Suresmile
Encyclopedia
SureSmile is a type of braces used by orthodontists to straighten teeth
. With SureSmile the orthodontist combines 3-D imaging, treatment planning software and a robot
to create the wires. The technique is reported in The World Journal of Orthodontics to decrease the time required to complete orthodontic treatment by 34% and increase the precision of the results.
or cone beam computed tomography
(CBCT). The 3-D
scanner transforms physical teeth into virtual teeth. The virtual model enables the orthodontist to visualize teeth not only from the front as with conventional orthodontics, but from all angles seeing roots, gums
, things they never would have seen before without the imaging and software. Then as described on the Science Channel, with the software tools the orthodontist takes the teeth and individually aligns them into the proper position. Dr. Michael B. Stewart an orthodontist at Atlanta Orthodontic Specialists explained on Good Morning America
that “[Orthodontists] have more control over how these teeth are moved than [they] ever had before."
Once the orthodontist has virtually designed the smile and bite, SureSmile software plans the most efficient and direct route for moving teeth into the proper place and sends this information to a robot
that bends and shapes the wires specifically for that patient. The wire with all of the custom bends is then sent back to the
orthodontist ready to place on the patient.
Note: Both studies used consecutively treated, non-extraction cases.
The SureSmile System received 510K marketing clearance from the U.S. Food and Drug Administration
(FDA) in November 2000. In 2003, OraMetrix relocated its U.S. corporate headquarters from Dallas to a larger, 25,000-square-foot facility in Richardson, Texas. Today, more than 100,000 patients have received or are in treatment with SureSmile at over 400 practices nationwide.
The editor of Techno Bytes, Dr. Robert Scholz, provides an in-depth interview with the Chief Clinical Officer of OraMetrix, Inc., Dr. Rohit Sachdeva.
According to the study, when compared with conventional finishing, SureSmile patients had significantly lower DI scores, less treatment time , and better CRE scores for first-order alignment-rotation and interproximal space closure.
Dr. Ed Lin gives an in-depth lingual case study using SureSmile QT.
The research shows that the SureSmile process results in a lower mean ABO OGS score and a reduced treatment time than conventional approaches with great potential to both decrease treatment time and improve quality.
This article describes the use of both ‘hard’ and ‘soft’ tools in managing the orthodontic care of a patient with SureSmile technology.
Orametrix website
Tooth
Teeth are small, calcified, whitish structures found in the jaws of many vertebrates that are used to break down food. Some animals, particularly carnivores, also use teeth for hunting or for defensive purposes. The roots of teeth are embedded in the Mandible bone or the Maxillary bone and are...
. With SureSmile the orthodontist combines 3-D imaging, treatment planning software and a robot
Robot
A robot is a mechanical or virtual intelligent agent that can perform tasks automatically or with guidance, typically by remote control. In practice a robot is usually an electro-mechanical machine that is guided by computer and electronic programming. Robots can be autonomous, semi-autonomous or...
to create the wires. The technique is reported in The World Journal of Orthodontics to decrease the time required to complete orthodontic treatment by 34% and increase the precision of the results.
Design
The orthodontists first take digital images of a patient's mouth and teeth using either a white light scannerWhite light scanner
A White Light Scanner is a device for measuring the physical geometrical characteristics of an object using White light interferometry. Frequency domain analysis is an alternate approach that uses all of the information available in the interferogram...
or cone beam computed tomography
Cone beam computed tomography
Cone beam computed tomography is a medical imaging technique that has become increasingly important in treatment planning and diagnosis in implant dentistry, among other things...
(CBCT). The 3-D
3D
3D or 3-D may refer to:*Three-dimensional space, the physical universe*Stereoscopy, any technique capable of recording three-dimensional visual information or creating the illusion of depth in an image-Music:*3D...
scanner transforms physical teeth into virtual teeth. The virtual model enables the orthodontist to visualize teeth not only from the front as with conventional orthodontics, but from all angles seeing roots, gums
Gingiva
The gingiva , or gums, consists of the mucosal tissue that lies over the mandible and maxilla inside the mouth.-General description:...
, things they never would have seen before without the imaging and software. Then as described on the Science Channel, with the software tools the orthodontist takes the teeth and individually aligns them into the proper position. Dr. Michael B. Stewart an orthodontist at Atlanta Orthodontic Specialists explained on Good Morning America
Good Morning America
Good Morning America is an American morning news and talk show that is broadcast on the ABC television network; it debuted on November 3, 1975. The weekday program airs for two hours; a third hour aired between 2007 and 2008 exclusively on ABC News Now...
that “[Orthodontists] have more control over how these teeth are moved than [they] ever had before."
Once the orthodontist has virtually designed the smile and bite, SureSmile software plans the most efficient and direct route for moving teeth into the proper place and sends this information to a robot
Robot
A robot is a mechanical or virtual intelligent agent that can perform tasks automatically or with guidance, typically by remote control. In practice a robot is usually an electro-mechanical machine that is guided by computer and electronic programming. Robots can be autonomous, semi-autonomous or...
that bends and shapes the wires specifically for that patient. The wire with all of the custom bends is then sent back to the
orthodontist ready to place on the patient.
Innovations
- The treatment time is faster. While a tooth will move at the same rate regardless of the method used, the SureSmile system moves a tooth to its target position in the most efficient path due to the software’s ability to calculate concurrent tooth movements and the robot’s ability to bend the wire to bend the wire precisely to generate the prescribed movement.
- The patient only has 1-2 wire changes compared to many wire changes and/or adjustments with conventional braces. Unlike conventional treatment where the orthodontist manually bends a series of straight wires using pliers to move the teeth one-by-one into position, with SureSmile all the bends to move teeth are made in a nitiNickel titaniumNickel titanium, also known as nitinol, is a metal alloy of nickel and titanium, where the two elements are present in roughly equal atomic percentages....
(nickel titanium) shape-memoryShape memory alloyA shape-memory alloy is an alloy that "remembers" its original, cold-forged shape: returning the pre-deformed shape by heating. This material is a lightweight, solid-state alternative to conventional actuators such as hydraulic, pneumatic, and motor-based systems...
wire and when it is placed into the patient’s mouth-- their body temperature activates those permanent bends to move teeth directly into place. The end result has a more precise result. - SureSmile produces more precise results than traditional braces because of the software planning and the robot. Dr. Sammy Thabet of Germantown, MD explains on CNNCNNCable News Network is a U.S. cable news channel founded in 1980 by Ted Turner. Upon its launch, CNN was the first channel to provide 24-hour television news coverage, and the first all-news television channel in the United States...
Health Minute with Sanjay Gupta, MD, The [treatment planning software] is accurate to 1/10th of a millimeter. The robots are able to reproduce the accuracy with the wires and that is something I cannot do by hand.
Outcome quality
| Study | Sample Size | Treatment Time | SureSmile Treatment Efficiency |
SureSmile Quality Improvement |
|---|---|---|---|---|
| Saxe et al. (WJO), 2010 University of Las Vegas |
SureSmile: 38 Conventional: 24 Doctors: 3 |
SureSmile: 14.7 months Conventional: 20 months |
25% less (6 months) | 14.3% better |
| Alford et al. (Angle), 2011 University of Indiana |
SureSmile: 69 Conventional: 63 Doctors: 1 |
SureSmile: 15.8 months Conventional: 23 months |
31% less (7.2 months) | 11% better |
Note: Both studies used consecutively treated, non-extraction cases.
Treatment time and cost
The range of treatment time for SureSmile varies from patient to patient. Generally however, finish times with SureSmile range from 6 months to 20 months. In the study also referenced above, it was shown that on average SureSmile treatment is completed 33% faster than conventional treatment. The cost of SureSmile varies from orthodontist to orthodontist. Some orthodontists include the cost of using SureSmile in their standard fees and some charge a separate fee. The price variance typically ranges fro 0-10%.Lingual braces
SureSmile has a lingual or behind teeth braces option called SureSmile QT. With lingual braces, brackets are adhered to the underside of the teeth on the to arch, bottom arch or both arches. Most patients choose lingual braces for aesthetic reasons, as they cannot be seen. Orthodontists that offer lingual braces will often suggest putting lingual braces on the upper teeth and clear ceramic braces on the bottom though patients can choose to have lingual braces on both arches. A news segment on WGN-TV Medical Watch recently featured SureSmile QT and explains that the same SureSmile robotic technology is used for the behind teeth braces.Advantages
- Faster and more efficient treatment time.
- SureSmile improves the treatment outcome over conventional treatment.
Disadvantages
- Not all orthodontists offer SureSmile. Approximately 400 orthodontists in the United States, Germany, England, Japan, and Australia offer SureSmile.
- The cost of SureSmile is often higher than traditional braces and varies from orthodontist to orthodontist.
History
The SureSmile technology was developed and is owned by OraMetrix, a company founded in 1998 through the merger of two medical technology companies, one U.S. based and the other German. The company was launched globally in 1999 with the help of a $150,000 investment from STARTech Early Ventures LLC. Other key investors include Brentwood Venture Capital, CenterPoint Ventures, Rho Ventures and STAR Ventures.The SureSmile System received 510K marketing clearance from the U.S. Food and Drug Administration
Food and Drug Administration
The Food and Drug Administration is an agency of the United States Department of Health and Human Services, one of the United States federal executive departments...
(FDA) in November 2000. In 2003, OraMetrix relocated its U.S. corporate headquarters from Dallas to a larger, 25,000-square-foot facility in Richardson, Texas. Today, more than 100,000 patients have received or are in treatment with SureSmile at over 400 practices nationwide.
Further reading and studies
- "Interview with an Innovator: SureSmile Chief Clinical Officer Rohit C. L. Sachdeva", American Journal of Orthodontics and Dentofacial Orthopedics Robert P. Scholz and Rohit C. L. Sachdeva
The editor of Techno Bytes, Dr. Robert Scholz, provides an in-depth interview with the Chief Clinical Officer of OraMetrix, Inc., Dr. Rohit Sachdeva.
- "Clinical Outcomes for Patients Finished with the SureSmile Method Compared with Conventional Fixed Orthodontic Therapy", Angle Orthodontist Timothy J. Alford; W. Eugene Roberts; James K. Hartsfield Jr; George J. Eckert; Ronald J. Snyder
According to the study, when compared with conventional finishing, SureSmile patients had significantly lower DI scores, less treatment time , and better CRE scores for first-order alignment-rotation and interproximal space closure.
- "Class I with Deep Bite and Crowding Treated with Lingual, i-CAT & SureSmile", Orthotown Dr. Ed Lin
Dr. Ed Lin gives an in-depth lingual case study using SureSmile QT.
- "Efficiency and Effectiveness of SureSmile", World Journal of Orthodontics Alana K. Saxe, DMD; Lenore J. Louie, MSc, DMD; James Mah, DDS, MSc, DMSc
The research shows that the SureSmile process results in a lower mean ABO OGS score and a reduced treatment time than conventional approaches with great potential to both decrease treatment time and improve quality.
- "Reframing Clinical Patient Management with SureSmile Technology",“Pacific Coast Society of Orthodontists Dr. Rohit Sachdeva and Dr. Mark P. Feinberg
This article describes the use of both ‘hard’ and ‘soft’ tools in managing the orthodontic care of a patient with SureSmile technology.
External links
SureSmile websiteOrametrix website