SmileCreation, an integrated methodology to overcome the limits of algorithms applied to orthodontics

In 2001, when I accidentally discovered the existence of a new computerized system for the management of dental movements in orthodontics, I was not yet clear where this new technology would lead us.

In the years following, the evolution of softwares, the introduction of algorithms,  managed by artificial intelligence, have progressively given less and less relevance to the role of the doctor in the design of the case. At the same time, in every course I attended, from year 2000 to today, the success of the treatment was increasingly associated with the exclusive use of treatment protocols (algorithms) for each single malocclusion to be applied more and more in an automatic mode.. In other words, after each course I attended  I was always coming back to my office with notes similar to cooking recipes and the take home message was always the same: the best clinical results would have been exclusively in the hands of those who would have had the most effective algorithms available, confining the doctor in the background with his diagnosis and the individualized orthodontic biomechanics to be applied to each individual case.

In my personal experience, this type of approach to digital orthodontics was rather disappointing and had two major limitations on a daily basis. The first is to achieve no more than ordinary results in most cases, without that touch of aesthetic personalization that I was looking for in all my treatments so that each new smile was unique and integrated with the patient's face. The second is that of not being able to treat as many different malocclusions as possible as the algorithm does not consider the individuality of each case, the patient chief compliance or the final aesthetic integration of the smile within the face.

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That was the time when I realized that, in order to continue to grow professionally in order to extend the treatment with aligners to as many malocclusions as possible, I had to change the work methodology, however, starting from what had made the difference in the past in my clinical practice: first of all the case diagnosis and secondly the orthodontic biomechanics.

Orthodontic biomechanics is a universal language that does not change in relation to the device in use because the biology with which it interacts is a variable not related to the device. Therefore, a sentence that I had often heard when talking about aligners "new tools new rules" needed necessarily to be changed with "new tools same rules".

This was the first step to rewrite the new rules of this game.

The second step was to define the necessary knowledge to be integrated:

The first one, the hardware, in other words all about the device with its unique characteristics and secondly the softwares, all the different set up programs and their tools.

Knowledge is the essential basis for taking conscious actions, however, knowledge alone without an applied methodology is not able to express 100% of all its broad potential in each different clinical context in which it is applied

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The SmileCreation work flow was created to combine all these aspects in a unique methodology that can be applied and repeated to any orthodontic case starting from the diagnosis, passing through the definition of a treatment plan, independent of the device in use, to be translated into the digital language of the dental movement with aligners according to the principles of traditional orthodontic biomechanics, free from standardized algorithms and always within the clinician control of the ongoing treatment to achieve in any case unique results.