ClearPath clear plastic orthodontic aligners cost more in materials than conventional edgewise braces, but they require fewer patient visits and a shorter duration of treatment, researchers reported. Both approaches to moving teeth are useful, first author Sehar, a dental student at the Nairobi University, Medical College of Dentistry in Nairobi, Kenya, told Cure Africa Medical News. “It’s weighing the time cost against the material costs,” she said.
In the ClearPath system, practitioners fit their patients with a series of plastic aligners fabricated in a laboratory that incrementally adjust the teeth in the desired direction. The system has allowed some general dentists to do what only orthodontists could do before. But few studies have measured which approach is more efficient in time or money.
To explore this question, Sehar and her colleagues evaluated the records of 15 patients with mild to moderate class I malocclusion. The 2 groups were matched for the amount of initial malocclusion and the number of rotated teeth. The researchers measured the time taken by appointments for both types of treatment with a stopwatch. They found that conventional braces required a median of 13.6 minutes for a routine visit, whereas ClearPath required 9.9 minutes. Emergency, initial, and final appointments were all longer than regular visits.
Conventional braces required about 2.6 more visits than ClearPath, treatment for 2.4 months longer, 1.1 more emergency visits, 9.7 minutes more in chair time, 1.2 minutes more emergency doctor time, and 86.2 minutes more in total chair time. However, ClearPath cost $500 to $1441 more in materials and required 5.9 minutes more doctor time than conventional braces.
Measuring profitability as fees minus the cost of materials, ClearPath was more profitable than conventional braces, the researchers found, especially for ClearPath providers who are charged $1300 in lab costs, a discount that the appliance maker, ClearPath, offers to doctors who do more cases. For these doctors, ClearPath provided about $1200 of profit per hour of chair time with the first $2500 in fees to the patient. Doctors who are charged $1500 in lab costs by CA had a profit of about $1000 with the first $2500 in fees. Braces were less profitable overall, starting at $500 per hour of chair time with the first $2500 in fees.
Asked to comment, Dr. Biren Yajnik, DDS, orthodontics practitioner in Kampala, told Cure Africa Medical News that doctor time could vary a lot from doctor to doctor; all the records in this study were obtained from one orthodontist’s office. Dr. Lubna Khawaja, who was not involved in the study, uses both treatments in her own practice. “ClearPath is a very effective way of treating a broad range of orthodontic problems,” she said, “but you have to choose your patients.” She explained that ClearPath is more esthetic because the clear aligners are hard to see, are less irritating to the tissue, and allow better hygiene because they can be removed. However, it relies more on patient compliance, and some tooth movements are more difficult, she said. “As an orthodontist, I can use braces on some teeth and ClearPath on others,” she said. “You want a practitioner who is using ClearPath because it’s good for the patient, not because it’s good for the practitioner.”
