How Combination Treatment Plans Can Yield Greater Efficacy for Patients

Orthodontic students are often taught to approach their work using one of two specific methods or philosophies. Throughout their careers, orthodontists often remain on that track without crossover or combining methods.

According to Dr. Adam Schulhof, DMD, of The Schulhof Center, creating a hybrid treatment plan has the potential to impact practices and the effectiveness of treatment for patients.

During his education, Dr. Schulhof had the unique opportunity to learn both methods, rather than the singular option most students are taught. “I was able to learn how to use different methods for the individual and mixing when necessary. Hybrid orthodontic treatments allow us to utilize the right tool at the right time,” he said.

Identifying Suitable Cases
Dr. Schulhof believes that through communication, orthodontists can better understand what treatment to use. When a patient comes to his practice, they are asked to rate factors such as cost, time, looks, comfort and lifestyle based on their importance.

Then, Dr. Schulhof rates the appliance options. He conducts treatment planning without separating brackets, lingual or aligners into silos. From this perspective, he can approach appliances like menu options, mixing and matching in a way that will meet the terms the patient cares about most and is most effective.

A recent combination case Dr. Schulhof treated was for a patient who had lifestyle and appearance concerns. This particular patient had an impacted canine. Because of her demanding work schedule, however, there was never a perfect time to begin her treatment. For this specific case, Dr. Schulhof determined the best method for her by thinking of the appliances chronologically, starting with lingual on top to correct the canine and aligners fitted on the bottom. Once the canine was brought in, he finished with aligners on the top as well. Embracing the advantages of different appliances and using them in conjunction ensured not only great results but also met the needs of the patient’s lifestyle and timing.

Achieving Predictable Results
Patient compliance is one of the big concerns with aligner therapy since aligners are not stuck to the tooth like fixed appliances. Compliance issues do exist with elastic bands and brushing, but Dr. Schulhof believes that compliance is a bigger challenge with aligners.

Because some patients dislike attachments, some practices skip attachments altogether. Forgoing aligner attachments can result in extended treatment and less predictable results. In Dr. Schulhof’s practice, if the patient does not want attachments, they will do lingual if it fits with the patient’s needs.

Practical Impacts
Previously, a large drawback to prescribing a hybrid treatment was the cost. A combo case that only needed upper aligners would incur a fee for the full set, and those costs were often a barrier for patients. Dr. Schulhof uses 3M™ Clarity™ Aligners because they have a much different model – pay only for what you use.

“This is where the clinical part meets the small business aspect of what we do. With Clarity Aligners, I have lower overhead for the case and don’t pass along inflated fees to the patient,” he said.

Conducting combo treatments is a new way of thinking, but it’s fitting in the new world of orthodontics. Modern procedures are not bound by brackets on the front of teeth – there’s lingual, clear aligners, clear brackets and more.

“Exploring the possibility of using each appliance for its strengths simultaneously can deliver greater efficacy for your patient’s treatment, as well as setting your practice apart. Ultimately, any way you can differentiate your business and better serve patients is a great combo,” said Dr. Schulhof.

To learn more about the 3M Clarity Aligners, visit the 3M Orthodontics website.