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ePaper created 2017-03-17, 13:11:17 | version 1.38.0
| feature interview “ In the not so distant future, half of all treatments will be done with aligners” An interview with Dr Sam Daher, Canada Dr Sam Daher Vancouver orthodontist Dr Sam Daher is one of the world’s leading experts in clear aligner treat- ment. Having performed more than 4,000 treat- ments with Invisalign, he currently runs two prac- tices entirely specialised in this treatment modality in addition to his other four clinics. At the last year's British Orthodontic Conference (BOC) in Brighton in the UK, where he presented a paper on open-bite treatment with clear aligners, Dental Tribune Inter- national had the opportunity to speak with him about the benefits of digital technology, the future of clear aligners in general and his business model. Dr Daher, this is the first time you have spoken at the BOC. How was your presentation received? Dr Sam Daher: I have never been to the BOC, but I have spoken in London many times before. I can re- call my first talk to a UK audience a couple of years ago. Back then, the interest in Invisalign was not what it is today, perhaps owing to a lack of faith in the system. Today, far more experience has been gleaned and we have seen much better results with it, so there is generally more interest from special- ists. The attendance of my lecture here in Brighton was amazing. There is clearly much interest and far greater acceptance than before. Also, the questions posed were far more genuine. Your presentation in Brighton focused on open-bite treatment with clear aligners. Could you summarise some of your key points for our readers? One of the main advantages of clear aligners is that with them we can control the vertical dimen- sion. One of the worst things we can do in open-bite treatment is to allow the posterior teeth to push through. With clear aligners, we do not only prevent the posterior teeth from extruding, but actually in- trude them a little, when needed, allowing us to con- trol the vertical dimension and close the anterior open bite at a much faster rate than with any other fixed appliance as a matter of fact. Thus, what I aim for is to intrude the posterior teeth when there is al- ready an anterior open bite. With both an anterior and posterior open bite, we create a mandible that simply autorotates and that will help close the an- terior open bite. ClinCheck and digital scanning have advanced clear aligner treatment. What impact have they had on digital technology in the field? I have been using scanners for six years and have not taken one conventional impression since then. The first thing one notices when one starts using scanners is that aligners adapt so much better to the teeth because the scan is far more accurate. Second, it allows for an improved patient experience. Using polyvinyl siloxane material is always a hassle and a discomfort for the patient if the material gets into the mouth. Using scanners saves a great deal of time and is more comfortable for the patient. Furthermore, with ClinCheck, which provides 3-D treatment planning, I am able to plan different ap- proaches and then decide for myself. If I am still not certain, I can show the patient what each treatment outcome will look like and then let him or her decide. This way, it becomes an educational tool that can enhance patient compliance. Aligner treatment is not without its critics. Is there any justification for this, in your opinion? The aligner market has actually advanced quite a bit and this development is based on science, tech- nology and experience. Aligners are custom made and that alone should be enough to elicit a positive response to aligners. What I personally like about this treatment modality is that the aligners do not apply a great deal of force, maybe 10, 20 or 30 grams. Research has shown that this is the optimal amount 14 ortho 1 2017