Hatamleh MM, Ong J, Hatamleh ZM, Watson J, Huppa C. Developing an in-house interdisciplinary three-dimensional service: challenges, benefits, and innovative health care solutions. J Craniofac Surg. 2018; 29:1870-1875
Lin HH, Lonic D, Lo LJ. 3D printing in orthognathic surgery− A literature review. J Formos Med Assoc. 2018; 117:547-558
Nguyen T, Jackson T. 3D technologies for precision in orthodontics. Semin Orthod. 2018; 24:386-392
Al Mortadi N, Eggbeer D, Lewis J, Williams RJ. CAD/CAM/AM applications in the manufacture of dental appliances. Am J Dentofacial Orthop. 2012; 142:727-733
Alcan T, Ceylanoğlu C, Baysal B. The relationship between digital model accuracy and time-dependent deformation of alginate impressions. Angle Orthod. 2009; 79:30-36
Taneva E, Kusnoto B, Evans CA. 3D scanning, imaging, and printing in orthodontics. Contemp Orthod. 2015; 3
Interactive orthodontic care system based on intra-oral scanning of teeth. United States patent: 6648640. 2003. https//
Christensen LR. Digital workflows in contemporary orthodontics. APOS Trends Orthod. 2017; 7:12-18
Groth CH, Kravitz ND, Shirck JM. Incorporating three-dimensional printing in orthodontics. J Clin Orthod. 2018; 52:28-33
Westerlund A, Tancredi W, Ransjö M, Bresin A, Psonis S, Torgersson O. Digital casts in orthodontics: a comparison of 4 software systems. Am J Dentofacial Orthop. 2015; 147:509-516
Rheude B, Lionel Sadowsky P, Ferriera A, Jacobson A. An evaluation of the use of digital study models in orthodontic diagnosis and treatment planning. Angle Orthod. 2005; 75:300-304[300aeotuo];2
Richmond S, Shaw WC, O'Brien KD, Buchanan IB, Jones R, Stephens CD, Roberts CT, Andrews M. The development of the PAR Index (Peer Assessment Rating): reliability and validity. The Eur J Orthod. 1992; 14:125-139
Mayers M, Firestone AR, Rashid R, Vig KW. Comparison of peer assessment rating (PAR) index scores of plaster and computer-based digital models. Am J Dentofacial Orthop. 2005; 128:431-434
Luqmani S, Jones A, Andiappan M, Cobourne MT. A comparison of conventional vs automated digital Peer Assessment Rating scoring using the Carestream 3600 scanner and CS Model+ software system: A randomized controlled trial. Am J Dentofacial Orthop. 2020; 157:148-155
Wiechmann D, Rummel V, Thalheim A, Simon JS, Wiechmann L. Customized brackets and archwires for lingual orthodontic treatment. Am J Dentofacial Orthop. 2003; 124:593-599
Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review. Angle Orthod. 2015; 85:881-889
Weir T. Clear aligners in orthodontic treatment. Aust Dent J. 2017; 62:58-62
Nasef AA, El-Beialy AR, Eid FH, Mostafa YA. Accuracy of orthodontic 3D printed retainers versus thermoformed retainers. Open J Med Imaging. 2017; 7:169-179
Cole D, Bencharit S, Carrico CK, Arias A, Tüfekçi E. Evaluation of fit for 3D-printed retainers compared with thermoform retainers. Am J Dentofacial Orthop. 2019; 155:592-599
Baan F, de Waard O, Bruggink R, Xi T, Ongkosuwito EM, Maal TJ. Virtual setup in orthodontics: planning and evaluation. Clin Oral Investig. 2019; 12:1-9
Gange P. The evolution of bonding in orthodontics. Am J Dentofacial Orthop. 2015; 147:S56-63
Czolgosz I, Cattaneo PM, Cornelis MA. Computer-aided indirect bonding versus traditional direct bonding of orthodontic brackets: bonding time, immediate bonding failures, and cost-minimization. A randomized controlled trial. 2020; 34:144-151
Brown MW, Koroluk L, Ko CC, Zhang K, Chen M, Nguyen T. Effectiveness and efficiency of a CAD/CAM orthodontic bracket system. Am J Dentofacial Orthop. 2015; 148:1067-1074
Christensen LR, Cope JB. Digital technology for indirect bonding. Semin Orthod. 2018; 24:451-460
Buckley J. Lingual orthodontics: an illustrated review with the incognito fully customised appliance. J Ir Dent Assoc. 2012; 58:149-155
Larson BE, Vaubel CJ, Grünheid T. Effectiveness of computer-assisted orthodontic treatment technology to achieve predicted outcomes. Angle Orthod. 2013; 83:557-562

Digital workflows part 1: applications of digital technology in orthodontics

From Volume 16, Issue 4, October 2023 | Pages 177-184


Chris Keating

BA (Hons) FdSc MOTA

Advanced Digital OMFS & Orthodontic Technologist, Royal United Hospitals NHS Foundation Trust, Bath, United Kingdom

Articles by Chris Keating

Email Chris Keating

Jennifer Haworth


Academic post-CCST trainee in Orthodontics, Royal United Hospitals, Bath and University of Bristol

Articles by Jennifer Haworth

Email Jennifer Haworth

Farnaz Parvizi

MPhil, BDS, FDS RCS(Eng), MOrth RCS(Ed)

Senior Registrar (FTTA) in Orthodontics, Child Dental Health, Bristol Dental Hospital

Articles by Farnaz Parvizi


This is the first article in a two-part series considering the relevance and clinical uses of digital technologies in relation to orthodontics. The aim is to take a closer look at a ‘point-of-care’ digital service and highlight the key areas in which digital workflows have been employed, along with areas of future development. The second article will document the application of digital workflows in joint orthodontic/orthognathic treatment and present two clinical cases which have undergone treatment by means of a digital workflow.

CPD/Clinical relevance: Digital technologies can enhance orthodontic clinical care.


The integration of digital technologies and three-dimensional (3D) printing in healthcare has risen drastically over the course of the past decade. Once reserved for industrial processes such as tooling design and fabrication, as well as visual and functional rapid prototyping methods, these technologies have since been developed and applied to several areas of dentistry, including orthodontics. While digital technologies might initially be more expensive, requiring relatively high levels of investment compared to more conventional methods, they offer distinct advantages. These include the ability to digitally replicate, modify and print human anatomical structures or appliances in 3D, with the potential to improve reproducibility, efficiency and the overall quality of orthodontic treatment.1,2,3

Current applications of computer-aided design (CAD) and computer-aided manufacturing (CAM) include a number of tasks specific to orthodontics.3,4 In their simplest form, these digital workflows can be divided into data acquisition (scanning) and data usage or outputs, including 3D printing. This article will describe the use of intra-oral scanning and 3D printing before turning to specific orthodontic applications of digital technology.

Register now to continue reading

Thank you for visiting Orthodontic Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Up to 2 free articles per month
  • New content available