Discussion

How Invisalign Became the World’s Biggest User of 3D Printers

hattmall: So shouldn't this really be something that could be opened sourced. I think I've seen a few write ups of people that did their own, but seems like a highly functional implementation could be democratized.

Legend2440: Certainly it's not impossible to DIY, but it's more difficult than just popping some aligners on your 3d printer.Manufacturing them requires a resin printer and a vacuforming setup, but that's still the easy part. It's a whole system with a dental 3D scanner, software for rearranging your mouth, and attachment points that have to be epoxied onto (and later removed from) your teeth by a dentist.

adwi: https://amosdudley.com/weblog/Ortho

lovich: They have to have at least 2 different materials as well. The temporary trays were much softer and I had almost ground through them in my sleep by the time I had to switch to the next one but the final set is much more robust.

afavour: I did Invisalign a few years ago. Manufacturing the retainers is surely only a small part of the puzzle.They used a specialized sort of 3D camera on a stick to get an incredibly accurate model of my mouth, any open source solution would need an equivalent. And you’d also need open source code from somewhere to work out which teeth need to move where and at what stage in the treatment.

maccard: That’s pretty wild. I got a mould taken with some sort of a putty .

doubled112: I wear a night guard and have had them made both ways.The 3D camera was really neat. A little faster, and I didn’t once dry heave.I could watch the software and a 3D model slowly form of my mouth. Looked surprisingly user friendly. Missed areas were highlighted, for example.

plomme: A point I didn’t see sibling comments make is that the dentist often has to file between teeth for them to sit and align correctly. They did so several times in my case. I would not want to do that to myself!

infinitewars: Most teeth align themselves as kids age. This is almost never necessary.

imperialdrive: There are folks working on solutions for when teeth do not align themselves.

tombert: Tangential, but I have sleep apnea. Fortunately I have it mild enough to get away with a mouthpiece instead of a CPAP (which is good anyway because I also have bruxism).The mouthpiece works great and I would recommend everyone get tested for sleep apnea if your insurance covers it, but I have to admit that paying for it bothered me. Even with insurance covering some of it, it cost me about $600.I know that there's a deceptively high amount of engineering required for these kinds of things, but it was very hard to wrap my head around paying $600 for what amounted to a couple pieces of clear plastic. I actually got them to send me the STL of the scan of my teeth, and some back of napkin math indicated that it would have cost me about fifteen cents of resin to print it out myself. Instead I'm paying about 4000x that price.Obviously this is not apples to apples, I'm sure they're using different and/or better resin that what I have, and as I said there's probably engineering and fine-tuning for this, but even still it was not fun to pay for.All the same, I sleep like 10x better, so I suppose that considering that $600 is a cheap price to pay.

ivan_gammel: It is definitely not that simple for a number of reasons. Yes, aligners and retainers in theory may be printed on some commercially available hardware. At your own risk, because you will be printing a medical device and you will need:1. A treatment plan: simulated movement of teeth at every step, taking into account all forces. That’s specialized software or external lab service.2. Precision. You put too much pressure at the wrong angle and you will need a surgery to fix the damage, because the tooth root moved in wrong direction.3. Plastic. You cannot use ordinary 3D printer ink. You need a plastic that can survive the chemical environment in your mouth, maintain the pressure, and you probably want it to look good (no discoloration etc).4. Finish: Align Tech, Straumann etc do not stop after 3D printing, there are few other steps involved to make sure there’s no sharp edges etc.5. Maybe you will need attachments (to focus pressure in the right direction on certain teeth) or wires.Align Tech is Apple of clear aligners, but now competition exists, producing aligners at scale is commercially more efficient, considering all the risks and required qualifications, and of course the best materials for aligners are patented and not sold OTC to everyone.Disclosure: I worked at Align 10 years ago and later was CTO of European DTC competitor.

natpalmer1776: How many of these risks and problems are exaggerated in scope and potential due to both a desire for a regulatory moat and a general fear of litigation in the medical space?That is to say, how good is “good enough” when done at small-scale in developing nations or medically underserved communities?

BoorishBears: Smile Direct Club and co have shown its founded 100% in real risk of harm.They were a company theoretically doing the same thing with still more resources than an average individual has, and ruined people's bites and teeth.I don't think there's a good enough here

leopld: Yes, the 12 billion dollar company must be doing something that no one needs.

chrony3705: > All the same, I sleep like 10x better, so I suppose that considering that $600 is a cheap price to pay.First time?Price is not determined by cost to produce.It’s determined by the price a customer is willing to pay.

hobofan: Every company operating on that basis is a busniess waiting to be disrupted by a cost-plus competitor.

shiandow: An important corollary to this rule is that that customer need not be you.

kube-system: Orthodontics is simply “making a retainer” the same way orthopedics is simply “putting screws in a leg”.The difficult part is not the manufacturing, but knowing how to do it properly so you don’t harm the patient.

roughly: As the joke goes, $10 to tighten the bolt, $90 to know which bolt to tighten.

moffkalast: And the material cost also isn't the main thing you're paying for, it's time and expertise involved in scanning and designing it.

joe_mamba: >They used a specialized sort of 3D camera on a stick to get an incredibly accurate model of my mouthAFAIK Align's 3D scanning system is more or less branched from the same Israeli tech that went into the Xbox 360 kinect camera and the iPhone face-ID.

avensec: While both were originally companies based in Israel, the technology behind the Kinect is different.iTero scanners (owned by Align Technology) use parallel confocal imaging via red light lasers. Their newer models also use Multi-Direct Capture techniques.Kinect used a Light Coding technique, an infrared projector and camera. It was developed by a company called PrimeSense, which was later purchased by Apple.

SilverElfin: I’ve tried custom molded mouthpieces for grinding but couldn’t adjust to sleep with them. I notice them and feel the discomfort of it not feeling natural despite it being a pricey professionally manufactured piece. It just feels too artificial. I also wonder about the long term effects of polymers in the mouth for long periods of time daily.

tombert: It took me a couple weeks to get used to it, but get used to it I did. I would still prefer a universe where I didn't have to wear it, but at this point it doesn't bother me too much.I agree the plastics might be bad for me, but I justify it because I suspect that just continuing with the apnea is almost certainly worse for me, considering how many diseases appear to be caused by it.