Step I – Digital Diagnostic Models
1. Registration of a user account on DDP-Ortho website – to work with digital DDP-Ortho models and IPA systems it is necessary to create a user account on DDP-Ortho website – www.ortolab.com.pl).
2. Sending diagnostic materials to the laboratory for the production of diagnostic digital models:
• An impression of the upper and lower dental arch made from alginate or PVC mass and an occlusion rim. NOTE! Important is the quality of the impressions and an occlusion bite registration.
• Obtained impressions, together with the bite registration should be wrapped in damp gauze and put into Ziploc bags.
• Ziploc bags with impressions should be put into standard bubble envelopes or boxes that can be ordered free of charge on the Internet page of the laboratory (www.ortolab.com.pl)
• An order form for designing a digital model should also be put in the box or envelope; to place an order log in to your account on the DDP-Ortho website, print the order form and fill it in, if necessary.
• Sent to the laboratory to the following address: Ortolab Sp. z o.o., ul. Krótka 29/31, 42-200 Częstochowa, Poland.
After two working days from receiving delivery you will receive information that the diagnostic digital model is ready for download in your account on the server DDP-Ortho.
Step II – Individually Projected Appliance (IPA)
Diagnostic digital model is prepared to make measurements, analysis, visualization, and allows individual design the appliance.
• “IPA” overlap is used for IPA® design and brackets positioning.
• Aftter design the model file is sent to the address email@example.com
• On the basis of the model sent to the laboratory, positioners will be 3D printed that will allow for gluing the brackets in the positions indicated by the doctor in the digital design.
• The positioners, together with brackets from the selected bracket system, the plaster model and the remaining documentation shall be sent to the doctor from their bracket supplier by post.
This procedure assumes 5 working days to complete individually designed appliance counted from the Doctor’s e-mail with properly designed IPA.
A short video guide to IPA
IPA – Procedure
We know indirect bonding have kind of “bad” reputation in eyes of clinicians but we are talking about CAD/CAM and 3D printers technology which is another technology at all.
Indirect bonding procedures is not (only) the issue of formal perspective (doctors or assistant obligation of fixed appliance bonding). Those are:
- precision of design = precision of positioning (less human mistakes , no product mistakes)
- time of design out of patient visit
- precision of clinical part no human mistakes , product mistakes stays but may be reduced by compensation during design
- time of clinical procedure (first user with first IPA procedure need 32 minutes booth arches counting patient sit on chair until patient is out of chair)
- delegation of workflows (to other doctors as well) One is doing diagnosis/treatment planning and bracket positioning but clinical part is done by others (like by designer as no changes possible)
- consultation via internet (telemedicine ready solution)
- interdisciplinary treatment where appliances are part of work flows of other specialist (to be known or confirmed by cooperating specialists working in 3D format- DDS PRO utilize as well CBCT data).
IPA – Indirect bonding of the appliance
- Digitaly bracket’s positioning in minutes
- Confidence bracket’s position through 3d printed transfers (jig)
- A simple procedure of bonding the appliance
- Save time in the process of bonding
- High quality and precision work
- Easy to removal jigs without weakening of the adhesive bond
- Available in a local laboratory
- Very good price
Do not guess how to position brackets
IPA (Individually Projected Appliances) is a system that allows for positioning brackets on the actual model of a patient’s occlusion, which has been moved to the digital world.
With the aid of specialized DDP-Ortho software (free of charge) a doctor can very carefully determine the position of the bracket on each individual tooth, making the best possible use of his or her knowledge on the subject. The doctor has several bracket systems to choose from, beginning with the traditional double wing brackets and ending with self-ligating ones.
At the beginning the software positions brackets according to specific principles pre-defined for the selected bracket system, placing the slot of a bracket at the appropriate distance from the cutting edge of a tooth. Depending on the type of patient’s malocclusion and individual characteristics of their dentition, the doctor may freely adjust that initial positioning by moving the brackets in the occlusive-alveolar or mesial-distal direction and determining their angulation.
After the position of the bracket on each tooth has been approved, the laboratory prepares positioners that will carefully project the positions of brackets determined on the digital model onto actual teeth.
The doctor receives from the laboratory positioners for both dental arches with embedded brackets that he or she chose at the stage of appliance preparation.
The design of the positioner enables steady placement of the bracket on a tooth and facilitates the application of glue onto the bracket base, as it is accessible from three sides. For the sake of convenience, while inserting the positioner into a patient’s mouth it can be divided into smaller fragments, but it is recommended that it be divided into segments encompassing at least two teeth so that it will be steadily placed. After gluing on and irradiating brackets, the positioners can be very easily removed by the doctor.