How Invisalign became the biggest user of 3D printers
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2) For 5k (Cdn) - I get 42 moulds, a method used to scan and submit my progress for each mould duration, feedback and advice from a dentist, a scan test to see who they fit
3) Considering the cost of braces and the flexibility these allow (as long as you are disciplined in wearing them) it's well worth it
4) My teeth were really misaligned. At 42 I just decided to do it so I could smile more in pics. Not confidence issue, just sometimes in life you have to do things for yourself
5) You can see the 3d printing lines and its pretty detailed given how lightweight and accurate the shape is for each tooth
6) There are little mounts they install on your teeth for the moulds to latch on to as well, so its not just a fit on the teeth but the mounts as well
7) Each individual mould has a unique number on the package in comes in as well as on the mould. Each package has my name, the dentist and the mould number out of 42.
8) I could see changes starting with mould 6
9) If look even close to mould 42, I will be extactic
10) it also comes with an attachment for your phone that alows you to submit self exams each mould. Its really cool. its very impressive
The dentist told me I’d only need it for like 3-4 months, minor corrections. But it seems like such a hassle. Always having to remove it before eating anywhere, no coffee, and gotta make sure I’d always travel with the next set of aligners etc.
Glad it worked well for you though!
Still looking forward to getting the stuff off my teeth.
I needed 15 trays so just 30 weeks. Not that bad.
As the sibling comment, it’s definitely worth it. Best of luck!
Disclaimer: I’m a health nerd and was an employee a couple years ago.
For younger patients that haven’t had braces before which is the majority of historical patient populations and future ones, 3D printed personalized braces systems are better as the tooth movement needed is more clinically substantial at tougher angles. Many younger patients forget and lose their plastic aligners.
That said: what is chosen should be what for the whole person at multiple levels.
>Many younger patients forget and lose their plastic aligners.
They can get a new one easily by post.
Lo and behold I read that as we age the jaws shrink which makes the teeth crowd together.
I'm going for a free mouth scan in a couple weeks.
Fun fact, I have one fully grown in wisdom tooth. The rest are still there, but never moved. My dentist is always after me to get all of them removed, telling me that they won't fill a cavity on the grown in one
Sounds like your Dentist is chasing $ over sense. My better half is a DDS, and they see quite a few patients wherein others in the field put their opinions and revenue over their hippocratic oath.
I grew up in a time/place where you never went to the dentist or doctor unless if you were pretty much dying, but at least times are changing now.
I haven't done any similar treatment and I'm considering it at 35. Worried about the length since I heard it takes far longer for adults.
There is some discomfort/soreness for the first few days after switching. My dentist's instructions were to wear each for at least a week and then switch to the next set whenever I wanted after that. Basically at whatever rate I was comfortable/could tolerate. I'm now at set 15 and have switched most of them after a week while a few I delayed a couple of days because I had something happening where I didn't want to worry about any discomfort.
As you probably know you're going to have to wear retainers at night for the rest of your life if you want your teeth to stay where they landed.
I wouldn't recommend it, mainly incase you mess up the teeth pressure and end up with a far higher dentist bill.
The mouthpiece works great and I would recommend everyone get tested for sleep apnea if your insurance covers it, but I have to admit that paying for it bothered me. Even with insurance covering some of it, it cost me about $600.
I know that there's a deceptively high amount of engineering required for these kinds of things, but it was very hard to wrap my head around paying $600 for what amounted to a couple pieces of clear plastic. I actually got them to send me the STL of the scan of my teeth, and some back of napkin math indicated that it would have cost me about fifteen cents of resin to print it out myself. Instead I'm paying about 4000x that price.
Obviously this is not apples to apples, I'm sure they're using different and/or better resin that what I have, and as I said there's probably engineering and fine-tuning for this, but even still it was not fun to pay for.
All the same, I sleep like 10x better, so I suppose that considering that $600 is a cheap price to pay.
First time?
Price is not determined by cost to produce.
It’s determined by the price a customer is willing to pay.
Since I do have the 3D scan of my teeth, I've debated designing my own, but I'm not sure which resins to buy that I could safely put in my mouth every night.
Might there be microscopic layer lines? Or other unknowns you're not familiar with? Making 3d prints that can be cleaned is non-trivial, maybe there is a surface finish involved, etc.
Also how do you know your design is correct? Won't cause your teeth to move? A 3d scan doesn't mean you know what a mouth guard should look like.
All of a sudden, having a product that's made with a vetted process is pretty attractive -- and 600 USD seems like a bargain.
What's the cost of having your teeth fixed, if they accidentally move? (Not to mention the discomfort, which can be considerable)
That doesn't really change the fact that it feels kind of viscerally wrong to pay $600 to pay for two glorified pieces of plastic, and a part of me still does feel I could clone it competently. I haven't bothered for the aforementioned safe resin, and also because I already have it and I have enough money to just eat the cost and complain about it.
Sometimes the entrenched default that collects an inertial premium doesn't get disrupted...
But, yes, anyone without a moat who operates with a presumption of retention runs the risk of being knocked off of their perch; their fate left to others.
I think there's a deceptively low amount of engineering required for most medical and medical-adjacent tech. The high costs are rooted in pervasive industry-wide centuries-long FUD campaigns.
That dastardly Ben Franklin with his bifocals..
I agree the plastics might be bad for me, but I justify it because I suspect that just continuing with the apnea is almost certainly worse for me, considering how many diseases appear to be caused by it.
Well that's pretty close to how much the entire CPAP system would cost depending on the sale.
To be clear I'm not even asking for you to account for the cost of your printer, the 3d scanner, and software licenses in your math. Let's assume that all those are free. How many hours of specialized human time was spent on consultations, scans, design, reviews, to produce working guards for you?
The next question is then, of course, how much do they charge for subsequent guards now that the scan has been done and validated? Is it still 4000x the cost of raw resin?
I'm sure labor is involved, and maybe it's a lot, but it still seems like an awful lot of money for a piece of plastic.
life changing for me
Manufacturing them requires a resin printer and a vacuforming setup, but that's still the easy part. It's a whole system with a dental 3D scanner, software for rearranging your mouth, and attachment points that have to be epoxied onto (and later removed from) your teeth by a dentist.
They used a specialized sort of 3D camera on a stick to get an incredibly accurate model of my mouth, any open source solution would need an equivalent. And you’d also need open source code from somewhere to work out which teeth need to move where and at what stage in the treatment.
The 3D camera was really neat. A little faster, and I didn’t once dry heave.
I could watch the software and a 3D model slowly form of my mouth. Looked surprisingly user friendly. Missed areas were highlighted, for example.
Dry heaving would have been great. I would regularly vomit from impressions. My orthodontist would just prepare two sets if impression trays, cause the first one was going to go in the medical waste bin.
Impressions for invisilign (when I did it, about a million years ago) weren't so bad though. Unfortunately invisilign resulted in an open bite for my molars, which I really should go back to an orthodontist to address, but I'd rather not.
AFAIK Align's 3D scanning system is more or less branched from the same Israeli tech that went into the Xbox 360 kinect camera and the iPhone face-ID.
iTero scanners (owned by Align Technology) use parallel confocal imaging via red light lasers. Their newer models also use Multi-Direct Capture techniques.
Kinect used a Light Coding technique, an infrared projector and camera. It was developed by a company called PrimeSense, which was later purchased by Apple.
There's something with Israel and 3D scanning tech. But I don't think I would like the answer.
My doctor knows I'm into this so he always does it right next to me and turns the PC monitor so I can watch the entire process. The software is so simple almost anyone could use it. Generating a medically correct result is obviously where all the skill lies.
1. A treatment plan: simulated movement of teeth at every step, taking into account all forces. That’s specialized software or external lab service.
2. Precision. You put too much pressure at the wrong angle and you will need a surgery to fix the damage, because the tooth root moved in wrong direction.
3. Plastic. You cannot use ordinary 3D printer ink. You need a plastic that can survive the chemical environment in your mouth, maintain the pressure, and you probably want it to look good (no discoloration etc).
4. Finish: Align Tech, Straumann etc do not stop after 3D printing, there are few other steps involved to make sure there’s no sharp edges etc.
5. Maybe you will need attachments (to focus pressure in the right direction on certain teeth) or wires.
Align Tech is Apple of clear aligners, but now competition exists, producing aligners at scale is commercially more efficient, considering all the risks and required qualifications, and of course the best materials for aligners are patented and not sold OTC to everyone.
Disclosure: I worked at Align 10 years ago and later was CTO of European DTC competitor.
That is to say, how good is “good enough” when done at small-scale in developing nations or medically underserved communities?
They were a company theoretically doing the same thing with still more resources than an average individual has, and ruined people's bites and teeth.
I don't think there's a good enough here
2. Let‘s say the practice does it in old way, with impressions - no intraoral scanner. The scanner of impressions still needed, but it can be cheaper. Someone needs to build it and achieve required accuracy (let’s say, 50 μm). Who? Why? Failure mode: bad scan leads to aligners not fitting your teeth from day 1. Oops.
3. Let‘s say someone builds a good OSS alternative to OrthoCAD (Who? Why?), so that orthodontist on site could build a treatment plan and export it into series of 3D models for printers. Failure mode: good treatment plans are rarely possible or output is garbage (aligners do not fit, cause pain etc)
4. Maybe some company develops good plastic or patent expires, so that it is possible to produce it in India, China or other inexpensive location with strong industrial base. That would be cool, otherwise: non-compliant plastic breaks in patient’s mouth, decomposes with patient ingesting some toxic chemicals or is simply not strong enough to move teeth in desired position, so you have problem with 2nd aligner.
5. Maybe you get to this point, but you still need a printer that can maintain the same precision in printing. And you need a good cutting and finishing process. Someone needs to build such device. Failure modes are similar to the mentioned above.
6. The ortho supervision sounds easy, but how many patients in developing countries do even have a possibility to see orthodontist? They are definitely not in position to treat themselves.
So, in this process, what is good enough exactly? Who and why would drive the costs down while building an on-site solution?
The difficult part is not the manufacturing, but knowing how to do it properly so you don’t harm the patient.
And yet I read plenty of horror stories of bad orthodontic results. Ask me how I know.
Went to 3 different orthodontist to fix what a bad orthodontist did to me when I was a kid, and each gave me a completely different treatment plan. I feel like being an orthodontist is just eyeballing and patching your way as you go to an acceptable resolution.
I don't doubt a high-IQ high functioning autist could self-teach this, but there's a ton of background there.
But it’s also something that’s not responsible to shortcut. Shifting teeth around too fast can result in permanent root damage and even loss of teeth. There was a whole cottage industry in the US for a while focused on under cutting Invisalign with a reverse-engineered product, but they often moved on accelerated treatment timelines that caused a not-insignificant amount of harm to patients, and cut corners on intake (DIY at home mold kits) that also contributed to problems. Pretty sure all of the companies doing this are basically dead now.
Also who’s attaching the attachments (I had 13 at first) to the teeth to help the aligners grab hold?
It should be illegal to pull kids teeth when this tech exists. Dentists were angry about this but it is superior in every way. I think costs will come down, but they are already cheaper then alternatives.
I am happy my wife researched and discovered Invisalign.
One required much more alignment, I don't remember but it was 20+ weeks, other was done in 16 weeks. Now they have retainers and that is it.
For some reason now it’s assumed these were some kind of injection molding, but it makes perfect sense that it’s 3-D printed.
I SO wish HN would tell me things I submit are dupes BEFORE I submit them! In the past that happened, but something changed and now I never get those notices....
If you keep them on soft food young, the jaw muscles don't get stimulated enough to grow so that the teeth that are coming out sit properly. Misalignment and opportunity for decay ensues.
If you give them decently hard food early on in life you solve most problems.
After that it can still happen but there's less chance.
Jaw and face bone grows by stimulation. It's not just a dental thing - it's sleep apnea, sinus infections, facial structure, voice timbre, and attractiveness.
If it's enough, they won't even need their wisdom teeth pulled - having your wisdom teeth pulled is substantially a standard american diet issue, not a human genetic issue.
My teeth have been crooked since forever. So?
Anecdotally, our three boys all were told they MUST have braces (each for different reasons). We did this for exactly none of them. And their teeth came out perfect by adulthood.
What the fuck are you on.
> Anecdotally, our three boys all were told they MUST have braces (each for different reasons). We did this for exactly none of them. And their teeth came out perfect by adulthood.
Give me your address so I can take my bum parents, put you together, and slap your bitch ass with my crooked teeth.
E.g. I do