Hybrid Orthodontic Treatment

In-Office Clear Aligners, and Hybrid Clear Aligners/Braces Treatment

Our office is proud to offer completely custom In-Office Clear Aligner Treatment. Our in-office clear aligners are exclusively doctor-designed and controlled. All stages from design through fabrication are done “In-Office”. 

For patients who might not have been candidates for clear aligner treatment alone, this in-office capability also allows us to provide hybrid combined treatment with both Clear Aligners and Braces. Sometimes this might include clear aligners on the upper teeth and braces on the lower. Sometimes this might include braces for a few months, to do the things only braces can do, and then phasing to clear aligner treatment. 

What is hybrid combined clear aligner and braces treatment?

Hybrid Treatment at Moorestown Orthodontics Moorestown NJ

Despite marketing and claims to the contrary, there are still some tooth movements that clear aligners will not do well or will not do at all. Experience, status level with a corporate CAT supplier, and number of patients treated, still will not allow us to violate the laws of physics. In the past, this meant that some patients would have to accept compromises because they wanted treatment with clear aligners or they were not candidates for clear aligner treatment at all.

Hybrid combined clear aligner and braces treatment can frequently solve this dilemma. For some patients, this might mean that they have the clear aligners they want on the upper teeth, while the lower teeth which require treatment that only braces can do, are treated with braces. Other patients might receive several months of treatment with braces to do the things that only braces can do, and then phase to clear aligner treatment on both upper and lower teeth when they are able. The possibilities to mix and match treatments are near endless with these hybrid combined options. 

Hybrid combined treatment allows us to have more options for our patients and can sometimes allow them to be treated with clear aligners when they otherwise might not be able to be. 

What is the difference between Invisalign, other brand clear aligners, and In-Office clear aligners?

This is a trick question as all three are “Clear Aligners” and all three are used for “Clear Aligner Treatment” (CAT). Invisalign is a well-known name, as they were the first to market. Sometimes their name is used to represent all clear aligner treatment just like sometimes we say Kleenex when what we mean is facial tissue. However, despite this history, since the clear aligner patents have expired, there are now literally dozens of different corporate clear aligner brands. Importantly, there is also now the ability to fabricate aligners completely within an orthodontic office. 

What are the advantages of in-office aligners?

The first is cost savings. The savings that we obtain by bypassing the corporate clear aligner companies are passed on directly to our patients. Frequently, clear aligner treatment and hybrid treatment can be done at the same cost as treatment with braces alone!

All tooth movements and the staging of these movements are done directly by Dr. Kazmierski. With the corporate clear aligner companies, tooth movements are usually done by non-orthodontist technicians. Frequently these technicians are located in countries outside the United States such as Costa Rica, are unlicensed, and can have as little as 4 months of training. To be fair, the doctors utilizing these corporate systems usually do have the final say in approving the technician’s tooth movements. However, I think you will agree that there is a difference between indirect control with a corporate clear aligner system and one where the doctor personally makes all of the tooth movements in the software. 

Doing all phases of clear aligner treatment in-office allows us to deliver aligners to patients quicker than corporate aligner companies. This allows us to start your treatment sooner.

The ability to move more efficiently from scan to aligner delivery also allows us the flexibility to quickly mix and match hybrid combined clear aligner and braces treatments. For example, a patient who is a good candidate for clear aligner treatment on their upper teeth though not their lower might receive clear aligners on their upper teeth and braces on their lower. Sometimes someone who is not initially a good candidate for clear aligner treatment might start with braces, to get the movements only braces can do, and then as soon as they are able, they will transition to clear aligners. This is all reasonably easy to do with in-office aligners. With the big aligner corporations, their high costs for even partial treatments and long delays for delivery, can make hybrid treatments impractical. 

If an aligner is lost or misplaced and a replacement is needed, this frequently can be provided within a few days and sometimes even the same day. For the corporate systems, this takes multiple weeks or longer. 

Doing aligners in-office removes all pressure placed by aligner companies for doctors to recommend treatment with aligners when patients are not ideal candidates for this. While the aligner companies tiered system of 1%, Diamond, platinum, and gold level providers is not openly marketed as putting pressure on doctors to use more of their product, that is how this system actually functions. To understand why, first we have to realize that being in a tier (1%, diamond, etc.) is based exclusively upon the number of patients a doctor treats with their system within a calendar quarter. It is not based upon the quality of treatment. The next thing to know is that aligner companies discount their product the more volume done with them per quarter. The higher the volume, the higher the tier, the greater the discount. 

While this sounds like a win-win situation for the aligner company and the doctor, it is not always the best situation for the patient. Aligner company fees for their products are high, and top tier discounts can be 40% or greater. This can create a hamster wheel for a practice feeling pressured to do more cases with a specific aligner company so that there is greater savings on the cases they do. This is not to say that this system will cause doctors to recommend a company’s clear aligner system for patients for whom it is not a good treatment. However, without question, there is pressure from the companies to do this.

Our solution to all of this is to get off of the hamster wheel entirely and do aligner design and fabrication in-office. Doing this entirely in-office means there is no tier to achieve. So there is not outside pressure to recommend any mode of treatment for a patient. The only pressure to recommend one treatment over another is which treatment is best for a patient. When we recommend a treatment or choices between treatments, you know that is because we sincerely believe those are good choices. If there are compromises involved with any treatment that might be preferred by the patient, we will be honest and discuss any of those with you, and whether they are worth accepting or not. So, another advantage of in-office aligners is the freedom to recommend and do what is right, without any concern about corporate pressure to use more of their product.

Because of the advantages of in-office clear aligners:

We have taken the process of clear aligner fabrication and treatment completely in the office. As a result, we have incorporated all of the technologies necessary to provide this. Patient’s teeth are digitally scanned with our 3D digital scanner. Dr. Kazmierski uses specialized orthodontic software to personally determine all tooth movements. This creates a digital model for each aligner stage. The resulting digital models are printed on our 3D printer, and custom clear aligners are fabricated from these 3D printed models. These are then delivered directly to our patients. From digital scan to custom design to fabrication, all of this is done completely in the office.