3D technologies for precision in orthodontics

The use of 3D technology in orthodontics has increased recent years. 3D intra-oral scanning, cone beam computed tomography (CBCT), 3D printing and computer-aided design and computer-aided manufacturing (CAD/CAM) technology has been utilized to create “personalized” orthodontic appliances. While technological improvements to orthodontic appliances seem promising, do they truly improve treatment efficiency and/ or treatment quality? This article will review currently available orthodontic appliances which utilizes 3D technology such customized wires and CAD/CAM fabricated brackets. Customized archwires are planned from 3D virtual setup and robotically bent. Studies have shown a decrease in treatment time with the use of customized wires, however data on quality of treatment results are conflicting. While this technology is fairly accurate for mesial-distal tooth movements, it is less precise for crown tip and root torque. CAD/CAM brackets were initially shown to be more effective and efficient when compared to standard brackets, but a follow-up study showed no difference in the quality of treatment of outcomes. The study also showed the majority of the reduction in treatment time resulting from CAD/CAM brackets may be due to the indirect bonding process rather than the personalized milled slots.