Orthodontic Practice US - AAO 2017 Supplement by MedMark, LLC

Clinical articles

• Management advice • Practice profiles • Technology reviews April 84 Supp April2017 2017– –Vol Vol No 21

The Future Will Be Arriving In...

3 2 1

Ways to Enhance Patient Conversion pg. 6 Decades Later, Invisalign® Treatment is Hitting Its Stride pg. 15 Minute Digital Impression with the iTero Element® Scanner pg. 2

THE REVOLUTION WILL BE DIGITIZED

Talking Technology with Rob Walker, General Manager, iTero North America

The Revolution Will Be Digitized

April 2017 - Volume 8 Supplement 1

EDITORIAL ADVISORS Lisa Alvetro, DDS, MSD Daniel Bills, DMD, MS Robert E. Binder, DMD S. Jay Bowman, DMD, MSD Stanley Braun, DDS, MME, FACD job. The second one covered 30% and the last one was 10%. it. Getting rid of brackets and bands and wires was a part Gary P. Brigham, DDS, MSD Now even on the most complex cases, using the Progress of it. But the technology is what lets us offer an unmatched George J. Cisneros, DMD, MMSc Assessment Tool, I can cut that down to two series of aligners. patient experience, increased efficiency in the front office and I can really focus on the next scan. I can tell if I’m missing improved patient communication. This digital era is here and Jason B. Cope, DDS, PhD something. This also helps me contain costs. I never wind up we couldn’t be happier. Neil Counihan, BDS, CERT Orth needing another set of aligners. Bradford N. Edgren, DDS, MS, FACD GP’s might want to use the Progress Assessment tool to Eric R. Gheewalla, DMD, BS Class III Case confirm compliance. I’m at the point where I don’t worry about Dan Grauer, DDS, Morth, MS compliance. I don’t let patients choose me. I choose them. We had a tough case of lower pre-molar extraction for Mark G. Hans, DDS, MSD a class III case. After the refinement scan, I was able to When we’re considering treatment, I lay out the rules for my share with the patient the challenge in the extraction site. patients. You will wear your aligners to eat. We’re going to William (Bill) Harrell, Jr, DMD ® It helped me try to obtain parallelism of the roots where switch every five days, not every fourteen days or even seven John L. Hayes, DMD, MBA I needed to change the design of the attachments. This days. You’re going to wear them 24 hours a day. helped me gain full collaboration from the patient for Paul Humber, BDS, LDS RCS, DipMCS the next set of aligners. It enables me to be precise and efficient, directing the exact positioning of teeth in a Ultimately, using the iTero Element Scanner and Invisalign Laurence Jerrold, DDS, JD, ABO relatively short time frame. Chung H. Kau, BDS, MScD, MBA, PhD, MOrth, FDS, FFD, FAMS treatment together has changed the entire orthodontic experience. Here’s another example; I tell parents that if I Marc S. Lemchen, DDS were treating identical twins, one with traditional braces and one with the technology we have, our Invisalign case will finish Edward Y. Lin, DDS, MS about 30 to 35% faster. That’s because of the accuracy and Thomas J. Marcel, DDS the precision. It’s because the force we’re delivering is lower, Andrew McCance, BDS, PhD, MSc, FDSRCPS, MOrth RCS, DOrthbut RCS it’s constant so we don’t have the see-saw effect that you get with braces. Mark W. McDonough, DMD Randall C. Moles, DDS, MS With Invisalign treatment and iTero there are no more Elliott M. Moskowitz, DDS, MSd, CDE emergency appointments when the family is on vacation or Atif Qureshi, BDS away from the office. We can literally predict everything for the whole session. We know if a patient is doing a semester Rohit C.L. Sachdeva, BDS, M.dentSc abroad, we can send the aligners they’ll need for treatment. Gerald S. Samson, DDS There’s absolutely no way to do this with braces. What are we Margherita Santoro, DDS going to send the braces and wires through the mail? Shalin R. Shah, DMD (Abstract Editor) Plus, the gap between appointments is much more Lou Shuman, DMD, CAGS flexible. It’s not like we’re doing a wire change and need to Scott A. Soderquist, DDS, MS schedule a follow-up appointment to make sure the wire is working or making sure it doesn’t over extend. If we need Robert L. Vanarsdall, Jr, DDS to pause treatment with Invisalign at a certain point, we John Voudouris (Hon) DDS, DOrth, MScD know we can do that. We just pause knowing the teeth Change the way you look at things...the things that you look at will change. Neil M. Warshawsky, DDS, MS, PC won’t relapse or overextend.

See How It Fits In Your Practice… CE QUALITY ASSURANCE ADVISORYLiterally! BOARD Dr. Alexandra Day BDS, VT John White, DDS, MSD Larry W. White, DDS, MSD, FACD

Change the Input, Change the Outcome

I’ve been doing Invisalign treatment for 13 years. The truth That’s the motivation behind the ad to the left. It uses augmented reality to let the is, I’ve never seen an unsatisfied patient. I’m having more user see what the iTero Element® Scanner will look like in their practice in real time. fun than ever before. We can let our guard down and really Because it’s not about the technology you use, it’s about the experience you create. interact with the patient on a fun level. I was recently thinking back on how things were before we

Julian English BA (Hons), editorial director FMC really embraced the technology. Back when I was doing Rob Walker conventional Dr. Paul Langmaid CBE, BDS, ex chief dental officer to the Government for Walesorthodontics, patients would ask “how long can I wait before we start treatment”? Today the question Dr. Ellis Paul BDS, LDS, FFGDP (UK), FICD, editor-in-chief Private Dentistry has become “how soon can we get started”. (It really blows Dr. Chris Potts BDS, DGDP (UK), business advisor and ex-head of Boots Dental, their mind when I tell them, “we started your treatment a few minutes ago when we took the impression!”) BUPA Dentalcover, Virgin Dr. Harry Shiers BDS, MSc (implant surgery), MGDS, MFDS, Harley St referral In the end, it’s about much more than just technology. implant surgeon Getting rid of the PVS impression was really a small part of

3D Progress Assessment scans for upper and lower arches

Dr. Christian Fournier graduated as an orthodontist from Université de Montréal. He was designated an Elite Provider in 2011 and has been an Invisalign Top 1% provider since 2015. Capture the imagination and you can drive the conversation.

Before signing on as the General Manager of iTero North America, Rob Walker served as Director of Sales Midwest for Align Technology. These positions have afforded him an up-close and personal view of the digital revolution that’s Differentiate your practice by redefining how you communicate. reshaping orthodontics. Recently we sat down with Mr. Walker and talked about the technology that’s driving the and where it’s taking the profession. PUBLISHER revolution | Lisa Moler LEADING THE INDUSTRY IN TARGETING THE NICHE SPECIALTIES OF DENTISTRY

Email: lmoler@medmarkaz.com EDITOR IN CHIEF | Mali Schantz-Feld, MA Tell us about your Align Technology Email: mali@medmarkaz.com | Tel: (727) 515-5118

When it comes to your brand, the medium is the message.

history and the move from the Invisalign® clear aligner business over to the iTero® intraoral scanner business. Was there any single aspect of the digital scanning business that encouraged you to move ? MANAGING EDITOR | Lou Shuman, DMD, CAGS LEADING THE INDUSTRY IN TARGETING THE NICHE SPECIALTIES OF DENTISTRY

Email: lou@medmarkaz.com

ASSISTANT EDITOR | Elizabeth Romanek Walker: I have been Email: betty@medmarkaz.com

with Align Technology for 4 years. Until 2017, I have served as an Area Sales Director for the Northeast and Midwest areas while also covering Central and Eastern Canada. I spent 20 years in the Medical/Hospital industry but after NATIONAL SALES DIRECTOR | Kristin Sammarco learning about the Invisalign treatment potential from a patient and doctor perspective there was no way I was going See to miss How it Fits in Your Email: kristin@medmarkaz.com the opportunity join Align CLIENT SERVICES/SALES SUPPORT to | Adrienne Good in 2013. While not being directly in the iTero organization I quickly realized the impact the digital Practice…Literally! Email: agood@medmarkaz.com revolution was having in the Orthodontic space. I believe the iTero Element® scanner is a crucial component in orthodontics for CREATIVE DIRECTOR/PROD. MGR. | Amanda Culver practice growth, clinical outcomes and a great patient experience. Email: amanda@medmarkaz.com

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© FMC 2017. All rights reserved. FMC is part of the specialist publishing group Springer Science+Business Media. The publisher’s written consent must be obtained before any part of this publication may be reproduced in any form whatsoever, including photocopies and information retrieval systems. While every care has been taken in the preparation of this magazine, the publisher cannot be held responsible for the accuracy of the information printed herein, or in any consequence arising from it. The views expressed herein are those of the author(s) and not necessarily the opinion of either Orthodontic Practice US or the publisher.

22 The Coming of Age for Invisalign Teen

Table of Contents The Revolution Will Be Digitized ..................................................................................... 2 Talking Technology with Rob Walker, General Manager, iTero North America Holliday in the Sun ........................................................................................................... 4 Talking Reputations with Honolulu’s ‘Go To’ Invisalign Treatment Guy Patient Conversion ........................................................................................................... 6 Getting to Yes With Invisalign’s Kamal Bhandal Looking Back, Thinking Ahead .......................................................................................10 The 2016 AAO Align & iTero Booth Change the Input, Change the Outcome .......................................................................11 Dr. Christian Fournier on the Role of Technology in His Practice Makers of Invisalign are Changing the Game .................................................................15 Align Technology’s Bold Plan to Deliver More Patients to Orthodontists Is All This Digital Efficiency Making Us Inefficient? ........................................................18 Augmented Reality App ................................................................................................ 20 See How It Fits In Your Practice…Literally! The Coming of Age for Invisalign Teen ......................................................................... 22 A Conversation with Dr. Scott Frey 1,000,000 and Counting .................................................................................................24 The millionth iTero Element Scan for an Invisalign Patient

THE REVOLUTION WILL BE DIGITIZED Talking Technology with Rob Walker, General Manager, iTero® North America

Rob Walker

Before signing on as the General Manager of iTero North America, Rob Walker served as Director of Sales Midwest for Align Technology. These positions have afforded him an up-close and personal view of the digital revolution that’s reshaping orthodontics. Recently we sat down with Mr. Walker and talked about the technology that’s driving the revolution and where it’s taking the profession. Tell us about your Align Technology history and the move from the Invisalign® clear aligner business over to the iTero® intraoral scanner business. Was there any single aspect of the digital scanning business that encouraged you to move ? Walker: I have been with Align Technology for 4 years. Until 2017, I have served as an Area Sales Director for the Northeast and Midwest areas while also covering Central and Eastern Canada. I spent 20 years in the Medical/Hospital industry but after learning about the Invisalign treatment potential from a patient and doctor perspective there was no way I was going to miss the opportunity to join Align in 2013. While not being directly in the iTero organization I quickly realized the impact the digital revolution was having in the Orthodontic space. I believe the iTero Element® scanner is a crucial component in orthodontics for practice growth, clinical outcomes and a great patient experience.

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How do you think your experience and success with Invisalign will benefit you in your new role within the iTero scanner business? You have the unique position to provide insight because of that duality.

I can imagine a future where the iTero scanner’s smart technology knows the doctor’s treatment protocols for specific cases and it could create multiple instant simulations for Invisalign treatment options at the time of scanning.

Walker: The biggest learn for me is the challenge that orthodontists face in continuing to grow their practice in a rapidly changing market. This challenge requires orthodontists to manage the technology advancement and consumer/patient savviness while at the same time delivering the high-quality clinical outcomes they demand as an orthodontic specialist.

What is your projection of how the Invisalign® Outcome Simulator will integrate into the patient conversion equation? Will that trajectory continue to soar or will it plateau?

Moving from analog treatment to digital orthodontics is the gateway to practice growth. The combination of Invisalign clear aligners and iTero scanner’s enables orthodontic practices to make the transition to digital simple. The digital orthodontic practice is now able to meet patient demands for digital consultations with 3D simulations and treatment solutions that provide reduced treatment times and improved esthetics during treatment. In recent weeks and months there have been significant technological advances with regard to the integration of digital scanning and imaging. Where do you see the iTero Element scanner positioned within this rapidly changing field? Walker: The iTero scanner is on the forefront of the digital revolution. We are the clear leader in digital scanning for orthodontics. We are now on the 4th generation of the iTero scanner with the launch of the iTero Element scanner in late 2015. Also, we are the only scanner with an Invisalign simulator that shows the patient his/her clear aligner treatment from start to finish which can now be sent directly to the patient versus only in the office. Additionally, we recently launched an Invisalign Progress Assessment feature which allows orthodontists to easily visualize how the teeth are progressing according to the treatment plan. Scanning the patient and using these unique features creates a great patient experience while giving the orthodontist greater clinical confidence. It’s a win/win for both. In your view, what do you think is the most distinguishable point of differentiation for the iTero Element Scanner in this competitive digital scanning space? Walker: I think the greatest differentiation is the partnership we continue to develop with the orthodontic community. Who better to partner with, to ride the wave that has been created in the market, than Align Technology? We are the leaders and creators of the digital orthodontic clear aligner market and the leaders in digital intraoral scanning. Furthermore, we continue to create programs for our doctors that not only help them in their clinical requirements but also growing their practice through patient demand.

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Walker: I definitely believe it will continue to soar. We have data that shows the vast majority of patients who have experienced the simulator will accept treatment with that orthodontist. I also believe with the ability to now share the treatment plan remotely with patients, which allows them to share their treatment and excitement with family and friends, the simulator will become more mainstream in orthodontic practices than ever before. Many doctors have shared recent stories of how the shared patient simulations have been a “wow” factor for the patient and led them to move into treatment. The simulation sharing feature also enables the orthodontist to share the treatment simulation and final position goals with their referring general dentist. This is a significant improvement in communication between the orthodontist and general dentist when collaborating on multi-disciplinary cases. Anecdotal evidence suggests that branded manufacturers have taken a page out of Invisalign consumer success playbook and are promoting their digital platform direct-to-consumer as a means to generate patient traffic. Can you envision a day when the general consumer comes into the practice asking for an iTero digital scan? Walker: Absolutely. While they may not specifically ask in the office, many patients have already begun researching which orthodontists offer “No Goop” impressions as part of their treatment plan. Our recently created “consumer concierge” team has indicated that the number one differentiator, when a consumer is seeking Invisalign treatment, is the iTero scanner. Many more patients than we may imagine are very fearful of gagging on traditional impressions and definitely would avoid them if given the opportunity. Finally, with our “powder free” patient scanning experience and now 1-Minute scans with the iTero Element scanner patients can be scanned, simulated and shown their potential treatment outcome in a matter of minutes. Thank you for your time and for presenting some insightful thoughts.

Holliday in the Sun

Talking Reputations with Honolulu’s ‘Go To’ Invisalign® Treatment Guy By all accounts, Dr. Sean Holliday is living the dream. The gregarious husband and father of three girls runs a successful orthodontic practice in the Pearl City area of Honolulu, Hawaii. He’s got two other locations, and is about to open his fourth. Just a hair over 40, Dr. Holliday has built a reputation as the premier provider of Invisalign treatment in the greater Honolulu area. His evolution from one time haole (Hawaiian slang for foreigner) to the “go to guy” for Invisalign treatment shows the importance of forming your own opinions, challenging conventional wisdom and the value of adaptability. Like many in the profession, he became interested in dentistry in high school when he realized how many aspirational boxes the profession allowed him to check off. He always had an outgoing personality. He liked making a difference in people’s lives. And he appreciated how the profession challenged the artistic and scientific sides of his personality. After seeing the positive impact orthodontic treatment had on both his mother and brother, he decided to pursue a path in orthodontics. Dr. Holliday earned his dental degree from the University of Missouri-Kansas City, followed by his master’s degree in oral sciences and Orthodontic Certificate from the University of Illinois at Chicago. After graduation he found himself in Hawaii, an area with one of the highest per-capita dental/orthodontic professionals in the United States. Rather than join an existing practice, he decided to see for himself if there was a market segment that was being underserved and then create a practice that he could differentiate. “We tried a lot of things in the early days. We tried clear, we tried lingual, we tried metal, a whole range of different things to see how we could stand out. What became obvious was that

Orthodontic Practice 4

The Holliday Family

patients wanted clear aligner therapy, specifically Invisalign.” This opportunity presented a problem. All throughout residency, he heard a steady drumbeat of professionals who were disappointed in the results they were getting. Just to be on the safe side, he decided to explore Invisalign treament for himself. What he started discovering was that the prevailing opinions and the demonstrated facts weren’t in agreement. “Once I got an inkling that the reputation didn’t match the result, I dove in to research it further. It was eye opening! I saw so many patients getting outstanding results.” Dr. Holliday came up with his own hypothesis. “I think when you’ve got guys who have been doing things the same way for 30 or 40 years, it’s going to be hard for them to change. A departure from fixed appliances to something as radical as Invisalign was too much. It won’t work for them because they don’t know how to do it.

As a result, I came to the realization that I needed to surround myself with people who knew how Invisalign treatment worked as opposed to those who wanted to see it fail. In a sense, it was up to me to teach myself how to do it. I started attending every CE course I could find. I was very fortunate to learn from pioneers such as Dr. Bob Boyd, who’s been an Invisalign Elite Advantage Provider since 2005 and has been treating Invisalign cases in the San Francisco Bay area since 1998. What I came to understand was that success with Invisalign treatment was predicated on talent and familiarity. The upside was that it could also be a good differentiator in what was essentially a saturated orthodontic market. Invisalign offered a real way to stand out.” It was around this time that Dr. Holliday made another important decision. In order to give the treatment, and the patient, the best chance at success, he had to eliminate what is often the weakest link in aligner therapy—the PVS impression. From a patient experience standpoint, it was a no brainer. “You never want the patient to have a negative experience. But that’s exactly what we were giving them with all the PVS impressions. Everyone understands PVS has a lot of gagging issues with it. But more than that, the remake rate was running around 10%! If you’re a low volume practice, that might not be that noticeable. But now, we average around 60 Invisalign case starts per month. So imagine about 80 cases a year that would require second impressions! We never knew if the impression was going to take 15 or 45 minutes, which makes scheduling incredibly difficult. Not to mention that PVS has its own cost associated with it. Working from a geographically remote area also made the shipping time especially burdensome. Of course when the patient needed a refinement that meant another impression. There’s a lot of stress generated when something goes wrong. Mind you, we got to be pretty good at taking PVS impressions, but there was too much outside of our control.”

This is a 12 year old male patient with a deep bite, Class I malocclusion. He presented with severe crowding, and we managed his erupting teeth. He was treated with Invisalign Teen in 14 months, 31 aligners, and no refinements.

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Dr. Sean Holliday

Dr. Holliday investigated all of the digital impression systems available at that time. He wanted a system that could scan every patient instead of taking alginate impressions. Ultimately, the acquisition of iTero® by Align Technology (makers of Invisalign) tipped the scales. He wound up purchasing four of the initial iTero digital scanners, all of which he still owns. With the digital technology in place, it was time to take the plunge. While he was confident the Invisalign treatment product could deliver esthetically, the clinical results would still need to meet his own technical expectations. From there, it was just a matter of doing quality work and letting the word of mouth create his brand. “Today our Invisalign Teen® cases almost match the number of fixed appliance, full-arch cases for adults and kids combined. We do so much Invisalign Teen we had to order six iTero Element® Scanners to keep up! Invisalign Teen is similar to regular Invisalign treatment. However, it also takes into account teeth that haven’t fully erupted, the progression path, and includes a compliance indicator. Not that it’s needed. “We can easily tell when the patient isn’t using their aligners. It’s really more for the parents. Most teenagers are more compliant than adults when it comes to wearing their aligners.” Of course, even being the go-to guy for Invisalign in a place like Hawaii has its drawbacks. Obviously the rents are high, overhead in general is high, and everything needs to be shipped in. But really, it’s a small price to pay when your reputation is that you’re the “go to guy” for Invisalign in the greater Honolulu area.

Patient Conversion Getting to Yes With Align Technology’s Kamal Bhandal At its most basic, patient conversion is about getting to “yes”. It’s about getting an individual to agree to begin treatment. Yet the simple act of saying yes can be anything but simple. From the clinical and biological elements that frame each case and the treatment preferences of each practice to the hopes, to the wants and needs of the consumer, there are a large number of variables that influence each decision. Few people understand the challenges of getting to yes better than Kamal Bhandal, director, Invisalign Brand Consumer Marketing. In many ways, helping consumers make a decision about their smile and creating a positive experience with the brand is the goal for everything marketing does. With so many individual variables going into the decision, it’s impossible to devise a ‘one size fits all’ approach to achieve this goal. Instead, Bhandal and her team work on removing barriers that the consumer might encounter between the decision to consider orthodontics and saying yes to Invisalign® clear aligners.

For Bhandal, getting to yes starts at the most basic level—awareness. Orthodontic Practice 6

“Our very first job is ensuring that consumers know they have a choice when it comes to their orthodontic treatment. Believe it or not, many consumers don’t know that clear aligner treatment even exists. They don’t know there’s a viable alternative to metal braces. “Getting the word out starts with our consumer messaging. We’ve just launched a new global campaign, ‘Made to Move.’ This campaign focuses on the innate desire that all people have to move forward and highlights the powerful role a smile can play in every aspect of life. It’s not about Invisalign clear aligners as a product, it’s about the consumer and how getting a better smile with Invisalign treatment can make their life better. “We’ve done a fantastic job of creating an adult market for Invisalign treatment. Our value proposition is even better for teenagers and we think clear aligners can replace metal braces in the teen market. That’s a big part of our focus in 2017.”

The next step in getting to yes is the informative step—education. Bhandal and her team know that today’s consumer is incredibly tech savvy. The consumer wants to have control of how they access information. Bhandal says it’s marketing’s responsibility to be ready to meet the consumer whenever and wherever they want to be reached. That means the company must have a robust presence online. “We know that consumers like doing their research and playing an active role in their treatment decisions. They want to know how Invisalign treatment works and they want to know what it’s like. We make sure they have access to an abundance of information—‘how do Invisalign clear aligners work’ and ‘what makes Invisalign technology different than any other technology’—at their fingertips. At the same time, we want to make sure the consumer has access to the experiential information—the ‘what is Invisalign treatment like’ questions—coming from their peers. This helps establish social credibility.”

Bhandal explains that the Invisalign Concierge team is trained in how to listen and effectively communicate with consumers. This can help them understand the consumer’s pain points and help them establish realistic expectations. Each member of the concierge team is trained on how to interact with doctor’s offices. This interaction plays an important role in the final step of getting to yes—action. “Our research tells us that there have been consumers who were interested in Invisalign treatment but didn’t know how to follow through on that desire. We’ve spoken to parents who wanted Invisalign treatment for their children but couldn’t locate a provider. That’s unacceptable. The Invisalign Concierge team is empowered to schedule an appointment for the consumer at a nearby practice. “We’ve already gotten a lot of feedback about how much consumers appreciate the service and how easy we make it for them. If it’s good for the patient, it’s good for the practice, and that means it’s good for the category as a whole. It becomes a win/win for the doctor and patient, which is a win for us.” Of course, getting to yes can only happen if the practice offers Invisalign treatment and keeping practices up-to-date on the technological advances can be a challenge.

The web or digital platforms are ideal for delivering what can be complex content. The consumer can dictate how deep they want to go. But it isn’t always the most personable medium. Some consumers want an interactive experience; they want a human connection. While this kind of communication can be much more labor intensive, it also affords Bhandal and her team an invaluable opportunity. “We know people want to have a relationship with the brand and this is an opportunity to establish and nurture that relationship. This year we launched our Invisalign® Concierge team who will do just that. Within 24 hours of the consumer contacting us, and often in the same business day, a member from our Concierge Team will reach out to them. “Unlike inbound call centers that want to keep every call short and drive traffic to an online site, we want to talk to consumers interested in Invisalign treatment. The power of this human contact can’t be overstated. This creates a connection and really helps shape the consumer’s impression of the brand.”

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“The current technology is amazing. The efficiency that comes from treating so many cases is significant. Looking at the technology of ten or even five years ago, it bears little semblance to the Invisalign treatment of today. We can already treat an ever widening variety of malocclusions and we’re committed to continuously innovating to meet consumer needs. ” In the end, Bhandal knows that getting to yes isn’t just for the good of Align Technology. “Our own research tells us that a significant number of adults would rather forgo treatment rather than go through the process of getting fixed appliances. That’s not just unfortunate for that individual. It’s unfortunate for practices and the profession as a whole. “My goal is to make sure that every consumer who wants Invisalign clear aligner treatment has the opportunity to say yes.”

The Most Preferred Scanner in the Profession With the new 1-minute* scan, the iTero Element® Intraoral Scanner is the fastest way to enhance the patient experience, improve clinical outcomes and expand your reputation. After the Treatment Coordinator has completed the scan, the doctor can use the iTero exclusive Invisalign® Outcome Simulator to show the patient what their smile might look like following treatment. For digital convenience and seamless integration with 3rd party systems and labs, nothing beats the iTero Element Scanner—the most-preferred scanner in the profession.

* Based on 40 iRecord scanning sessions with an average scan time of 58 seconds by 2 experienced users.

New Multi-Bite Scan Feature

Maintain natural occlusion while capturing highly-detailed multi-bite registration, export as an STL file for compatibility with third party systems.

Invisalign Outcome Simulator

The Invisalign Outcome Simulator gives you a fun and engaging way to communicate the potential benefits of Invisalign treatment while increasing case acceptance. Share the image with patients direct from the iTero Element Scanner.

Optimized Orthodontic Scanning The iTero Element enables the capture of two bite scans to review bite discrepancies, like CO/CR and prescribe appliances that may require an alternate bite relationship. iTero also provides an open STL export of each bite relationship for use in third party CAD/CAM systems.

3D Progress Assessment Tool

At any time during treatment, the clinician will now be able to compare a patient’s new scan with a specific stage of their ClinCheck treatment plan to visually assess and communicate treatment progress.

Enhanced visualization improves view of the dentition, margin and soft tissue, while the real-time scan in color enables a more precise clinical evaluation during and after treatment.

Orthodontic Workflow

Engineered to work with all Invisalign systems, Invisalign® Outcome Simulator, OrthoCAD® Software, and OrthoCAD Viewer. Connect seamlessly with labs and third-party systems.

Schedule an in-office demonstration of the iTero Element Scanner online at itero.com or by calling 800-577-8767.

Looking Back, Thinking Ahead. The 2016 AAO Align & iTero Booth

Highlighted by the immensely popular iTero Iron Records Challenge, the 2016 American Association of Orthodontists Annual Session had something for everyone.

Stop by booth 505 at the 2017 AAO to say hello and try your hand at the iTero Iron Records Challenge.

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Change the Input, Change the Outcome. Dr. Christian Fournier on the Role of Technology in His Practice.

As much as we love working with the new scanner, the patients may love it more than we do. Let’s put it this way, no patient ever said “wow” when we finished with a conventional impression. But the wow moment has become a regular occurrence when patients first see their impression in 3D. If we didn’t get the “wow” immediately after the scan, we knew the next step—the simulation—would do the trick. The Invisalign® Outcome Simulator The Clinic of Montreal Team

As one of the top Invisalign® providers in Montreal, Canada, my practice is 100% committed to the latest orthodontic technology. My goal is to deliver a business-class experience that’s unsurpassed in convenience, comfort and esthetics. Technology is what is possible. This “all in” commitment has enabled us to reinvent the typical orthodontic experience. Using two key pieces of technology, we’ve eliminated brackets, bands, elastics, wire changes, emergency visits, broken wires, PVS impressions, gagging and it bears mentioning, just about all the stress. Today our cases start easier, finish faster and progress with the utmost precision. Here’s how we did it. Back in the year 2000, Invisalign made their debut at the AAO. As someone who had braces when I was growing up, I remember how uncomfortable the brackets and elastics could be, how my jaw would ache after the wire changes, what a pain it was when the wire would break and just how long it all took! I was intrigued by any system that could do away with all those headaches, so I decided to watch how the technology performed. By 2004 it seemed like Invisalign treatment was on its way so I made the decision to put the technology to the ultimate test; I used it on myself. Hey, I’m not just a doctor, but also a patient! Well, not only did it work as advertised, but the comfort of the process blew me away. From that point on, I began offering Invisalign to my patients. I was generating great results with Invisalign treatment. But it became abundantly clear that the PVS impression was the weak link in my treatment protocol. So in 2013, we decided to go digital. We wound up with two scanners in the office, but quickly the iTero® became the unit of choice with my staff. Today we have three iTero Element® Scanners! The difference between the PVS and iTero is night and day. The precision of the scan is always perfect, which translates to better fitting aligners. As a result, the quality of care we provide is better. With the iTero Element Scanner, there are no more rejected impressions, no retakes, and no more frustrated staff members who had to take a second or third impression.

For those who aren’t familiar with the Invisalign Outcome Simulator, it takes the patient’s impression and simulates what the outcome will look like at the end of treatment. I don’t have to tell you how huge this can be. In the past, we would be showing the patient photos of similar cases. “Here’s a case that was similar to yours, here’s how it finished.” It was very impersonal and in the end, the takeaway from the consultation would just be a piece of paper with my fees. Now we have two large screens in my office. On the one screen I show them their current scan. On the other I show them the simulated result. We want it as big and bold as possible. We make it a point to email a copy of the simulated scan to the patient as they’re sitting there in the office. (We love hearing a notification on the patient’s phone when they’re still sitting in the chair!) We know the patient will share the image with their family, but we know there’s a great chance it’s also going to show up on their social media pages and posts, so I always include a personal note with the simulation that says “this is your brand new smile” with our practice name conveniently conspicuous. Even if the patient hasn’t decided whether to pursue treatment, the excitement is palpable. The Invisalign Outcome Simulator is one of the best communication tools we have at our disposal. It’s so easy to use and generates so much enthusiasm. We get a lot of patients who will say yes on the spot. We know it has increased our case acceptance rate significantly. The second really impressive feature with the iTero Element Scanner is the 3D Progress Assessment Tool. We use it after taking a refinement scan. It allows us to superimpose the case against the ClinCheck to show us how our plan is progressing. No other company offers a similar tool. We are now able to know in degrees, the expression on the torque of the anteriors and the amount of expansion. Let me give you an example. Like I said, I’m treating all my cases with Invisalign. Even the complex ones. In the past, I was making three series of aligners for the most challenging cases. The first set took care of 60% of the Just completed Invisalign treatment, a very happy patient!

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job. The second one covered 30% and the last one was 10%. Now even on the most complex cases, using the Progress Assessment Tool, I can cut that down to two series of aligners. I can really focus on the next scan. I can tell if I’m missing something. This also helps me contain costs. I never wind up needing another set of aligners. GP’s might want to use the Progress Assessment tool to confirm compliance. I’m at the point where I don’t worry about compliance. I don’t let patients choose me. I choose them. When we’re considering treatment, I lay out the rules for my patients. You will wear your aligners to eat. We’re going to switch every five days, not every fourteen days or even seven days. You’re going to wear them 24 hours a day. Ultimately, using the iTero Element Scanner and Invisalign treatment together has changed the entire orthodontic experience. Here’s another example; I tell parents that if I were treating identical twins, one with traditional braces and one with the technology we have, our Invisalign case will finish about 30 to 35% faster. That’s because of the accuracy and the precision. It’s because the force we’re delivering is lower, but it’s constant so we don’t have the see-saw effect that you get with braces.

it. Getting rid of brackets and bands and wires was a part of it. But the technology is what lets us offer an unmatched patient experience, increased efficiency in the front office and improved patient communication. This digital era is here and we couldn’t be happier.

Class III Case We had a tough case of lower pre-molar extraction for a class III case. After the refinement scan, I was able to share with the patient the challenge in the extraction site. It helped me try to obtain parallelism of the roots where I needed to change the design of the attachments. This helped me gain full collaboration from the patient for the next set of aligners. It enables me to be precise and efficient, directing the exact positioning of teeth in a relatively short time frame.

With Invisalign treatment and iTero there are no more emergency appointments when the family is on vacation or away from the office. We can literally predict everything for the whole session. We know if a patient is doing a semester abroad, we can send the aligners they’ll need for treatment. There’s absolutely no way to do this with braces. What are we going to send the braces and wires through the mail? Plus, the gap between appointments is much more flexible. It’s not like we’re doing a wire change and need to schedule a follow-up appointment to make sure the wire is working or making sure it doesn’t over extend. If we need to pause treatment with Invisalign at a certain point, we know we can do that. We just pause knowing the teeth won’t relapse or overextend. I’ve been doing Invisalign treatment for 13 years. The truth is, I’ve never seen an unsatisfied patient. I’m having more fun than ever before. We can let our guard down and really interact with the patient on a fun level. I was recently thinking back on how things were before we really embraced the technology. Back when I was doing conventional orthodontics, patients would ask “how long can I wait before we start treatment”? Today the question has become “how soon can we get started”. (It really blows their mind when I tell them, “we started your treatment a few minutes ago when we took the impression!”) In the end, it’s about much more than just technology. Getting rid of the PVS impression was really a small part of

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3D Progress Assessment scans for upper and lower arches

Dr. Christian Fournier graduated as an orthodontist from Université de Montréal. He was designated an Elite Provider in 2011 and has been an Invisalign Top 1% provider since 2015.

You started your practice to move more than teeth. Invisalign® clear aligners were designed with short and long term oral care in mind and are made with proprietary SmartTrack® material to move teeth with control and precision. Weekly aligner changes may reduce treatment time up to 50% compared to two-week changes, so your treatments can go beyond just transforming your patients’ smiles.

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Makers of the Invisalign® System are Changing the Game Again Align Technology’s Bold Plan to Deliver More Patients to Orthodontists In less than two decades, the Invisalign system has evolved from technological curiosity to a force in the orthodontic space. It has exponentially expanded the market for orthodontic treatment, adding a new revenue source to many orthodontic practices while making orthodontic treatment more appealing, comfortable, and esthetic. While early iterations of Invisalign clear aligners had their limitations, the Invisalign system of today is more effective, predictable, and efficient than ever before. It is the centerpiece of a digital transformation that allows practices to deliver a patient experience that is radically different from the old-school approach of a mouth full of wire, bands, and brackets. While we’ve accomplished a lot in 20 years, research suggests that the Invisalign system and practices that use it have only scratched the surface of what’s possible. There’s a tremendous amount of untapped opportunity in the marketplace, in the technology, and in the way orthodontic treatment is delivered to patients. We are partnering with practices to fully leverage those opportunities. Let’s start with some facts. Since Align was founded in 1997, over 4 million patients have been treated globally with the Invisalign system. The experience and know-how from having treated that many patients is continually incorporated into Align technology’s treatment planning process. The manufacturing process of Invisalign clear aligners is the largest, most advanced mass-customization process in the world delivering more than 269 million unique appliances to date. Reaching Out to Potential Patients There are a considerable number of potential patients in the U.S. alone who would benefit from having straighter teeth,

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but not all of them want metal braces. Unlocking this market segment represents a significant growth opportunity within the profession, potentially delivering millions of new patients to the doors of orthodontic practices every year. Creating consumer demand and generating new patients for orthodontists is one of the things Align does best. We know from our research that given a choice, many patients prefer clear aligners to traditional bracket and wire treatment, yet only a fraction of adults and teenagers are treated with Invisalign clear aligners. We’re about to change things. In the past, many consumers who were motivated by an Invisalign branded, direct-to-consumer campaign would find a doctor on the Invisalign Doctor Locator, visit them for an Invisalign consult but often times would walk out of the orthodontist’s office with braces or no treatment at all. With our new media campaign, interested consumers who reach out by phone in response to an Invisalign brand campaign will connect with our new call center in Raleigh, NC, where they will be introduced to one of our new smile consultants. Smile consultants will provide personalized support, sometimes connecting consumers directly to a practice over the phone or helping to schedule an appointment. When patients schedule a consult with the practice, the concierge will work to ensure the practice is prepped on the specific needs of the individual. But the benefits to the practice do not end there. Partnering with Select Practices The goal of the smile consultant is to pair consumers who want Invisalign treatment with an experienced Invisalign provider in their area. The new Next Level Provider program will do just that.

Created to strengthen relationships with experienced Invisalign practices, the program aims to connect interested consumers with doctors who have the clinical confidence and systems in place to have the highest likelihood of patient conversion. In addition to leads from the concierge, Next Level Providers earn premier placement on the Invisalign Doctor Locator as well as being publicly recognized as a VIP partner. Finally, Next Level Providers can earn exclusive discounts on low-stage Invisalign products, on Vivera retainers and on iTero services. New Product and Education Offerings On the clinical education and professional development side, Align is excited to introduce Invisalign Teen® with mandibular advancement for treating teen Class II cases. With the mandibular advancement feature, a pair of buccally placed, reinforced precision wings, are integrated into the aligner shape. The wings are located between the first molars and premolars and are made of the same proprietary SmartTrack® material used in Invisalign clear aligners. There’s a raised gingival cutline at the precision wings that prevents impingement of the gingiva. A minimal inter-arch opening ensures patient comfort. It’s available for all Invisalign Teen cases in Canada and select other countries, and is pending FDA approval in the U.S. In addition to increasing the applicability of Invisalign treatment with new products, we are also differentiating ourselves in the way we offer professional education to orthodontists. We have just introduced Invisalign Pro®, a 90-day comprehensive training program delivered to meet a doctor’s experience level and interests. With Invisalign Pro, we design an educational experience with (and for) clinicians to sharpen their clinical skills, elevate patient engagement, and move their practice to the next level. Invisalign Pro doctors will enjoy exclusive access to a team of highly trained Invisalign advisors who will provide customized, one-on-one training sessions. They’ll also receive ongoing technical support from a dedicated team and a ClinCheck® plan advisor to help optimize their treatment plans. Participating Invisalign Pro clinicians can select topics to deepen their technical expertise, increase clinical confidence, and refine office processes to improve overall efficiency. Training topics include: • Default protocols, including Anterior-Posterior (AP) correction, Teen, and Vertical correction • The latest Invisalign treatment advances, including SmartForce® features and attachments training • ClinCheck Pro software reviews—from process to 3D control • Monitoring procedures—from office processes to tracking issues Orthodontic Practice 16

The educational opportunities aren’t limited to Invisalign Pro doctors. We will also be offering two CE portfolios, modular and focused, that range from beginner to expert. Modular The modular channel is made up of individual courses with a concentration of clinical and business topics for the orthodontist. Doctors can follow a pathway recommended by Align or develop their own pathway. The progression of the Align pathway goes from Inspire (Beginner Level), A-P Correction (Intermediate Level), Vertical Correction (Intermediate to Advanced Level) all the way to Complex Cases (Expert Level). In the Align recommended pathway, the courses are specifically designed to build from the previous course. Focused The focused path offers three channels: Invisalign Orthodontic Master Program, Master Edge and Teen Edge. The programs are designed to provide progressive support to doctors who want to ramp up on the full range of Invisalign treatment for teenagers and adults. Teen Edge is designed to address all facets of treating teenagers – from business considerations to clinical range to staff training and marketing. By the end of the course (over a six-month period), the doctor will have learned and implemented Invisalign efficiency milestones and increased their clinical confidence level allowing them to treat more challenging cases and expand their usage in their practice. The Invisalign System is the market leader because it is the most advanced clear aligner system in the world. We will continue investing in research and development to continuously improve and innovate around the most technically advanced clear aligner system in the world. We will continue offering personalized service for today’s savvy consumers, and continue providing doctors with the tools they need to increase their clinical confidence and in turn, patient conversion.

Sarah Sharfstein is the DIRECTOR- NORTH AMERICA PROFESSIONAL MARKETING for Align Technology, makers of Invisalign. She earned her Bachelor’s degree from the University of California at Davis and her MBA from Santa Clara University with an emphasis in Product Management and Marketing. She’s been in the orthodontic field for over 9 years and has been in healthcare for almost 12.

From analog to digital. From metal to plastic. We’re moving. What are you waiting for? Our precision technology combined with your knowledge can help change lives and grow your practice. Unleash the power of the most advanced clear aligner technology. Visit the Invisalign® iTero® Booth #505 today

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Is All This Digital Efficiency Making Us Inefficient? All you want is to get your computer working again. You’ve read through the support forums, you’ve called up customer service, you’ve repeated the same three problem-solving steps eighteen times with different helpers, yet there’s no solution in sight. Worse, that 30-page presentation you’ve been slaving over the past three months is locked away, inside your malfunctioning box, and it still needs work before you hand it in later this week…We’ve all been through this, or something very much like it. The older you are, the more you’ve been through it, since computer stability is a relatively new invention (if we can truly claim to have it today).

It’s been hours. Hours and hours.

When you’re going through one of these frustrating episodes, you’ve almost certainly asked yourself, is this all worth it? The time you save writing by word processor instead of by hand – do you lose it tending to your tools? The ease of creating a PowerPoint compared to working with display boards, is it worth the weeks or months of training it takes to become proficient? The short answer is yes, of course it is. And the more advanced the technology becomes, the more obvious the advantages. This is the same messy, two-steps-forward-one-step-back process humanity always has with new technology. Even the benefits of transitioning from hunting and gathering, to farming, weren’t obvious for centuries. But small – even miniscule – gains found during the first generations of technology lead to much larger gains as the tech matures. And we’re already seeing some of those giant leaps emerging. So, yes – overall, switching to a digital world makes for a smarter, more efficient world.

The better question, really, is this: Will these changes lead to detrimental effects upon us. And there, the jury is still out. Orthodontic Practice 18

Think about it for a moment. Back in the ‘50s, Spelling Bees were a big deal. Indeed, mastering the art of spelling was considered a sign of intelligence. Now, anyone who wastes their time spelling appears backwards. As long as you can distinguish between a few homonyms, and know how to properly use a spell checker, your time is better spent elsewhere. For millennia, memorization has been a major component of education. Learning names, dates, even memorizing entire passages or books was essential for mastering material. Today, in a world of smartphones and Google, who needs to remember anything that’s available with a quick search? And why bother learning foreign languages, when we’ll have instant translators in our pockets? In many ways, we’re becoming more and more dependent on the technology that surrounds us. And that technology is literally changing our brains, in ways that we don’t yet fully understand. Writing in The Daily Mail, Oxford professor Baroness Susan Greenfield posted, “By the middle of this century, our minds might have become infantilized – characterized by short attention spans, an inability to empathize and a shaky sense of identity1.” She may be right. There are some who would argue we don’t need to wait until the middle of the century – that the signs are all around us today. Meanwhile, researchers at Dartmouth College have found that readers have very different cognitive relations to things they read in a book, versus those they read on an e-reader, tablet, or laptop2. Digital delivery devices push us towards concentrating on concrete details, and are good for focusing our attention. Books, on the other hand, allow the mind to wander – but also to think more abstractly, and get a better idea of the big picture. Whether the changes afoot excite or frighten you, there can be no doubt: Living in the digital world is changing human intellect. The human brain is a marvelously adaptive machine, and it will change and adapt to this new environment. Traditionalists may mourn the aspects of the intellectual life that will be lost. And some parts of our mental world will be lost. It’s quite likely that, within a few short generations, humans deprived of technology will find themselves unable to think for themselves. Much as most of modern humanity would be unable to feed itself today without supermarkets. But, by offloading some of the heavy, rote lifting to machines, we may discover entirely new ways of thinking, and new types of thought. Just as mastering food production allowed most of humanity to specialize elsewhere, becoming everything from professors, to pilots, to coders.

Will we see a similar growth of specialization in thought? It’s too soon to say for sure. But the patterns of history certainly suggest it. Looked at from the current viewpoint, we may be horrified to find our descendants incapable of the sort of intelligence we prize. Take away their computers – which may or may not be embedded in their bodies – and they might not be able to figure out the most rudimentary puzzles, or able to remember straightforward facts without help. But they will also be able to answer questions we can’t even imagine asking today. Growing up in a digital world, they won’t live surrounded by it, as we are. They will be it. Their brains will have adapted and enveloped today’s technologies in ways we can’t even imagine. So, to answer our original question, is digital efficiency making us less efficient? Viewed through today’s lens, yes. As how we communicate changes, our language skills will weaken. As access to information changes, our ability to memorize will weaken. As how we consume information changes, reading comprehension will likely weaken. It’s simply a matter of use it or lose it. But, when looked at through the lens of tomorrow, this will likely be seen as a time of transition. It will be a time when our minds began (or continued) to specialize, allowing for much greater overall efficiency. Just as you can’t fathom having to hunt and gather to survive, the intellectual skills of future generations will evolve in ways we cannot fathom. The next generation may have softer language skills, but they may also develop the ability to communicate with different cultures or even species. Their ability to memorize might weaken, but they may develop a cognitive way to “google” every moment they’ve ever experienced. Their reading comprehension may slip, but they may also find a way to consume and comprehend multiple sources simultaneously. The things they discover through intellectual specialization will boggle our “primitive” minds. We sacrifice individual efficiency for greater efficiency of the whole. And, just as you are happy that all your time isn’t spent growing food or finding shelter, your ancestors will be happy their time isn’t spent with inefficient concepts like spelling or multiplication.

It’s a trade we will all gladly make. http://www.zdnet.com/article/your-brain-vs-technology-how-our-wired-world-ischanging-the-way-we-think

2 https://www.psychologytoday.com/blog/the-athletes-way/201605/how-are-digitaldevices-changing-the-way-we-think

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See How It Fits In Your Practice… Literally! The new iTero Element ® Intraoral Scanner is engineered to deliver everything doctors look for in digital impression technology in a compact footprint with even bigger capabilities. It’s fast, portable, powerful, and intuitive, demonstrating our continued investment in clinical precision and patient satisfaction. Now with the iTeroScanner App, in about 60 seconds you can visualize in 3D what the scanner will look like in your practice.

Step One:

Download the iTeroScanner App from your mobile device's app store or visit itero.com/augmentedreality

Step Two:

Place this page where you'd like to see the iTero Element Scanner. This page is your Augmented Reality Marker.

Step Three:

Point your phone or tablet at this page and experience the magic!

Interactive AR

Change the way you look at things...the things that you look at will change. That’s the motivation behind the ad to the left. It uses augmented reality to let the user see what the iTero Element® Scanner will look like in their practice in real time. Because it’s not about the technology you use, it’s about the experience you create.

Capture the imagination and you can drive the conversation.

Differentiate your practice by redefining how you communicate.

When it comes to your brand, the medium is the message.

The Coming of Age for Invisalign Teen® Like all new technologies, Invisalign® treatment took a few years to fine-tune the performance and refine the service. Launched in 1997 by a pair of Stanford students, the company was founded in part to give adults a discrete way to pursue orthodontic treatment. It was made available to the public in July of 1999. As the clinical efficacy improved and the marketplace matured, the company started branching out with related product offerings such as Invisalign Express 10 and Vivera® Retainers. In 2008 they launched Invisalign Teen, a service geared towards offering teens the same discrete treatment option as adults. Like Invisalign treatment as a whole, Invisalign Teen has benefitted from technological innovation in a number of fields. Yet for all the maturation, as of 2016, Invisalign Teen represented just 4% of the total number of cases treated with Invisalign. According to orthodontist Dr. Scott Frey, as an open-minded treatment provider, the Invisalign system performance (including Teen) has matched—and in some ways surpassed—fixed appliances. “The majority of parents recognize that a lot of technological advances have occurred since they had braces. So they’re Orthodontic Practice 22

usually open to the idea of a technology such as Invisalign Teen. I tell them that as of today, the teeth don’t know the difference between fixed appliances and aligners. We’ve also had a number of studies that have validated that with Invisalign Teen, you now get the exact same force systems that are required for moving teeth with fixed appliances. The performance myth should be completely dispelled at this point.” Invisalign Teen differs from the traditional Invisalign service in a few ways. Teenagers often begin orthodontic treatment while their permanent teeth are still erupting. As such, Invisalign Teen accommodates this growth by allowing doctors to prescribe the space necessary for erupting teeth. These specially engineered “eruption tabs” compensate for second molars that continue erupting during treatment. Another difference between the Teen and traditional Invisalign service is the inclusion of a compliance indicator. Each aligner in Invisalign Teen has a small, blue indicator that fades over time when the appliance is used as directed. While Dr. Frey admits it’s not something he relies upon, (“we can tell just by looking at their teeth if the teen has been compliant”) he realizes it might offer some reassurance to apprehensive parents.

“Parents’ primary concern is a fear that kids aren’t going to wear the aligners. That teens lack the responsibility. But that’s not what we’ve found having treated over 500 teen cases in the last three years. We know that if the child has bought into the idea of orthodontics, and into the idea of clear aligners, then we can strongly recommend the patient go that route. I find that my peers who are concerned with teen compliance feel that way through limited experience versus actually having compliance issues with teens in aligners.

My philosophy is to provide the best results with the best technology. Patients want quality, they want technology, they want comfort and convenience. Invisalign Teen checks all those boxes off, so that’s what we use.”

I think with Invisalign treatment, we actually have more leverage over compliance. If teens are in braces but not brushing and not wearing their rubber bands, the only thing you have to bargain with is removing the braces. But that’s exactly what the teen wants, so it’s not much of a threat at all. If the patient isn’t internally motivated, then you’re going to have poor compliance and a poor outcome no matter how you treat the case.” Research confirms that the overwhelming majority of patients, teens or otherwise, prefer clear aligners over fixed appliance treatment. Dr. Frey believes offering the patient what they want is self-evident. “With fixed and clear aligners delivering the exact same results, it comes down to secondary concerns. The goal is to efficiently deliver a stunning smile while having the least detrimental impact to the teeth and gums along the way. From a lifestyle standpoint, aligners are a lot more accommodating with teens, there’s been no difference in compliance between teens and adults.

Dr. Scott Frey of Freysmiles Orthodontics

Dr. Frey is board certified in orthodontics, a Top 1% Invisalign provider, and an Invisalign faculty member. Dr. Frey is a a published scientific author and reviewer for the Journal of Aesthetic Plastic Surgery, Journal of Cosmetic Dermatology, and the Angle Orthodontist. He lectures internationally on the subjects of digital and esthetic orthodontics and is responsible for developing the Soft Tissue Orthodontics® curriculum for Henry Schein Orthodontics.

Right Intaroral Clinical before and after photos of a Teen patient. 9 total months of treatment.

Plus there’s also some efficiency that’s built into the aligners as far as requiring fewer appointments, fostering shorter appointments, and other factors that are a benefit to their lifestyle. This can also be huge for on-the-run parents. Really, if you’re not offering teens the opportunity to be treated with clear aligners, you’re doing the patient a huge disservice and limiting your practice growth.

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Align Technology reaches major milestone Align Technology reaches®major milestone for the iTero Element Scanner with over one for the iTero Element Scanner with over one million scans submitted million scans submitted ®

The Millionth iTero Element Scan is for an Invisalign Patient The Millionth iTero Element Scan is for an Invisalign Patient

SAN JOSE, Calif., March 21, 2017 — Align Technology, Inc. (NASDAQ: ALGN) today announced that over one million scans have theAlign iTeroTechnology, Element® scanner since it was introduced in 2015 atthat the over world’s SAN JOSE,been Calif.,submitted March 21, using 2017 — Inc. (NASDAQ: ALGN) today announced oneleading milliontrade scans fair, haveInternational Dental Show conference in Cologne, The one millionth scan for an Invisalign patient being treated by been submitted using the iTero Element scannerGermany. since it was introduced in 2015 at submitted the world’swas leading trade fair, International Dr.conference Troy Moore, a general Germany. dental practitioner who has scan practiced for nearly 20 an years in Amarillo, Texas. Dental Show in Cologne, The one millionth submitted was for Invisalign patient being treated by Dr. Troy Moore, a general dental practitioner who has practiced for nearly 20 years in Amarillo, Texas. “I am thrilled that my Invisalign case submission was the one millionth iTero Element scan,” said Dr. Troy Moore. “As a general practitioner dentist, case I wassubmission interestedwas in increasing efficiencies my practice Invisalign treatment “I am thrilled that my Invisalign the one millionth iTeroinElement scan,”and saidadopting Dr. Troy Moore. “As a generalmore fully. I iTero Element scannerefficiencies and how itincould benefit my practice whiletreatment attending more the Reingage practitionerlearned dentist,about I wasthe interested in increasing my practice andoverall adopting Invisalign fully. I Invisalign course 2016. I went from doing about Invisalign casemy starts perpractice quarter using impressions, to doing over 60 per quarter learned about the in iTero Element scanner and how six it could benefit overall while PVS attending the Reingage Invisalign by scanning patients the Element also use the iTero Element scanner our course in 2016. I went from doing with about sixiTero Invisalign casescanner. starts perWe quarter using PVS impressions, to doingfor over 60restorative per quartercases, which scanthe so iTero accurate that restorations better ever before and remakes the laboratory arewhich rarely needed. It by scanningproduces patients awith Element scanner. Wefitalso usethan the iTero Element scanner forfrom our restorative cases, so user friendly,that fastrestorations and easy to fit scan that than my team to use any other than ourare iTero Element scanner.” produces aisscan so accurate better ever refuses before and remakes fromscanner the laboratory rarely needed. It is so user friendly, fast and easy to scan that my team refuses to use any other scanner than our iTero Element scanner.” “Reaching our one millionth iTero Element scan in less than two years from its launch, and having it be for an Invisalign patient anone exciting milestone for our company and demonstrates the its trust and dedication share with Align to improve “Reaching isour millionth iTero Element scan in less than two years from launch, and havingour it bedoctors for an Invisalign patient patient outcomes,” Raphael Alignthe Technology Marketing Officer.share “Thewith proven digital technology is an exciting milestone for our said company andPascaud, demonstrates trust and Chief dedication our doctors AligniTero to improve enables doctors to perform high Align levels Technology of restorative and orthodontic workflows that enhance their patient care and help them patient outcomes,” said Raphael Pascaud, Chief Marketing Officer. “The proven iTero digital technology enables doctors perform high levels of restorative and orthodontic workflows that enhance their patient care and help them grow to their practice.” grow their practice.” About Align Technology, Inc. About Align Technology, Inc.is the leader in modern clear aligner orthodontics that designs, manufactures and markets the Invisalign Align Technology Align Technology the leader in modern clear aligner with orthodontics that designs,options manufactures andand markets the Invisalign system,iswhich provides dental professionals a range of treatment for adults teenagers. The Company also system, which provides dental professionals with a range of treatment options for adults and teenagers. The Company also offers the iTero 3D digital scanning system and services for orthodontic and restorative dentistry. Align Technology was offers the iTero 3D in digital scanning system andFDA services for orthodontic and restorative dentistry. Align Visit Technology was founded March 1997 and received clearance to market Invisalign clear aligners in 1998. www.aligntech.com for founded inmore March 1997 and received FDA clearance to market Invisalign clear aligners in 1998. Visit www.aligntech.com for information. more information. For additional information about Invisalign treatment or to find an Invisalign provider in your area, please visit www.invisalign. com. For additional information about the iTero scanner, please visit www.itero.com

please visit invisalign.com. For additional about theabout iTerothe scanner, please visit itero.com please visit invisalign.com. Forinformation additional information iTero scanner, please visit itero.com

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