Orthotown June 2023 - 6

Board Profi les
Each month this year,
Orthotown will spotlight
a member of its editorial
advisory board-the
doctors who've agreed to
help our staff determine
whether an article is a
3 QUESTIONS WITH
Dr. Jonathan
Nicozisis
This Philadelphia-area orthodontist has helped Invisalign develop and refine its
product off erings almost since the company's clear aligners were introduced to
doctors-he was a pilot tester for aligners for teens, optimized attachments, the
iTero Element 1 scanner, SmartTrack material and more. (His article about his
approach to using clear aligners to treat patients missing U2s begins on p. 26.)
1. How did your relationship with Invisalign develop?
When I graduated in the fall of 1999, Invisalign was
not yet commercially available for doctors in private
practice. I took my fi rst Invisalign certifi cation course in
January 2000 and for the fi rst few years, I was part of a
group of six to eight doctors in the greater Philadelphia
area who would share best practices and approaches to
treating patients with this new appliance.
My fi rst offi cial Invisalign speaking engagement was
in Boston in 2003, and my fi rst splash was suggesting
that attachments should be beveled gingivally to better
engage and allow for tolerance for improved tracking,
making extrusion of anterior teeth eff ective and predictable.
Th is was the opposite of what was being done at
the time and was rather provocative, but the 2009 fi rst
generations of optimized attachments validated my idea.
Shortly thereafter, I was asked to be a member of the
Align Tech faculty. I think it was a mutual calling, where
we approached and challenged each other at diff erent
points along the developmental journey to get each of
us to where we are today. Still lots of innovation and
impact to come! I truly believe that fi ve to 10 years from
now, how we use, design and deliver Invisalign will be
completely diff erent than what we're doing now.
2. Based on your interactions with the doctors who've
taken the Aligner Intensive Fellowship you codeveloped,
which aspects of aligner treatment do
orthodontists seem to have the most trouble with?
Translating the action of fi xed appliances that orthodontists
take for granted everyday to aligner therapy-
and by that, I mean how much movement is needed
great fit for publication, vet
those articles for accuracy
and clarity, and suggest
ideas and sources for
content that will run in
future issues.
to really accomplish what is desired clinically. Factors
such as age of the patient, type of movement, type of
perio, etc., all play into the mix, making it diffi cult for
doctors to take what they've learned in our course and
put it into eff ect when they're in front of their computer
treatment-planning a case. Th e real challenge and benefi
t for doctors is to commit to review the cases when
they're scanning for additional aligners, to see what was
designed originally and what was actually expressed
clinically. Only then-after such a commitment to
reviewing cases, over a period of years-will a doctor
gain confi dence and acumen in doing orthodontics with
aligners eff ectively and effi ciently.
3. What is the most interesting case you've
presented as a member of the Edward H. Angle
Society of Orthodontists?
One case that sparked much debate was a Class 3,
four-bicuspid extraction case with a 3 mm CR/CO slip.
Th e fi nal occlusion was fi ne but the controversy occurred
when I presented my superimpositions because I had
used centric relation, rather than centric occlusion, for
my initial ceph image, so the patient was biting edge to
edge with a posterior open bite. Th ere was much debate
about proper reference points when comparing movements
during treatment, because the initial and fi nal
ceph may have not been with the mandible in the same
positions, so some thought was a less-than-ideal comparison
while others thought it was perfectly OK. Right there
was a microcosm of eternal debates we have-and will
forever have-about any- and everything that orthodontists
do. I still chuckle about it to this day. OT
JUNE 2023 | 6 | ORTHOTOWN.COM
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Orthotown June 2023

Table of Contents for the Digital Edition of Orthotown June 2023
