. Orthodontists solve their treatment problems per patient in the chair on an individual basis. We have to do this on a large scale. Some clinicians, like Dr David Couchat from France, who spoke today, are treating patients with substantially atypical malocclusion. They are very difficult cases to treat. These doctors give us fantastic insights into treatment.

In your presentation, you emphasised the way in which technology has changed the development process.
We now have highly advanced sensors to measure the force systems produced by Invisalign aligners. As I said in my presentation, the design process used to be quite long, but technology has miniaturised the sensors significantly. With this type of technology, we can measure every force and movement on every tooth, and we are able to build shapes and attachments that doctors have not dreamed of. Moreover, we can do it all in the virtual world, fabricate in the laboratory and have our measurements within an hour to see if the design is better or worse than previously used.

We can try many different things in the computer programmes and learn from our mistakes without ever touching a patient. Ten years ago, we would have to put each design through a clinical trial for six months or so, only to find that it is the wrong design and have to start over. Today, the design process is down to hours instead of years.

With the latest generation, does the Invisalign system or clear aligners offer a complete solution for orthodontists?
The Invisalign system is a complete orthodontic appliance today, yet there is always room for further development. We can certainly design new materials, new parts or different ways of treating patients. There are all sorts of improvement we can do. The appliance is unlimited, as has been shown by our expert clinicians. There is some resistance still because building experience and confidence takes time and effort. Our task as a company is to provide more education and support to doctors and to give them the opportunity to become confident in using Invisalign aligners.

Thank you very much for the interview.

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