A new dimension in orthodontics called 4D

The 22nd of February 2019 Dusseldorf, Germany.

That is the date I wrote this blog. Almost 4 years after I started my project 4D dynamic clear aligners. I finally had to start writing a bit about it, as I come to the final round in product development. A new dimension in the field of orthodontics, that proved very special to me over the years of hard work.

A roller coaster full of ambiguous paths. Many times it proved daunting to me and I decided to stop and give up, as I thought this could be a total waste of time.

As the 4D clear aligners are ready to come into the market, I am very excited about the vast opportunities, this technology opens up for so many patients worldwide, seeking affordable care and an eco-friendly solution.

Clear aligners or invisible orthodontic trays are a very unique and promising method for straightening teeth, as an alternative to braces. The credit goes to Align Tech and specifically to Zia Chisti, one of the co-founders of Align Tech, at its embryonic stages.

Clear aligners are manufactured through high-end 3D technology, from 3D scanning dental models to 3D-designing of teeth movements, then printing the sequential steps through a 3D printer and finally thermoforming plastic materials chemically, made out of TPU or PETG to conclude a clear aligner form.

Inspite, the market has grown exponentially within the last few years. However, as a common pattern seen in the market with most industries, we did the same foolish mistake. We focused on the gains and forgot our planet. We adopted a business model that is totally destructive to our planet. The economics vs. planet problem was somehow well highlighted in a book I enjoyed reading, by the author Kate Worth. She coined the wording “Doughnut economics”, where she describes how misleading our initial understanding of the economy and accordingly business growth, agility and finally GDP, is. We have indulged ourselves, our work and surroundings in a vicious circle that works well to generate better income and orient growth, based upon GDPs.

Money goes into supplier's and doctor's pockets, while plastic dumped into the planet’s waste containers. We used currently an average of 33,000 tons of plastic waste per year, only in the field of clear aligners! This is according to my own rough calculation for 2017, according to estimations of the market size, the number of cases treated and an average treatment of 10 months, without even counting the plastic waste from packaging. All of this ends up in the ocean to resemble almost 0.004% of the total plastic waste, thrown into the ocean worldwide per year, according to statistics from 2017.

Volume of plastic waste by 2050 (source: Ellen MacArthur Foundation)

Within the next 2 – 3 years, clear aligners will penetrate the teeth straightening market by over 10% and maybe 30% or more by 2030. But what about the plastic waste?

Unfortunately, no one is considering, nor criticizing the fact that in the clear aligner field, we use 3D models and plastic aligners that are not biodegradable nor recyclable. For every client, almost 40 pieces of 3D models are manufactured and 40 clear aligners are delivered, which all end up as waste burnt or thrown into the ocean one day.

And with the biggest plastic consumer in the market, i.e. Align Tech - not taking a serious move to save the planet, while focusing all efforts on the rising competition in the market, we are heading to a disastrous irreversible problem.

I hope that 4D dynamic aligners could help even the slightest, to save plastic waste and raise the market's concern about the ethical responsibility towards our environment.

I hope we could decrease the number of plastic aligners needed by over 70 % - 80% and even recycle the 3D dental models, used throughout the manufacturing procedure. If this proves efficiently to be applied vast in the market, I would urge everyone from orthodontic practices to labs - even Align Tech to consider, shifting their technology to help our planet and environment.

4D dynamic aligners are produced through using special shape memory polymers that could be formed on the targeted shape of teeth. Let’s assume the fourth step in the process of teeth aligning S4, the clear aligner is re-engineered in-lab, under specific temperatures to shape S1; I call it “Back from the future” concept. The patient has an activation device (the Aligner booster) to activate the clear aligners every 2 weeks and thus, recover the shape of the clear aligner gradually to go back to S4 “Back to the future”.

The result is, instead of using 4 aligners per arch, to align teeth over 2 months, we use only 1 aligner by this technique.

Both in-lab, as well as in the first waves of clinical trials, this technique proved to be supremely successful and functional.

On the other side, recycling the 3D models is also considered a huge benefit, not only would any lab decrease the material waste but also save a lot of money. Recycling somehow represents a bit of investment at the start, but it is worth it on the long run.

A call to action, align teeth but don’t forget, aligning your business to our planet, and make your patients and planet smile :)

This is the future of us and our grandchildren.