Date: Wed, 29 Nov 2006 00:20:17 -0600
From: "ESCO automatic digest system" <LISTSERV@LISTSERV.UIC.EDU>
Subject: ESCO Digest - 20 Nov 2006 to 28 Nov 2006 (#2006-44)

There are 3 messages totalling 237 lines in this issue.

Topics of the day:
1. Re: Invisalign
2. Re: Invisalign


Date: Wed, 22 Nov 2006 02:48:12 EST
From: Typodont@AOL.COM
Subject: Re: Invisalign

Dear Barry,   

I appreciated your comments, at least how my past comments have seemed reasonable, in the midst of some heated discussions.  And quite frankly, the other comments as well. Some of my recent comments were admittedly, a bit "tongue in cheek" and I do not want to give the impression that I am insensitive to the feelings of my colleagues who either defend Align's position or that of the now defunct OrthoClear.  The "stock comments" were merely meant to emphasize my confidence in the ability of Invisalign to help "push the envelope" of the clear removable aligner capabilities into a place that all of us will feel comfortable.   Really, nothing more.  None of us are more right or more wrong than the other on this subject.   We are all dealing with a relatively new technology that has been leading us rather than the reverse.  Quite frankly, this is rather unnerving for every serious critically thinking orthodontist.  I don't think that any of us have seen such a public demand for a product or service in orthodontics as we are now witnessing with Invisalign.  While the technology is trying to catch up with our expectations of producing occlusions similar to what we know that we can achieve with fixed appliances, we are now in the midst of a certain "dumbing down" of predictable outcomes for our patients.  That aspect disturbs me.  And the thought that anyone is led to believe that he or she can perform these services with a minimal degree of fundamental orthodontic knowledge or background in the evidence based literature (and empirically learned orthodontic caveats) is probably the most disturbing consequence of this entire matter.  For that comment, I know that I will be labelled an "Elitist" and just another one of those territorial based "specialists".  While I have had my own issues with Invisalign in the past, one thing appears to be abundantly clear (no pun intended); And that is that Align Technology, no matter how they got there, is indeed "the only show in town".  The OrthoClear debacle, although rather costly, to Align, has probably served as a prophylactic "wake up call" to them with respect to the fact that they cannot remain complacent with the current "achievable optima" of the appliance itself, or deny what their true ultimate mission should indeed be: And that is to achieve comparable results with these high tech computerized clear aligners to that of sophisticated pre-adjusted fixed appliances.  We are, sadly to say, a long way from this goal.  I would also hope that individuals like you, me, and others, will remain somewhat skeptical and critical of any manufacturers claims and activities so that these same manufacturers (Align included) will continue to acknowledge the value of our input in their corporate decisions. 
     I am also somewhat comforted to know that respected colleagues like Orhan Tuncay, (a noted academic, clinician, and person of high integrity), have rolled up their sleeves, and appear to be making some significant progress in helping all of us make some sense of the legitimate use of the Align product.  Align has indeed opened the doors to such possible vistas.  But it will be us, who will utlimately lead Align to the "greener pastures" of clinical excellence.  I honestly believe that they are now more receptive to such input and understand that their ultimate success will indeed depend upon their ability to perfectly meld the harsh realities of business with the even the more demanding challenge of producing a product that will help us attain outstanding and predictable orthodontic treatment outcomes.  They have already accomplished the former goal; let's you and I help them attain the latter one.  That's what I am really betting on!

Elliott Moskowtiz


Date: Tue, 21 Nov 2006 20:22:12 -0500
From: "Roy King" <rkking@BELLSOUTH.NET>
Subject: Re: Invisalign

Dear ESCO,

I tried to refrain from writing but oh well. I am shocked that Invisalign would offer to make aligners at no charge to the Orthoclear users. I know that if I recieve a transfer case from another orthodontist and the patient has paid in full. I will still charge the patient for my services. I feel that it is up to the patient and the former orthodontist to come to an agreement of the monies and I keep out of it. This is why I wonder why Invisalign does not charge and I feel that there must be an agreement between Invisalign and Orthoclear. Otherwise would not we sue Orthoclear for failure to deliver on its services(Not that we could get blood out of a turnip). I am sorry to rub salt into a wound but how could anyone use Orthoclear when it couldnot and would not provide a staging editor. If one does not do a staging editor for aligner cases, then how can you predictably do excellent aligner cases. If you are not doing the staging editor then one cannot know when a tooth is moving and what order of movement is taking place. I find that there is two types of practitioners, one is useing a staging editor and one is useing Faith. As far as the use of Invisalign, Invisalign is neither good or bad but how Invisalign is used can be good or bad. I think Will Rogers said that he never met a bad orthodontic technique but only bad way of useing the orthodontic technique. On a different note, does anybody have knowledge when companies like Invisalign, LingualCare, Orthocad, Insignia(Ormco) will start useing cone beam radiographics instead of impressions?

Happy Thanksgiving,
Roy King