Roughly 20 years have elapsed since the commercial introduction of the first clear aligners and today they are an established and well accepted treatment modality. Not many remember but back in the early 2000’s, the Invisalign® device was greeted with much skepticism and doubt. A great deal of clinical work and marketing efforts were needed to convince the orthodontic community that this method is here to stay. Today, in many cases, aligners have become the preferred treatment option for clinicians and patients alike.
The purpose of this paper is to describe in detail the eXceed workflow. In general, it can be divided into 3 parts:
1) Submission - patient records and treatment instructions are communicated to the eXceed Design Center.
2) Planning and approval - treatment plan is prepared and approved by the doctor.
3) Manufacturing - print files are generated and then aligners are manufactured, cleaned and provided to the patient.
What is different in the eXceed workflow?
The whole process of aligner manufacturing is depicted in the picture above and color-coded with 2 colors: grey for the regular workflow of aligners manufacturing and blue for the part of work done by eXceed.
Please note that eXceed DOES NOT produce aligners, we provide only a virtual plan of treatment and print files which can be used alongside other equipment (such as 3D printers and vacuum formers) to print models and produce aligners.
Let’s take a closer look at each of the individual stages and the necessary requirements.
1. The submission stage is almost the same: doctors are asked to provide us with a set of patient records which include:
1) an STL scan made of two separate arches oriented in correct occlusion;
2) intra-oral and facial images;
3) a panoramic X-ray;
4) case objectives.
All data should be uploaded to the customer’s eXceed page (“my eXceed”).
eXceed works not only with intraoral scans but also with analog PVS impressions made at your office and then scanned by any desktop model scanner. However do not work with PVS impressions alone or with any kind of physical models.
*We accept STL files from all intra-oral or desktop scanners, provided the quality is good. Moreover, eXceed has a direct integration with the iTero, CS 3600, Trios and the CEREC intra-oral scanners, which means that you can easily share a scan with eXceed without having to manually upload the files.
2. The planning and approval stage starts as soon as we receive all the necessary files.
First, our specialists use the uploaded files and special software to create a detailed aligner treatment plan, showing necessary teeth movements and rotations, if needed. At this stage, it is possible to say if the case can be treated with aligners and if there is a need to extract the 3rd molars (wisdom teeth) prior to the treatment.
Other Features included in the Plan:
- Detailed visual 3D simulation of teeth movements (each step showing two-weekly movements);
- terms of treatment (from 3 to 15 months on average);
- number of aligners for upper and lower arches;
- which teeth require attachments (dental filling material attached to the tooth used to better control mesial rotation, extrusion, and bodily movements).
- Teeth that require IPR (inter-proximal reduction)
The process of designing a virtual setup usually takes up to 5 business days. The count starts from the moment all necessary records are available.
As soon as the plan is generated, it goes to the eXceed supervision team, a group of certified orthodontists whose role is to ensure who that plan is clinically accurate and effective to deliver the best result for the patients. Our Orthodontists check each and every plan and maintain exclusive authorization to make the plan visible to the customer.
The third step is to secure customer approval for the plan. To do so, we upload the virtual plan to “my eXceed”, the doctor’s personal eXceed web page. The Doctor then appoints an appointment with the patient (in office or virtual) and presents the 3D treatment plan. The plans can be displayed on any device, a PC or even a mobile phone.
When both the patient and the doctor agree the plan, the approval is granted and print file preparation then follows. in case some adjustments are still needed, the plan may be sent back for revision by the eXceed Tech team. The plan can be revised as many times as needed until the customer is fully satisfied with the treatment plan. The resulting print files are produced within a few hours from the approval.
As soon as the print files are ready, the order goes to the fourth stage - Manufacturing. After downloading the print files, the customer can print the print the working models using 3D printers such as the Form 2 or 3 or the MoonRay from SprintTray. Next, aligners can be produced with press or vacuum formers like Biostar or Ministar.
The entire workflow described takes up to 5 business days, assuming the plan are approved within 24-48 hours.
Working with eXceed helps you to
- save time and money versus buying ready aligners from traditional vendors;
- get easy-to-use and well-visualized treatment plans;
- be assured that the cases you treat provide the best possible results for your patients.