Skip to main content

Innovations and new technologies in daily orthodontic practice

The orthodontist in his practice finds himself in the role of manager, marketing and financial director, host, hr specialist and even a trainer for his team. for this new role, he is not always sufficiently prepared and only his intuitiveness and education can help him move in the right direction for the development of his business. innovation systems have a key role in the development of clinical orthodontic practices, reducing the need for human intervention, saving time and minimizing errors.

The article presents the most modern technological and innovative methods that are the future of orthodontic practice: direct printing of aligners in the office; robotic bending of arches; use of ai in analyzing 2d (x-ray) and 3d (CbCt) images.

Digitalized orthodontic practice would provide patients with more comfortable, personalized and related to new experiences treatment and care. this encourages orthodontists to implement leading innovations to meet the growing demands in the field.

Dr Mirela Georgieva
Department of Orthodontics
Faculty of Dental medicine
Medical University – Sofia
1,“St. Georgi Sofiiski” Blvd.
Sofia 1431, Bulgaria
e-mail: mirela.georgieva@fdm.mu-sofia.bg

1. Amasya, H.; Yildirim, D.; Aydogan, T.; Kemaloglu, N.; Orhan, K.
Cervical vertebral maturation assessment on lateral cephalometric radiographs using artificial intelligence: Comparison of machine learning classifier models. Dentomaxillofac. Radiol. 2020, 49, 20190441.
2. Berghaus, S., & Back, A. (2016). Association for Information Systems AIS Electronic Library (AISeL) Stages in Digital Business Transformation: Results of an Empirical Maturity Study stages in digital business transformation: results of an empirical maturity study Completed Research.
3. Bichu, Y.M.; Alwafi, A.; Liu, X.; Andrews, J.; Ludwig, B.; Bichu, A.Y.; Zou, B. Advances in orthodontic clear aligner materials. Bioact. Mater. 2023, 22, 384–403.
4.Can, E.; Panayi, N.; Polychronis, G.; Papageorgiou, S.N.; Zinelis, S.; Eliades, G.; Eliades, T. In-house 3D-printed aligners: Effect of in vivo ageing on mechanical properties. Eur. J. Orthod. 2022, 44, 51–55.
5. Furr, N., Ozcan, P., & Eisenhardt, K. M. What is digital transformation? Core tensions facing established companies on the global stage. Global Strategy Journal. 2022;12(4):595–618. 6. G. Yordanova, G. Gurgurova, I. Kostov and M. Georgieva, „Software Orthodontics -Myth or Reality? Technological Management of Clinical Practice,“ 2023 International Scientific Conference on Computer Science (COMSCI), Sozopol, Bulgaria, 2023, pp. 1-4.
7. Goracci, C.; Juloski, J.; D’Amico, C.; Balestra, D.; Volpe, A.; Juloski, J.; Vichi, A. Clinically Relevant Properties of 3D Printable Materials for Intraoral Use in Orthodontics: A Critical
patient-centered. This encourages orthodontists to adopt leading innovations to meet the increasing demands in the field. It provides patients with the opportunity to make informed choices regarding their treatment location and team. This engages them in researching treatment options and places them in front of difficult decisions.
*All figures presented in this paper are sourced from the authors‘ personal archive.
Review of the Literature. Materials 2023, 16, 2166.
8. Graf S, Tarraf NE, Kravitz ND. Three-dimensional metal printed orthodontic laboratory appliances. Semin Orthod. 2021;27:189–93.
9. Hwang, H.-W.; Park, J.-H.; Moon, J.-H.; Yu, Y.; Kim, H.; Her, S.-B.; Srinivasan, G.; Aljanabi, M.N.A.; Donatelli, R.E.; Lee, S.-J. Automated identification of cephalometric landmarks: Part 2-Might it be better than human? Angle Orthod. 2020, 90, 69–76. 10. Ismail, I.N.; Subramaniam, P.K.; Chi Adam, K.B.; Ghazali, A.B. Application of Artificial Intelligence in Cone-Beam Computed Tomography for Airway Analysis: A Narrative Review. Diagnostics 2024, 14, 1917
11. Jindal, P.; Juneja, M.; Siena, F.L.; Bajaj, D.; Breedon, P. Mechanical and geometric properties of thermoformed and 3D printed clear dental aligners. Am. J. Orthod. Dentofac. Orthop. 2019, 156, 694–701.
12. Khan, M.I.; Sm, L.; Gopal, T.; Neela, P.K. Artificial Intelligence and 3D Printing Technology in Orthodontics: Future and Scope. AIMS Biophys. 2022, 9, 182–197.
13. Kiełczykowski, M.; Kami ́nski, K.; Perkowski, K.; Zadurska, M.; Czochrowska, E. Application of Artificial Intelligence (AI) in a Cephalometric Analysis: A Narrative Review. Diagnostics 2023, 13, 2640.
14. Kim, K.B.; Graf, S. Direct printing of clear aligners. J. Clin. Orthod. 2023, 57, 450–458.
15.Knode, V.; Ludwig, B.; Retrouvey, J.-M.; Pandis, N.; Schmid, J.Q.; Erbe, C.; Fleming, P.S. Directly Printed Aligner Therapy: A 12-Month Evaluation of Application and Effectiveness. Am. J.Orthod. Dentofac. Orthop. 2024, 167, 73–79.
16. Koenig, N.; Choi, J.Y.; McCray, J.; Hayes, A.; Schneider, P.; Kim, K.B. Comparison of dimensional accuracy between direct- printed and thermoformed aligners. Korean J. Orthod. 2022, 52, 249–257.
17. Kök, H.; Acilar, A.M.; ̇Izgi, M.S. Usage and comparison of artificial intelligence algorithms for determination of growth and development by cervical vertebrae stages in orthodontics. Prog. Orthod. 2019, 20, 41.
18. Laal M. Innovation and Medicine. Procedia Technology. 2012; 1:469–473.
19. Lee, S.Y.; Kim, H.; Kim, H.J.; Chung, C.J.; Choi, Y.J.; Kim, S.J.; Cha, J.Y. Thermo-mechanical properties of 3D printed photocurable shape memory resin for clear aligners. Sci. Rep. 2022, 12, 6246.
20. Liu, L.; Watanabe, M.;Ichikawa, T. Robotics in Dentistry: A Narrative Review. Dent. J. 2023, 11,62.
21. Lo Giudice, A.; Ronsivalle, V.; Gastaldi, G.; Leonardi, R. Assessment of the accuracy of imaging software for 3D rendering of the upper airway, usable in orthodontic and craniofacial clinical settings. Prog. Orthod. 2022, 23, 22.
22. Ma, L.; Yu, S.; Xu, X.; Moses Amadi, S.; Zhang, J.;Wang, Z. Application of Artificial Intelligence in 3D Printing Physical Organ Models. Mater. Today Bio. 2023, 23, 100792.
23. Omachonu V. K., Einspruch N. G. Innovation in Healthcare Delivery Systems: A Conceptual Framework. In The Innovation Journal: The Public Sector Innovation Journal. 2010;15(1):2-18. 24. Palovcík M., Tomášik J., Zsoldos M., Thurzo A. 3D-Printed Accessories and Auxiliaries in Orthodontic Treatment. Appl. Sci. 2025;15: 78.
25. Park, J.-H.; Hwang, H.-W.; Moon, J.-H.; Yu, Y.; Kim, H.; Her, S.-B.; Srinivasan, G.; Aljanabi, M.N.A.; Donatelli, R.E.; Lee, S.-J. Automated identification of cephalometric landmarks: Part 1-Comparisons between the latest deep-learning methods YOLOV3 and SSD. Angle Orthod. 2019, 89, 903–909.
26. Petrunov V. The digitalization of orthodontics – evolution or revolution. Infodent Bg. Sofia, 215 p.
27. Petrunov, V.: CAD/CAM appliance for maxillary molar distalization, made by the use of additive manufacturing. Orthod. Rev. 2021/23 Issue 2.
28. Sabbagh, H.; Heger, S.M.; Stocker, T.; Baumert, U.; Wichelhaus, A.; Hoffmann, L. Accuracy of 3D Tooth Movements in the Fabrication of Manual Setup Models for Aligner Therapy. Materials 2022, 15, 3853.
29. Sayahpour, B.; Eslami, S.; Stuhlfelder, J.; Buhling, S.; Dahmer, I.; Goteni, M.; Kopp, S.; Nucci, L. Evaluation of thickness of 3D printed versus thermoformed aligners: A prospective in vivo ageing experiment. Orthod. Craniofac Res. 2024, 27, 831–838. 30. Solis, B. (n.d.). The six stages of digital transformation maturity.
31.Tartaglia, G.M.; Mapelli, A.; Maspero, C.; Santaniello, T.; Serafin, M.; Farronato, M.; Caprioglio, A. Direct 3D Printing of Clear Orthodontic Aligners: Current State and Future Possibilities. Materials 2021, 14, 1799.
32. Tonjang, S., & Thawesaengskulthai, N. Total Quality and Innovation Management in Healthcare (TQIM-H) for an Effective Innovation Development: A Conceptual Framework and Exploratory Study. Applied System Innovation. 2022;5(4).
33. Tsolakis, I.A.; Gizani, S.; Tsolakis, A.I.; Panayi, N. Three Dimensional-Printed Customized Orthodontic and Pedodontic Appliances: A Critical Review of a New Era for Treatment. Children 2022, 9, 1107.
34. Yanev N, Yordanova G, Emiliyanov E. CBCT evaluation methods in orthodontics – review and clinical correlation. J of IMAB. 2024 Jul-Sep;30(3):5680-5687.
35. Yoo I., Yi C. G. Economic Innovation Caused by Digital Transformation and Impact on Social Systems. Sustainability (Switzerland). 2022;14(5).
36. Yordanova G, Chalyovski M, Gurgurova G, Georgieva M. Digital Design of Laser-Sintered Metal-Printed Dento- Alveolar Digital Design of Laser-Sintered Metal-Printed Dento- Alveolar Anchorage Supporting Orthodontic Treatment. Appl Sci. 2023;13(13):7353.
37. Yordanova-Kostova G, E. Emiliyanov, N. Yanev. Digital Laser-Sintered Expander in Adolescent Patient with Hyperdontia and Molar Impaction. Case report in Dentistry. 2023; Article ID 8824900
38. Zinelis, S.; Panayi, N.; Polychronis, G.; Papageorgiou, S.N.; Eliades, T. Comparative analysis of mechanical properties of orthodontic aligners produced by different contemporary 3D printers. Orthod. Craniofac Res. 2022, 25, 336–341.