InBrace vs. LightForce Orthodontic Solutions
Dr. Robert Miller’s orthodontic practice philosophy is to offer patients orthodontic options that fit their needs and lifestyles. InBrace and LightForce are complementary choices for fixed appliances that appeal to the majority of his patients.
“InBrace and LightForce are focused on customization — InBrace’s lingual system with its custom Smartwire™ and Lightforce’s labial system with fully custom 3D-printed bracket and wire technology both bring accuracy and detail; one from the lingual side and one from the labial. InBrace appeals to patients who absolutely want invisible braces,” says Dr. Miller.
“The important part of having these digital systems, and aligners too, is that we are able to scan patients and give them options — do you want braces on the inside, on the outside, or aligners? We inform them of the pros and cons of each, and they don’t even have to decide until the day we scan. That is a huge plus,” says Dr. Miller. Compliance should be addressed before deciding on whether aligners are appropriate treatment. “We ask the basic questions: Will you wear them 20-22 hours a day? Are you prepared to wear them longer than six months? A majority of patients have a 6-month burn out for aligner-wear. So, in my office, we only offer aligners to patients who require minor treatment.”
“Many patients who choose InBrace in my practice were failed aligner patients because of non-compliance. With the exception of keeping their teeth clean, the system is 100-percent compliance-free,” he explains. For patients who still want esthetics but not totally invisible treatment, LightForce is also compliance-free. “Patients appreciate that LightForce brings digital and 3D-printed detail to their treatment. With all that precision and accuracy built in to the fully custom 3D-printed bracket, we just put the initial wire in on bonding day and let it work.”
LightForce brackets provide an esthetic labial braces option. “While adults may request totally invisible braces, kids come in asking one question—what colors do you have? They want colorful elastics like their friends.” Dr. Miller continues, “We have found elastic tie colors really ‘pop’ on LightForce white brackets, and that’s really appealing to them. After 6-8 months, they tend to care more about when the braces can come off.” The precision of the LightForce bracket and wire technology addresses that too. “Both InBrace and LightForce digital workflow technologies combined with indirect bonding, are fast in the eyes of the patient because they give us the best 3D control of individual tooth positions. Both start with the scan. Both need fewer office visits, and seem to reduce overall treatment time,” says Dr. Miller. He also prefers a compliance-free approach when correcting Class ll patients, which occurs before brackets are placed. Dr. Miller says, “I use a very efficient Class II corrector for patients who need that type of treatment, such as Crossbow which also is created from a scan and often utilizes 3D-printed metal bands.”
Digital workflow of InBrace and LightForce follow basically the same steps. Here are the steps to receiving LightForce indirect bonding trays.
✔Scan
✔Submit the scan and orthodontic records
✔Receive the digital treatment plan back within 48 hours
✔Submit modifications to the case
✔Hit accept
✔Look for your delivery in 7-10 business days
While InBrace is an efficient lingual option, as with all systems, Dr. Miller notes benefits and drawbacks. “A positive for InBrace is that although it is a fixed appliance, the patient can floss conventionally. But, we would not recommend InBrace to a patient who does not have clean teeth,” says Dr. Miller. “Patients can experience tongue irritation at first, and it may take a few weeks to overcome some speech issues.” For clinicians, bonding lingual braces has somewhat more of a learning curve than labial braces. But, Dr. Miller adds, “Once you overcome the training issue, the workflow is almost identical.”
“With LightForce, in our office, we have bonding down to 7 minutes per arch with a 4-handed technique from the time the patient is isolated to the time the cheek retractor comes off,” says Dr. Miller. (He notes that the “four hands” can be him and an assistant or two assistants. With InBrace, he describes the technique as “5-handed” with the patient’s “extra hand” holding the tongue out of the way.) With InBrace, bonding takes about 20 minutes. Dr. Miller adds, “The key to keeping the bond time shorter is indirect bonding and becoming familiar with both systems.”
“With LightForce fully custom 3D-printed brackets, bonding is extremely accurate,” says Dr. Miller. “The 3D-printed bracket base fits the contour of the labial surface of the tooth. Since it is not a stock bracket, the custom base matches the tooth anatomy exactly, so bonding material is just a thin interface.” Dr. Miller recalls, “In the past, with indirect bonding, we needed to create a custom base for a stock bracket. But LightForce is different. Even the trays are 3D printed. And that helps us reach our goal of having the check retractor in the patient for the least amount of time.”
Karyn Bena, Area Sales Manager for LightForce, has worked with Dr. Miller and other innovative orthodontists in her area. She notes, “Consumers today are very educated, and prior to starting treatment most are doing extensive research on the latest technologies. With LightForce, they find the newest generation treatment option for labial braces — cutting-edge technology, 3-D printed, fully customized treatment which is made specifically to fit just their teeth.” She adds, “LightForce gives orthodontists the capability to maximize a 100% digital workflow environment where they can use the same workflow with their aligner and InBrace patients, as appropriate. That way, from the initial scan of the patient, to digital treatment planning, orthodontists are able to achieve 100% custom treatment and consistent appointment intervals for all patients.”
Bena recognizes that having digital technologies help take orthodontic practices to the next level. She says, “LightForce is a practice differentiator in cutting edge technology and pure customization.” Mike Bonnes, Area Sales Manager for LightForce shares a similar sentiment. “There are a lot of benefits to patients and practices that have digital workflow. We recognize that not every patient is a good aligner patient, and not every patient will want visible braces. So, it is good to have options. Also, it is good to have access to platforms that are created for orthodontists by orthodontists because the quest for efficient tooth movement is in orthodontists’ DNA.”