Orthotown November 2022 - 32

EARNED PLACEMENT
Is there a difference
in delivery or bonding
procedure with printed
bands?
The delivery is similar, but the bonding
procedure is a little different. The recommended
procedure begins with etching
the areas to be bonded, which are bands
and any bonding pads. Next, apply a bond
enhancer, such as Assure, and utilize
Band-Lok Plus adhesive. The areas to be
etched and bonded are easily identified
by the bands or bonding pad areas.
Do I need to rely on
mechanical retention when
using 3D-printed bands?
Crimping or adjusting the 3D-printed
appliances is not necessary. There is
minimal mechanical retention with printed
bands because they do not extend into
the subgingival or interproximal areas;
instead, retention depends upon the
bond strength achieved during delivery.
We have hundreds of the appliances in
use with minimal bond failures. The bond
failures we have seen are typically the
result of issues with material or technique.
Are printed bands stronger
than traditional bands?
Printed bands are generally made from
cobalt-chromium, which is much stronger
than stainless steel. The technology has
32 NOVEMBER 2022 // orthotown.com
advanced such that this material can
be printed as small as 0.004 of an inch,
offering great versatility in appliance
design.
How does the design
eliminate separators?
The bands are designed on the buccal
and lingual of the clinical crown; they are
attached only through the occlusal embrasures
of the teeth. The cobalt-chromium
is strong enough to allow this design to
eliminate separation of the teeth.
Can you print the
entire appliance?
Several appliances can be fully printed,
including lingual arches, transpalatal
arches, habit appliances and space maintainers.
Some appliances, meanwhile,
are only partially printed-for example,
because expansion screws are not yet
being printed, only the bands and lingual
extensions can be printed on an expander.
The screw is then subsequently laserwelded
to the printed pieces.
Can orthodontists influence
the design process?
Yes, the best way to influence the
design process is to be in regular communication
with the lab about design
preferences. Orthodontists can purchase
design software and make changes as
needed. Files can also be submitted to
a printing house.
Are there any limitations
with the printed appliances?
The basic limitations are path-ofinsertion
issues because of tipped molars
or severe undercuts. Alterations to the
undercuts on the model can be made in
the lab before digital design. These can
be addressed but are not eliminated.
How do you attach
expansion screws and
archwire tubes to the
printed appliances?
Any accessories such as expansion
screws or archwire tubes will be laserwelded
to the printed parts. The method
of laser welding is much stronger and
cleaner than the brazing process.
Do the 3D-printed metal
appliances cost more?
As a result of the extra expenses
associated with the printing technology
and material, there is an additional fee to
print metal appliances, which varies from
lab to lab. Specialty Appliances charges
only a small amount per arch to cover
our costs. When considering the benefit
of eliminating the separator appointment
and giving the patient a better experience,
the additional fee is minimal.
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Orthotown November 2022

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