Pacific Coast Society of Orthodontists Bulletin Spring 2020 - 55

Doctors

Presentation Summary

Clinical Success With Aloha and Aligner
Dr. Charity Siu
PCSO Bulletin Contributor

Dr. Sean Holliday
Holliday Orthodontics

Presented by Dr. Sean Holliday at the PCSO Annual
Session, Oct 5, 2019
Dr. Holliday is an orthodontic graduate from the
University of Illinois at Chicago. He became certified in Invisalign in 2001 and has since treated
more than 4,000 cases and counting. He is a diamond plus provider, and two-thirds of his practice
is treated by aligners. Now he practices at four
locations with three other orthodontists, and his
mindset is making efforts to "grow the pie, rather
than taking a bigger piece of the pie." Hence, he is
very generous in helping to educate/teach others
how to do aligner therapy well; he is an Aligntech
faculty member, cofounder of Orthocosmos, and
founder/educator for Orthomasterclass.com.
His lecture explores three aspects outlined herein.
1. Digital Workflow and Fundamentals to Clear
Aligner Therapy
The key is to be efficient with technology and
ClinChecks because modern clear aligner therapy relies on mass customization and manufacturing. It is a new age of specialization in mass
production. Dr. Holliday recommended a book,
The Inevitable, by Kevin Kelly, which discusses
the impact of technological changes that will
affect our world over the next 30 years. What is
mass customization? It starts out with nonprescription brackets, then proceeds to selecting
prescriptions in brackets and wires for specific
cases and making small adjustments based on
individual patient needs. Similarly, we have to
customize the aligners for each malocclusion
and add specific details for each patient. For
mass production, the care is standardized on a
larger scale, and storage is needed for inventory.
For mass customization, the appliance does not
exist until it is ordered, but then there can be
many variations and high volume. For it to be
successful, computer-based systems, flexible
manufacturing systems, and instant communication media are required.

Spring 2020    PCSO Bulletin	

This type of work can be outsourced or insourced,
and there are benefits to both options:

▫▫ Higher lab fees

versus capital investment, subscriptions, labor costs

▫▫ (Align Technology)

versus increase in
staff and doctor
time
versus effectiveness
for comprehensive
cases
versus personalized
marketing

How Do You Decide?
▫▫ It is about the plastic (comparable to why
some doctors use certain companies for wires
and brackets). Factors include force delivery,
color stability, cost, and availability.
▫▫ It is about the software and data, as it drives
innovation and results.

▫▫ It is about the experience for the patient.
The steps in the digital workflow are as follows:
Scan → Submit → Computer-aided design (CAD)
software → Revision → Approval
Scanning is performed by the clinical team, while
the middle three steps are done by a CAD technician. Approval is given by the doctor.
2. Clinical Techniques and Biomechanical Principles in Treating Malocclusions with Clear Aligners
Aligners are force delivery systems, and there will
always be controlled and uncontrolled movements. Attachments assist in retention of the
aligner, intrusion or extrusion, rotations of teeth,
root control, and bite ramps for deep-bite cases.
Velocity of tooth movement (crown velocity): the
standard linear movement velocity is 0.25 mm per

55


http://Orthomasterclass.com

Pacific Coast Society of Orthodontists Bulletin Spring 2020

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